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Radiation Protection in Nuclear Medicine

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IAEA Training Material on Radiation Protection in Nuclear Medicine. Version December 2004. – PowerPoint PPT presentation

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Title: Radiation Protection in Nuclear Medicine


1
Part 13
IAEA Training Material on Radiation Protection
in Nuclear Medicine
Organization and Responsibilities
2
Objective
To become familiar with the radiation protection
requirements in nuclear medicine including
staffing, responsibilities and duties.
3
Contents
  • Managerial requirements
  • Radiation Protection Committee
  • Radiation Protection Officer
  • Nuclear Medicine Staff
  • Manufacturers/Suppliers
  • Regulatory Authority

4
Organizational Structure
Regulatory Authority Authorization and Inspection
Licensee Overall responsibility for application
of BSS
Employer Overall responsibility for application
of BSS
and/or
Nuclear Medicine Facility
5
Part 13Organization and Responsibilities
IAEA Training Material on Radiation Protection
in Nuclear Medicine
  • Module 13.1 Managerial Requirements

6
Responsibilities of a Licensee
  • Licensees shall
  • Establish radiation safety objectives
  • Develop, implement and document a radiation
    safety programme
  • Ensure compliance with requirements set out in
    legislation and regulations

7
Responsibilities of a Licensee
The licensee may appoint other people to carry
out actions and tasks related to these
responsibilities, but they shall retain the
responsibility for the actions and tasks
themselves. Registrants and licensees shall
specifically identify individuals responsible for
ensuring compliance with the Standards.
8
Organization (Large Hospital)
Hospital Manager (Licensee)
Occupational health service
Radiation protection committee
QualityAssurance committee
Radiation protection officer
HeadNuclear Medicine
Nuclear MedicineTechnician
Nuclear MedicineSpecialist
Nuclear Medicine Physicist
9
Organization (Small Hospital)
Hospital Manager (Licensee)
QualityAssurance committee
Head of Department
Radiation protection officer
Occupational health service
Radiation protection committee
Nuclear MedicineTechnician
Nuclear MedicineSpecialist
Nuclear Medicine Physicist
10
Administrative Manager
  • Appoint the necessary personnel and ensure the
    individuals have the necessary education to
    perform their duties.
  • Establish a radiation protection programme and
    provide the necessary resources.
  • Assign clear responsibilities for personnel.
  • Appoint a Radiation Protection Officer.
  • Establish a Radiation Protection Committee
  • Establish a comprehensive QA programme.
  • Support education and training of personnel.

11
Radiation Protection Program
  • Determine measures and resources required to meet
    objectives and ensure they are provided
  • Review measures and resources regularly
  • Identify failures and shortcomings and take steps
    to prevent them
  • Establish consultation and co-operation of all
    parties
  • Maintain records of activities

12
Typical Elements of a RPP
  • Assignment of responsibilities
  • The Radiation Protection Officer
  • Designation of radiation areas
  • Local rules
  • Education and training
  • Planning for accidents and emergencies
  • Health surveillance and monitoring
  • Review and audit
  • System of recording and reporting

13
Documentation of RPP
  • The assignment of responsibilities for radiation
    protection and safety to individuals or to
    positions within the organization, including
    corresponding organizational arrangements and, if
    applicable (for example, in the case of itinerant
    workers), the allocation of the respective
    responsibilities between employers and the
    licensee
  • The classification of controlled or supervised
    areas
  • The local rules for workers to follow and the
    supervision of work
  • The arrangements for monitoring workers and the
    workplace, including the acquisition and
    maintenance of radiation protection instruments
  • The system for recording and reporting all the
    relevant information related to the control of
    exposures (occupational and public), safety of
    sources including waste management, the decisions
    regarding measures for radiation protection and
    safety, and the assessment of doses to
    occupationally exposed individuals.

14
Documentation of RPP
  • Specifically in relation to medical exposure, the
    system for calibration of sources, clinical
    dosimetry of patients and provision of quality
    assurance programmes.
  • The system for constraining the exposure of
    comforters, carers and volunteers.
  • The education and training programme on the
    nature of the hazards, protection and safety
  • The methods for periodically reviewing and
    auditing the performance of the radiation
    protection programme
  • The plans to be implemented in case of
    intervention
  • The health surveillance programme for workers
  • The requirements for the assurance of quality and
    process improvement.

15
Local Rules
  • Local rules are intended to provide adequate
    levels of protection and safety through the
    establishment of common work procedures and other
    systems to be followed by all workers in the area
  • They should include all information required for
    work in the area, and be made known to all
    workers

16
Local Rules
  • Set down in writing
  • person(s) responsible for supervising the work
  • description of controlled and supervised areas
  • general radiation safety measures
  • dose investigation levels
  • emergency plans

17
Radiation Safety Manual
  • The RSM is ideally a local reference book, and
    made available to (and possibly mandatory reading
    for) all radiation workers
  • An effective aid to training, and a valuable tool
    in itself is a Radiation Safety Manual
  • This now is required practice in many countries

Radiation Safety Manual
18
Radiation Safety Manual
  • The RSM should include sections on
  • basics of radiation safety
  • sources, risks and effects of radiation
  • local radiation safety organization
  • national/state regulations
  • personnel monitoring
  • emergency procedures

19
Part 13Organization and Responsibilities
IAEA Training Material on Radiation Protection
in Nuclear Medicine
  • Module 13.2 Radiation Protection Committee

20
Radiation Protection Committee
  • review and oversee compliance with, and
    implementation of, the RPP
  • formulate radiation protection policies to update
    and improve the RPP
  • provide the RPO with guidance on operational
    aspects of the RPP, and request actions on
    specific matters
  • investigate any radiation incidents or accidents
    and provide a comprehensive report on these to
    the employer and
  • assess potential hazards from foreseeable
    incidents and prepare contingency plans.

21
Radiation Protection Committee
  • The RPC shall recommend actions to the licensee
    to
  • correct identified deficiencies in the RPP
  • review new uses of radiation sources that may
    lead to modifications of the RPP
  • identify any amendments to the licence
  • identify staff needing personal authorization
    and
  • periodically review the training programme.

22
Radiation Protection Committee
RPC should be composed of clinical staff
representing the hospital departments using
radiation sources, medical physicists and persons
who have special knowledge of the hazards of
radiation and are experienced in radiation
protection. Also included should be a
representative of the hospitals administrative
unit, and a union or staff representative. The
radiation protection officer, and possibly a
physician from the occupational health service
should also be members.
The RPC should hold meetings at least every three
months, and perform comprehensive internal audits
annually, or when necessary, and report the
outcome of its activities to the
licensee/management.
23
Part 13Organization and Responsibilities
IAEA Training Material on Radiation Protection
in Nuclear Medicine
  • Module 13.3
  • Radiation Protection Officer

24
Radiation Protection Officer (1/4)
  • providing a link between the RPC and the users
    of radiation within the institution
  • supervising operational aspects of the RPP
  • providing practical advice on implementation of
    local rules and procedures
  • identifying deficiencies in compliance with the
    RPP and reporting to the licensee and the RPC
  • identifying training needs and organizing
    training activities
  • systematically verifying that tasks requiring
    personal authorization are only performed by
    staff with a valid authorization
  • monitoring source security receiving sources and
    maintaining the source inventory
  • co-operating with officers of the Regulatory
    Authority and facilitating internal and external
    audits

25
Radiation Protection Officer (2/4)
  • contributing to the planning and design of any
    new or modified radiation facility
  • undertaking the radiation safety assessment of
    new installations, processes and equipment, prior
    to their acceptance
  • identifying and establishing controlled and
    supervised areas
  • specifying appropriate monitoring procedures
  • ensuring that enough radiation monitoring
    instruments are available and that they are
    calibrated and serviced as required
  • implementing a personal and workplace monitoring
    programme
  • systematically and periodically reviewing
    monitoring programme in all areas where radiation
    sources are used, stored or disposed of
  • analysing and interpreting radiation monitoring
    data
  • informing all radiation users of their personal
    doses and ensuring that these are consistent with
    optimization

26
Radiation Protection Officer (3/4)
  • ensuring that appropriate measures are taken to
    control the exposure of a pregnant employee
  • assessing potential hazard from foreseeable
    incidents and drafting contingency plans
  • exercising and carrying out emergency procedures
  • being available for consultation on radiation
    protection matters
  • ensuring that appropriate action is taken when an
    employee reports a matter which can compromise
    radiation protection
  • ensuring that appropriate radiation protection
    training is provided on a regular basis as part
    of an ongoing "radiation protection awareness
    programme" for all users and for those who
    occasionally come into contact with radiation
    sources (i.e. cleaning staff, security,
    maintenance people)
  • ensuring that necessary leak testing of sealed
    sources is performed

27
Radiation Protection Officer (4/4)
  • supervising decontamination procedures
  • providing instruction to nursing staff on the
    correct procedures for handling and disposal of
    soiled linen and for dealing with spillage of
    urine from patients receiving bone pain
    palliation therapy
  • providing waste disposal procedures in accordance
    with the conditions of the licence or as
    specified by the Regulatory Authority
  • investigating all overexposures, accidents and
    losses of radiation sources and reporting to the
    RPC/Regulatory Authority as necessary
  • maintaining required records and
  • preparing a comprehensive annual report for the
    RPC and for forwarding to the Regulatory
    Authority if required.

28
Part 13Organization and Responsibilities
IAEA Training Material on Radiation Protection
in Nuclear Medicine
  • Module 13.4
  • Nuclear Medicine Staff

29
Nuclear Medicine Specialist
  • ensuring overall radiation protection of the
    patient
  • prescribing and justifying diagnosis and therapy
    in writing, taking into account relevant
    information from previous examinations
  • ensuring that the exposure of patients is the
    minimum required to achieve the intended
    objective taking into account the relevant
    guidance levels for medical exposure
  • providing consultation and clinical evaluation of
    patients
  • establishing optimized protocols for diagnostic
    and therapeutic procedures, in consultation with
    the medical physicist
  • evaluating any radiation incident or accident
    from a medical point of view and
  • providing criteria to manage the examination of
    pregnant women, paediatric patients, medico-legal
    procedures, occupational health examinations and
    medical and biomedical research.

30
Medical Physicist
-participating in the continuing review of the
nuclear medicine practices resources (including
budget, equipment, and staffing), operations,
policies and procedures -planning, in
conjunction with the nuclear medicine physician
and the RPO, the facilities for nuclear medicine
practice -preparing performance specifications
for equipment with regard to radiation
protection -carrying out acceptance testing of
equipment -supervising equipment
maintenance -designing, implementing and
supervising QA procedures -performing dose
calculations -participating in the investigation
and evaluation of incidents and accidents
and -contributing to the radiation protection
training programme
31
Nuclear Medicine Technologist
  • Patient identification
  • Patient information
  • Information to accompanying persons and staff
    nursing a patient after a nuclear medicine
    examination or therapy
  • Verifying that the female patient is
    non-pregnant
  • Assure that a mother in lactation is given
    information about discontinuation of nursing
  • Make the calculation of administered activity to
    a child according to the local rules
  • Verify the administered radiopharmaceutical and
    its activity
  • Perform regular quality control of activity
    meter and other relevant equipment
  • Perform regular workplace monitoring
  • Correct handling of the equipment and safety
    accessories
  • Inform the RPO in the case of accident or
    incident
  • Inform the Nuclear Medicine Physician in the case
    of misadministrations
  • Participate in education and training of new
    personnel.

32
Nuclear Medicine Technologist
  • The technologist may have the following
    additional responsibilities, which -
    alternatively - may be the responsibility of a
    radiochemist or radiopharmacist
  • Elution of sterile pertechnetate from a
    99Mo/99mTc generator
  • Preparation of radiopharmaceuticals from
    lyophilized kits according to the manufacturers
    instructions and
  • Performance of quality control procedures on the
    prepared radiopharmaceuticals.

33
Part 13Organization and Responsibilities
IAEA Training Material on Radiation Protection
in Nuclear Medicine
  • Module 13.5
  • Manufacturers and Suppliers

34
Authorized Services
  • Considering that, according to the BSS, the
    activities listed below also require
    authorization, regulatory authorities may require
    the licensee of a nuclear medicine practice to
    contract any of the following services only to
    enterprises authorized by the Regulatory
    Authority
  • import, distribution, sale or transfer of
    radioactive sources
  • personal monitoring
  • installation, maintenance of nuclear medicine
    equipment
  • disposal of radioactive sources

35
Manufacturer/Supplier
  • Design facilities for likely conditions of use
  • Transport sources as per IAEA ST-1
  • Approval test prototype devices
  • Provide certificate of conformity
  • Provide instructions for safe use and maintenance

36
Part 13Organization and Responsibilities
IAEA Training Material on Radiation Protection
in Nuclear Medicine
  • Module 13.6
  • Regulatory Authority

37
Regulatory Authority
  • Technical services
  • Dosimetry services
  • Laboratory services
  • Calibration services
  • Waste management
  • Medical services
  • Training services
  • Expert assistance

38
Regulatory Authority
  • The Regulatory Authority should be an important
    national expertise in radiation protection.

39
Questions?
40
Discussion
In a department having a newly installed gamma
camera, the collimator fell off and killed a
patient. Who is responsible?
41
Discussion
A private clinic is setting up a practice
ofthyroid treatments (5 patients/week, max 1GBq
I-131). How should they organize the radiation
protection?
42
Where to Get More Information
  • Further readings
  • IAEA, International Basic Safety Standards for
    Protection Against Ionizing Radiation and for the
    Safety of Radiation Sources Safety Series No.115,
    Interim Edition (2011)
  • WHO/IAEA/PAHO/EC. Manual on Radiation Protection
    in Hospital and General Practices. Volume 1,
    Basic Requirements
  • IAEA. Practice-specific Model Regulations on
    Radiation Safety in Nuclear Medicine
  • IAEA, Organization and Implementation of a
    National Regulatory Infrastructure Governing
    Protection against Ionizing Radiation and the
    Safety of Radiation Sources, IAEA-TECDOC-1067,
    Vienna (1999).
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