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Radiation Safety (Surgery / PACU) - MCM

Radiation Safety (Surgery / PACU) Radiation Safety Review

If the patient requires emergency surgery or dies immediately notify the medical physicist identified on the door posting.

II. General Radiation Safety Instructions

It is intended that workers who receive this instruction will develop respect for the risks involved, rather than excessive fear or indifference.

What is radiation? Ionizing radiation (e.g. x-rays, gamma radiation, and ultraviolet light) is electromagnetic radiation that has enough energy to break apart atomic structures and thus cause damage. It is generally understood that the term “radiation” usually refers to the “ionizing radiation”.

What is radiation dose? The term radiation dose describes the quantity of energy absorbed per unit mass. The commonly used radiation units that are used to measure radiation are:

Rad (or Gray): Absorbed radiation energy. This unit is used to describe the dose prescribed to treat a patient.

Rem: Absorbed dose equivalent. This unit is often used in radiation protection to quantify the biological dose received from different radiation types. We usually specify dose in milli-rem; abbreviated mrem which is 1/1000 of a rem.

Roentgen: Unit of radiation exposure in air. Most radiation survey meters measure this quantity which is related to the amount of dose one may receive. Usually measured as milli-Roentgen per hour.

Where do I find rules, regulations, and guidelines that apply to me? Regulations regarding the safe use of radioactive materials may be found electronically at NRC.gov under the following sections:

NRC Part 20 STANDARDS FOR PROTECTION AGAINST RADIATION
NRC Part 35 MEDICAL USE OF BYPRODUCT MATERIAL
Regulations regarding the safe use of radiation producing devices can be found at michigan.gov under the State of Michigan Radiation Safety Section. Additional help may be obtained by speaking with your radiation safety officer (RSO), radiation protection supervisor (RPS), or Medical Physicist.

What is a radiation safety officer or radiation protection supervisor? The RSO and RPS are identified by the institution as responsible for maintaining compliance with federal and state regulatory standards and guidelines and ensuring radiation safety in the workplace. Your RSO is listed on the Radioactive Material License. Your RPS is listed under the State Registration Certificate for the x-ray equipment used in your department. The RSO and RPS work with the radiation safety committee to keep the radiation dose to all individuals “As Low As Reasonably Achievable” or ALARA.

What is natural background radiation exposure? The average person is constantly exposed to ionizing radiation from several sources. Our terrestrial environment, cosmic radiation, and even the human body contain naturally occurring radioactive materials that contribute to the radiation dose that we receive. In Michigan, this background is about 300 mrem per year or about 1 mrem per day. The impact of this average annual radiation exposure cannot be measured conclusively due to the extremely low incidence of effects, but it is generally assumed that the low-level exposure carries insignificant health risk.

How much radiation am I allowed? Both the Nuclear Regulatory Commission and the State of Michigan allow up to 1250 mrem of exposure to radiation workers per quarter. Your medical institution is committed to making every reasonable effort to keep exposures less than 1/10 of the regulatory allowed dose or 125 mrem per quarter. Any employee who receives greater than this limit will be notified and the case reviewed by the radiation safety committee.

What are some typical exposures during procedures? The exposure to staff at 2 meters (~6.5 feet) from the patient is about 0.02 mrem from fluoroscopy and 0.01 mrem from radioactive seeds, for a total estimated exposure of 0.03 mrem. That is 3/100 of a millirem… much smaller than the average daily dose from background radiation. How can I minimize my radiation exposure? The three basic methods are to: (1) minimize unnecessary TIME near patients being fluoroscoped, or time near patients containing radioactive implants or drugs; (2) keep your DISTANCE as far as practical while providing the necessary care. Even a small increase in distance will reduce your exposure dramatically; (3) use SHIELDING whenever possible. This may include lead aprons, lead thyroid shields, leaded glasses or even other staff in the room who must work closer to the patient than you. Pregnant visitors and children under 18 are not allowed.

What if I see something that I suspect is radioactive? Call the Nuclear Medicine Department, Radiation Oncology Department or the Medical Physicist(s) listed below.

How is my radiation exposure monitored? Occupational radiation exposure is monitored with use of clip-on radiation badges, ring, and eye badges. The RSO or RPS are responsible for the assignment of radiation monitors. State regulations require monitoring of workers who are likely to exceed 300 mrem per quarter or individuals doing fluoroscopy. Obtain and wear a radiation badge.

What about exposure to the embryo/fetus? If an occupationally exposed woman declares her pregnancy in writing, she is subject to the more restrictive dose limit for the embryo/fetus during the remainder of the pregnancy. The dose limit of 0.05 rem (50 mrem) per month or 0.5 rem (500 mrem) for the total gestation period applies. In most cases radiation workers can continue their present job with no change in duties and still meet the dose limit for the embryo/fetus. However, to eliminate any risk, pregnant employees should not care for I-125 implant patients.

How do I declare pregnancy in writing and to whom? Notify your immediate supervisor, RSO, or RPS that you wish to declare your pregnancy. The appropriate declared pregnancy form will be provided to you. The radiation worker who has declared pregnancy will receive an assigned “fetal” radiation monitor, and will be instructed ton the radiation safety practices and risks related to radiation exposure to the embryo/fetus. The declaration of pregnancy is voluntary. Also, the declaration of pregnancy can be withdrawn in writing for any reason.

If I have not declared my pregnancy in writing and my supervisor suspects that I am pregnant, does the embryo/fetus dose limit apply?No. Your employer may not restrict you from a specific job if you have not declared pregnancy.

Can normal occupational radiation exposure cause sterility or impotence? No.Temporary or permanent sterility cannot be caused by radiation at levels allowed under states occupational limits.

Who do I contact to report unsafe conditions? It is your responsibility to report promptly to the RSO or RPS any condition that may lead to or cause a violation of regulations or any condition that may cause unnecessary exposure to radiation or radioactive material.

For questions or concerns, you may contact the Leann Kruger in Nuclear Medicine Department (989) 772-6794 or the Radiation Safety Officer below:

Jim Botti
Radiation Safety Officer
Medical Physics Consultants
Office: 1-800-321-2207