Basic Principles Of Radiation Protection Research Articles

Evaluation of radiation safety levels in the monitor rooms of selected diagnostic centres in Lagos State using thermoluminescent dosimeter

The hazard of exposure to ionizing radiation at low doses has been scientifically proven to be possible for cancer and non-cancer diseases. International and national regulatory bodies have recommended dose limits for occupationally exposed workers to ionizing radiation and the general public. The objective of this study was to assess the radiation safety levels in monitor rooms of x-ray diagnostic radiology facilities. Sixty monitored rooms in twenty radio diagnostic centers were visited. Three tissue-equivalent thermoluminescent dosemeters (TLD-100 (LiF: Mg. Ti)) chips were placed in strategic places a few centimeters from the viewing glass in the monitored rooms for two weeks. The TLDs were analyzed using the RADOS RE 2000 TLD reader. Questionnaires were also distributed to ascertain compliance with the basic principles of radiation protection. The average personnel dose equivalents in the monitored rooms of conventional x-rays, mammography, computed tomography, and fluoroscopy were 0.33, 0.32, 0.28, and 0.34 mSv/year, respectively. The status of the radiation safety levels in the selected monitored rooms is satisfactory because the values obtained were below the international recommended dose limit of 50 mSv in a single year for occupationally exposed radiation workers.

Academic program recommendations for graduate degrees in medical physics: AAPM Report No. 365 (Revision of Report No. 197).

Academic program recommendations for graduate degrees in medical physics: AAPM Report No. 365 (Revision of Report No. 197).

TE-NORM Radiological Impact and Radiation Protection in Oil and Gas Industry: A review

Materials having radioactive nuclei and exist naturally on earth are called Naturally Occurring Radioactive Materials (NORM).235U,238U and 232Th series in addition to 40K are few examples of radioactive elements and their daughter nuclei. NORM can be found either in soil, in water, in plants, in animals or in human being. In oil and gas industries NORM accumulates at different locations (the wellheads, pumps and separation vessels), That may take the form of scales, sludge, scrapings and some other wastes. Unless adequate control procedures are employed, it may be hazardous to workers, ordinary people and environment. The most critical concern to public health from exposure to NORM is the possibility of development of cancer. Having no threshold dose, the induction of cancer due to radiation exposure is thus a stochastic process. Nevertheless, no acute or severe effects comparable to those due to high doses of radiation are expected in case of exposure to Technologically Enhanced NORM (TE-Norm). Uncontrolled release of NORM waste will probably contaminate the environment and threaten human health. Such risks can be avoided through the use of a program for NORM control by oil and gas firms. The program will monitor NORM, control contaminated waste, contaminated equipment, train workers and increase their awareness. By the implementation of appropriate protective procedures at work places one can ensure that the basic principles of radiation protection are functionalized. Therefore, the control of exposure and application of sample dosimetry are the main components of any program for health and safety.

Inventory of Radiation Protection in Hospitals of Level III in Senegal

The aim of this study was to evaluate the level of protection of employees who are exposed to radiation in a level III hospital establishment. It was a descriptive cross-sectional survey of six months’ duration, involving eight level III Hospitals (Aristide Le Dantec, Fann, Hoggy, Hear, Abass Ndao, Pikine, Touba, and Thies) in Senegal. Sixty-one of the one hundred questionnaires were recovered (overall response rate of 61%). The population of the study was mainly female (54.1%). The average age was 38.57 with extremes ranging from 23 to 65 years old. In the places where ionizing radiation sources are handled, only at the Aristide Le Dantec Hospital did we find a “competent person in radiation protection”. This explained the lack of a classification of employees and work areas. Forty out of sixty-one (73.77%) had no knowledge of the basic principles of radiation protection (justification, optimisation, dose limitation) and had not ever taken radiation holidays. For radiovigilance, exposure time limits to ionizing radiation concerned only 29/61 or 47.54% of the study population. The inverse square law of distance was known by only 40 workers, of whom 15 had no compliance. We found the presence of dosifilms in only 7/61 or 11.47% of the workers. On the other hand, the use of lead aprons was well established and concerned 57/61 workers, i.e., 93.44%. In sum, ionizing radiation causes adverse health effects. The absence of a good radiation protection culture in Senegal requires the presence of at least 4 to 5 competent persons in radiation protection for quality training of workers in radiobiology, radiopathology and radiation protection.

Radiation Hazard, Safety, Control and Protection

The field of Radiology and Nuclear medicine has advanced from era of X-rays to today's modern imaging techniques, most of which use the ionizing radiation. With the benefits of better diagnosis and treatment, it has caused manifold increase in radiation exposure to the patients and the radiology and nuclear medicine personnel. Many studies done till date have clearly documented the harmful effects of ionizing radiation from radiation exposure, especially cancer. This is more important in paediatric population as their tissues are more radiosensitive, and they have more years to live. Diagnostic and therapeutic radiological procedures including nuclear medicine are integral part of modern medical practices, exposing both patients and medical staff to ionizing radiation. Without proper protective measures, this radiation causes many negative health effects. Hence, proper knowledge and awareness regarding the radiation hazards and radiation protection is mandatory for health professionals, especially the nuclear medicine and radiology professionals. International Commission on Radiation Protection (ICRP) has recommended two basic principles of radiation protection, justification of the practice and optimization of protection.
 Faridpur Med. Coll. J. Jul 2019;14(2): 100-103

Requesting physicians’ knowledge of X-radiation exposure from computed tomography scan examinations: A case study of two Nigerian tertiary hospitals

Objective: Physicians who often request for computed tomography (CT) scan examinations are expected to have sound knowledge of radiation exposure (risks) to patients in line with the basic radiation protection principles according to the International Commission on Radiological Protection (ICRP), the Protection of Persons Undergoing Medical Exposure or Treatment (POPUMET), and the Ionizing Radiation (Medical Exposure) Regulations (IR(ME)R). The aim is to assess the level of requesting physicians’ knowledge of ionizing radiation from CT scan examinations in two Nigerian tertiary hospitals. Materials and Methods: An 18-item-based questionnaire was distributed to 141 practicing medical doctors, excluding radiologists with work experience from 0 to >16 years in two major teaching hospitals in Nigeria with a return rate of 69%, using a voluntary sampling technique. Results: The results showed that 25% of the respondents identified CT thorax, abdomen, and pelvis examination as having the highest radiation risk, while 22% said that it was a conventional chest X-ray. Furthermore, 14% concluded that CT head had the highest risk while 9% gave their answer to be conventional abdominal X-ray. In addition, 17% inferred that magnetic resonance imaging had the highest radiation risk while 11% had no idea. Furthermore, 25.5% of the respondents have had training on ionizing radiation from CT scan examinations while 74.5% had no training. Majority (90%) of the respondents were not aware of the ICRP guidelines for requesting investigations with very little (<3%) or no knowledge (0%) on the POPUMET and the IR(ME)R respectively. Conclusion: There is low level of knowledge of ionizing radiation from CT scan examinations among requesting physicians in the study locations.

Knowledge and Behaviors of Industrial Radiography Workers about Radiation Protection

In our day, radiation sources have been used for useful purposes in industrial fields, but unrestrained and unconscious usage of radiation sources can be fatal. In this study, a survey has been shared online with 65 industrial radiography workers in order to assess their knowledge and behaviors towards radiation protection. The Cronbach's alpha coefficient of 0.85 demonstrated good reliability of the questionnaire. Of the participants, 53.8% had high school diploma and 29.2% had bachelor’s degree. The majority of workers (98.5%) was male and 43% of them had 11 years and more experience. The maximum percentages of industrial radiography workers’ knowledge about radiation safety basic concepts such as three basic principles of radiation protection, collimator, dosimeter usage in working condition A and effective dose were 95.4%, 93.9%, 93.8% and 90.8%, respectively. 65 participants (100%) agreed the definition as “I check radiography device and auxiliary equipment before the work commences”. 98.4% of the workers stated that they restricted the working area by using radiation warning signs and flashlights during the radiographic test. While working with radioactive sources, personnel must wear special PPE (Personal Protective Equipment) such as; lead gloves, lead glasses, lead apron, gonad and thyroid protection equipment etc.57% of radiographers (37) stated that they have been using the special PPE’s during the work. About 40% of responding workers (24) stated that they have not been using and 3% of them (4) stated that they have no idea about the usage of special PPE. Finally, survey results indicated that most of the radiographers who are occupationally exposed to radiation have a good knowledge and behaviors. However, some of them need to be trained about special radiation PPE usage.

Diagnostic Reference Levels for Computed Tomography Examinations in Iran: A Nationwide Radiation Dose Survey

Introduction: International Commission on Radiological Protection introduced three basic principles of radiation protection, namely justification, optimization, and dose limit. Medical exposure has no dose limits, and generally, diagnostic reference levels are used as a tool for optimization of patient protection. Material and Methods: Dosimetry was performed on 20 CT scanners located in 14 cities in 12 provinces of Iran. A calibrated pencil-shaped ionization chamber, standard head and body CT dosimetry phantoms and a radiation monitor were used to determine and calculate Computed Tomography Dose Index (CTDI) and Dose Length Product (DLP). The DLP-based estimates of effective dose were derived using effective dose conversion coefficients. Results: The nCTDIw values for head phantoms fell within the range of 22.05-168.38 and 43.77-426.69 µGy/mAs for 5 and 10mm slice thicknesses, respectively. These values for body phantom were 4.65-146.39 and 9.43-308.92 µGy/mAs for 5 and 10mm slice thicknesses, respectively. The third quartile of CTDIvol and DLP values for head CT examinations were 49.85 mGy and 1161.00 mGy-cm, respectively. The body CT examinations had the values of 8.89 mGy and 370.97 mGy-cm, respectively. The findings of this study revealed that the above-mentioned values can be considered as national diagnostic reference levels for head and body CT examinations in Iran. Conclusion: The results of the current study suggested that there is a need to re-assess DRLs for CT examinations at regular time intervals by the appropriate regulatory authority which can improve the continuous performance of CT scanners in Iran.

A Survey on the Radiation Protection Status among Radiology Staff

Introduction: Radiation exposure during radiological examination is a health concern, of which radiology professionals should be cognizant. We sought to evaluate the radiation protection knowledge, attitudes, and practice (KAP) amongst radiology staff of hospitals across 10 provinces of Iran. Materials and Methods: For evaluating the level of radiation protection KAP, 553 radiology staff were enrolled. A 32-item questionnaire was designed to assess radiation protection KAP, the validity which was confirmed by members of the Medical Physics and Biostatistics departments. The questionnaire evaluated the respondents' knowledge, practice, and attitudes towards the basic principles of radiation protection, the necessity of using protective equipment, and their performance in the implementation of radiation protection recommendations. Results: We found no significant difference in the level of radiation protection KAP between male and female radiology staff and among those with different educational levels and ages (P>0.05). However, there was a significant association between radiation protection KAP and working experience, hospital size, and hospital type (P 0.05). Conclusion: Our results showed that the level of radiation protection KAP among radiology staff is inadequate. This might be due to the lack of ongoing training courses concerning protection against ionizing radiation. Thus, sustained training of radiation protection principles can promote KAP among the staff of radiology departments, and in turn, reduce public dose from medical diagnostic modalities.

Radiation Safety in Nuclear Medicine Procedures.

Since the nuclear disaster at the Fukushima Daiichi Nuclear Power Plant in 2011, radiation safety has become an important issue in nuclear medicine. Many structured guidelines or recommendations of various academic societies or international campaigns demonstrate important issues of radiation safety in nuclear medicine procedures. There are ongoing efforts to fulfill the basic principles of radiation protection in daily nuclear medicine practice. This article reviews important principles of radiation protection in nuclear medicine procedures. Useful references, important issues, future perspectives of the optimization of nuclear medicine procedures, and diagnostic reference level are also discussed.

КОНУСНО-ЛУЧЕВАЯ КОМПЬЮТЕРНАЯ ТОМОГРАФИЯ В ДЕТСКОЙ СТОМАТОЛОГИИ: обзор современной литературы

<p>The use of cone beam computed tomography (CBCT) in paediatric dentistry has been mentioned in numerous publications and case reports. The indications for the use of CBCT in paediatric dentistry, however, have not yet been properly addressed. On the other hand, the three basic principles of radiation protection (justification, limitation and optimisation) should suffice. A review of the current literature was used to assess the indications and contra-indications for the use of CBCT in paediatric dentistry. Paramount is the fact that CBCT generates a higher effective dose to the tissues than traditional dental radiographic exposures do. The effective radiation dose should not be underestimated, especially not in children, who are much more susceptible to stochastic biological effects. The thyroid gland in particular should be kept out of the primary beam as much as possible. As with any other radiographical technique, routine use of CBCT is not acceptable clinical practice. CBCT certainly has a place in paediatric dentistry, but its use must be justified on a patient case individual basis. </p>

Radiologic protection in pediatric radiology: ICRP recommendations

On Aug. 24, 2011, the US Joint Commission issued a sentinel event alert on radiation risk from diagnostic imaging that could change the way radiology departments are run in the near future [1]. The Joint Commission, cognizant of the benefits of diagnostic imaging, is also aware of the known risks of radiation dose for the development of cancer and the alarming increasing utilization of medical imaging (in particular of CT) over the last decades. The Joint Commission is concerned specifically about potential overutilization and the lack of justification for radiologic exams and suggests raising awareness of the increased risks associated with radiation among providers, equipment manufacturers and patients. The specific actions suggested by the Joint Commission emphasize the main principles of radiation protection: justification and optimization. The Joint Commission also endorses the implementation of a national registry to track radiation doses as the start of a process to identify optimal and reference doses. The International Commission on Radiological Protection (ICRP) has recently issued specific radiation protection recommendations for diagnostic and interventional radiology in the pediatric population [2]. The main purpose of this report is to provide referring physicians and staff performing diagnostic and interventional procedures, as well as equipment vendors, with common and specific pediatric radiation protection guidelines. The ICRP is an independent, nonprofit international organization that has, since 1928, offered recommendations on the principles and practice of radiation protection. The ICRP comprises a main commission and five committees whose members are international leaders in the field of radiation protection. The ICRP is an advisory body and does not provide regulatory text. The recommendations issued by the ICRP are followed widely by international, national, regional and local agencies. Because the implementation of these recommendations is a time-consuming process that requires significant institutional effort, the ICRP avoids making frequent changes to its main recommendations. The ICRP report provides an executive summary focusing on the basic principles of radiation protection: justification and optimization. Every examination performed must be justified and result in a net benefit to the patient. The principle of justification is specially emphasized for image modalities that deliver a relative high dose such as CT and interventional radiology. The report outlines examples of unjustified examinations and emphasizes the importance of using alternative techniques that do not use ionizing radiation when feasible. The document provides examples of organ-system-based referral guidelines to help pediatric radiologists and ordering physicians make a better use of the departments of radiology, improve clinical practice and reduce unnecessary radiation exposure. Optimization of medical exposures in diagnostic and interventional radiology is another fundamental principle of radiation protection and advice and input from medical physicists must be sought. The report outlines ways in which unnecessary dose to patients and operating staff can be minimized during diagnostic and interventional procedures. It also provides specific advice on how technical parameters should be adjusted to deliver sufficient image quality without reducing diagnostic capabilities. The report emphasizes the concept and use of DRLs (diagnostic reference levels) and gives multiple examples of how implementation of quality criteria and R. Sanchez (*) Department of Radiology, C. S. Mott Children’s Hospital, University of Michigan Hospital, 1540 E. Hospital Drive, 3-220, Ann Arbor, MI 48109-4252, USA e-mail: ramonsan@umich.edu

Three-dimensional imaging in paediatric dentistry: a must-have or you’re not up-to-date?

Radiation protection guidelines are very simple and straightforward and are simply common sense. First of all the exposure should be justified, secondly the exposure should be as low as reasonably achievable, and finally the exposure should result in the best diagnostic image possible. These are the three basic principles of radiation protection and they hold for every exposure to ionising radiation, whether twoor three-dimensional. Nonetheless, numerous publications mention the use of three dimensional (3D) imaging in dentistry as a diagnostic aid without assessing the potential health risk for a patient. There is no doubt that a 3D procedure will provide a better-looking image than a traditional two-dimensional (2D) one. However, the basic principles of radiation protection should still be followed carefully at all times. This is even more important with regard to the use of ionising radiation in children. Children’s tissues are much more susceptible than that of adults to any biological effects of ionising radiation. In dentistry so-called stochastic or probabilistic effects are those we should take into account. The assumption that these effects may take place are derived from the so-called linear no-threshold model, which is based on effects occurring from high exposures, such as those encountered in nuclear plants or nuclear accidents. The fact that the effects from lower energy radiation are unpredictable necessitates the paramount consideration for any dental care provider to keep radiation to a minimum and not to use too many radiographs. As mentioned before, the three basic principles of radiation protection are paramount. Digital radiography was supposed to decrease the radiation burden to a patient, but time and experience has shown that the opposite is true. The proportion of medical exposures within the total of all exposures to ionising radiation has increased dramatically over the past 10 years. The actual reduction in radiation dose that could be achieved when switching from D-speed analogue film to phosphor storage plates (PSPP) or solid-state sensors [charged coupled devices (CCD) or complementary metal oxide semiconductors (CMOS)] has been lost because more radiographs are taken. Dentists using E-/F-speed analogue film use the same exposure parameters as those who have switched to digital, but the former do not take as many radiographs. The increase in the number of radiographs is because solid-state sensors do not always cover the whole area of interest (there is a substantial discrepancy or dead zone between the exterior surface dimensions of the sensor and the real interior sensor surface), so multiple radiographs of the same area are needed. Another reason is that practitioners erroneously assume that the reduction in radiation dose compensates for two or three digital radiographs (CCD/CMOS or PSPP). A third reason is that it is very tempting to push the button once more as it is hoped that just a bit better image may be achieved than the one that occured on the monitor initially. This is a false feeling of safety or security. Digital imaging is therefore not always as safe as assumed. That same false feeling of ‘‘it is okay’’, is clearly a misconception and also occurs with cone-beam computed tomography (CBCT), which is promoted commercially as a technique with a low radiation dose. The latter is true only when compared to medical CT, definitely not when compared with intra-oral peri-apical imaging. As ever in life, comparisons are relative. J. K. M. Aps (&) The Center for Pediatric Dentistry, University of Washington, 6222 NE 74th Street, Seattle, WA 98115, USA e-mail: johan.apsdmfr@hotmail.com

Cone beam computed tomography in paediatric dentistry: overview of recent literature

The use of cone beam computed tomography (CBCT) in paediatric dentistry has been mentioned in numerous publications and case reports. The indications for the use of CBCT in paediatric dentistry, however, have not yet been properly addressed. On the other hand, the three basic principles of radiation protection (justification, limitation and optimisation) should suffice. A review of the current literature was used to assess the indications and contra-indications for the use of CBCT in paediatric dentistry. Paramount is the fact that CBCT generates a higher effective dose to the tissues than traditional dental radiographic exposures do. The effective radiation dose should not be underestimated, especially not in children, who are much more susceptible to stochastic biological effects. The thyroid gland in particular should be kept out of the primary beam as much as possible. As with any other radiographical technique, routine use of CBCT is not acceptable clinical practice. CBCT certainly has a place in paediatric dentistry, but its use must be justified on a patient case individual basis.

Radiation risk: A primer

Man has always been exposed to natural radiation arising from the earth as well as from outside the earth. No human activity or practice is totally devoid of associated risks. Radiation should be viewed from the perspective that the benefit from it to mankind is less harmful than from many other agents. In general, the basic principles of radiation protection (justification and optimization of a procedure) need to be respected to help counteract the unjustified exposure in the number of procedures being performed. However ALAR A (As Low as Reasonably Achievable) doses should be the guiding principle in dealing with radiation.

COMMUNICATION OF BENEFITS AND RISKS OF MEDICAL RADIATION: A HISTORICAL PERSPECTIVE

X-rays were discovered by Wilhelm Röntgen in 1895. Within one year, benefits of x-rays, such as visualization of fractures, and detriments, such as x-ray dermatitis, were recognized. Nobel Laureates Pierre and Marie Sklodowska Curie discovered the radioactive element radium in 1898, and a year later the application of radiation to cure cancer was reported. A significant price was paid for this: Marie Curie died of aplastic anemia related to her radiation exposure, and her daughter Irene Joliot Curie, Nobelist for radiochemical research, died of radiation-induced leukemia. Internationally developed radiation protection recommendations were formalized starting in the late 1920s. The increasing use of ionizing radiation in medical diagnosis and radiation therapy has brought significant societal benefits. Known risks of therapeutic radiation include coronary artery disease and secondary malignancy. However, recently concerns have been raised of possible very small but incremental increases in malignancies due to diagnostic medical radiation. Patients are largely unaware of, and referring physicians and even radiologists often underestimate, the carcinogenic effects of radiation. There is a need to determine the appropriateness of imaging tests that use ionizing radiation prior to performance; optimize imaging protocols to reduce unnecessary radiation; include patients in the decision process and encourage and enable them to track their radiation exposure; and promote education about medical radiation to patients, referring physicians, radiologists, and members of the public. The basic radiation protection principles of justification, optimization, and application of dose limits still pertain.

Radiation protection in fixed PET/CT facilities--design and operation.

We describe the design of a fixed positron emission tomography (PET)/CT facility and the use of a simulated instantaneous dose-rate plot to visually highlight areas of potentially high radiation exposure. We also illustrate the practical implementation of basic radiation protection principles based on the use of distance and shielding and the minimisation of time spent in hot areas. Staff whole body doses for 4 years are presented with results of an optimisation study analysing the dose arising from the different phases within each study using direct reading dosemeters. The total whole body dose for all staff for each patient fell from 9.5 μSv in the first full year of operation to 4.8 µSv in 2008. The maximum dose to an individual member of staff per patient decreased over the same period from 3.2 to 0.9 µSv. The optimisation study showed that the highest dose was recorded during the injection phase.

Ethical concerns arising from screening procedures such as mammography and self-referral

Shortly after the discovery of X-rays, their harmful effects became apparent. While the harmful effects of ionising radiation were recognised at an early stage, it took some time before a systematic approach to radiation protection evolved. This began with the development of simple rules to reduce the risk of stochastic effects (such as cancer induction) and the occurrence of deterministic injuries (e.g. cataract formation). These rules have evolved into the basic principles of radiation protection, one of which is the concept of justification, which in its simplest form may be taken as doing more benefit than harm. The concept of justification has particular ethical concerns when applied to population screening procedures. These problems are described in this paper with a particular emphasis on the cases of screening and self-referral procedures.

Programa de controle de qualidade: a visão do técnico de radiologia

OBJETIVO: Pretendeu-se averiguar que importância os técnicos de radiologia atribuem à implementação de um programa de controle de qualidade em radiologia, e conhecer a importância da existência de critérios de proteção. MATERIAIS E MÉTODOS: Estudo descritivo e transversal. Os dados foram recolhidos por meio de um questionário (quatro partes), tendo sido garantido o anonimato e a confidencialidade dos dados. Participaram neste estudo 48 técnicos de radiologia que exercem funções em instituições de saúde, situadas no Distrito de Vila Real (norte de Portugal). RESULTADOS: Dos técnicos de radiologia participantes do estudo, 62,5% não sabem em que consiste um programa de controle de qualidade em radiologia, mas 85,4% consideram muito importante a sua implementação nos seus serviços, e 89,6% consideram que a sua implementação seria um fator de motivação. Verificamos também que as instituições estudadas (hospitais e centros de saúde) não se encontram adequadas com os princípios básicos da radioproteção. CONCLUSÃO: Embora os técnicos de radiologia não saibam em que consiste um programa de controle de qualidade em radiologia, estariam dispostos a colaborar na sua elaboração. Este estudo permitiu constatar uma realidade que pensávamos não ser possível existir: instituições públicas, cuja missão se baseia na promoção da saúde, ignorarem as não conformidades existentes nos diferentes serviços, no que diz respeito à proteção radiológica.

Quality Initiatives Radiation Risk: What You Should Know to Tell Your Patient

The steady increase in the number of radiologic procedures being performed is undeniably having a beneficial impact on healthcare. However, it is also becoming common practice to quantify the health detriment from radiation exposure by calculating the number of cancer-related deaths inferred from the effective dose delivered to a given patient population. The inference of a certain number of expected deaths from the effective dose is to be discouraged, but it remains important as a means of raising professional awareness of the danger associated with ionizing radiation. The risk associated with a radiologic examination appears to be rather low compared with the natural risk. However, any added risk, no matter how small, is unacceptable if it does not benefit the patient. The concept of diagnostic reference levels should be used to reduce variations in practice among institutions and to promote optimal dose indicator ranges for specific imaging protocols. In general, the basic principles of radiation protection (eg, justification and optimization of a procedure) need to be respected to help counteract the unjustified explosion in the number of procedures being performed.