Radiation Safety & Compliance

• External Beam– Electrons (linacs)– Photons (linacs, Gamma Knife)– Protons (Summer 2013)

• Brachytherapy – Sealed Sources– Radiopharmaceuticals

Radiation Monitoring

• Radiation Badges• Whole Body

badges• Extremity badges

• Radiation Monitors– Exchanged quarterly (10/15, 1/15, 4/15,

7/15)– Must wear monitors while operating or

working near radiation producing machinery or isotopes

– Ideally wear body monitors (badges) at waist level. If using lead apron, wear on the outside (collar)

– Maintain them in a dry, ambient location.

– Only wear the ones assigned to you by a facility at that facility. If working elsewhere, that facility must monitor you. Ensure records are being cross-transferred.

• Radiation Monitors– If you lose your monitor alert

Radiation Oncology Department’s Chief of Compliance or Compliance Coordinator ASAP.

– If your monitor is irradiated off-body, try to be specific about location and duration.

– When not working, maintain monitor in dependable location (use of monitor boards in Lounge and across from LL Conf Room).

– Rings will be provided to those handling isotopes.

– Supervisors: Please alert the Chief of Compliance about upcoming new employees.

Radiation Exposure Reduction – Occupational Dose

Time – minimize the duration of your exposureDistance – maximize

your distance from the source of radiation

Shielding – use appropriate shielding

What are precautions for working with radioactive material?

Caution SignsGloves & Lab CoatContamination ControlFume HoodsShieldingNo Eating or DrinkingProper Radwaste Storage

• Worker Classifications– Gamma Knife and Brachytherapy

Nurses & Technicians will be classified as Radiation Workers.

– All Radiation Workers are required to completed WU Radiation Safety Department Exam.

– All Radiation Workers are required to wear radiation monitoring badges.

– Rings will be provided to those handling isotopes.

– Brachytherapy Radiation Workers may also be required to wear radiation monitoring ring badge dependent on job function.

What are our radiation worker’s annual dose limits?

Whole Body (DDE) 5 rem 5,000 mrem

Eyes (LDE) 15 rem 15,000 mrem

Extremities 50 rem 50,000 mrem

Skin (SDE) 50 rem 50,000 mrem

Fetal (gestation period) 0.5 rem 500 mrem

Gen. Public* 0.1 rem 100 mrem

*Public limit for released radiation patient = 500 mrem

Dose Reduction A.L.A.R.A.

• As Low As Reasonably Achievable.• Limits are the maximums

allowable• Reduce radiation exposure as

much as possible– Improvement/efficiency of

procedures and techniques– Better Shielding

Radiation Safety• Linac Radiation Safety Practices

– Anything out of the ordinary (sounds, odors, temperature) should be reported immediately to maintenance/physics.

– When working on machine for 1st time, become familiar with Emergency Off locations.

– Video and Audio must be functional.– Everyone is responsible for room

clearance.– Door Interlocks and Beam-On

indicators must be functional to treat.

Radiation Safety

• Low energy X-ray Device Safety– Applies to CT Simulators, AND

linac OBI x-ray sources

• Requires Door interlock, and

• X-ray on Indicator Light

Fetal Radiation Safety• Prenatal Exposure (Voluntary

Disclosure)– Limit is 500 mrem over gestation

period.– Further limit of 50 mrem per month.– Risk will increase above these limits.– Most sensitive time period: 8-15 weeks

• Steps if you find that you are pregnant:– Encouraged to alert Radiation

Oncology Department’s Chief of Compliance, in writing, in confidence, using declaration form.

– Will be provided additional monthly monitor.

Regulatory Compliance

• State of Missouri regulates radiation producing equipment such as the Linacs and CT SIM.

• Require registration of each unit,• Set exposure limits, • Set training & monitoring

requirements, inspection frequency, etc…

Regulatory Compliance

• U.S. Nuclear Regulatory Commission regulates the radioactive material, radiopharmaceuticals and sealed sources ( i.e. Brachytherapy and Gamma Knife).

• Some of the NRC requirements are: written procedures, QA, training, exposure monitoring, contamination monitoring, security of RAM and sealed sources, and the list goes on for miles.

• NRC unannounced inspections

Written Policies & Procedures• They are located on the OCF

website: http://ocf.wustl.edu/ (click on Clinical Applications, then Policies and Procedures)

• Be familiar with them• A written policy or procedure

documents how we will do things.• They may address regulatory

agency requirements or in-house requirements.

• Regardless of why they were generated they must be followed.

Written Policies & Procedures• If you are responsible for generating Policies

& Procedures:

– Review periodically or as required by regulatory agency

– Why do we review?

To ensure accuracy and completeness, to make sure everyone has the same understanding of the policy, process or situation

To ensure effective communication which will lead to the desired outcome

– Many problems with procedures once implemented can be traced to inadequate or no review

– Ensure they are current and address changes when needed

Questions or issues with training?

• Any questions you may have regarding this training please contact the Radiation Oncology Department’s Chief of Compliance through the Physics Division administrative staff.