2.3 - Radiation Safety Legislation Flashcards
What are the 2 key regulations in radiology?
IRR - ionising radiation regulations 2017
IRMER - ionising radiation medical exposure regulations 2017n
What is dental x-ray exposure equivalent to?
1.5 days or less of natural background radiation exposure
What must all radiation exposures me?
Justified - must do more good than harm and must be benefit to individuals or society that outweighs risk of radiation exposure
Optimised - ALARP - as low as reasonably practicable - we can take excellent images but would require higher dose but we can still get a diagnostic image with lower dose
Limited - radiation dose limit to ensure no one gets unacceptable level of exposure
What does IRR17 deal with?
occupational exposures and exposure of general public (NOT TO DO WITH THE PT - ANYONE WHO WORKS WITH RADIATION AND GENERAL PUBLIC)
What does IRMER17 deal with?
pts
Describe IRR17
This is in place to deal with the exposure of staff and the general public (those in waiting room, staff)
employer is responsible for putting in place arrangements for compliance
What is an RPA?
Radiation protection advisors advise on how to meet radiation safety requirements and help to do risk assessments and design safe designated radiation areas
What must we consider in radiation area?
That adjacent areas are protected - may need controlled area, or if using CT or OPT units may need lead in the walls
What is a controlled area?
Designated radiation area defined around the equipment - no one should be in this zone whilst using the x-ray machine
What is the controlled area of intra-oral x-ray units?
1.5m from the X-ray tube
What is the controlled area for CBCT?
Whole room
If the entire room is a controlled area what must be present?
must be signage
set of local rules that sets out working instructions
What training must those operating x-ray units and working in or around controlled area receive?
basic radiation safety measure training
basic understandings of risks
awareness of regulations
What is the annual radiation dose limit for radiation works?
6mSV/yr
What is annual radiation dose for general public?
1mSv/yr
What does IRMER17 do?
It protects the pt and some other groups such as those undergoing exposure for research, health screening, asymptomatic individuals, carers
What level of protection are carers given by IRMER?
Same as pts as they are knowingly and willingly exposed to ionising radiation through support and comfort of the pt undergoing the exposure
What are the outlined duty holders in IRMER17?
referrer
practitioner
operator
employer
Who is the referrer?
They are a registered HCP who provides medical info to the practitioner for justification for radiograph to be taken
Who is the practitioner?
They are a registered HCP with adequate training who must justify and authorise each exam, ensure the dose is alarp
How doe practitioner justify radiation dose?
They must consider the information from referral and why the exposure may be needed and then consider risks and benefits and any other techniques to reach diagnosis
What must happen to a justified exposure?
It must then be authorised
What role does the operator have?
They carry out practical aspects - take the x-rays
Who is the employer?
Person who ensures that clinical evaluation fo each medical exposure is recorded
What roles can the dentist have?
referror
practitioner
operaor
employer
Describe the basic framework for radiograph?
Referral for image by referrer (ie dentist decides pt needs x-ray)
this referral must be justified by practitioner who can also authorise it
radiograph then taken by operator
image assessed and reported by operator
the image and report are provided to the referror
Staff carrying out any role under IRMER must be what?
appropriately trained
deemed competent by employer
What does IRMER require all doses to be?
optimised - this means that all doses must be ALARP
How do we ensure x-ray dose is optimised?
Select approproate investigation
select appropriate equipment
use appropriate exposure factors
assess pt dose
Why must we do regular quality assurance of radiation equipment?
To ensure its working fine and delivery expected dose level
What are DLRs?
guideline dose levels for standard sized pts undergoing typical exams
