2012 Radiation Safety Training Program
Radiation Safety
Abdulrahman Al Suwayan, DABMP, ARPB
Chief Medical Physicist & Hospital RSO
Medical Physics Section
Department of Medical Imaging
Ext. 18232/ 18390. Pager:1316
Email: suwayana@[Link]
Atomic Structure
A
Z X
A
Z X
Electromagnetic Spectrum
•X-rays are photons and form part of the
electromagnetic spectrum
•Only X-rays and gamma rays have enough
energy to cause ionization.
INCREASING ENERGY
Ionizing Radiation
Radiation: Energy in transit, either as
particles or electromagnetic waves.
Ionization: The removal of electrons from an
atom. The essential characteristic of high
energy radiations when interacting with
matter.
Types of Radiation
1. Ionizing Radiation: Include X-ray and
Gamma rays.
2. Non Ionizing Radiation: Include Laser,
Radio waves.
RADIATION
IONIZING NONIONIZING
X-RAYS LASER
GAMMA RAYS ULTRVIOLET
ELECTRONS MICROWAVE
BETA PARTICLES INFRARED
ALPHA PARTICLES
interaction of Ionizing radiation
with Matter
Three main interactions: Photoelectric,
Compton Scattering and Pair
Production
all three types will result in an ionization of
the target atom
Photoelectric Effect
Compton Scattering
Medical Use of Ionizing Radiation
MEDICAL APPLICATIONS OF
IONIZING RADIATION
Diagnostic & Surgery
• X-ray Producing Machines
Therapy
• Radiography
• Radiation Therapy
• Fluoroscopy (Linacs, CyberKnife )
• IVR (CcathLab, DSA) • Brachytherapy
• CT • I-131 Therapy
• Mammography • Y-90 Therapy
• Dental
• Radioactive Isotopes
• Gamma Camera
• PET
X-Ray Production
X-RAY TUBE
Anode
- - ++
+
e
Filament Target
Cathode
X-rays
X Ray Tube Components
1. Cathode: heated filament which
is the source of the electron
beam directed towards the
anode (Tungsten Filament)
2. Anode: (stationary or rotating):
impacted by electrons, emits X
Rays
3. Housing: a surrounding glass
(or metal) X Ray tube (electrons
are travelling in vacuum)
4. Shielding material (protection
against scattered radiation)
Radiation Units
Absorbed Dose: Energy absorbed per unit
mass of the irradiated material.
SI unit is Gray (Gy), (1 Gy = 1 J/kg).
Old unit was rad (radiation absorbed dose)
Not all types of radiation cause the same
biological damage
Radiation Units
Equivalent Dose: Measure the biological
effect of specific type of radiation
SI unit is Sievert (Sv)
Old unit was rem (radiation equivalent man)
To get the Equivalent dose we multiply the
absorbed dose by a radiation weighting
factor (WR).
DEQ = WR x D(Absorbed)
WR for X-ray, Gamma = 1
WR for Alpha ray = 20. The biological
effect of Alpha rays is 20 times greater
than that of X-ray.
Radiation Units
Effective Dose: (Whole body exposure)
SI unit is Sievert (Sv)
Old unit was rem (radiation equivalent man)
DEffec = WT x WR x D(Absorbed)
WR: Radiation Weighting Factor
WT: Tissue Weighting Factor
Tissue Weighting Factors
(Update, ICRP 2007)
Tissue or Organ (WT)
Red bone marrow 0.12
Lung 0.12
Stomach 0.12
Breast 0.12
Gonads (testes or ovaries) 0.08
Bladder 0.04
Liver 0.04
Thyroid gland 0.04
Skin, Brain, Bone Surface 0.01
Radiation Biology
How Dose Radiation Interacts with Our
Body Cells?
The critical biological target of ionizing
radiation is the DNA.
Radiation attacks the DNA directly or
indirectly.
The interaction will cause a single-strand or
a double-strand brake in the DNA
DNA Radiation Induced Brakes
Single Strand Double Strand
Brake Brake
Exposure of the cell
No change
radiation DNA Damage
hit cell
nucleus!
Outcomes after cell exposure
Correct repair Viable Cell
Cell death Unviable Cell
DNA Damage Incorrect Repair Mutation
Stochastic vs. Deterministic
Effects
Stochastic Effects Deterministic Effects
• Probability of their • Certain dose (threshold)
occurrence, but not their is required for the effect
severity will depend on to take place. Below this
dose threshold, no effect is
• NO dose threshold value
noticed
• e.g. Cancer
• The higher the dose the
more sever the effect is.
• e.g. skin reddening
Somatic & Genetic Effects
Somatic effects Genetic Effects
appear in the exposed abnormalities that may
person. occur in the future
Some may appear
early, some may generations of exposed
appear late individual
e.g. skin reddening, e.g. Mutation
Cancer
Early Effects
Skin burns
Hair loss
Skin Injury attributable to X-rays
from Fluoroscopy
6 to 8 weeks after 18 to 21 months
exposure after exposure
Late Effects
Cataracts
Genetic
Cancer
RISKS
Expected reduction of life
Unmarried man 3500 days
Smoking man 2250 days
Unmarried woman 1600 days
30% overweight 1300 days
Cancer 980 days
Construction work 300 days
Car accident 207 days
Accident at home 95 days
Administrative work 30 days
Radiological examination 6 days
Radiation Safety
¾ Why Radiation is Dangerous?
¾ National & International Safety Organizations
¾ Practice & Intervention
¾ ALARA Principle
¾ Factors Affecting the Dose
¾ Radiation Safety
o Patient
o Worker
o Public
¾ Hospital Radiation Safety Program
Why Radiation is Dangerous?
Ionizing Radiation deposits LARGE amount
of energy in a SMALL volume.
It produces ions & free radicals which will
lead to chemical & biological reactions.
You Can NOT
See it
Feel it
Smell it
Hear it
Taste it
National & International Safety
Organizations
IAEA (International Atomic Energy
Agency: [Link] )
ICRP (International Commission on
Radiological Protection: [Link] )
KACST (King Abdulaziz City for
Science and Technology:
[Link] ). National
Regulations.
KAMC Safety Committee
THREE BASICS FOR SAFE
PRACTICES
1. Justification
2. Dose Optimization
3. Dose Limits
1. Justification of a Practice
• No practice involving exposures to radiation
should be adopted unless it produces
sufficient benefit to the exposed individuals or
to society to offset the radiation detriment it
causes.
Net Benefit > Radiation Detriment
2. Optimization
• In relation to any particular source of
radiation within a practice, all reasonable
steps should be taken to adjust the protection
so as to maximize the net benefit &
Minimize the risk
• economic and social factors being taken into
account
• ALARA:
ALARA As Low As Reasonably Achievable
Patients
Staff
Public
3. Dose Limitation
• A limit should be applied to the dose (for
NON medical exposures) received by
any individual as the result of all the
practices to which he or she is exposed.
• The main goals of setting dose limits are
1. preventing deterministic effects
2. reducing stochastic radiation effects
Exposure Types & Limits
Dose Limit Occupational Public
Whole Body 20 mSv/yr 1mSv/yr
Skin 500 mSv/yr 50 mSv/yr
&Extremities
Lens of the eye 150 mSv/yr 15 mSv/yr
Cumulative Age × 1 rem
dose
ALARA- Patient
Trade off between minimizing patient dose
and improving image quality.
Unfortunately, improving image quality is
impeded by increasing patient dose.
ALARA- Patient
Techniques to reduce patient’s dose in
Diagnostic radiology:
Routine equipment QC
High efficiency X-Ray image receptors
High KVP technique when practicable.
Beam collimation
Use gonad shields
Patient immobilization
AEC if applicable.
ALARA- Patient
Radiographic factors affect Amount and
Quality of radiation and hence image
3 important factors for any X-Ray
machine:
mA - current through x-ray tube
(electrons)
KVP - voltage across the x-ray tube
(accelerates the electrons)
Time - time of exposure
Patient Protection during
Examinations
Radiographer’s responsibilities
ALARA - As Low As Reasonably Achievable
Correct exposure factors
Correct radiographic technique
Appropriate radiation protection(shielding)
Appropriate radiographic positioning
Minimize repeat examinations
Organ Shielding Shield reproductive organs
Eliminate radiation incidents (e.g.
Misadministration)
Using gonad Shields
Correct Positioning
Typical DRLs (expressed as entrance surface
dose per image for single views)
Exam Entrance dose in mGy
Chest Posterior-Anterior 0.3
Chest Lateral 1.5
Chest CT 20
Lumbar Spine Ant-Post 10
Pelvis AP 5
Skull PA 5
Head CT 40
Patient Safety
“How do you know the X-ray machine is
tested & safe for patient examination?”
Pregnant Patients & Fetal
Radiation Risk
There are radiation-related risks
throughout pregnancy which are related
to the stage of pregnancy and absorbed
dose
Radiation risks are most significant during
1st trimester and less in the 2nd trimester
and least in the 3rd trimester
Most
risk Less Least
Pregnant Patients
Fetal Exposure Considerations
Fetus Risk from High
Doses
First Two Weeks fetal death
Weeks 2-15 Brain abnormalities
Weeks 16 until birth Risks similar to the
risks for a newborn
Fetal Exposure Considerations
For Workers: Fetal Exposure Limit = 1 mSv
Fetus treated as member of the public
Mother must declare pregnancy
Controlled to 0.11mSv/month to spread
dose across the 9 months
ALARA- STAFF
Three main Factors that affect your Dose
Time – Reduce your exposure time as short
as possible without affecting patient care.
Distance - inverse square law
Shielding – Room shielding and other
personal protective materials such as: lead
aprons, lead gloves, eye shields, thyroid
shields, drapes for fluoroscopy & mobile or
rolling shields
Penetration Ability
Distance
Inverse Square Law (I.S.L)
Portables must have 2m long exposure switch cords
Methods of dose reduction
for personnel
lead aprons
lead gloves
eye shields
thyroid shields
drapes for fluoroscopy
only those necessary for examination in room
use mobile or rolling shields
Proper
way
of wearing
lead
apron
and
thyroid
collar
TLD
badge
should be
worn
under the
lead apron
Nuclear Medicine Shielding
PREGNANT STAFF
To minimize stochastic effects:
TotalEffective Dose: 20 mSv/year
Fetus: 1 mSv for the gestation period
Staff Pregnancy
At orientation
Documents to read
Document to sign
Notification of pregnancy
Notify supervisor & RSO
Documents read again
Document to sign
RSO will counsel pregnant worker and
establish protective measures to follow
Additional controls
Limitation of dose to abdomen of 2 mSv
Wear second dosimeter.
Controlled & Supervised Areas
Access restrictions
Require warning signs
Monitoring of staff
Interlocks where
appropriate
Written procedures
Monitoring of doses to personnel
Film badges most cost effective for large
numbers of persons, permanent record,
contains filters, minimum dose 0.1 mSv,
some are only as good as 0.2 mSv
TLD’s – not permanent, can measure lower
doses, but much more expensive initially
$ 50 / badge
Pocket ionisation chambers – expensive,
needs to be read every day
Action levels
RSO will investigate if your dose reach or
exceeds the dose limit.
TLD
The badges comprise
thermoluminescent dosimeter
(TLD) cards issued for
placing in TLD holders and
are issued for wearing periods
of 4, 8 or 12 weeks.
TLD
Pocket Ionization chambers
RADIATION SAFETY
PROGRAM
Radiation safety practice and policies
are set by the KACST (National
regulations) and KAMC policies
Radiation Safety Subcommittee
Radiation Safety Manual
You can access radiation safety
policies on line via Intranet:
Regulations → Manuals → Radiation
Safety Manuals
Radiation Worker Responsibilities
Radiation workers are required to
Comply with KAMC radiation
protection policies
Completing required training
Taking measures to avoid
unnecessary radiation exposure
ALARA
Wear dosimeters, where assigned
Report any radiation incident to the
supervisor and RSO
Radiation Worker Responsibilities
For public safety, ensure that only
authorized person is allowed to enter
controlled area
No person should hold the patient
frequently
X-ray room door should be locked all
the time
Radiation Worker Responsibilities
Use of Protective Garments
Use the supplied rack to hang the
protective garments when not in-use
Radiation Worker Responsibilities
Use of Protective Garments
Not to fold the garment or store it on the
floor, table, etc. (To prevent cracking
Radiation Worker Responsibilities
Use of Protective Garments
Not to use any defected garment or
untagged garment
Inform area Supervisor and the RSO for
any defect in the garment
Not to store the garment in personal
locker cabinet
Not to take the garment from one
working area to another
Radiation Worker Responsibilities
“How do know the lead garment is tested
& safe to be used?”
Radiation Worker
Responsibilities
Wearing Personal Dosimeters (TLD)
Place the TLD badge in correct position
Return the OLD badge and take the NEW
badge during replacement period of
radiation badges. Replacement period is
one month of each quarter: January,
April, July & October
If you do not return the badge during
placement period, you may be requested
to pay the late penalty fee
Radiation Worker
Responsibilities
Wearing Personal Dosimeters (TLD)
Late Penalty Fee
50 SR: If returned after one month
exchange period and within the following
2 months
250 SR (Whole body TLD & 100 Ring
badge): If you do not return the badge
within 2 months after exchange period
No new badge will be issued until the
employee pays the fee at Cash office
Radiation Worker Responsibilities
Wearing Personal Dosimeters (TLD)
If you do not submit your TLD badge for 3
consecutive times, removing your name
from the wearers list may be considered
by the RSO
If your badge is lost, inform the hospital
RSO immediately. You may be requested
to pay the penalty of reissuing a new
badge
Do not expose your TLD badge to extreme
heat or humidity
Radiation Worker Responsibilities
Wearing Personal Dosimeters (TLD)
Leave the dosimeter(s) in specified
location in hospital and do NOT take
them outside hospital after work or
during your vacation
Do not share the dosimeter with others.
It is only to be used by you
Do not store your dosimeter in a
radiation areas
Radiation Worker Responsibilities
Wearing Personal Dosimeters (TLD)
If the dosimeter is contaminated or exposed to
heat, moisture, or medical X-rays, it should be
returned to the hospital RSO for replacement.
After any accident or if an overexposure is
suspected, the dosimeters should be returned
immediately to the hospital RSO to be read
Do not intentionally expose your TLD badge to
radiation source or damage it in any way
Contact Information
For further information, please contact
medical physics on the following
extensions:
18232 (RSO)
18109
18390