Radiation Safety - Legislation & Practice PDF

Radiation safety – legislation & practice FUNDAMENTALS OF RADIATION AND RADIATION SAFETY MODULE TIMELINE 2024-25 Mock...

Radiation safety – legislation & practice FUNDAMENTALS OF RADIATION AND RADIATION SAFETY MODULE TIMELINE 2024-25 Mock Assessment Seminar Seminar Seminar 3 1 2 MCQ Exam Lecture Lecture Lecture Lecture 2 4 6 7 Lecture Lecture Lecture Lecture Lecture Lecture 1 3 5 8 9 10 Holidays SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY Virtual 1 3 October 2024 Simulations Radiation safety - legislation & practice 2 2 1 3 On-Campus Simulations 2 TOPICS KEY: Skills for module Fundamentals of completion Radiation Radiation Safety Radiation Protection Assessment Skills & in Context Assessment Module Learning Objectives  Learn the three basic Begin to appreciate principles of radiation Gain an understanding the legal basis for safety of the need for radiation protection in radiation protection Three methods of the UK personal radiation safety Introduction of Awareness of local radiation dose limits rules, content and and their role in safety application October 2024 Radiation safety - legislation & practice 4 Song of the week! Rate the song ⓘ Start presenting to display the poll results on this slide. Group discussion – 5 minutes Radiation protection Radiation is a hazard! The public When we use radiation in Patients healthcare, who needs to be Staff protected? How do we go about protecting these people? Radiation safety is enshrined in international, European and UK law Where does the UK law come from? International Commission on Radiological Protection Produces framework for radiation legislation (current version is ICRP 103 (2007)) European Commission Converts ICRP recommendations into European Basis Safety Standard (2013/59/Euratom) UK government Adopts EU BSS into UK law (2017) – not sure what happens post-Brexit… What is the UK law? Ionising Radiations Ionising Radiations (Medical Exposures) Regulations 2017 Regulations 2017 Applies to all uses of Applies only to ionising radiation medical uses of Seeks to protect Staff ionising radiation and the Public Seeks to protect patients The Basic Principles of Radiation Protection Practices – the deliberate use of ICRP describe two types ionizing radiation of exposure Interventions – emergency situations Justification For practices, the three Optimisation principles are Limitation Justification Is the use of radiation needed? Can I use a less hazardous technique? Optimising the use of radiation Optimisation Whilst achieving the required objective, keeping the radiation dose as low as reasonably practicable (ALARP) or as low as reasonably achievable (ALARA) Place limits on acceptable levels of radiation exposure Limitation These limits are enshrined in law – in our case in the Ionising Radiations Regulations 2017  IRR17 Based on a revision of the EU Basic Safety Standards The Ionising Radiations Regulations (IRR) 2017 are concerned with occupational exposures and the radiation protection of the public. IRR 17 is relevant to: Replaced existing IRR85 and IRR99 Employers and employees who work with ionising radiations Radiation Protection Advisers (RPA) Came into force on 01/01/18 Radiation Protection Supervisors (RPS) Health and Safety Officers Enforced by Health & Safety Executive  IRR17 The Ionising Radiations Regulations (IRR) 2017 Consist of: Regulations Have full Legal Status Approved Code of Practice, L121 Not the law, but guidance on the law Both freely downloadable from the HSE website The public… How could we protect the public from radiation in a hospital environment?  If you came to this X-ray department with a relative that needing imaging, where could you be? In the waiting room On the outside of the building Anywhere if you’ve wandered unnoticed! The public… Protected by: Control of Access Room shielding Lead shielding built into walls, ceiling & doors. Lead highly attenuating to X-rays Calculation of shielding requirements Need to know: Distance to each barrier Who is beyond barrier? How much of time are they present? How many X-rays are taken in the room? Primary or scattered radiation? Provide recommended thickness of lead to architect/builders Staff How could we protect staff from radiation in a hospital environment? Restriction of exposure Employers must reduce radiation doses to staff ‘so far as is reasonably practicable’ and must demonstrate this Issues include: adequate shielding position of staff during exposures position of the mains isolator beam directions Restriction of exposure Can we eliminate the hazard? Can we replace the hazard with something else? Room shielding, warning signs/lights, use of dose constraints Local rules, other systems of work, personal monitoring Lead aprons, thyroid shields, glasses Controlled Areas Where any person working in the area may exceed 6mSv/yr Controlled Areas should be adequately demarcated includes the possible need for signage Most hospital x-ray rooms also have a fail-safe, two-bulb, two-stage warning light Restriction of Exposure Shielding is particularly important in situations where radiation doses are high – such as interventional radiology Dose Limitation Classified workers [20mSv/y] Non-classified workers [6mSv/y] UK average for medical radiation workers 0.14 mSv/y Member of the public [1mSv/yr] Dose limits for certain organ types Skin dose limit is 500mSv/y (averaged over 1cm 2) Eye – limit lowered to 20mSv/y Dose Limitation Classified worker is someone likely to exceed 6mSv/yr. Traditionally strongly resisted by HSE say – why not just classify them? healthcare workers. This attitude is not understood by HSE HSE’s view is that all those working with unsealed radionuclides in Some interventional radiologists, medicine (ie all NM workers) should be cardiologists & orthopaedic surgeons classified unless a robust risk assessment struggle to keep within the 6mSv demonstrates this is not needed classification threshold Classified workers subject to additional requirements: inc. annual medical, more dose recording Dose Limitation Note that a foetus is a member of the public subject to a 1mSv/y dose limit even if the pregnant person is a Classified Radiation Worker Pregnant staff member/student must notify their employer in writing as soon as possible Personal monitoring Think about who and how we monitor Need to be able to demonstrate that doses to all staff members are ALARP Whole body For all staff working with radiation dose Badge worn between waist and chest For staff in high dose environments (e.g. those Eye dose performing interventional procedures) Small dosemeter worn on protective glasses For staff with fingers close to radiation source (e.g. Finger dose interventionalists, some nuclear medicine staff) Ring dosemeter worn at base of finger Personal monitoring Usually TLDs (Thermo-luminescent dosemeters) Passive device – stores radiation related signal, has to be sent away to be read out Replaced every month – two months Threshold of approx. 0.1 mSv Some electronic dosemeters E.g. Mirion Instadose, which we use Can be read out by user at any point ‘Real time’ monitoring of doses Threshold of approx. 0.001mSv Personal Protective Equipment A range of PPE may well often be needed Appropriately sized to provide adequate protection Lead equivalence will vary depending on the results of the risk assessment Local Rules Local rules must identify the main working instructions intended to restrict any exposure in that controlled or supervised area. Must read and sign local rules before Must be disseminated to all concerned working in any and you must comply with them radiation area!!! eg a sign sheet with the Local Rules Keep up-to-date when staff change You should all have been asked to read the local rules in our x-ray room! Why do we need all this?! Prevent the occurrence of deterministic effects Keep doses below thresholds Reduce the induction of stochastic effects Use ALARA / ALARP 35 Who is responsible for radiation safety? The Ionising Radiations Regulations (IRR17) put most responsibility on the employer but also put some on employees. Radiation Protection Adviser Radiation Protection Supervisor (RPA) (RPS) 37 RPA & RPS RPA RPS Qualified expert Appointed to secure Advises the employer on how compliance with the Local Rules to ensure compliance with ‘On the ground’ responsibility IRR17 for radiation safety Usually a Clinical Scientist Usually a Radiographer October 2024 Radiation safety - legislation & practice 40 Time The radiation dose you receive is directly proportional to the time you spend near the radiation source Though you need to ensure that what you are doing achieves the object of the exercise! Distance Physically small, divergent radiation sources obey the inverse square law Dose α 1 / distance2 Need to keep as far away as reasonably practicable during the exposure Shielding Dense materials are best due to their high atomic number Lead > concrete > brick > plaster The higher the energy of the x-ray beam, the greater thickness you need to provide the same level of protection  You take X- Changing Exercise ray from here rooms You are working in this X-ray department Your patient arrives with a relative and they sit in waiting area You will be doing the X-ray procedure in the top-right X-ray room What can you do ensure staff and public safety? Discuss in groups, get ready to feed back Who is responsible for radiation safety? The Ionising Radiation (Medical Exposure) Regulations (IRMER17) put responsibilities on the employers, referrers, operators & practitioners. 47 Link to webinar on Canvas pages  You take X- Changing Exercise ray from here rooms You are working in this X-ray department Your patient arrives with a relative and they sit in waiting area You will be doing the X-ray procedure in the top-right X-ray room What can you do ensure patient safety? Make notes on your thoughts – we can discuss at a later date... What are the three principles of radiation protection? ⓘ Start presenting to display the poll results on this slide. Summary