Mersey Radiation Protection Legislation Flashcards
UK Radiation Protection Legislation
- Embodies the ideas of the ICRP via EU directives
- All exposures are potentially harmful & must be:
- Justified (have a net benefit)
- Optimised (“ALARP” -as low as reasonably practicable)
- Below legal dose limits
- The employer has most responsibility for providing
protection, but individuals are also responsible - There is legislation to protect staff, the general public,
patients and the environment
Ionising Radiation Regulations 2017
IRR17
- Protects staff and the general public
- Enforced by the HSE
- Employer (Chief Executive of NHS Trust) responsible for
protecting staff & public - Employer must be registered with HSE to work with x-rays
- Employer must seek HSE ‘consent’ for nuclear medicine
- Radiation protection adviser (RPA) advises the Employer
- Radiation protection supervisor (RPS) oversees in clinical
areas
IRR 2017
- Radiation risk assessments needed for new
procedures - Restrict access to areas where doses are likely to be
high (controlled & supervised areas) - Local Rules tell staff how to work in controlled areas
- Radiation doses must not exceed legal limits
- Staff need to be classified if they receive >3/10 of any
dose limit
IRR Dose Limitation
MEMORISE FOR EXAM
IRR17 - Other Dose Levels
“Classification” of individual workers
– Staff must be classified if likely to receive ≥ 3/10th of any dose limit
– Classification doses: 6mSv for effective dose, 150mSv for hands/skin/extremities
– Classification also needed if eye dose ≥ 15mSv (Dose Limit=20mSv)
– Classified staff must have an annual medical, be issued with personal radiation
monitoring and the results kept for 30yr
IRR17 - Other Dose Levels
“Investigation level”
– Employer sets a voluntary level for effective dose & must investigate if exceeded
– Investigation level is written in the Local Rules & must be less than 15mSv
– Investigation levels are typically between 1 and 4mSv in hospitals
IRR17 - Other Dose Levels
During Pregnancy
– Restrictions required only when pregnancy declared in writing to the employer
– Employer must review work to ensure dose to foetus < 1mSv for the remainder of
the pregnancy
– Radiation risk assessment will be part of an overall risk assessment for that person
IRR17 - Area Designation
Controlled Areas
– when precautions are needed to avoid significant radiation
exposure, or
– if dose received likely to be > 3/10 of any dose limit
– Need local rules to highlight safe working procedures
– Need an RPS to enforce the local rules
IRR17 - Area Designation
Supervised Areas
– Lower risks than for controlled areas
– When work needs to be reviewed periodically, or
– if annual dose received likely to be > 1mSv
– Don’t need local rules or an RPS
IR(ME)R 2017
Protects patients / persons having a medical exposure
* Covers a range of medical exposure scenarios
* Diagnosis, therapy, research, medico-legal, health screening
* No dose limits but all medical exposures must be
justified & optimised
Enforced by:
- Care Quality Commission – England
- Healthcare Inspectorate Wales
- Healthcare Improvement Scotland
- The Regulation and Quality Improvement Authority - NI
IRMER17 Stakeholders
- The employer – responsible for providing a radiation
protection framework - The referrer – provides clinical information to support the
request for a medical exposure - The practitioner – a registered health care professional who
is entitled to justify & take responsibility for an individual
exposure
- The operator – any person who is entitled to carry out
practical aspects of a medical exposure - The medical physics expert (MPE) – a state registered
professional who can advise on regulatory compliance &
provides radiation dose measurements/calculations
Role of the Employer under IR(ME)R17
- Responsible for setting up a framework for the radiation protection of
patients. - Must establish a set of written procedures, such as:
– Checking patient id
– Checking pregnancy/breastfeeding status
– Establishing Diagnostic Reference Levels (DRLs)
– Minimising accidental exposures
- Must ensure written protocols are available for every type of standard radiological practice carried out
- Must establish referral guidelines for medical exposures, including radiation doses
- Ensure that practitioners and operators are properly trained and maintain training records.
- Report accidental/unintended exposures
National Diagnostic Reference Levels - PLAIN RADIOGRAPHY
HAVE A RELATIVE IDEA OF THESE
IRMER17 – Justification
* Exposures are prohibited unless they have been justified &
authorised
* “Justification” – the exposure must be shown to introduce a net
benefit after consideration of:
* Patient characteristics
* Objectives of the exposure
- Potential diagnostic or therapeutic outcomes
- Risks & benefits of alternative investigations
- Justification must be carried out by a Practitioner
- “Authorisation” of an exposure demonstrates that justification has been carried out.
- Authorisation can be performed by an operator following written guidelines
IRMER17 – Optimisation
“Optimisation” – the radiation exposure must be as low as
possible yet be sufficient to guarantee satisfactory image quality
- The operator must select equipment and methods to ensure that the patient exposure is ALARP and consistent with the intended diagnostic purpose
- All equipment must be subject to a QC programme
- An assessment of patient dose or administered activity must take place for each exposure
- The operator must adhere to DRLs established by the employer
- DRLs indicate achievable patient exposure factors for average sized patients
National Diagnostic Reference Levels - CT
Thresholds for reporting of an incident - LEARN FOR EXAM
