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Radiation protection

Evidence‐based approaches

Rationale

Radiation protection is based on three principles.
  1. Justification: no practice should be adopted unless its introduction produces a net benefit.
  2. Optimization: all exposure shall be as low as reasonably practicable (ALARP).
  3. Limitation: the dose equivalent to staff and members of the public shall not exceed the dose limits (1 mSv annually).
The requirements for procedures involving unsealed sources include the following.
  • Those administering radioactive material must hold an approved Administration of Radioactive Substances Advisory Committee (ARSAC) certificate for each radionuclide they intend to use.
  • Administration of therapeutic and diagnostic radioactive substances can only be carried out in centres with appropriate facilities (Cormack et al. [12]).
  • Therapeutic unsealed sources generate a significant amount of liquid radioactive waste, from showers and toilets. The amount of radioactive waste that enters the sewage system is governed by local regulations. Multiple holding tank systems can be employed where waste can be held to allow decay to occur before being released into the main waste drainage system (Leung and Nikolic [46]).
  • Risk assessments must be carried out prior to work with ionizing radiation, to ensure risks are properly controlled (Pearson et al. [55]).
  • All controlled areas will have warning notices to restrict entry.
  • All controlled and supervised areas have local rules and systems of work, summarizing the arrangements for controlling work with ionizing radiation. The radiation protection supervisor ensures that the local rules are followed.
  • Visitors are restricted. Doses received by relatives/friends of patients undergoing treatment or examination with ionizing radiation are restricted to the doses allowed to members of the public unless they are classified as ‘comforters and carers’, when different rules and restrictions will apply.
  • Exposure is controlled using time, distance and shielding.
  • Personal protective clothing including gloves, aprons and overshoes must be used to limit the risk of contamination (Ionising Radiations Regulations [34], IRMER [35]).
  • Procedures are in place for reporting incidents (RIDDOR [59]).
  • Adequate training is provided and only trained staff can work unsupervised.
  • Pregnant staff or staff who are breastfeeding cannot enter the controlled area.
  • Quality assurance initiatives must be undertaken; these include clinical audit of procedures and standards.
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