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Radiation Safety TrainingRadiation Safety Training Nuclear Medicine Nuclear Medicine

TechnologistsTechnologists

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PPatient Safetyatient Safety

GGeneral Safetyeneral Safety

OverviewOverview

Federal & State Regulatory ConcernsFederal & State Regulatory ConcernsNatural Sources of Radiation ExposureNatural Sources of Radiation ExposureOccupational Sources of Radiation ExposureOccupational Sources of Radiation ExposureRegulatory Exposure LimitsRegulatory Exposure LimitsBasic Radiation Safety PrinciplesBasic Radiation Safety PrinciplesBiological EffectsBiological EffectsUCHC Safety RequirementsUCHC Safety Requirements

Radiation vs. RadioactivityRadiation vs. Radioactivity

RadiationRadiation - Energy in transit in the form of high speed - Energy in transit in the form of high speed particles and electromagnetic waves.particles and electromagnetic waves.

Ionizing RadiationIonizing Radiation - Radiation with enough energy so - Radiation with enough energy so that during an interaction with an atom, it can remove that during an interaction with an atom, it can remove tightly bound electrons from their orbits, causing the tightly bound electrons from their orbits, causing the atom to become charged or ionized.atom to become charged or ionized.

RadioactivityRadioactivity - Spontaneous transformation of an - Spontaneous transformation of an unstable atom and often results in the emission of unstable atom and often results in the emission of radiation. This process is referred to as a transformation, radiation. This process is referred to as a transformation, a decay or a disintegration of an atom.a decay or a disintegration of an atom.

Beta DecayBeta Decay

NEUTRON

PROTON

NEUTRON

PROTON (Nuclear Transformation)

β+

(Nuclear Transformation)

β

Gamma DecayGamma Decay

GAMMA RAYS

X-RAYS

γ

External vs. Internal External vs. Internal Radiation ExposureRadiation Exposure

External exposureExternal exposure – x-rays, brachytherapy – x-rays, brachytherapy patients, iodine therapies, dose preparation and patients, iodine therapies, dose preparation and administrationadministration

Internal depositionInternal deposition – contamination from an – contamination from an iodine patient resulting in an ingestion of iodine patient resulting in an ingestion of radioactive materialsradioactive materials

§20.1201 Occupational dose limits for adults.

(a) The licensee shall control the occupational dose to individual adults, except for planned special exposures under §20.1206, to the following dose limits.

(1) An annual limit, which is the more limiting of -- (i) The total effective dose equivalent being equal to 5 rems (0.05 Sv); or(ii) The sum of the deep-dose equivalent and the committed dose equivalent to any individual organ or tissue other than the lens of the eye being equal to 50 rems (0.5 Sv).

(2) The annual limits to the lens of the eye, to the skin of the whole body, and to the skin of the extremities, which are:

(i) A lens dose equivalent of 15 rems (0.15 Sv), and(ii) A shallow-dose equivalent of 50 rem (0.5 Sv) to the skin of the whole body or to the skin of any extremity.

Radiation Exposure LimitsRadiation Exposure Limits   Type of exposureType of exposure

  

Total effective dose equivalent (TEDE) which is the sum of the Total effective dose equivalent (TEDE) which is the sum of the deep-dose equivalent (for external exposures) and the deep-dose equivalent (for external exposures) and the committed effective dose equivalent (for internal exposures) for committed effective dose equivalent (for internal exposures) for the whole bodythe whole body

Sum of the deep-dose equivalent and the committed dose Sum of the deep-dose equivalent and the committed dose equivalent to any individual organ or tissue other than the lens equivalent to any individual organ or tissue other than the lens of the eyeof the eye

  

Eye dose equivalent (lens of the eye)Eye dose equivalent (lens of the eye)

  Shallow dose equivalent to the skin or to any extremityShallow dose equivalent to the skin or to any extremity

  

Rem Per YearRem Per Year

  5 or 5,000 5 or 5,000

mremsmrems

  50 or 50,000 50 or 50,000

mremsmrems

15 or 15,000 15 or 15,000 mremsmrems

  50 or 50,000 50 or 50,000

mrems mrems  

Radiation Exposure LimitsRadiation Exposure Limits

Whole body; Head and trunk; Active Whole body; Head and trunk; Active blood-forming organs; Lens of eyes, blood-forming organs; Lens of eyes, or gonads.or gonads.

Hands and forearms; Feet and ankles.Hands and forearms; Feet and ankles.

Skin of whole body.Skin of whole body.

1.251.25

18.7518.75

7.57.5

((1,250 mrem)1,250 mrem)(5.0 rem/yr)(5.0 rem/yr)

(18,750 mrem)(18,750 mrem)(75 rem/yr)(75 rem/yr)(7,500 mrem)(7,500 mrem)(30 rem/yr)(30 rem/yr)

Rem Per Calendar Rem Per Calendar QuarterQuarter

Type of Exposure Type of Exposure

(State of Connecticut Administrative Regulations Sect. 19-24-5) (State of Connecticut Administrative Regulations Sect. 19-24-5)

FetusFetus 500 mrem Total Gestation500 mrem Total Gestation(0.5 rem)(0.5 rem)

Basic Radiation Safety PrinciplesBasic Radiation Safety Principles

TTimeime

DDistanceistance

SShieldinghielding

CContamination Controlontamination Control

Inverse Square LawInverse Square Law ((137137Cs Cs 192192Ir)Ir)

For a point source, the intensity varies inversely For a point source, the intensity varies inversely as the square of the distance from the source.as the square of the distance from the source.gamma gamma

radiationradiation

1 1 cmcm

10,0010,0000

2 2 cmcm

2,5002,500

5 cm5 cm 400400

10 cm10 cm100100

20 cm20 cm

2525

Radiation Exposure MonitoringRadiation Exposure Monitoring

Whole Body Whole Body Radiation BadgeRadiation Badge

Worn Underneath Worn Underneath Pb ApronPb Apron

Collar Radiation Collar Radiation BadgeBadge

Worn Outside Pb Worn Outside Pb Apron At Neck LevelApron At Neck Level

BLACK ICON RED ICON

Extremity Radiation Badge Extremity Radiation Badge

Worn on Primary Hand Worn on Primary Hand

Closest to Radiation SourceClosest to Radiation Source

ALARA Investigational Level IALARA Investigational Level I

Phosphorus-32 SynovectomyPhosphorus-32 Synovectomy

Within The same week for 131-IWithin The same week for 131-I Within 7 days 125-IWithin 7 days 125-I MDA about 0.0005 UCI, o.5 NCIMDA about 0.0005 UCI, o.5 NCI MDD, 131-i 0.5 mrem TODEMDD, 131-i 0.5 mrem TODE

Thyroid countsThyroid counts SignaturesSignatures SpillsSpills Package surveysPackage surveys Gloves in hot lab-monitoringGloves in hot lab-monitoring Access to the departmentAccess to the department Incorrect 99m-TC doseIncorrect 99m-TC dose

CONTAMINANT AVERAGE DPM/CM^2 DPM/100 CM^2

Beta/Gamma 22 2200

Alpha 2.2 220

T.I. = mrem/hr @ 1 meter from sufrace

TRANSPORT INDEX MAX. MR/HR SURFACE LABEL

0 (<= 0.05) < 0.5 mr/hr White I

0.05 to <= 1.0 0.5 to <= 50 mr/hr Yellow -II

1.0 to <= 10 50 to <= 200 mr/hr Yellow- III

> 10 200 to <= 1000 mr/hr Exc. Use!!!

Personnel protective equipment Personnel protective equipment required for entry required for entry

GlovesGloves DosimetryDosimetry Lab coatLab coat

PPE highly recommended when PPE highly recommended when enteringentering

PPE required if injectingPPE required if injecting PPE required if assistingPPE required if assisting PPE required if handling any possibly PPE required if handling any possibly

contaminated itemcontaminated item

PPE requiredPPE required Injecting rad matInjecting rad mat Handling/assisting patients who have Handling/assisting patients who have

been injectedbeen injected Handling items that may be Handling items that may be

contaminatedcontaminated

A survey of the hands and other body A survey of the hands and other body areas with documentationareas with documentation

Suggested very strongly to survey Suggested very strongly to survey shoesshoes

Report contamination to RSOReport contamination to RSO This is an NRC requirementThis is an NRC requirement

What label is required on a package What label is required on a package with the following monitoring results ?with the following monitoring results ?

10 MR/hr surface, 1 MR @ 1m, wipe 10 MR/hr surface, 1 MR @ 1m, wipe test BKG. 285 CPM, gross CPM of test BKG. 285 CPM, gross CPM of 1250 1250

Background 430 CPM, outside wipe 360 Background 430 CPM, outside wipe 360 CPM?CPM?

Background 310 CPM, outside wipe 349 Background 310 CPM, outside wipe 349 CPM?CPM?

Background 265 CPM, outside wipe 5500 Background 265 CPM, outside wipe 5500 CPM?CPM?

Nuclear Medicine Nuclear Medicine Diagnostic ProceduresDiagnostic Procedures

Radionuclides with short half lives (e.G., Radionuclides with short half lives (e.G., 99m99mtc @ 6 hrs)tc @ 6 hrs)

No significant external radiation No significant external radiation exposure hazard to staff or familyexposure hazard to staff or family

Contamination precautions and universal Contamination precautions and universal precautions should always be followedprecautions should always be followed

NRC requires a signed NRC requires a signed

declaration of pregnancy declaration of pregnancy

for occupational workers for occupational workers

to limit exposures to 500 to limit exposures to 500

mrem/9months or 50 mrem/9months or 50

mrem in any one month.mrem in any one month.

Pregnancy Pregnancy DeclarationDeclaration

The United States Nuclear Regulatory Commission requires in the Code of Federal Regulations

Title 10, Chapter I, Part 20.1208, that special consideration be given to limitation of embryo/fetus

radiation exposure only in those instances where a woman has declared the pregnancy to the

appropriate representative of the employer (the UCHC). In cases where a pregnancy is not declared

in writing, the larger occupational exposure limit for the working mother is used as a maximum

permissible dose limit. The purpose of this form is to officially notify the employer, through the

Medical Director of Employee Health Services, that dose limitation to your embryo/fetus is

requested. The information contained on this form will be treated as confidential, and only those

directly involved in assessing the potential for embryo/fetal exposures will be informed. Please

sign the form where indicated and forward to:

PREGNANCY DECLARATIONConfidential Document

Marcia Trape-Cardoso, M.D., Medical Director Employee Health ServicesMC-6210

I, _________________________________ ______ , formally declare my pregnancy and request

dose limitation to my embryo/fetus such that my total radiation exposure during the gestational

period does not exceed 500 mrem, and if exposed, received at a uniform rate of no more than 50 mrem

per month. As required by the Nuclear Regulatory Commission, my approximate date of conception

was __________________.

Signed: Date:

Department:

Telephone #:

c:\flw\pregwrk.pre ( rev. 10/2000 )

Emergency ProceduresEmergency Procedures

Follow radiation patient code procedures.Follow radiation patient code procedures.

If the patient should die or require If the patient should die or require emergency surgery, contact a member of emergency surgery, contact a member of the Radiation Safety Office immediately the Radiation Safety Office immediately at at X-2250X-2250..

Address medical emergency Address medical emergency firstfirst !! !!

Radiation Exposures from Radiation Exposures from Consumer Products Consumer Products 11

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EEExxxpppooossseeeddd PPPooopppuuulllaaatttiiiooonnn

PPPaaarrrttt ooofff BBBooodddyyy

EEExxxpppooossseeeddd

TTTeeellleeevvviiisssiiiooonnn RRReeeccceeeiiivvveeerrrsss 222333000 <<< 111 mmmrrreeemmm WWWhhhooollleee BBBooodddyyy

VVViiidddeeeooo DDDiiisssppplllaaayyy TTTeeerrrmmmiiinnnaaalllsss 555000 <<< 111 mmmrrreeemmm WWWhhhooollleee BBBooodddyyy

LLLuuummmiiinnnooouuusss 333 HHH iiinnn WWWaaatttccchhheeesss aaannnddd CCCllloooccckkksss

111111 000...111 mmmrrreeemmm WWWhhhooollleee BBBooodddyyy

LLLuuummmiiinnnooouuusss 111444777 PPPmmm iiinnn WWWaaatttccchhheeesss aaannnddd CCCllloooccckkksss

888 000...000444 mmmrrreeemmm WWWhhhooollleee BBBooodddyyy

BBBuuuiiillldddiiinnnggg MMMaaattteeerrriiiaaalllsss 111222000 777 mmmrrreeemmm WWWhhhooollleee BBBooodddyyy

HHHiiiggghhhwwwaaayyy aaannnddd RRRoooaaaddd CCCooonnnssstttrrruuuccctttiiiooonnn MMMaaattteeerrriiiaaalllsss

555 444 mmmrrreeemmm WWWhhhooollleee BBBooodddyyy &&& GGGooonnnaaadddaaalll

DDDooossseee

1 Adapted from NCRP 95

Radiation Exposures from Consumer Radiation Exposures from Consumer ProductsProducts

SSSooouuurrrccceee ### OOOfff PPPeeeooopppllleee iiinnn UUU...SSS... EEExxxpppooossseeeddd (((iiinnn mmmiiilllllliiiooonnnsss)))

AAAvvvggg... AAAnnnnnnuuuaaalll DDDooossseee EEEqqquuuiiivvvaaallleeennnttt tttooo ttthhheee EEExxxpppooossseeeddd PPPooopppuuulllaaatttiiiooonnn

PPPaaarrrttt ttthhheee BBBooodddyyy

EEExxxpppooossseeeddd 222

TTTooobbbaaaccccccooo PPPrrroooddduuuccctttsss 555000 111666,,,000000000 mmmrrreeemmm BBBEEEDDDEEE

DDDooommmeeessstttiiiccc WWWaaattteeerrr SSSuuuppppppllliiieeesss 222333000 111555 --- 999000 mmmrrreeemmm BBBEEEDDDEEE

FFFeeerrrtttiiillliiizzzeeerrr PPPrrroooddduuuccctttsss 222000000 000...555 --- 555 mmmrrreeemmm WWWBBB aaannnddd IIIDDDFFF

NNNaaatttuuurrraaalll GGGaaasss HHHeeeaaattteeerrrsss 111666 222222 mmmrrreeemmm BBBEEEDDDEEE

NNNaaatttuuurrraaalll GGGaaasss CCCooooookkkiiinnnggg RRRaaannngggeeesss 111222555 555 mmmrrreeemmm BBBEEEDDDEEE

DDDeeennntttaaalll PPPrrrooottthhheeessseeesss 444555 777000000 mmmrrreeemmm BBBMMMDDDEEE

OOOpppttthhhaaalllmmmiiiccc GGGlllaaassssss 555000 444000000000 mmmrrreeemmm CCCGGGDDDEEE

GGGaaasss MMMaaannntttllleeesss 555000 000...222 mmmrrreeemmm WWWBBB aaannnddd SSSOOODDDEEE

1 Adapted from NCRP 95 1 Adapted from NCRP 95 22 BEDE = Bronchial Epithelial Dose Equivalent; WB = Whole Body; IDF = Ingestion Dose from Foods BEDE = Bronchial Epithelial Dose Equivalent; WB = Whole Body; IDF = Ingestion Dose from Foods

BMDE = Bronchial Mucosa Dose Equivalent; CGDE = Corneal Germinal Dose Equivalent; SODE = Selected Organ Dose EquivalentBMDE = Bronchial Mucosa Dose Equivalent; CGDE = Corneal Germinal Dose Equivalent; SODE = Selected Organ Dose Equivalent

11

Radiation Exposures From ?

Smoking a pack and a Smoking a pack and a half of cigarettes a day half of cigarettes a day

will add about 1,300 will add about 1,300 mrem/year to one's mrem/year to one's

effective doseeffective dose

Flying from New York to San Flying from New York to San Francisco results in the Francisco results in the absorption of an extra absorption of an extra

2-3 mrem of cosmic radiation2-3 mrem of cosmic radiation6-8 from NY to Japan 6-8 from NY to Japan

Radiation Exposures From ?

For the Skylab For the Skylab astronauts, astronauts,

2,000 to 8,000 2,000 to 8,000 mrem from mrem from

cosmic radiationcosmic radiation

Risks which Increase Chance of Risks which Increase Chance of Death by 1 in 1 millionDeath by 1 in 1 million aa

Smoking 1.4 cigarettes Cancer, Heart disease Drinking 1/2 liter of wine Cirrhosis of the liver Spending 1 hour in a coal mine Black lung disease Spending 3 hours in a coal mine Accident Living 2 days in New York or Boston Air pollution Traveling 6 minutes by canoe Accident Traveling 10 miles by bicycle Accident Traveling 300 miles by car Accident Flying 1000 miles by jet Accident Flying 6000 miles by jet Cancer from cosmic radiation Living 2 months in Denver on vacation from N.Y. Cancer from cosmic radiation Living 2 months in average stone or brick building Cancer from natural radioactivity One chest x-ray taken in a good hospital Cancer from radiation Living 2 months with a cigarette smoker Cancer, Heart disease

a B.L. Cohen and I.S. Lee, ”Catalog of Risks Extended and Updated”, Health Physics, Vol. 61, Sept. 1991.

More Risks which Increase Chance of More Risks which Increase Chance of Death by 1 in 1 millionDeath by 1 in 1 million aa

Drinking Miami drinking water for 1 year Cancer from chloroform

Drinking 30, 12 oz. cans of diet soda Cancer from saccharin

Living 5 years at site boundary of a typical nuclear power plant in the open

Cancer from radiation

Drinking 1000, 24 oz. soft drinks from banned plastic bottles

Cancer from acrylonitrile monomer

Living 20 years near PVC plant Cancer from vinyl chloride (76 standard)

Living 150 years within 20 miles of a nuclear power plant

Cancer from radiation

Eating 100 charcoal broiled steaks Cancer from benzopyrene

Risk of accident by living within 5 miles of a nuclear reactor for 50 years

Cancer from radiation

Eating 40 tablespoons of peanut butter Liver cancer from aflatoxin B

a B.L. Cohen and I.S. Lee, “Catalog of Risks Extended and Updated”, Health Physics, Vol. 61, Sept. 1991.

Remember !!!

Controlling Exposures

Minimizes Risk

The EndThe End