Radiation Safety: Principles and Protection

• The International Atomic Energy Agency (IAEA) is an intergovernmental organization promoting peaceful nuclear energy use and inhibiting its use for military purposes.
• Radiation protection involves protecting people from the harmful effects of radiation.

Importance of Radiation Protection

• Reduces unnecessary radiation exposure
• Minimizes harmful effects of ionizing radiation

Principles of Radiation Protection

• Practices must be justified, ensuring the exposure is necessary.
• Examination requests should be carefully reviewed, selecting only truly needed ones
• Doctors are often not knowledgeable about radiation effects.
• Doses should be "As Low As Reasonably Achievable" (ALARA) while still achieving optimal image quality
• Dose equivalents to individuals should not exceed standard values

10 Commandments of Radiation Protection

• Always employ the principles of time, shield, and distance.
• Time of exposure should be minimized
• Distance between source and individual should be maximized
• Shielding should be used between the radiation source and the individual
• Concrete wall thickness should be 6 inches
• Use lead aprons/gowns with 0.25 mm or 0.5 mm lead (Pb) equivalence
• Use thyroid collars/shields
• Use lead glasses, typically used in the OR.
• A CT chest equals 80-150 CXRs
• Use ceiling-mounted and rollaway shields
• Do not become complacent or falsely secure regarding radiation
• Always check the machine functions to avoid errors and repeat exposures
• Avoid creating bad habits during examinations.
• Follow proper collimation for all patients.
• Never rebuild an image without a technician's instruction
• Avoid repeating images as much as possible and verifying everything before exposure
• Never stand in the primary beam's path.
• Only secondary radiation from patient scatter should be present
• Position the x-ray tube UNDER the patient, not above.
• Higher scatter occurs due to the natural divergence and polyenergetic nature of x-rays
• The most scatter radiation occurs when the x-ray is above the patient
• Positioning the x-ray tube below decreases radiation reaching the upper body.
• Scatter radiation from the patient is highest at the primary beam and least at the II side (Fluoro/C-Arm)
• Always wear protective apparel if not behind the protective barrier.
• Always wear an occupational radiation monitor (OSL, TLD) outside the protective apron at the collar
• Occupational Radiation Monitors only measure radiation exposure, they do not protect workers.
• Only wear assigned dosimeters.
• Wear badges when working with radiation devices/radioactive materials
• Do not store badges in radiation areas
• Wear it on the upper left chest.
• Exposure reports are available.
• Any badge wearer can obtain a copy of their radiation reports by contacting the Radiation Safety Officer (RSO)
• Machine errors should be immediately reported for investigation.
• Never hold the patient during radiographic examination, use mechanical restraints if possible, otherwise, parents or friends can hold them
• less repeat = longer tube lifespan
• The person holding the patient should wear a lead gown
• Use gonadal shielding on all childbearing age patients if it does not interfere with the procedure
• Exams of the pelvis and lower abdomen of a pregnant patient should be avoided during the trimester
• 10-day rule states that women of reproductive capacity should only be examined 10 days from menstruation
• Always collimate to the smallest field size
• Collimate tightly to the area of interest (AOI).
• This reduces the total patient entrance skin exposure (ESE).
• It will also increase contrast and decrease patient dose

Best Practices

• Wear gonadal shielding
• X-ray room doors should be closed at all times
• Ensure collimator lights are working
• Utilize a technique chart
• Use high kVp and low mAs