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Textbook of Radiological Safety
K Thayalan
CHAPTER 1:
Safety Concepts
INTRODUCTION
RADIATION UNITS
Exposure – Roentgen
Kerma
Absorbed Dose—Rad/Gray
Exposure Rate Constant
RHM and RMM
RMM and CURIE
EQUIVALENT DOSE
EFFECTIVE DOSE OR EFFECTIVE DOSE EQUIVALENT
COMMITTED DOSE
COLLECTIVE DOSE
Collective Effective Dose Equivalent
GENETICALLY SIGNIFICANT DOSE
DETRIMENT
ANNUAL LIMIT ON INTAKE
ALARA
SOURCES OF RADIATION
Natural Radiation Source
Cosmic Rays
Terrestrial Radiations
Internal Radionuclides
Enhanced Natural Sources
Artificial Sources
Medical Exposure
Consumer Products
Radioactive Fallout
Nuclear Fuel Cycle
Occupational Exposure
CHAPTER 2:
Biological Effects of Radiation
CELL
INTERACTION OF RADIATION WITH TISSUE
LINEAR ENERGY TRANSFER
BIOLOGIC EFFECTS
Early Somatic Effects (Whole Body Irradiation)
Early Somatic Effects (Partial Body Irradiation)
Late Somatic Effects
Hereditary Effects
Deterministic Effect
Stochastic Effect
Radiation Induced Cancer
Genetic Effects
RADIATION EFFECTS ON DNA
RADIATION EFFECTS IN UTERO
RADIATION RISK
Risk Models
Relative Risk
Absolute Risk
BEIR Report V and VII Risk Estimate
Somatic Risk
Genetic Risk
Fetus Risk
TEN DAY RULE AND ITS PRESENT STATUS
CHAPTER 3:
Radiation Exposure Control
TIME
DISTANCE
SHIELDING
HALF VALUE LAYER
Tenth Value Layer
SOURCES OF EXPOSURE
Primary Radiation
Scattered Radiation
Leakage Radiation
LEAKAGE LIMITS
Leakage Limits for X-ray Housing
Leakage Limits for Cobalt Teletherapy
Leakage Limits for Brachytherapy
PROTECTIVE BARRIER DESIGN
Work Load (W)
Use Factor (U)
Occupancy Factor (T)
Distance (d)
Radiation Exposure Level (XT or P)
FACILITY DESIGN FOR DIAGNOSTIC X-RAYS
Workload
Shielding Calculation for Diagnostic X-ray
Shielding Design for Computed Tomography
Work Load
Shielding Calculation
FACILITY DESIGN FOR NUCLEAR MEDICINE
FACILITY DESIGN FOR RADIOTHERAPY
IDR and TADR
Primary Barriers
Weekly Dose Rate Method
Instantaneous Dose Rate Method
Width of the Primary Wall
Secondary Barrier for Scattered Radiation
Secondary Barrier for Scattered Radiation, When the Primary Beam Strikes the Wall
Ceiling
Secondary Barrier for Leakage Radiation
Worked Examples
Facility Design for Brachytherapy
CHAPTER 4:
Planning of Radiological Facility
GENERAL GUIDELINES
ESTABLISHING A DIAGNOSTIC X-RAY FACILITY
Controlled and Uncontrolled Areas
GENERAL RADIOGRAPHY INSTALLATION
FLUOROSCOPY INSTALLATION
MAMMOGRAPHY INSTALLATION
COMPUTED TOMOGRAPHY INSTALLATION
ESTABLISHING A NUCLEAR MEDICINE FACILITY
General Guidelines
Categorization
Level 1
Level 2
Level 3
IN-VIVO DIAGNOSTIC FACILITY
Introduction
Equipment
Imaging Rooms
IN-VITRO AND RADIOIMMUNOASSAY (RIA)
Types of RIA Laboratories
Radiopharmacy
RADIONUCLIDE THERAPY
Introduction
Licensing
Facility design and construction
Responsibilities
Records
Training
ESTABLISHING A RADIOTHERAPY FACILITY
Location
Access
Room Size
Maze
Doors and Interlocks
Treatment Control Area
Patient Observation and Communication
Ducts and Shielding
Conduit
Room Lighting and Lasers
Construction Materials
Air Conditioning
Warning Signs and Lights
Associated Facility
Additional Installation Requirements
Model Plan 1
Model Plan 2
Model Plan 3
BRACHYTHERAPY FACILITY DESIGN
LDR and MDR Treatment Rooms
HDR Treatment Rooms
CHAPTER 5:
Radiation Monitoring
PERSONNEL MONITORING
FILM BADGE
THERMOLUMINESCENT DOSIMETER
Guidelines for Using TLD Badge
Optically Stimulated Luminance Dosimeter
POCKET DOSIMETER
PERSONNEL MONITORING SYSTEMS AND FEATURES
Overexposure
AREA MONITORING
Ionization Chamber Survey Meter
GM Type Survey Meters
Radiation Survey
RADIATION SURVEY IN DIAGNOSTIC RADIOLOGY
Introduction
Inspection of the Equipment
General Checks
Instruments and Accessories
Workload
Survey Procedure
RADIATION SURVEY IN NUCLEAR MEDICINE
Swipe Test
Radionuclide Therapy
Spillage
RADIATION SURVEY IN RADIOTHERAPY
Linear Accelerator
Source ON Position Leakage
Area Survey
Cobalt-Teletherapy Machine Survey
Head Leakage-source OFF Condition
Head Leakage Source ON Position
Area Survey
Primary Barrier Adequacy
HDR Brachytherapy Survey
CALIBRATION AND MAINTENANCE OF RADIATION MONITORING INSTRUMENTS
CHAPTER 6:
Quality Assurance
INTRODUCTION
QUALITY ASSURANCE FOR DIAGNOSTIC RADIOLOGY
QUALITY ASSURANCE FOR RADIOGRAPHY UNITS
Congruence of Radiation and Optical Fields
Procedure
Central Beam Alignment
Focal Spot Size
Tube Voltage
Timer Checking
Total Filtration
Linearity of mA Station
Linearity of Timer
Output Consistency
Tube Housing Leakage
Quality Assurance Test Format
QA FOR MAMMOGRAPHY X-RAY UNIT
QA FOR FLUOROSCOPY X-RAY UNIT
Table Top Exposure Rate
Focus to Table Top Distance
Low Contrast Sensitivity
High Contrast Sensitivity
Image Intensifier Assembly Leakage
QUALITY ASSURANCE FOR COMPUTED TOMOGRAPHY
Mechanical Tests
Alignment of Table Gantry
Scan Localization Light Accuracy
Gantry Tilt
Table Position /Increment
Collimator Test
Radiation Profile Width
X-ray Generator Tests
Measurement of Operating Potential
Measurement of mA Linearity
Measurement of Timer Linearity
Output Consistency
Resolution
Low Contrast Resolution
High Contrast Resolution
Radiation Dose Tests
Measurement of Computed Tomography Dose Index (CTDI)
Tube Housing Leakage
QUALITY ASSURANCE FOR NUCLEAR MEDICINE
QA FOR GAMMA CAMERA
Intrinsic Resolution
System Resolution
Spatial Linearity
Uniformity
Counting Rate Performance
Energy Resolution
System Sensitivity
QA FOR SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY (SPECT)
QUALITY ASSURANCE FOR PET-CT
Spatial Resolution
Sensitivity
Scatter Fraction and Count Rates
Accuracy of Corrections for Count Losses and Random
Image Quality—Attenuation and Scatter Correction Accuracy
Performance Evaluation of CT
Electromechanical Tests
Gantry and Couch
Radiation Sensitivity and Profile Widths
X-ray Generator
IMAGE QUALITY TESTS
Image Uniformity and Pixel Noise
Low and High Contrast Resolution
CT Number Linearity
Radiation Safety
QA FOR RADIOPHARMACEUTICALS
Introduction
Control of Starting Materials
Radionuclide Activity
Radionuclide Purity
Radiochemical Purity
Chemical Purity
Determination of Particle Size
Particulate Contamination
Control of pH
Sterility and Apyrogenicity
Ongoing Evaluation of Product Performance
SUMMARY
QUALITY ASSURANCE FOR RADIOTHERAPY
QA FOR LINEAR ACCELERATOR
Radiation Survey
Jaw Symmetry
Coincidence
Collimator Axis, Light Beam Axis and Cross-hairs Coincidence
Optical and Radiation Beam Congruence
Mechanical Isocenter
Collimator Rotation
Gantry Rotation
Radiation Isocenter
Collimator
Gantry
Table
Multiple Beam Alignment Check
Photon Beam Data
Energy
Field Flatness
Field Symmetry
Electron Beam Data
Energy
Flatness and Symmetry
Other Checks
QA FOR HDR BRACHYTHERAPY
Electrical and Mechanical Tests
Positional Accuracy
Applicator Integrity
Pin Prick Method
Staggered Autoradiography
Temporal Accuracy
Timer Error
Timer Linearity
Leakage and Contamination
Source Strength Verification
QA for Treatment Planning System
Periodic QA schedule
CHAPTER 7:
Regulations and Dose Limits
ATOMIC ENERGY ACT-1962
ATOMIC ENERGY REGULATORY BOARD
RADIATION PROTECTION RULES-2004
Rule 1. Short Title, Extent and Commencement
Rule 2. Definitions
Rule 3. Licence
Rule 4. Fees for License
Rule 5. Exemption
Rule 6. Exclusion
Rule 7. Conditions Precedent to the Issuance of a License
Rule 8. Issuance of License
Rule 9. Period of Validity of License
Rule 10. Suspension, Modification or Withdrawal of a License
Rule 11. Modification of Radiation Installation or Change in Working Condition
Rule 12. Restrictions on Use of Sources
Rule 13. Restriction on Certain Practices
Rule 14. Radiation Symbol or Warning Sign
Rule 15. Dose Limits and Other Regulatory Constraints
Rule 16. Safety Standards and Safety Codes
Rule 17. Prohibition of Employment of Persons below Certain Age
Rule 18. Classified Worker
Rule 19. Radiological Safety Officer
Rule 20. Responsibilities of the Employer
Rule 21. Responsibilities of the Licensee
Rule 22. Responsibilities of the Radiological Safety Officer
Rule 23. Responsibilities of Worker
Rule 24. Records of Workers
Rule 25. Health Surveillance of Workers
Rule 26. Medical Exposures
Rule 27. Radiation Surveillance Requirements
Rule 28. Directives in the Cases of Exposures in Excess of Regulatory Constraints
Rule 29. Power to Appoint or Recognize Persons or Agencies
Rule 30. Inspection of Premises, Radiation Installations and Conveyances
Rule 31. Power to Investigate, Seal or Seize Radiation Installation or Radioactive Material and to give Direction to the Employer
Rule 32. Directives in Case of Accidents
Rule 33. Emergency Preparedness
Rule 34. Decommissioning of Radiation Installation
Rule 35. Offences and Penalties
REGULATORY CONTROLS FOR DIAGNOSTIC X-RAY EQUIPMENT AND INSTALLATIONS
Personnel Responsibilities
Manufacturer
Service Engineer
Employer
Radiologist
X-Ray Technologist
Student/Trainee
Radiological Safety Officer (RSO)
REGULATORY CONTROLS FOR NUCLEAR MEDICINE FACILITIES
Consent
Personnel Requirements
Personnel Responsibilities
Consentee
Nuclear Medicine Physician
Nuclear Medicine Technologist
Radiological Safety Officer (RSO)
Management of Cadavers Containing Radionuclides
AERB Guidelines for Starting Radioisotope Laboratory
AERB Classification of Radioisotope Laboratories
AERB Guidelines to Set Up a Radioimmunoassay (RIA) Laboratory
Introduction
Minimum Facilities Required
Procedure for Authorization
REGULATORY CONTROL FOR RADIOTHERAPY EQUIPMENT AND INSTALLATIONS
Teletherapy Installation
Brachytherapy Sources, Equipment and Installations
Personnel Requirements
Personnel Responsibilities
AERB Specification for the Layout of Radiotherapy Facility
DOSE LIMITS
Dose Philosophy
Workers
Trainess
Public
Why the Public Dose Limits is less?
Dose Limits to Patients
Radiation Limits for Shielding Design
Type-I (Simple)
Type-II (Medium)
Type-III (Stringent)
CHAPTER 8:
Personnel Protection
RADIOGRAPHY
Protective Devices
Lead Apron
Thyroid Shield and Lead Glass
Ceiling Mounted Barriers
Organ Shield
Work Practice
Occupancy in the Room
Assistance to Patients
Protection in Radiography
Equipment and Peripherals
Tube Voltage (kVp)
Filtration
Field Area
Source to Object Distance
Carbon Fiber Materials
Image Receptors
Image Intensifier
Patient Positioning
Patient Motion
PROTECTION IN FLUOROSCOPY
Dose Reduction in Fluoroscopy
PROTECTION IN COMPUTED TOMOGRAPHY
PROTECTION IN PEDIATRIC IMAGING
Pediatric Radiography
Equipment and Peripherals
Special Considerations
Patient Motion
Dose Reduction Methods in Pediatric Radiography
Pediatric Fluoroscopy
Pediatric Computed Tomography
Dose Reduction Methods
Dose Reduction Methods in Paediatric Chest CT
Dose Reduction Methods in Pediatric Abdominal CT
PREGNANCY AND RADIATION
Effects on Radiation Exposure In Utero (ICRP-84)
Chest and Extremity Radiography in Pregnancy
CT and Pregnancy
Cardiac Catheterization and Pregnancy
Termination of Pregnancy after Radiation Exposure
Continuation of Work of a Pregnant Employee in X-ray Department
Chance of Approaching the Dose Limits of Exposure
Counseling of Patients
Other Factors
PROTECTION IN NUCLEAR IMAGING
Protective Devices
Personnel Wear
Radiation Dose from Patients
Patient Dose Reduction
Pediatric Exposure
Contamination Control
Safety Work Practices that Can Reduce Internal Radiation Dose
Labeling and Identity
PROTECTION IN RADIONUCLIDE THERAPY
First 4 Days
Next 3 Days
Breastfeeding
PREGNANCY AND RADIATION PROTECTION IN NUCLEAR MEDICINE
Woman of Childbearing Age and Nuclear Medicine Examinations
Actions and Precautions that can Reduce Radiation Exposure to the Fetus
RADIOIODINE THERAPY AND PREGNANCY
Treatment of Pregnant Patients with Radionuclides
Steps to be taken in Patients Found to be Pregnant after Administration of Radioiodine Therapy
Risk to a Pregnant Woman, When a Family Member is Treated with Radioiodine
Avoid of Pregnancy after Radionuclide Therapy
STAFF PROTECTION
Pregnant Staff and Continuation of Work
Maternal Hydration
PERSONNEL SAFETY DURING SOURCE TRANSFER OPERATIONS OF TELETHERAPY AND HDR BRACHYTHERAPY UNITS
Make and Models
General Precautions
PREGNANCY AND RADIATION PROTECTION IN RADIOTHERAPY
Pregnant Woman and Radiotherapy
Reduction of Fetal Dose When a Pregnant Patient Undergoes Radiotherapy
Pregnant Patient with Cervical Carcinoma Who Needs Radiotherapy Treatment
Avoid of Pregnancy after Receiving Radiotherapy for Breast Cancer Treatment
Illustration 1
Illustration 2
RECORDS
CHAPTER 9:
Transport of Radioactive Materials
INTRODUCTION
TYPES OF PACKAGES
Type A Packages
Type B Packages
Excepted Packages
Industrial Packages
Fissile Packages
TRANSPORT INDEX
Categories
Category I-white
Category II-Yellow
Category III-Yellow
PACKAGING AND PACKAGE REQUIREMENTS
General Requirements
Additional Requirements for Type A Packages
Test for Type A Package
Water Spray Test
Free Drop Test
Stacking Test
Penetration Test
Additional Requirements for Type B Packages
Test for Type B Package
Mechanical Test
Thermal Test
Water Immersion Test
Package Handling
Storage in Transit Requirements
Package Radiation Levels
PREPARATION OF THE PACKAGE FOR TRANSPORT
MARKING OF THE PACKAGE
LABELING OF THE PACKAGE
PLACARDS
BOOKING, STORAGE, TRANSPORT AND DELIVERY OF PACKAGE
CONSIGNOR'S DECLARATION
TREMCARD
INFORMATION TO CARRIERS
CHAPTER 10:
Radioactive Waste Disposal
INTRODUCTION
WASTE MANAGEMENT
Delay and Decay
Dilute and Disperse
Concentrate and Contain
SOURCES AND NATURE OF WASTE
CLASSIFICATION OF WASTE
TYPES OF RADIOACTIVE WASTE
Liquid Waste
Chemical Treatment
Ion Exchange
Reverse Osmosis
Evaporation
Solid Waste
Disposal of Radioactive Solid Waste
Incineration
Burial of Solid Waste
Storage
Sea Dumping
Gaseous Waste
DISPOSAL OF LOW ACTIVITY WASTES INTO THE ENVIRONMENT
DISPOSAL OF RADIOACTIVE EFFLUENT INTO THE GROUND
DISPOSAL OF P-32 AND I-131 INTO MUNICIPAL SEWERS BY MEDICAL USERS
DISPOSAL OF RADIOACTIVE WASTE FROM NUCLEAR MEDICINE PROCEDURES
ROUTINE PROTECTIVE CLOTHING
Laboratory Coat
Overalls (Boiler suit)
Aprons
Rubber Gloves
Foot Wear
Overshoes
Rubber Boots
Breathing Apparatus
DECONTAMINATION PROCEDURES
Skin and Surface Contamination
Decontamination of Personnel
Decontamination of Working Areas
Removal of Loose Contamination
Removal of relatively Fixed Contamination
Decontamination of Equipment
Protective Clothing
Decontamination of Protective Clothing
White Coats and Coveralls
Rubber Gloves
Respirators and Dust Masks
Impressive Protective Clothing
Footwear
CHAPTER 11:
Radiation Emergency
TYPE OF RADIATION ACCIDENTS
Emergency Procedures
Responsibility in the Control of Radiation Accidents
Emergency Protective Clothing
Fully Impervious Clothing
Pressurized Clothing
Breathing Apparatus
DIAGNOSTIC RADIOLOGY-SKIN INJURIES
NUCLEAR MEDICINE: RADIATION ACCIDENTS
Radiation Emergencies in Radioisotope Laboratory
Emergency Preparedness
Emergency Procedures
Procedures for Handling Spills
RADIOTHERAPY: RADIATION EMERGENCIES
Emergency Situations
Leakage of Mercury (Shutter)
Failure of Shutter Movement
Pneumatic System Failure
Improper Functioning of Timer
Software Mix-up in Accelerator
San Jose, Costa Rica
Panama Accident
Ottawa Hospital Cancer Center
Overexposure During Source Exchange
Radiation Emergencies-Fall of Source Drawer
BRACHYTHERAPY: RADIATION ACCIDENTS
EMERGENCY PREPAREDNESS: ACTIONS
Line of Command of Actions
Source not Returning to “OFF” Position
Removal of the Patient
Restoring the Source to “OFF” Position
Requirement of Equipments and Accessories
Legal and Regulatory Requirements
Prevention of Emergency
MEDICAL MANAGEMENT OF PERSONNEL EXPOSED TO RADIATION
Partial Body Exposures – Localized Exposure (Radiation Burns)
Skin Effects Following Exposure
Transient Erythema
Epilation
Dry Desquamation
Moist Desquamation
Transepidermal Burn
Full Thickness Radiation Burn
Long Term Effects
Management of Radiation Burns
History
Investigation
Specific Treatment
INDEX
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