Medical Imaging Department

(Final Assignment)

Protection Against Radiation Exposure

Student name: Shahad Juma Al-Rashdi. Student number: RAD758

Year Level: Second year.

Course Title: RADIOGRAPHIC SCIENCE III

Due Date: 20/7/2020 Word count (if applicable): In range of 2000

I understand what is meant by plagiarism and I accept penalties will occur under the
O.C.H.S Academic Misconduct Policy for any plagiarism detected in my work.

Signature:
Date: 20/7/2020
Received by: AQILA AL-MAHROUQI

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 Table Of Content:

1. Introduction................................................................................................3

2. ALARA and the cardinal principle of radiation protection..................4

3. Three main principle of radiation protection.........................................5

4. Diagnostic reference levels in medical imaging.......................................7

5. Reducing occupational radiation exposure and unnecessary patient

radiation dose.............................................................................................8

6. Describe the recommended management procedures for pregnant

health workers and patients....................................................................11

7. CONCLUSION........................................................................................12

8. References.................................................................................................13

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 Introduction

We receive cosmic radiation or cosmic rays that are radiation from outer space.
we also receive exposure from man-made radiation, such as X-rays, radiation
used to diagnose diseases and for cancer therapy.[ CITATION Rad15 \l 1033 ]

In our specialty, radioactivity is a term that describes the dissociation of atoms.

And it refers to ionizing radiation, which means that radiation passes through a
substance, which can cause it to become charged or electrically ionized. This
radiation can affect living tissue in natural biological processes. We have different
types of radiation, each with different characteristics:[ CITATION Rad15 \l 1033 ]
 Alpha.
 Beta.
 Gamma.

So, I will discuss the ALARA, principle of radiation protection, Diagnostic

reference levels in medical imaging, ways to reduce occupational radiation
exposure, and the recommended management procedures for pregnant radiation
workers and for the pregnant patient.

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 ALARA concept
and the cardinal principle of radiation protection
ALARA stands for “as low as reasonably achievable”. Each radiation dose of any
magnitude can produce some level of detrimental effects that may include
increased risk of genetic mutations and cancer. With that in mind, this principle
aims to reduce and avoid the dose of radiation if it does not have direct benefits,
even if it is a small dose.

To apply ALARA we have three basic protective measures in radiation safety:

[ CITATION ALA15 \l 1033 ]

Time:
It is the time that patient or specialist spends close to the x-rays. Reducing
Minimize the time the proximity to a radioactive source is what we should do.
of exposure We must complete the work in minimum time and leave the area of radiation
dicrease half of the in order to protect ourselves and the patient.
dose.

Distance: The distance to how close we are to the x-ray. This method protects us
because the ride and dose are related to the inverse relationship.
Doubling the The higher the distance, the lower the dose from the radioactive
distance dicrease source.
1/4 of the dose. Also by doubling the distance it reduces the dose by factor of 4.

Shielding: To intensify protection for us and the patient, we must use something
between us and the source of the radiation.
Useing shields We have many kind of shields that are effective in absorbing and blocking
dicrease half of the radiation as much as possible from our body such as plexiglas for beta
dose. particles and lead for gamma rays and x-rays.

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 Three main principle of radiation protection

Ionizing radiation can trigger both deterministic and stochastic impacts.

Deterministic impacts happen as it were over the limit esteem of the dose. For
that, the point of radiation security is to anticipate dependably the deterministic
impacts of radiation and to decrease the chance of stochastic impacts to a sensibly
achievable level. The dosage restrain values are set so that deterministic impacts
are ruled out. In arrange to keep the chance of stochastic harm from ionizing
radiation as low as possible, three common principles have been set out in
radiation protection to manage the ionizing radiation.[ CITATION JKo16 \l 1033 ]
[ CITATION Wha19 \l 1033 ]

So, according to the ICRP (Publication 103), the System of Radiological

Protection is based on the following three principles:[ CITATION JKo16 \l 1033 ]
[ CITATION Wha19 \l 1033 ]

1- Justification. All decisions in case of radiation exposure should do more good than
harm.
Any new use or application of ionizing radiation by humans must be justified. This condition applies
during this particular period due to the increasing of exposing to radiation to the people in work and
new activities. That is why these activities are allowed now when they have a reasonable benefit for
the individual and society only. In this case, we mean that the benefit must be more than the health
damages.

2- Optimisation of
Protection. Doses should all be kept as low as reasonably achievable (ALARA).
It is the standard limits in which all sources of radiation under total control are controlled. Its goal is
not only to maintain total exposure below these dose limits, but also to make continuous efforts to
reduce permissible exposure doses.
Regarding medical exposure in treatment or health checkups, dose limits are not applied. This is
because the application of dose limits to medical exposure may hinder patients from receiving
necessary inspections or treatment and is sometimes detrimental to them.

3- Dose Limitation.
The total dose to any individual should not exceed the appropriate limits.
Radiation from planned exposures of human beings must not exceed certain dose limits
.Diverse limit values apply to the common populace and to people occupationally exposed to
radiation.
The limit values for the general population determine
5 the maximum total radiation an
individual person may receive from justified activities.
6
 Diagnostic reference levels in medical imaging

They are key principles of radiation safety. It is considered a form of investigation

to help improve protection for patients' exposure to diagnostic and intervention
procedures.

DRLs should be used by authorized bodies to help manage the radiation dose to
patients so that the dose is commensurate with the clinical purpose.[ CITATION
DIA15 \l 1033 ]

The concept of a DRL permits flexibility in the choice of quantities, numerical

values, and technical or clinical specifications in order to allow authorized bodies
to meet the objectives relevant to their circumstances. The guiding principles for
setting a DRL are:[ CITATION DIA15 \l 1033 ]

1- the regional, national, or local objective is clearly defined, including the

degree of specification of clinical and technical conditions for the medical
imaging task.
2- the selected value of the DRL is based on relevant regional, national, or
local data.
3- the quantity used for the DRL can be obtained in a practical way.
4- the quantity used for the DRL is a suitable measure of the relative change
in patient tissue doses and, therefore, of the relative change in patient risk
for the given medical imaging task; and
5- the way the DRL is to be applied in practice is clearly illustrated.

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 Reducing occupational radiation exposure and
unnecessary patient radiation dose

Radiation exposure for both the health workers and the patient was a major
concern for their possible side effects and future health issues. But, to know what
the possible ways are of reducing radiation exposure, we need to know what the
determinants of exposure are in a x-ray or fluoroscopic environment. This
includes:

1. Magnitude of total x-ray exposure used. These include minimizing

fluoroscopy time and cine acquisition time, modulating the fluoroscopy
dose per frame, decreasing the radiation detector magnification, reducing
the field size (by collimation), and decreasing the frame rate. Use of these
techniques can dramatically reduce the radiation exposure to the patient
and the radiologist. (John W. Hirshfeld Jr., 2018)

2. Distance from the radiation source. As the distance increases the

radiation dose decreases. (John W. Hirshfeld Jr., 2018)

3. Shielding (0.5-mm lead shielding absorbs about 90% to 95% of

radiation in the diagnostic energy range). (John W. Hirshfeld Jr., 2018)

Knowing this, strict guidelines and procedures must be made for solving this
issue. Therefore, there are three basic safety measures to reduce radiation
exposure, this includes time, distance and shielding.

It is important for healthcare workers to limit the amount of time spent near the
radiation sources. Thus, reducing the effective radiation dose proportionally.
(Jaquith, 2016)

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Proper positioning of the patient as far as possible from the x-ray tube and as
close as possible to the image receptor. This will lead to less radiation exposure to
the patient skin and better image quality. Also, reducing the distance between the
patient radiation scatter and the radiologist will reduce the operator radiation dose.
(Catherine T. Vu, 2013)

Shielding is a very crucial protective factor against radiation which can be done in
three levels of protection. These three levels are architectural shielding, mobile
shielding and personal protective equipment’s. (Heidbuchel, 2014)

Architectural shields include the walls, windows, control booths and doors in any
radiological room. Mobile shields includes Table-suspended drapes, which they
hang from the side of the patient table between the under-table X-ray tube and the
operator (Jaquith, 2016). Another form of mobile shields is the ceiling-suspended
shields which dramatically reduce occupational exposure, including operator eye
dose, if they are positioned correctly during the procedure (Ariel Dura´ n, 2012).
During the use of fluoroscopy, the radiologist must use two separate shielding
screens that are 0.5mm lead screens which can absorbs about 90% of scattered
radiation (Heidbuchel, 2014).

Personal protective devices include the lead aprons and vests, lead thyroid collar,
lead gloves and safety goggles (Ariel Dura´ n, 2012). All the people in the room must
be protected with at least a lead apron. Also, employers should make sure to
inspect the lead apron regularly for any signs of damage and stored in hangers
when not used (Ionizing Radiation, 2014). The thyroid gland is particularly sensitive
for the radiation, therefore, lead thyroid collar should be worn by the operating
radiologists (Ariel Dura´ n, 2012). In some X-ray equipment’s, the radiologist must
use his hand which will be in the x-ray field. Therefore, wearing lead gloves
might offer some protection. Safety goggles are also important for protecting the
lens of the eye from radiation exposure (Ionizing Radiation, 2014).

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Another important way of protection against radiation exposure is monitoring
radiation exposure in the work environment or the radiation exposure that the
health worker receives. This can be done by radiological sampling and analysis
and personal dosimetry (Ionizing Radiation, 2014). The dose limit of the occupational
radiation exposure is about 50mSv on a single year (OCCUPATIONAL RADIATION
PROTECTION, 2003). Therefore, the dosimeters which are devices worn by the
radiology workers are used to monitor their radiation exposure (Ionizing Radiation,
2014). Sampling and analytical methods and tools are used to detect areas and
materials which were contaminated by radioactivity and quantify the amount of
contamination to further protect the health workers from getting exposed to high
radiological exposure (Ionizing Radiation, 2014).

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 Describe the recommended management procedures for
pregnant health workers and patients

The effect of radiation on health workers is minimal due to the strict guidelines
and protective equipment’s provided. But, their must be more protection for
pregnant health workers and female patients, as several animal and human studies
showed significant impact of ionizing radiation to the unborn fetus (Shaw, 2010).
The radiation risk through out the pregnancy is related to the pregnancy stage and
the absorbed dose (Shaw, 2010). The fetal radiation dose limit must not exceed
5mSv (which is 10 times lower than the normal occupational dose) during the
entire pregnancy period (WashingtonUniversity, 2010). However, in exposure doses of
5-50mSv there was no observable effects in the development of the fetus and no
reported miscarriages or birth defect, but, there might be an increased risk of
cancer later in life for those who are exposed in this range (WashingtonUniversity,
2010). Higher exposure of 50-500mSv is related to low IQ, mental retardation and
high risk of cancer later in life (WashingtonUniversity, 2010). Therefore, female
radiation workers must notify the radiation safety workers about their pregnancy
to proper manage them and provide a healthy working environment (Dauer, 2015).
In addition to the personal dosimeter the pregnant female worker must also
receive a fetal dosimeter to monitor the fetal exposure to radiation (Shaw, 2010).

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 CONCLUSION

There are many benefits to radiation protection practitioners, employing

organizations and society in general from active participation in national/regional
Radiation Protection Societies.

we can protect from the radiation by using radiation safety accessories when
required, personal monitoring devices, Follow the basic principles of radiation
safety, Follow radiation dose reduction techniques, Radiation safety awareness
and training program.

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 References

ALARA - As Low As Reasonably Achievable. (2015, December 7). Retrieved from CDC:
https://www.cdc.gov/nceh/radiation/alara.html#:~:text=The%20guiding
%20principle%20of%20radiation,as%20low%20as%20reasonably
%20achievable%E2%80%9D.&text=To%20do%20this%2C%20you
%20can,time%2C%20distance%2C%20and%20shielding.
DIAGNOSTIC REFERENCE LEVELS IN MEDICAL IMAGING:. (2015, FEB 31).
Retrieved from ICRP: https://www.icrp.org/docs/DRL_for_web.pdf
Livingstone, D. R. (2015, Dec 11). Occupational radiation safety in Radiological
imaging, . Retrieved from slideshare:
https://www.slideshare.net/ohscmcvellore/occupational-radiation-safety-in-
radiological-imaging-dr-roshan-s-livingstone
Radiation in Everyday Life. (2015, January 2). Retrieved from IAEA:
https://www.iaea.org/Publications/Factsheets/English/radlife
Sci., J. K. (2016, Feb 31). General Principles of Radiation Protection in Fields of
Diagnostic Medical Exposure. Retrieved from NCBI:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756345/
What Are the Three Principles of Radiation Protection. (2019, march 29). Retrieved from
Lancsindustries: https://www.lancsindustries.com/blog/what-are-the-three-
principles-of-radiation-protection/

Ariel Dura´ n, S. K. (2012, April 25). A Summary of Recommendations for Occupational.

Retrieved from The Society for Cardiovascular Angiography and Interventions:
https://solaci.org/wp-
content/uploads/2015/06/recomendaciones_proteccion_radiologica.pdf
Catherine T. Vu, D. H. (2013, December 30). Pregnancy and the Working Interventional
Radiologist. Retrieved from NCBI:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835582/

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Dauer, L. T. (2015, February). Occupational Radiation Protection of Pregnant.
Retrieved from J Vasc Interv Radio: https://www.jvir.org/article/S1051-
0443(14)01152-X/pdf
Heidbuchel, H. (2014, July 7). Practical ways to reduce radiation dose for patients and
staff during device implantations and electrophysiological procedures .
Retrieved from Oxford Academic:
https://academic.oup.com/europace/article/16/7/946/481012
Ionizing Radiation. (2014, March 22). Retrieved from Occupational Safety and Health
Administration: https://www.osha.gov/SLTC/radiationionizing/prevention.html
Jaquith, K. (2016, January 2). 5 Ways To Minimize Your Occupational Radiation
Exposure. Retrieved from Universal Medical:
https://blog.universalmedicalinc.com/5-ways-minimize-occupational-radiation-
exposure/
John W. Hirshfeld Jr., P. N. (2018, March 11). Important Strategies to Reduce
Occupational Radiation Exposure in the Cardiac Catheterization Laboratory.
Retrieved from Journal of the American College of Cardiology:
https://www.onlinejacc.org/content/71/11/1255
OCCUPATIONAL RADIATION PROTECTION. (2003, July). Retrieved from
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pub.iaea.org/MTCD/publications/PDF/Pub1145_web.pdf
Shaw, P. (2010, May 28). Radiation exposure and pregnancy. Retrieved from Journal of
vascular Surgery: https://www.jvascsurg.org/article/S0741-5214(10)01733-7/pdf
WashingtonUniversity. (2010, July). Occupational Radiation Exposure During
Pregnancy. Retrieved from University of Washington:
https://www.ehs.washington.edu/system/files/resources/FetalDosDescription.pdf

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