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Regulatory Environment
Regulatory Environment
This training is mandated by regulation, but why?
There are a number of factors involved and during the process of this training session you should gain a larger understanding of the reason. We will first look at where the regulations originate from and what agencies govern our operational use of radiation producing machines and radioactive materials.
Scientific Community
International Commission on Radiation Protection ICRP
The ICRP and NCRP are advisory bodies that collect and analyze data regarding ionizing radiation and put forth recommendations on radiation protection. The regulatory groups utilize these recommendations when developing regulations.
074-296-A1, Physics Linear Accelerator 074-296-A2, LJCC Accelerators 074-296-7, ECHI Nuclear Cardiology
Committee Responsibilities
Develop policies and procedures for the safe use of radioactive materials and radiation producing equipment. Approve authorized users. Provide technical advice to the RSO. Review all instances of alleged infractions of the use of ionizing radiations or safety rules with the RSO and responsible personnel and take corrective actions. Review periodic reports from the RSO.
Atom
Whether we talk about ionizing or non-ionizing radiation, its genesis is either within or very close to the exterior of the atom. The following is a brief review the atomic structure.
The atom is comprised of a nucleus, which is made up of positively charged protons and electrically neutral (no charge) neutrons, surrounded by negatively charged electrons. In an electrically neutral atom, the number of positively charged protons and negatively charged electrons are equal.
Radiation Origins
Ionizing radiation (hereafter, referred only as radiation) can be generated by electronic means (xray units) or radioactive materials. When electronic-product radiation is produced, the source is turned on and off like a light switch. Once the unit is off, the radiation exposure is over. The xray unit does not continue to radiate or become radioactive. With radioactive materials, there is a little more involved. The source is always on until it decays away.
Next: A review of both types of ionizing radiation generators X-rays and Radioactive Materials.
Radioactive Material
Types of Radiations
GAMMA AND X-RADIATION
Gamma rays and X-rays are essentially the same, except for where they originate. Gamma rays originate from the nucleus, and Xrays originate outside the nucleus of an atom. These rays have no mass or no charge, and are very penetrating. These rays are the same as light (electromagnetic radiation), only much more energetic. Considered more of an external hazard than internal. Both rays are great for imaging patients.
Medical imaging
FYI: As discussed earlier, x-rays can be produced by radioactive decay or electronic production. Both originate outside the nucleus of the atom.
X-ray Generation
Review
X-rays as produced by an x-ray unit are also know as Bremsstrahlung. It is a German word for braking radiation. As depicted in the diagram, when the electron slows very fast (brakes) as it gets close to the atom of the target nucleus, x-rays (radiation) are formed. X-rays are emitted in all directions; therefore, the structure housing the x-ray tube is shielded except for a port where the x-rays escape and can be used for diagnostic purposes.
FYI: If youve ever had an x-ray, when the x-ray technologists takes your picture, it is over. The x-ray unit does not continue to produce radiation after the exposure is complete.
Radiation Units
Now that you have a little understanding of the physics behind ionizing radiation, how do we measure or quantify radiation? Here are a few units of measure that are used (often interchangeably) in radiation protection: Exposure
A measure of ionization produced in air by X or gamma radiation. Highly specific in that the unit specifies the matter being exposed and radiation producing the ionizations. Unit: roentgen (R) 1 R = 1000 mR
Absorbed Dose
A measure of energy deposition per unit mass irradiated. Considers all radiations imparting energy to all types of matter. Unit: rad 1 rad = 1000 mrad SI Units: gray (Gy) 1 Gy = 100 rad
Dose Equivalent
It is numerically equal to the absorbed dose by a quality factor Dose equivalent is needed because the biological effect from a given absorbed dose is dependent upon the type of radiation producing the absorbed dose. Unit: rem 1 rem = 1000 mrem SI Units: sievert (Sv) 1 Sv = 100 rem
Who cares about electrons being stripped from atoms? Electrons are essential in creating molecular bonds. When radiation breaks those bonds, the molecule ceases to function properly. Research has shown that the body has great repair mechanisms, but when overwhelmed the repair may be incomplete or incorrect. If enough damage to a region occurs, the result may be cell death. Damage may manifest as delayed or acute effects.
Delayed Effects: Can occur in the individual receiving the radiation dose or the offspring. Probabilistic effect, whereby the increase in dose increases the probability that the effect occurs. Example: Cancer or genetic mutation
Biological Effects
What we know about the effects of radiation come from a number of different exposed populations:
Atomic bomb survivors Accident victims Radium watch dial painters Radiation therapy patients Early experimenters with radiation
Epidemiological studies of these groups have shown that following significant radiation doses, effects were observed. The effects were both acute and delayed.
FYI: There are other theories regarding the effects of radiation dose (as represented by the other lines blue and gray), to include radiation hormesis. Radiation hormesis is a theory that chronic low doses of radiation is good for the body.
Radiation Risk
Understanding the different types of effects, regulatory agencies impose radiation dose limits that eliminate the likelihood of acute effects and reduce the likelihood of delayed, or risk-based, effects. Regulatory groups are concerned with fatal risk estimates. The current regulatory limit for an occupationally exposed worker is 5,000 mrem per year. When initially instituted, the radiation dose limit represented a risk that was equal to that of other safe industries.
Given that the regulatory limits are risk-based, and that increasing ones dose increases ones chance that an effect may occur, the law also requires radiation workers to employ the philosophy of ALARA, or keeping your radiation dose As Low As Reasonably Achievable.
Did you know some of the foods you eat contain naturally occurring radioactive material? Bananas contain low quantities of Potassium-40.
External Radiation Protection Consider This Exposure to a source of ionizing radiation is very similar to
the exposure from a light bulb (i.e. light and heat).
The closer you are to the source, the more intense the light and heat are. Likewise, if you move away, the intensity decreases. If you put something opaque between you and the light bulb, you effectively eliminate the light. The longer you are close to the light bulb, you begin to feel the warming effects of the light. If however, you move quickly to and from the light, youll not likely feel the warming effect.
Radiation Symbols
Caution Radioactive Materials Caution Radiation Area Caution Radiation Area when X-ray Energized
Highlights of NCRPAR
15A NCAC 11 .1600, Standards for the Protection Against Radiation. 15A NCAC 11 .0300, Licensing of Radioactive Material. 15A NCAC 11 .0600, X-rays in the Healing Arts (Not included in this Presentation). 15A NCAC 11 .0900, Requirements for Particle Accelerators (Not Included in this Presentation)
How do we comply with the Dose Limits for Members of the Public?
Radiation Safety Policies and Procedures Radiological Area Surveys
Contamination surveys External Radiation surveys
Environmental Monitoring
Landauer OSL Environmental monitors Standard OSL monitors
Written Directives
The prescription or order given by a physician that is documented in the patient chart or electronic charting system (Lantis). A written prescription must be completed by the authorized Physician. Treatment summary will be completed by the chief radiation therapist and medical physics staff upon completion of treatment The patients identity will be verified before each and each administrations written directive.
2. The name of the prescribing physician 3. Brief description of the event 4. Why the event occurred 5. The effect on the individual(s) who received the administration 6. Corrective Actions 7. Certification that we notified the individual involved
The Medical Event reporting form is available on the web at: www.ncradiation.net
Accelerator Safety
Maintenance should only be performed by a qualified expert with the proper training. Before entering the treatment room for any reason, always verify that LINAC or Cyberknife is in a beam off condition. Notify the operator before entering.
Before rotating the gantry, always verify that the treatment couch is positioned and the patient restrained so a collision cannot occur. Notify your supervisor of any abnormal occurences with the LINAC/Cyberknife.. Do not continue operation of the LINAC/Cyberknife or attempt to deliver a treatment if there is any indication of a malfunction of any kind.
Always remove the console keys and deposit them in a secure area when the LINAC/Cyberknife is unattended. The keys should always be removed at night and on the weekend.
Accelerator Safety
If a power failure or emergency stop should shut down the LINAC/Cyberknife during treatment, always remove the patient and have a maintenance check of the unit before completing treatment.
Emergency procedures are posted at all three shielded vaults. Emergency contacts are also listed. Quality Assurance checks should be performed daily, monthly and annually. Review the Radiation Oncology policies and procedures regarding the the type of checks that are to be performed No one except the patient under treatment shall be in the accelerator room when the beam (x-ray or electron) is energized. When a patient must be held in position for radiation therapy, mechanical supporting or restraining shall be used. This is a North Carolina Regulation for the Protection Against Radiation, 15A NCAC 11 .0609(e)(2). Absolutely NO exceptions to this rule.
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References
The North Carolina Regulations for the Against Radiation May be found at the following Website:
http://ncradiation.net/documents/15ANCA C11_1107.pdf