INTRODUCTION TO RADIATION HAZARDS &

ROLE OF REGULATORY STANDARDS

REENA KASHYAP
RADIATION SAFETY OFFICER,
CNBC
 GENERAL OBSERVATION

´ Awareness on the radiation hazards and

knowledge of radiation protection in diagnostic
installations are very poor among the Workers
Who Work with it.
 Radiation

Radiation is a type of energy, like heat or light, emitted

through space and matter and which cannot be
detected by any of our senses.
 TYPE OF RADIATION
´ Non-Ionizing Radiation- Radiation refers to any type of
electromagnetic radiation that does not carry enough energy per
quantum to ionize atoms or molecules. ultravoilet, visible light,
infrared, microwaves, radiowaves, and low-frequency RF
´ Ionizing Radiation- Radiation consists of particles or
electromagnetic waves that are energetic enough to detach
electrons from atoms or molecules, therefore ionizing them.
Direct ionization from the effects of single particles or single
photon produces free radicals, which are atoms or molecules
containing unpaired electrons, that tend to be especially
chemically reactive due to their electronic structure. Alpha
particles, Beta particles, gamma, X-ray, neutrons etc
 TYPES OF IONIZING RADIATION

Alpha Particles
Stopped by a sheet of paper
Radiation
Source
Beta Particles
Stopped by a layer of clothing
or less than an inch of a substance
(e.g. plastic)

Gamma Rays
Stopped by inches to feet of concrete
or less than an inch of lead
 Is there
RADIATION in
this room?

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 RADIATION - WE LIVE WITH
Natural Radiation: Cosmic rays, radiation within our body, in
food we eat, water we drink, house we live in, lawn,
building material etc.
Human Body: K-40, Ra-226, Ra-228
e.g. a man with 70 kg wt. 140 gm of K
140 x 0.012%=
0.0168 gm of K-40
0.1 μCi of K-4
≈28,000 photons emitted/min
(T1/2 of K-40 = 1.3 billion yrs)

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RADIATION - WE LIVE WITH
Earth: Top 1m of 0.1 acre garden
=1200 kg of K of which K-40 =1.28 Kg
= +3.6 Kg of Th + 1 Kg Ur
μGy/yr
New Delhi 700
Bangalore 825
Bombay 424
Kerala 4000
(in narrow coastal strip)

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RADIATION RISK IN PERSPECTIVE

We are all exposed to

radiation from the
sun, rocks and food
and other natural
resources.
Average background
3 mSv/year

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HUMAN PERCEPTION

´ As humans, we are virtually incapable of detecting the

presence of radiation

´ Individuals who have been exposed to high levels of

radiation have reported feeling “a burning sensation” in
their eyes, nausea, dizziness and other symptoms,
however, these symptoms have all resulted from
exposure to lethal or near lethal doses

´ Exposure to radiation doses within the occupational

limits produce no apparent indications of exposure

´ As a result, we must employ devices to detect and

measure radiation
WHAT CAN RADIATION DO?
Death
Cancer
Skin Burns
Cataract
Infertility
Genetic effects
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So

Radiation safety is important in diagnostic

radiology, not only because of regulatory
requirements but also because of personnel
and patient considerations.

In Radiation Protection, the guiding

philosophy is ALARA

In diagnostic radiology, the main source of

occupational exposure is scattered radiation
from the patient – particularly from
fluoroscopically guided procedures.
 ROADMAP TO REGULATORY
CONTROL
´ Atomic Energy Regulatory Board has been setup to
carry safety regulatory functions of the atomic energy
act 1962
´ Safety of radiation generating equipment (x-ray) is
covered under section 17 of the act
´ A task group was constituted by AERB on November
29, 1985
´ The task group (known as Gajaraj committee)
recommended effective country wide registration and
inspection of x-ray installations
´ Committee recommended setting up of
regional enforcement directorates to
institute regulatory control and to enforce
radiation surveillance

´ To further accelerate the regulatory control,

a directorate for radiation safety is needed
 System of Regulatory Control

Codes
Act Standards
Rules Guides
Notifications Manuals
Directives
 SALIENT FEATURES OF ATOMIC ENERGY
ACT 1962
´ To provide control over radiation generating equipment
in order to
´ Prevent radiation hazards
´ Secure public safety & safety of personnel handling
radiation generating equipment
SALIENT FEATURES OF ATOMIC ENERGY
RADIATION PROTECTION RULES 2004

´ Licence :
´ No person shall without a licence establish a
radiation installation
´ A licence shall be issued for operation of
1.Computed tomography (CT unit)
2.Interventional radiological x-ray unit
´ A registration shall be necessary
1.Medical diagnostic x-ray equipment
PLANNING OF DIAGNOSTIC X-RAY
INSTALLATION
The most important aspect in planning a diagnostic x-ray
installation is to facilitate radiation safety for the medical
staff, the patient and the members of the public, who
may likely to be in the vicinity. Good planning involves the
following steps:
The Users shall submit a description of the following to
Regulatory Body (AERB):
· Location of the facility
· Layout of the facilities
· Safety devices
The Users shall obtain plan approval from the
Regulatory Body (AERB) before initiating any x-ray
installations.
It is Now Mandatory to Recruit Radiation
Safety Officer either Full time /Part time
Who is Trained By BARC on Radiation Safety
aspects of Radiodiagnosis Deptt with Prior
Approval from AERB whose responsibility
includes Survey of Any leakage radiation in
the patient waiting area etc & overall
Surveillance of the Deptt in Context wuth
Radiation Safety,Quality Assurance &
Patient Safety.
Location of x-ray installation
The room housing of a diagnostic x-ray unit should be
located as far away as feasible from areas of high occupancy
and general traffic such as maternity and pediatric wards and
other departments of the hospital that are not directly related
to radiation and its use.
Warning Light
A suitable warning signal such as a red light shall be
provided at a conspicuous place outside the x-ray room and
kept ‘ON’ when the x-ray equipment is in use to warn
persons not connected with the particular examination from
entering the room
Placard
An appropriate warning placard shall be posted outside the
X-ray room.
 Caution ionizing Radiation
Diagnostic Radiology

Caution ionizing Radiation

(Nuclear Medicine) CAUTION NON-IONIZING
RADIATION
 ORGAN RADIO-SENSITIVITY

High Medium Low

Lymphoid Tissue Skin Muscle
Marrow Vascular Bone
endothelium
GI Epithelium Lung Connective tissue
Gonads Kidney Cartilage
Embryos Liver
Lens
SOURCES OF RADIATION IN RADIOLOGY
LEAKAGE RADIATION
Leakage radiation is radiation the passes
through the lead shielded protective
housing of the x-ray tube when the beam is
turned on. AERB Recommends the
maximum permissible leakage radiation
exposure at 1 meter from a diagnostic x-
ray tube is 0.1 R/hour with the tube
operating continuously at its maximum kVp
and mA.
OCCUPATIONAL EXPOSURE: SCATTER
 PRIME OBJECTIVES

1 Persons who use x-ray equipment do not receive

radiation doses in excess of the prescribed dose
constraint i.e. 100 mSv averaged over 5 years (or
20 mSv per year).

2 Members of the public who work in or near a

facility; or who accompany & assist in supporting
a patient during an x-ray examination do not
receive a radiation dose in excess of the
prescribed dose constraint. i.e. 1 mSv per year.
RADIATION RISK IN PAEDIATRIC RADIOLOGY

´ The risk associated with the

chance of developing a fatal
cancer from radiation exposure
in children is higher then in
adults
´ Special needs for children can
often be addressed at
dedicated paediatric care
centers or other centers with
pediatric imaging expertise

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 Principles of radiation protection

1. Justification of practices
2. Optimization of protection by keeping exposure as
low as reasonably achievable
3. Dose limits for occupational exposure
OBJECTIVES OF RADIATION PROTECTION

´ Prevention of tissue reactions (deterministic effect)

´ Limiting the probability of stochastic effect

 HOW DO WE APPLY
THESE PRINCIPLES IN
RADIOLOGY?
 RADIATION RISK IN RADIOLOGY

Health benefits:

« Let us not forget that radiological imaging provides

significant benefits to the health care of the population

« Therefore we have to reduce the risk to a minimum by strict

adherence to justification, optimisation, essentially the
ALARA principle in both adult and paediatric imaging

« As the dose and risk increases

benefits should be greater

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 JUSTIFICATION

´ Process in which the referring

health care provider and
radiologist make a decision as
to whether the examination is
clinically indicated and
whether the benefits outweigh
the likely radiation risks

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 JUSTIFICATION

´ Tools to help improve justification:

« Use of evidence based referral guidelines and local
protocols
« Use of clinical audit of justification (including
appropriateness of examinations)
´ Examinations will only be conducted when
appropriate and necessary
´ When available, alternative techniques such as
ultrasound and MRI will be used
´ Pay attention to previous procedures and the
information available from the referring practitioner,
the patient and their family
 OPTIMISATION

´ ALARA principle states that dose should be kept As

Low As Reasonable Achievable

´ But not to the extent that compromises diagnostic

image quality

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 OPTIMISATION

´ All persons directing and conducting medical radiation

exposure of PATIENT , including radiologists and technologists,
should have received recognised education and training in
their discipline, including radiation protection, and specialist
training in its paediatric aspects
´ Radiological equipment shall be in accordance with
international standards
´ A team approach to each stage should be taken
´ All examinations should be conducted using STANDARD
OPERATING protocols/exposures
COST BENEFIT
 PRINCIPLE OF RADIATION
PROTECTION

Time, distance and shielding are the three major

factors, which influence the radiation exposure and
hence the radiation dose i.e. the dose received at a point
depends upon
´ the distance of the source of radiation from that point

´ the shielding between the source of radiation and that

point

´ the time during which the source (X-ray unit) is ON.

Time

.
Lesser the time of Operation,
Lesser will be the radiation dose
 DISTANCE

The amount of dose an individual receives will also

depend on the distance between the person and
the source.

More the distance from the source,

Lesser the radiation dose
 SHIELDING

Shielding used in diagnostic radiology to reduce

exposure to patients, staff and the public.

As the thickness of the shielding material is)

increased, the exposure rate decreases
exponentially.
 SHIELDING REQUIREMENTS

PROTECTIVE ACCESSORIES

y Lead Glass(V.W.) : 2.0 mm Pb

Equv.
y Lead Aprons : 0.25 mm Pb Equv.
y Lead Gloves : 0.25 mm Pb Equv.
y Pb Rubber Flaps : 0.5 mm Pb Equv.
 Responsibilities

Personal Individual
protective exposure
devices Occupational
Protection
monitoring

Pregnant Workplace
workers monitoring
Health
surveillance

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OCCUPATIONAL PROTECTION:
TIME-DISTANCE-SHIELDING

• Distance:
« Doubling your distance from patient reduces
your exposure by 75% (inverse square law)
« Patient Holding ( AERB guideline)

« Radiology staff Must not hold

² 1stchoice: Family Members
² 2nd choice: non-occupational exposed staff
OCCUPATIONAL PROTECTION:
TIME-DISTANCE-SHIELDING

• Film Badges / TLD BADGES

« Facility
can be cited and possibly fined if
BARC / AERB PERSONNEL see staff working
without wearing TLD badges
TLD DETECTOR
Radiation moves electrons & holes into “traps”
Heating moves them out and recombine to produce luminescence
Luminescence produced is proportional to energy absorbed
Energy absorbed is proportional to radiation field
Response is ~ linear
Trapped data is stored in TLD for a long time
 PREGNANCY ISSUES

Special care should be observed with respect to

« irradiation of pregnant or potentially pregnant
occupationally exposed workers
« comforters and carers
« members of the public
SPECIAL CATEGORY
´ No occupational exposure is permitted below
the age of 18 yrs.
´ For students and apprentices between 16 – 18
years of age
² Eff.
Dose = 6 mSv
² Equi.dose = 50 mSv for skin
= 150 mSv for extremities

´ Volunteers and comforters = 6 mSv

´ Medical exposure = no limit (optimum)
CONCLUSION

With proper planning, installing type

approved units, performing periodic QA,
use of protective accessories, employing
qualified staff and good work practice we
can achieve radiation safety in diagnostic
x-ray installation.
 FOR MORE INFORMATION ON REGULATORY
AND RADIOLOGICAL SAFETY ASPECTS IN USE
OF IONISING RADIATION, PLEASE VISIT WEB
SITE AT, “WWW.AERB.GOV.IN”

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 7/14/2011

THANK YOU FOR ATTENTION !

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