Radiation Safety Instructions Research Articles

A Nontraditional Method of Providing Radiation Protection Instruction at a Large Health Science Center

In the 4 quarter of 2001 the University of Alabama at Birmingham (UAB) converted its traditional classroom radiation safety course, taught exclusively in a classroom setting four times each year, to a combined online-classroom format in which the majority of the course is taught online. This change was instituted in an effort to minimize the time spent in the classroom for UAB research personnel. This format should provide the additional benefit of self-paced instruction for course participants. The hypothesis that the combined online/lecture format was as effective as the lecture-only format was tested. A statistical analysis was performed on the average first-attempt test scores of the tests (number of tests = 334) taken during a 2-y period before the online transition (average score = 75.5), and the average first-attempt test scores of the tests (number of tests = 359) taken during a 2-y period after the online transition (average score = 74.1.) A two-tailed Student's t-test was performed on the data. The t-value was 1.73, and P (T< or = t) was 0.083. At alpha = 0.05, the null hypothesis that the two averages are equal cannot be rejected. Thus the online course format appears to be as effective a method of radiation safety instruction as the more traditional, exclusively-classroom method of instruction. This article also reviews steps under consideration to improve the current online course to make it a more effective tool in radiation safety instruction.

Radiation dose to family members of hyperthyroidism and thyroid cancer patients treated with 131I

The thermoluminescence dosemeter (TLD) was used for measuring radiation dose to family members of thyrotoxicosis and thyroid cancer patients treated with (131)I using CaSO(4):Dy discs. There were 45 family members of thyrotoxicosis patients, who were divided into two groups with 22 in the first and 23 in the second group. Radiation safety instructions were the same for both the groups except in the second group where the patients were advised to use a separate bed at home for the first 3 d of dose administration. An activity ranging from 185 to 500 MBq was administered to these patients. The whole-body dose to family members ranged from 0.4 to 2.4 mSv (mean 1.1 mSv) in the first group and 0-1.9 mSv (mean 0.6 mSv) in the second group. A total of 297 family members of thyroid cancer patients were studied for whole-body dose estimation. An activity ranging from 0.925 to 7.4 GBq was administered to the thyroid cancer patients. The family members were divided into three groups depending upon the mode of transport and facilities available at home to avoid close proximity with the patient. Group A with 25 family members received a dose ranging from 0 to 0.9 mSv (mean 0.4 mSv), group B with 96 family members received a dose ranging from 0 to 8.5 mSv (mean 0.8 mSv) and group C with 176 family members received a dose ranging from 0 to 5.0 mSv (mean 0.8 mSv). The thyroid monitoring was also done in 103 family members who attended the patients in isolation wards for >2 d. Thyroid dose in them ranged from 0 to 2.5 mGy (mean 0.1 mGy).

Radiation safety considerations with yttrium 90 ibritumomab tiuxetan (Zevalin)

Radioimmunotherapy is a recently approved treatment modality for non-Hodgkin’s lymphoma that enables physicians to target cytotoxic localized radiation to tumor sites without using external-beam sources. Because it uses a pure beta emitter for therapy, 90Y ibritumomab tiuxetan can be safely and routinely administered in an outpatient procedure, with few discharge instructions, and minimal risk of radiation exposure to a patient’s family and acquaintances. Safety precautions for medical professionals administering 90Y ibritumomab tiuxetan are universal precautions, with the addition of acrylic shielding for the administration of radiolabeled doses. The risk of radiation exposure to healthcare workers and family members is minimal. The primary route for biologic elimination of 90Y ibritumomab tiuxetan is through the urine. While radiation safety instructions are not required according to the relevant patient release criteria, basic instructions to the patient and family may be valuable to further minimize the risk of radiation exposure and help alleviate patient and family concerns.

Assessment of radiation safety instructions to patients based on measured dose rates following prostate brachytherapy

Purpose To validate radiation safety instructions to patients and to evaluate the potential radiation doses to members of the public after 125I or 103Pd prostate implantation. Methods and materials Radiation dose rate measurements were made in the immediate postoperative period on 636 consecutive patients with stage T1-T2 prostate cancer who underwent transperineal 125I or 103Pd implantation at Memorial Sloan-Kettering Cancer Center during the period from August 1995 through January 2003. Results The mean radiation dose rate at the anterior skin surface following a prostate implant was 37 μSv/hr for 125I and 8 μSv/hr for 103Pd. At 30 cm from the anterior skin surface, these dose rates were reduced to 6 μSv/hr for 125I and 3 μSv/hr for 103Pd. At 1 m from the anterior skin surface the dose rates from both types of implants were reduced to less than 1 μSv/hr. The effect of body weight on dose rates from 125I sources was examined for a select sub-group of patients and the measured dose rate was found to decrease with increasing body weight. In another group of patients, dose rate measurements were made on both lateral skin surfaces and were less than 16.8 μSv/hr in all cases. Assuming a 33% occupancy factor and utilizing the mean measured dose rate for 125I, the time required to reach an effective dose equivalent limit of 5 mSv for caregivers was estimated to be 19 days on contact with the skin surface. Using a similar calculation, the lifetime doses for 125I at a distance of 30 cm from the anterior skin surface, as well as the lifetime doses for 103Pd on contact with the skin surface and at 30 cm from the anterior skin surface can be shown to be less than 5 mSv. Conclusions The large number of cases available for this study permits a validation of radiation safety recommendations and provides concrete information from which the permitted exposure times following implantation can be estimated. The data support the conclusion that patients treated with these implants do not represent a radiation risk to members of the public.

Radiation safety considerations with therapeutic 90Y Zevalin.

ABSTRACT Radioimmunotherapy with the 90Y-labeled Zevalin radioimmunoconjugate is a new and promising modality in cancer treatment that combines the targeting power of monoclonal antibodies with the cytotoxicity of localized radiation. 90Y is a pure beta emitter, with different physical characteristics than traditional therapeutic radionuclides such as 131I. It is important that radiation safety professionals understand the characteristics of this radionuclide so that effective radiation safety procedures can be implemented with the Zevalin regimen. Because 90Y is a pure beta emitter, the Zevalin regimen is routinely administered as an outpatient procedure and is administered by using plastic shielding. Once the radioimmunoconjugate has been administered, the risk of radiation exposure to healthcare workers and family members is minimal. The primary route of biologic elimination of 90Y Zevalin is through the urinary system, with approximately 7% of the total activity administered eliminated over the course of 1 wk. Standard universal precautions, which should already be in place in healthcare facilities, should be sufficient to prevent radiation exposure to personnel working with patients who have been treated with Zevalin. Written radiation safety instructions for patients are not required, but basic instructions to the patient and his or her family may help further minimize the risk of radiation exposure and help alleviate patient and family concerns.

Interactive software automates personalized radiation safety plans for Na131I therapy.

NRC regulations have liberalized the criteria for release from control of patients administered radioactive materials but require written radiation safety instruction if another individual is expected to receive more than 1 mSv. This necessitates calculation of expected doses, even when the calculated maximum likely dose is well below the 5 mSv release criterion. NRC interpretations of the regulation provide the biokinetic model to be used to evaluate the release criterion for patients administered Na131I, but do not provide guidance as to either the specifics of minimizing the dose of others or the length of time restrictions should remain in effect. Interactive software has been developed to facilitate creation of radiation safety plans tailored to patients' expected interactions. Day-by-day and cumulative effective exposures at several separation distances, including sleeping, are presented in grid format in a graphic interface. In an interview session, the patient proposes daily contacts, which are entered separately for each individual by point-and-click operation. Total dose estimates are accumulated and modified while negotiating contact schedules, guided by suggested age-specific limits. The software produces printed radiation safety recommendations specific to the clinical, dosing, and social situations and reflective of the patient's choice of combinations of close contact with others. It has been used in treating more than 100 patients and has been found to be very useful and well received.

Radiation safety instruction for non-radiation workers.

In today's society, neglecting to provide adequate hazard-awareness instruction to workers can be successfully used to file suit against institutions where radioactive material (RAM) or radiation generating devices (RGDs) are used. Because of the lack of instruction, in some cases, just the perceived risk (even where no significant exposure to radiation existed) has proven to be more important than the actual risk. Groups of non-radiation workers such as custodian, maintenance and laboratory personnel, whose duties may require them to work in the vicinity of RAM and RGDs, sometimes do not receive proper hazard-awareness instruction. Misinterpretation of the applicable hazard-awareness regulations is a reason why institutions sometimes fail to instruct their workers. The objectives of this paper are to help radiation safety program managers become more aware of the importance of having well-instructed non-radiological personnel and to develop and provide basic information to help implement an effective hazard-awareness instruction program for workers. Topics discussed in this paper include regulatory aspects regarding the instruction to non-radiation workers, a list of radiological incidents that could have been prevented with proper instruction to workers and recommendations for the development and implementation of an effective instruction program.

ALARA study of teaching effectiveness on reducing radiation exposure.

The purpose of this study was to measure the effectiveness of radiation safety instruction and the impact on radiation film badge levels. A convenience sample of 144 endoscopy nurses and technicians was pretested for radiation safety knowledge, given a course in radiation safety, and then posttested immediately after the course and then 6 months later. Radiation badges were analyzed for radiation exposure at preinstruction, 1 month postinstruction, and 6 months postinstruction. Results showed that the instruction was effective. There was only a slight decrease in radiation badge readings; the decrease, however, was not statistically significant.

Procedure for Intraperitoneal P-32 Administration

Details of the Intraperitoneal P-32 administration are presented. Rationale, general instructions, technique, infusion of P-32, orders and Radiation Safety instructions are discussed.