1. Unit 3 Radiation Protection RAD101
Chapter 5: Radiation Monitoring
Unit 3 Radiation Protection RAD101

2. Objectives- Chapter 5
State the reason why a radiation worker should wear a personnel dosimeter, and explain the function and characteristics of such devices.
Identify the appropriate location on the body where the personnel dosimeter(s) should be worn during the following procedures or conditions: (1) routine computed radiography, digital radiography, or conventional radiographic procedures, (2) fluoroscopic procedures, (3) special radiographic procedures, (4) pregnancy.
Describe the various components of the film badge, optically stimulated luminescence (OSL) dosimeter, pocket ionization chamber, and thermoluminescent dosimeter (TLD), and explain the use of each of these devices as personnel monitors.
Explain the function of radiation survey instruments.
List three gas-filled radiation survey instruments.
Explain the requirements for radiation survey instruments.
Explain the purpose of the following instruments: (1) ionization chamber-type survey meter (cutie pie), (2) proportional counter, (3) Geiger-Müller (GM) detector.
Identify the radiation survey instrument that can be used to calibrate radiographic and fluoroscopic x-ray equipment.

3. Personnel Monitoring
Can’t see, hear or feel radiation so we have instruments designed to detect ionizing radiation
Devices can measure effect on film( density) or air( ionization )
Monitor on a regular basis
Required to ensure radiation exposure levels are kept within allowable limits ( Efd)
Personnel dosimetry- any occupational worker exposed to radiation
Personnel dosimeter- provides the detecting over a period of time, but does not protect
REQUIRED – when risk is > 10% of annual EfD 50mSv / 5rem ( 5 mSv or .5 rem )
Most provide when dose could reach 1% per month of annual limit ( 0.04mSv or 4mrem)

4. Placement of Dosimeter
Routine Placement
collar level – anterior-to provide maximum does measurements of thyroid, neck and head
Should be consistent placement
Don’t wear during personal testing
With Apron
Outside the apron at collar level – thyroid/eye dose
Head, neck and eyes receive X higher than trunk of body
2nd Monitor w/ apron
Used for techs with high readings . Ie: fluoroscopy, CAC, IR
Worn at waist level UNDER apron
Fetal Badge
Records dose to abdomen for estimate of embryo-fetal dose
Worn under apron during fluoro exams
Extremity
Extremity dosimeter or thermoluminescent dosimeter (TLD) ring
Worn by techs doing “hands-on” fluoro

5. Personnel Monitoring Reports
Must be maintained to meet state and federal regulations
List Deep, eye and shallow doses for each person monitored
Report is based on length of time worn
Monthly, bimonthly, quarterly, yearly
Can provide TEDE- total effective dose equivalent at end of year
Control badge reading
Legal document- require signature before exposure records can be released to other individuals, new employers
Must be maintained in perm record- length may vary on policies and exposure area

6. Report contents Contain Doses received:
Personal data- name, SSN , gender DOB
Badge type and location
Radiation type, x, beta or neutron
Monthly dose received
Quarterly accumulated dose
Cumulative occupational exposure history
Doses received:
Deep dose equivalent ( DDE)
Dose at depth of 1 cm in soft tissue( whole body dose)
Shallow dose equivalent ( SDE)
Dose at depth of .007 cm deep in soft tissue( skin dose)
Eye dose equivalent ( LDE ) (EDE)
External exposure to lens of the eye- depth of 0.3 cm
“M” minimal or no exposure

7. Characteristics of Dosimeters
Portability- lightweight / easy to carry
Ruggedness- durable
Sensitivity- detecting radiation
Reliability- consistent
Low cost

8. Types OSL- optically stimulated luminescence dosimeters Film badges
TLDs - Thermoluminescent dosimeters
Pocket Ionization chambers

9. 1. Optically Stimulated Luminescence -OSL
Most common- has replaced the film badge
Contains aluminum oxide detector Al2O3
Contain filters – aluminum, tin, and copper
Identifies static, contaminant and dynamic exposure to low energy x-rays
- beta particles too-
Deep , eye and shallow doses
Read by laser light- luminesces in proportion to amount of radiation
exposure
1- 3 month wear time
Can be read “in-house” or mailed out
Use control monitor- provides base reading

10. Optically Stimulated Luminescence -OSL
ADVANTAGES:
Preloaded/self-contained packet
Color coded
Tamperproof from heat, moisture and pressure
Can be reanalyzed
Increased accuracy- as low as 1mrem
DISADVANTAGES:
Only accurate for the area of body worn
Does not work if not worn

11. 2. Film Badge Still used although OSL has taken their place 3 Parts
Plastic film holder
Low atomic number for passage of radiation
Metal filters
Aluminum or copper
Helps determine energy of radiation and from what direction radiation was received from ( posterior or anterior)
Helps determine if mostly scatter or a single exposure from primary beam
Film packet- radiation-dosimetry film
Sensitive from .1 mSv to 5000 mSv less .1 mSv are reported as minimal (M)
Darkens just like regular film if exposed to radiation
Density is measured

12. Film Badge Causes of Inaccurate reading ADVANTAGES:
Leaving badge on apron
Washing
Left in car- cosmic radiation and heat from sun
Not correctly inserting film into plastic holder
ADVANTAGES:
Inexpensive
Easy to handle
Easy to process

13. 3. Thermoluminescent Dosimeter
Resemble film badge
Contain crystalline form of lithium fluoride ( LiF) – functional material
Radiation interacts with LiF to change physical properties (emit light- luminescence)
Light intensity is proportional to amount of radiation that interacts with crystals
TLD analyzer – use to measure radiation

14. Thermoluminescent Dosimeter
ADVANTAGES
LiF reacts similarly to human tissue- more accurate
5 mR
Humidity, pressure and temp changes do not affect
Can be worn for 3 months
Can be re-used after crystals read
DISADVANTAGES:
Twice the cost of film badge
Can be read only once- info destroyed after read
Batch/group readings

15. 4. Pocket Ionization Chamber(pocket dosimeter)
Most sensitive
Use is uncommon in diagnostic imaging
Fountain pen shape- cylindrical- clip on end to hook on pocket
2 types
Self reading- contains built electormeter – most common of two
Non-self reading
Components:
2 electrodes – one + , one –
Quartz fiber – functions as indicator
When electrodes are exposed to gamma or x-rays + end becomes ionized and discharges -

16. Pocket Ionization Chamber
ADVANTAGES:
Can be as sensitive as 0-200mR
Immediate exposure
Used in nuclear power plant tours, people assisting in dept
DISADVANTAGES:
Cost $150 for initial setup / unit
Require special charge stations for accuracy
Charge can leak or escape- false readings
Trauma to device can cause false readings
No permanent legal readings
Must be read daily

17. AREA Monitoring Categorized as Radiation survey instruments
3 Gas filled types:
1. Ionization chamber based instruments
2. Proportional Counter
3. Geiger-Muller (GM) tube
May or may not have calibrated readouts
Not all equally sensitive
Very basic to complex
No cumulative exposure readings – detect presence of radiation

18. Requirements 1. Portability- one person operation 2. Durable
3. Reliable
4. Need to be as reactive as human tissue is ionizing radiation
5. Sensitive to all types of ionizing radiations- increases usefulness
6. Direction and energy of radiation should not affect response
7. Should be cost effective
8. Need annual calibration

19. Ionization Chamber-Type Survey Meter
AKA: Cutie Pie- nicknamed because of small size
2 functions:
rate meter device for exposure rate for area surveys
integrating or cumulative exposure instrument
Specifics:
Measures x and gamma radiation
Some measure beta
Sensitivity Ranges:
Can measure intensity ranging from 10- several 1000microGy ( 1mRoentgen/hr-several 1000mR / hr
Can sum exposures from 1mR – several R

20. Ionization Chamber-Type Survey Meter
Uses:
Monitoring x-ray machine installs – long exposures
Fluoroscopic scatter radiation exposure rates
Exposure rates from patients receiving therapeutic doses
Assess radioisotope storage facilities
Quantifying the cumulative exposures outside of protective barriers

21. Ionization Chamber-Type Survey Meter
Advantages:
Can measure a wide range of radiation exposures in a few seconds
Sensitive to broad range of radiation energies
Disadvantages:
Sensor is delicate
Can be inaccurate if not warmed up properly
Not useful for short exposure times

22. Proportional Counter No useful purpose in diagnostic imaging
Lab setting for alpha and beta
Small amounts of low level radioactive contaminants
Advantages:
Can discriminate between alpha and beta
Disadvantage:
Operator must stand close to source ( alpha can’t travel far)

23. Geiger-Muller Detector
Uses:
Primarily used in portable radiation survey uses in Nuclear Medicine
Detection of lost sources
Low level radioactive contamination
Can be used for barriers for defects
Sensitivity:
Can detect individual particles- individual electrons
Can detect any area contaminated by radioactive material – x, gamma, beta and sometimes alpha

24. Geiger-Muller Detector
Components:
Audible sound system to alert user- can use headphones or has speaker
Metal encloses gas filled tube or probe- units functional sensor-
Metal shield can be open or closed to discriminate between energies
low energy radiations when closed
Readings are in Milliroentgens/hr
“Check source “ on outside to verify consistency

25. Geiger-Muller Detector
Disadvantages:
Not dependent on energy- can’t discriminate- causes GM to respond differently
Can give false readings when in high intensity radiation area

26. Calibration and Regulation
Must be calibrated to meet state and federal requirements for patient dose evaluation
American Association of Physicists in Medicine
Lists calibration labs available
Used by medical physicists to perform standard measurements required by state, federal and health care accreditation organizations

27. During radiographic procedures when an apron is NOT worn , where should the dosimeter be worn
Collar level
Chest level
Waist level
Do not need to wear
Response Counter

28. Where should the dosimeter be worn during procedures when an apron IS worn
Collar level inside apron
Collar level outside apron
Waist level outside apron
Waist level inside apron
Response Counter

29. Which of the following is used to calibrate radiographic and fluoro equipment
Proportional counter
Geiger-Mueller counter
Ionization chamber
Pocket ionization chamber
Response Counter

30. Which of the following is used to find lost radiation sources?
Geiger-Mueller Counter
Proportional counter
Ionization Chamber- cutie pie
TLD analyzer
Response Counter

31. Which should be used in x-ray install to assess fluoro scatter?
Geiger-Mueller
Ionization chamber
Proportional counter
TLD
Response Counter

32. Chapter 10
Dose limits for exposure to ionizing radiation

33. Objectives
1. List the four major organizations that share the responsibility for evaluating the relationship between radiation dose equivalents and induced biologic effects.
2. Explain the purpose of the Radiation Control for Health and Safety Act of 1968 and the consumer Patient Health and Safety Act of
3. Recognize the United States regulatory agencies responsible for enforcing established radiation dose equivalent limiting standards.
4. Define the "effective dose equivalent" limits.
5 . Explain the ALARA concept.
6. State the formula for determining the maximum permissible dose equivalent.
7. Solve problems utilizing the cumulative effective dose for the whole body.
8. Explain current radiation protection philosophy.
9. State in terms of traditional units and System International units the occupational radiation absorbed dose limits for combined whole- body exposure and for selective body area exposures.
10. State in terms of System International units the various absorbed dose limits which apply to the general population.

34. Exposure Levels Limits
Must have exposure limits to the general public, patients and radiation workers
Limits the risk of harmful biologic effects
Nuclear Regulatory Rules and Regulations
Categorized as:
EfD- effective dose limits for occupational and non-occupational
EqD- equivalent dose limits for tissues and organs
EfD limiting system- calculations of risks

35. RISK
General terms- the probability of injury, ailment or death resulting from an injury
Medical Imaging- the possibility of inducing a radiogenic cancer or genetic defect after irradiation
Radiation induced malignancy- the basis of the effective dose limiting system
Genetic defect
The benefit obtained from any diagnostic radiologic procedure must always be weighed against the risk
National Council on Radiation Protection Report No 116 and International Commission on Radiological Protection Publication No 60- provide resources for recommendation on radiation dose limits and radiation protection- most up-to-date

36. Radiation Protection Standards Organizations
Four major organizations responsible for evaluating radiation EqD and biologic effects
Formulate risk estimates of somatic and genetic effects
IRCP- International Commission on Radiological Protection
General recommendations for occupational and public dose – does not enforce –
each nation responsible for enforcing specific regulations
NRCP- National Council on Radiation Protection and Measurement
Recommends standards for US based on IRCP
Publish NRCP Reports
UNSCREAR-United Nations Scientific Committee on the Effects of Atomic Radiation
Evaluates exposures on humans / radioactive material, machines and accidents
Report and Research – reports to IRCP
NAS/NRC-BEIR- National Academy of Sciences/ National Research Council Committee on Biological Effects of Ionizing Radiation
Reports and Research on groups – radiation workers, Hiroshima, Nagasaki , Chernobyl victims
Reports to IRCP

37. U.S. Regulatory Agencies
NRC-Nuclear Regulatory Commission –
Oversees and Enforces standards of dose limits, inspection and testing on sites- nuclear energy industry
Agreement States-
Regulate Hospitals, radioactive material (nuc med)
Agreement States- regulations give to health departments from NRC for self regulation
Non-Agreement States- state and NRC enforce policies
EPA-Environmental Protection Agency -
facilitates the development and enforcement of regulation of radiation in the environment
FDA- U.S. Food and Drug Administration
Conducts an ongoing product radiation control program, regulating the design and manufacture of electronic products, including x-ray equipment
OSHA- Occupation Safety and Health Administration-
Functions as a monitoring agency in places of employment- mostly industry

38. Radiation Safety Program
Facilities must have radiation safety program to ensure patient and worker safety
Radiation Safety Committee- provides guidance
Radiation Safety Officer- daily operations and formal annual review
Medical physicist, health physicist, radiologist
Approved by the NRC
Organizations must provide
Budgeting
Oversee the development of policies and procedures
Provide equipment for starting and continuing the program

39. RSO Responsibilities
RSO must be properly trained and experienced to perform job
Developing program to coincide with international radiation protection guidelines
Ensure all persons are protected from unnecessary exposure to radiation
Must be able to implement and enforce policies
Identify problems, corrective actions, stop operations, verify implementation of corrective actions
Reviews and maintains radiation monitoring records for all personnel
Provide counseling to those receiving high doses

40. Radiation Control for Health and Safety Act of 1968
Protected public from hazards of unnecessary exposures such as x-ray
Act also allowed establishment of Bureau of Radiologic Health under the FDA (later known as Center for Devices & Radiological Health - CDRH) sets up standards for manufacturing, installation & operation for machines
* Code of Standards for X-ray equipment- see page Box 10-4

41. ALARA Concept
Nat’l Committee on Radiation Protection (NCRP) now known as Nat’l Council on Radiation Protection & Measurements came up with concept that radiation exposures should be kept ”As low as reasonably achievable “
Radiologist and YOUR responsibility as a tech to do this – optimization
Use good safety rules: collimate, technique charts, shielding, no repeats
* although an occupational exp person can receive up to 5 rem/yr, this doesn’t mean you can receive 5 rem every year
Dose response curve- as dose increase- effect increases- no threshold
Effect
dose

42. FDA White Paper Published Feb 2010
Launch of initiative to reduced unnecessary radiation exposure from medical imaging.
“Each patient should get the right imaging exam, at the right time, and with the right radiation dose”
3 main objectives:
1. Promote safe use of medical imaging devices
2. Support informed clinical decision
3. Increase patient awareness

43. Consumer-Patient Radiation Health and Safety Act of 1981
standards for accreditation of educational programs & for people taking x-rays and certifying them
No legal penalty exists for noncompliance
Result: many states have not responded with appropriate legislation

44. CARE Bill Consumer Assurance of Radiologic Excellence Act of 2003
Purpose is to amend the Public Health Service Act to ensure the safety and accuracy of medical imaging examinations and radiation therapy treatments
6 States do not require licensure of any kind for person who perform or plan medical imaging exams and radiation therapy treatments

45. Goals for Radiation Protection
NRCP Report No 116 ( replaces 91) – Limitation of Exposure to Ionizing Radiation
Provides the most recent guidance for radiation protection
Sets the limits of radiation dose limits for members of the public including:
Background
Medical imaging
Security Screening

46. Radiation Induced Responses
2 Categories for radiation responses:
1. Deterministic effects ( old term Non-Stochastic)
2. Stochastic ( probabilistic) effects

47. 1. Deterministic Effects
Biologic somatic effects of ionizing radiation ( to the body) verses genetic ( sperm/eggs)
Directly related to dose received
Exhibit a threshold-
below threshold no or not normally a occurrence
above threshold severity of damage increases as dose increases
Occur only after a large dose of radiation
Can occur as a result of long-term individual low doses of radiation over several years
Usually do not occur with typical diagnostic x-ray
Example- no radiodermatitis/erythema below a certain dose ( threshold) - above threshold dose the damage will be worse as the dose increases- ( Early Deterministic Somatic effect)
Cataracts- the more the radiation/absorbed dose to the lens of the eye, the worse the cataract will become ( Late Deterministic Somatic effect)

48. Early and Late Deterministic Effects
Early Deterministic
Appear within minutes, hours, days, weeks
Substantial dose is required to produce changes soon after irradiation
Severity is dose related
Examples: nausea , fatigue, erythema, epilation , depressed sperm count, temp or perm sterility in male and female. Acute radiation syndrome.
Late Deterministic
Slowly developing changes to the body from radiation exposure
Months or years after continued exposure to high levels of radiation
Examples : cataracts, fibrosis , organ atrophy, reduced fertility, sterility

49. 2. Stochastic Effects Mutational, nonthreshold, random, all-or-none
Biological somatic changes
Mutations that effect our own individual cells when they divide ( non-genetic )
Chance of occurrence increases with radiation exposure
NO MINIMUM safe dose exists ( non-threshold) could happen if one cell is damaged
Examples :
CANCER , genetic alteration ( hereditary)

50. Current Philosophy
1. Radiation dose received and biological effects have a linear, nonthreshold relationship
The more dose the more chance of damage
2. No known level where you have a zero probability of having biological damage
Small amount can cause damage
3. Can be beneficial in the best interests of the patient. Benefit must outweigh risk BEFORE exam is done
Up to the Physician to determine this

51. Effective Dose Limiting System
Designed to assess radiation exposure to public and radiation workers
Separate limits for each group
Non-occupational (public) excludes medical exams and background (natural ) exposure
Someone accompanying a patient to the hospital and assisting in the exam
Concerned with upper boundaries that result in a negligible risk of
Bodily injury
Hereditary damage
Limits are broken into sections : because of tissue weighting factor
Whole-body
Partial body ( hand, feet, skin)
Individual organs

52. PERSON RECEIVING DOSE SI
Traditional
OCCUPATIONAL EXPOSURE
Whole body annual limit
50mSv
5 rem
Max in 13wk period
30mSv
3rem
Cumulative
10mSv x age ( worker)
1 rem x age ( worker)
Tissue and Organ annual limit
Lens of eye
150mSv
15rem
Localized area- hands, skin , feet
500mSv
50rem
Pregnant Worker
Monthly
.5mSv
.05rem
Entire gestation
5mSv
.50rem
Negligible Individual Dose(Annual)
.01mSv/year
.001rem
NRCP Report 116

53. PERSON RECEIVING DOSE SI
Traditional
GENERAL PUBLIC LIMITS
Whole Body Dose
Continuous/frequent ( minus natural and medical procedures)
1 mSv
0.1rem
Infrequent exposures
5mSv
.5rem
Tissue and Organ Annual Limit
Lens of eye
15mSv
1.5rem
Localized areas hands,skin,feet
50mSv
5rem
Students (<18yrs)
Annual dose
1mSv
Localized hands,skin,feet
Jeffco Policy % of max occupational exposure
Annual 5mSv
Monthly .4mSv
500mrem (.5rem)
< 40mrem (.04rem )

54. PERSON RECEIVING DOSE SI
Traditional
OCCUPATIONAL EXPOSURE
Whole body annual limit
50mSv
5 rem
Max in 13wk period
30mSv
3rem
Cumulative
10mSv x age ( worker)
1 rem x age ( worker)
Tissue and Organ annual limit
Lens of eye
150mSv
15rem
Localized area- hands, skin , feet
500mSv
50rem
Pregnant Worker
Monthly
.5mSv
.05rem
Entire gestation
5mSv
.50rem
Negligible Individual Dose(Annual)
.01mSv/year
.001rem

55. PERSON RECEIVING DOSE SI
Traditional
GENERAL PUBLIC LIMITS
Whole Body Dose
Continuous/frequent ( minus natural and medical procedures)
1 mSv
0.1rem
Infrequent exposures
5mSv
.5rem
Tissue and Organ Annual Limit
Lens of eye
15mSv
1.5rem
Localized areas hands,skin,feet
50mSv
5rem
Students (<18yrs)
Annual dose
1mSv
Localized hands,skin,feet
Jeffco Policy % of max occupational exposure
Annual 5mSv
Monthly .4mSv
500mrem (.5rem)
< 40mrem (.04rem )

56. Pregnant Radiation Workers
The nine month ( gestational ) level excludes medical and natural background radiation
Designed to restrict significantly the total lifetime risk of leukemia and malignancies to persons exposed in utero
The deterministic effects if at or below EqD:
small head size
mental retardation

57. Effects on Fetus 5 main effects of radiation in utero:
Death in utero
Malformation
Growth retardation
Congenital defects in function
Cancer – especially leukemia
Effects depend on :
Stage of Development
Radiation Dose

58. Radiation Hormesis
Beneficial consequences of radiation for populations continuously exposed to moderately high levels of radiation
Not proven
2 STUDIES :
1. Bomb survivors having moderate exposures have reduced cancer death rates
Someday better mutations with respect to radiation exposure may result
2. Some states with high background levels have lower incidence of cancer deaths
Resources:
Radiation Protection in Medical Radiography by Mary Alice Statkeiwicz Sherrer, Paula Visconti, E. Russell Ritenour and Kelli Welch Haynes. 6th and 7th Edition. Elsevier online.
Essentials of Radiographic Physics and Imaging. James N. Johnston and Terri L Fauber. 1st Edition. Elsevier Online.

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