Radiation protection legislation Flashcards
IRR99 overview
Concerned with safety of staff and members of public, not pxs Stems from Management of Health and Safety at Work Act Some of main requirements: -RPAs -Risk assessment -Local rules and RPS -Controlled areas -Dose limits
IRR99 Documentation
Approved Code of Practice
-contains both raw IRR and explanatory notes on interpretation and some official non-regulatory guidance
Medical and Dental Guidance Notes
Contains advice of examples for all requirements of IRR and IRMER e.g.
- risk assessment forms
- incident forms
- signs and warnings
Guidance notes for dental practitioners on safe use of x-ray equipment
More useful
What you need to know
RPA
Radiation protection adviser
Appointed expert who can help you will all things legislative, assist in determining necessary requirements for your facilities and
setting up a QA programme for your equipment.
Can be found in local hospital Medical Physics departments or private
consultancies
RPS
Radiation protection supervisor
Ensures that local rules are followed when
working in controlled areas. E.g. senior
radiographer, a senior partner in a private dental
practice
Regulation 4: duties of employer
The employer is responsible for…
-Fulfilling IRR99 with regard to the exposure to employees
and exposure to members of public that arise from
work done within organisation
-Employer may delegate tasks and other managers may have some responsibilities under IRR99
-Responsible for managing risk to employees and public
-For NHS Trusts employer would be taken to Chief
Executive. If you run your own practice, YOU are the
employer
Regs 5 and 6: authorisation and notification of work
Before starting any new work with IR:
• Appoint/notify a local Radiation Protection Adviser (RPA)
• Notify Health and Safety Executive (HSE)
• 28 days before commencing
• By email, fax or letter
• Generic Authorisation (providing all conditions are met)
• General info
• The necessary form
Regulation 7: Prior risk assessment
Identify hazard –> evaluate risk –> record findings –> identify provisions –> review/ revise –> back to beginning
Must be done prior to commencing any new work involving ionising radiation
Reg 7 - doing your assessment
Must be written down
Do one whenever introducing new procedures/ equipment/ locations
Update if anything changes and periodically changes and periodically review
Investigate incidents
Must involve RPA
Special procedures for expectant mothers
Should be ‘suitable and sufficient’
ALARP
As Low as Reasonably Practicable
Reg 8: Restriction of exposure (ALARP)
Hierarchy of controls
Engineering (design) –> Administrative –> PPE
Reg 8: restriction of exposure
Acceptance testing for new equipment Hierarchy of controls Monitoring Proper use of PPE Dose constraints Restrictions for pregnant workers Formal investigation levels
Regs 9 & 10
Wear and look after your PPE
Reg 11: dose limitation
Employees ages 18+, whole body dose 20mSv/annum
Trainees under 18, whole body dose 6mSv/annum
General public, whole body dose 1mSv/annum
Reg 12: contingency plans
If risk assessment shows radiation accident is reasonably
foreseeable, contingency plans must be designed to restrict
exposure
Must be reasonable grounds for believing it could
occur
E.g. failure of intraoral x-ray exposure to terminate – switch off at wall
Reg 14: info, instruction and training
People need to be trained first, if you haven’t been trained, don’t do it!
Reg 16: designation of controlled or supervised areas
Controlled: areas where there is potential to exceed 6mSv per year
>7.5 µSvh-1 (time averaged over 1min and untrained employees likely to gain access)
OR if special procedures needed to restrict exposure
Reg 17: local rules and radiation protection supervisors
Must have local rules if there is a controlled area
Must contain
• Name of RPS/RPA
• Details and designation of area
• Summary of working procedures (including any ‘special
procedures’ for entry)
• Investigation dose level
• Contingency plans
RPS needs to be appointed to ensure adherence to LRs
Referrer
Registered health care professional entitled in accordance with employers procedure to refer individuals for medical exposure to practitioner
Practitioner
Registered health care professional entitled in accordance with employers procedures to take responsibility for an individual medical exposure
Operator
An person entitled, in accordance with employers procedures, to carry out practical aspects of exposure
Can include radiographs, medical physics experts, engineers, dark room technicians or staff asking px identification questions
Reg 15: co-operation between employers
Working for multiple trusts or private clinics, take care of combined dose
IRMER 2000 - Employer’s duties
Written procedures:
– How is px identified?
– Enquiring if female pxs pregnant/ breastfeeding
– Reducing risk of accidental or unintended doses
as much as reasonably practicable
– Establishing ‘Reference Levels’ for diagnostic exams
Naming of Referrer, Practitioner and Operators and ensuring they have appropriate training
Establish a Quality Assurance programme
Referrer duties
Shall supply practitioner with sufficient medical data relevant to medical exposure to enable practitioner to decide on whether medical exposure is justified
Practitioner duties
Responsible for process of justification of medical exposure – Is there net benefit to px? Must comply with employers procedures Shall co-operate with other specialists and staff involved in medical exposure regarding practical aspects
Operator duties
Operator who personally carries out any practical aspect shall be responsible for that aspect Shall comply with employer’s procedures Shall co-operate with other specialists and staff involved in medical exposure regarding practical aspects
Justification of medical exposures
Every exposure must be justified
• Does the benefit to the patient/society
outweigh the costs?
• Exposure objectives
• Individual detriment
• Alternative techniques
-if for research, must be approved by ethics committee
Optimisation through
QA program
Assessment of px dose
Diagnostic reference levels (DRLs)
DRLs
Ball park dose figure for typical
examinations for standard sized pxs for broadly defined types of equipment
• To be established by employer
• To be set in units directly applicable to exam to enable px dose to be calculated,
e.g. exposure time.
• National group including RCR, CoR, IPEM &
PHE collate data to set guideline figures
Reporting incidents
Radiation incidents more common than you think
– Accidental exposures
– Wrong Exam/ Wrong Px
– Equipment faults
Care Quality Commission responsible for
enforcing IR(ME)R and incidents with a dose “much greater than intended” or unjustified must
be reported to them
Immediately inform your RPS, Consult your RPA, inform CQC if appropriate.
PM 77
HSE guidance document
This is where dose ‘much greater than intended’ definitions come from
