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BDS3 Dental Radiology > Radiation safety legislation > Flashcards

Radiation safety legislation Flashcards

1
Q

What is a typical dental x-ray exposure equivalent to in days of natural background radiation exposure?

A
  • 1.5 days or less
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2
Q

What does ICRP mean?

A
  • International Commission of Radiology Protection
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3
Q

What is the ICRP?

A
  • The ICRP is an independent, international, non-governmental organisation, with the mission to provide recommendations and guidance on radiation protection
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4
Q

What are the basic principles of the ICRP system? ‘All radiation exposures should be…’? (3)

A
  • Justified
  • Optimised
  • Limited
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5
Q

One of the basic principles of the ICRP is that all radiation exposures should be JUSTIFIED. What does this mean?

A
  • They must do more good than harm

- There must be sufficient benefit to individuals or to society to offset ant detriment

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6
Q

One of the basic principles of the ICRP is that all radiation exposures should be OPTIMISED. What does this mean?

A
  • The magnitude of radiation exposures, and the number of persons exposed, must be As Low As Reasonably Practicable, taking into account social and economical factors
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7
Q

One of the basic principles of the ICRP is that all radiation exposures should be LIMITED. What does this mean?

A
  • A system of individual radiation dose limited is used to ensure no person receives an unacceptable level of exposure
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8
Q

What are the important legislations in diagnostic radiology? (2)

A
  • Ionising Radiations Regulations 2017 (IRR17)

- Ionising Radiation (Medical Exposure) Regulations 2017 (IRMER17)

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9
Q

What does IRR17 deal with?

A
  • Deals with occupational exposures and exposure of the general public (anyone who is being paid to work with radiation and general public)
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10
Q

What does IRMER17 deal with?

A
  • Deals with medical exposures of patients (making sure that patients are looked after)
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11
Q

What are employers responsible for in relation to radiation safety?

A
  • Responsible for putting in place arrangements for compliance
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12
Q

What are employees responsible for in relation to radiation safety?

A

Employees are responsible for following the safety arrangements

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13
Q

What does RPA stand for?

A
  • Radiation Protection Adviser
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14
Q

What is a radiation protection adviser?

A
  • An RPA is a person meeting HSE requirements to advise on radiation safety; a certificate issued by ‘RPA2000’ based on portfolio of evidence, renewed every 5 years
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15
Q

Give a list of things that an employer needs to consult a radiation protection adviser about? (7)

A
  • Designation of areas
  • Prior examination of plans for installations & acceptance into service of safety features & warning devices
  • Regular equipment checks
  • Periodic testing of safety features and warning devices
  • Radiation risk assessment & dose assessment
  • Investigations
  • Contingency plans
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16
Q

A radiation risk assessment must be carried out (regulation 8) to consider issues including…? (2)

A
  • What safety features are required?

- What level of radiation exposure could staff receive?

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17
Q

Adjacent areas must be protected, particularly when cone-beam CT or OPT units are used. How can we protect them?

A
  • An RPA will advise if additional plasterboard or lead is required in the walls
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18
Q

What is a ‘controlled area’?

A

Space where no one should be while the x-rays are being used unless it is essential

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19
Q

For an intra oral x-ray how far from the x-ray tube and within the primary beam (controlled area) should anyone be?

A
  • 1.5m
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20
Q

For cone beam CT how big is the controlled area?

A
  • Usually the entire room

- No one should enter this area during exposure, unless special procedures are in place

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21
Q

Where the entire room is a controlled area, or when the entrance leads directly into the controlled area, what is likely to be required?

A
  • Signage
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22
Q

IRR17 specifies training that staff operating x-ray units and working in or around a controlle d area should receive. What would this include? (4)

A

May include basic radiation safety measures, any specific requirements for that workplace, basic understanding of risks and awareness of the regulations

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23
Q

IRR17 specifies annual radiation dose limits for radiation workers and members of the public. What is the dose limit for radiation workers?

A
  • Whole body limit of 6mSv/yr (unclassified staff)
24
Q

IRR17 specifies annual radiation dose limits for radiation workers and members of the public. What is the dose limit for members of the public?

A
  • Whole body limit of 1mSv/yr
25
Q

IRR17 specifies annual radiation dose limits for radiation workers and members of the public. What is the dose limit for dental staff?

A
  • Dental staff dose levels should be far below the dose limits
26
Q

IRMER applies to various medically-related types of exposure. Give examples of these? (6)

A
  • Patients as part of diagnosis or treatment
  • Health screening
  • Research
  • Asymptomatic individuals
  • Carers and comforters
  • Individuals undergoing non-medical imaging unsing medical equipment
27
Q

What is a ‘carer and comforter’?

A
  • Individuals who are ‘knowingly and willingly’ exposed to ionising radiation through support and comfort of those undergoing exposure
  • Individuals acting as carers and comforters are NOT those doing so as part of their employment
28
Q

Who are commonly carers and comforters?

A
  • Relatives or friends of those undergoing exposure
29
Q

Give examples of non-medical imaging using medical radiological equipment (which do not confer a health benefit to the individual exposed)? (5)

A
  • Health assessment for employment purposes
  • Health assessment for immigration purposes
  • Health assessment for insurance purposes
  • Radiological age assessment
  • Identification of concealed objects within the body
30
Q

The employer must create a set of employer’s procedures setting out how the regulations are complied with. The regulations specify 14 particular procedures that must be in place. Give 3 examples of these?

A
  • Patient identification
  • Entitlement of staff
  • Information provided to patients
31
Q

IRMER17 defines particular roles during medical exposures. Identify these 4 roles?

A
  • Referrer
  • Practitioner
  • Operator
  • Employer
  • A dentist may perform all these roles
32
Q

What is the job of the referrer?

A
  • Referral for imagin requested by the referrer
33
Q

What is the job of the practitioner?

A
  • They must justify the examination and can also authorise it
34
Q

What is the job of the operator?

A
  • The examination will be carried ot by the operator and may be justified by the operator
  • The image is assessed and reported by an operator
35
Q

Who is the referrer?

A
  • Registered health care professional

- Decide locally which groups can refer

36
Q

What is the responsibility of the referrer?

A
  • Responsible for providing ‘sufficient medical data’ to the practitioner to enable justification: patient identification, clinical details
  • Employer must provide referral criteria
37
Q

Who can be the practitioner?

A
  • Registered health care professional
  • Decide locally who performs this role
  • Must have ‘adequate training’
38
Q

What are the responsibilities of the practitioner? (3)

A
  • Justification and authorisation of each exam
  • Ensure doses ALARP
  • Comply with Employer’s procedures
39
Q

In order to justify the procedure the practitioner must take into account the information supplied by the referrer and consider what? (3)

A
  • The objectives of the exposure and the efficacy, benefits and risks of available alternative techniques
  • All the potential benefits of carrying out the exposure, including the direct health benefits to the individual and the benefits to society
  • The detriment to the individual
  • A justified exposure must then be authorised: it must be recorded that the exposure is justified and may proceed
40
Q

After an exposure has been justified, what must happen?

A
  • It must then be authorised: it must be recorded that the exposure is justified and may proceed
41
Q

Justification & authorisation may be a 2 step process where it is not practicable for the practitioner to carry out authorisation. What would the 2-step process be?

A
  1. Written justification guidelines prepared by a PRACTITIONER
  2. Authorisation as justified by an ‘operator’ at the time of exposure - provided the referral meets the criteria in the written guidelines
42
Q

An exam cannot LEGALLY proceed unless the justification process is complete, therefore…? (3)

A
  • Any requests with insufficient information MUST be referred back to the REFERRER
  • Ant exams that the practitioner feels are NOT justified MUST be referred back to the referrer
  • Exams must be authorised as justified BEFORE the exposure
43
Q

Who can the operator be?

A
  • Anyone who carries out the practical aspects that can affect patient dose is an OPERATOR
  • They must be suitably trained
  • Person taking the x-eay
  • Person performing quality control on x-ray set
  • Person cleaning film processor
  • Person performing clinical evaluation
44
Q

What are the responsibilities of the operator? (3)

A
  • To select equipment and methods to limit dose to patient consistent with the purpose
  • Follow the employer’s procedures
  • Must not perform exam unless authorised as justified
45
Q

The EMPLOYER must have procedures to ensure that a clinical evaluation of the outcome of each medical exposure is recorded. what are the procedures for? (2)

A
  • Procedures for in-department reporting

- Procedure for images sent externally for reporting

46
Q

If it is known that a clinical evaluation will not be performed, is an exposure justified?

A
  • No
47
Q

Staff carrying out any role under IRMER must be appropriately trained, who must they be deemed competent by?

A
  • The EMPLOYER
48
Q

IRMER17 requires that all exposures are optimised. What does this mean?

A
  • Means that exposures are as low as reasonably practicable, consistent with the intended purpose
49
Q

Who’s responsibility is it to ensure that all procedures are optimised?

A
  • It is the responsibility of both the PRACTITIONER and the OPERATOR
50
Q

Optimisation will typically involve considering several e lements. What are these? (6)

A
  • Selecting appropriate investigations
  • Selecting appropriate equipment
  • Using appropriate exposure factors
  • Ensuring quality assurance is carried out
  • Assessing patient dose
  • Adherence to diagnostic reference levels
51
Q

What does MPE stand for?

A
  • Medical physics expert
52
Q

What is the role of a medical physics expert?

A
  • An individual having the knowledge, training and experience to act or give advice on matters relating to radiation physics applied to exposure, whose competence is recognised by the secretary of state
  • Involved as appropriate for consultation on optimisation
53
Q

The regulations specify that radiation equipment should be regularly tested to ensure it is working correctly and delivering the expected dose level. What are tests normally split into? (2)

A
  • Routine local tests, carried out by local staff who normally operate the equipment
  • Physics tests, carries out every 1-3 years by specialist staff
54
Q

What does DRL stand for?

A
  • Diagnostic reference levels
55
Q

What are diagnostic reference levels?

A
  • DRL’s are guideline dose levels for ‘standard sized’ patients undergoing typical examinations
56
Q

Some equipment display a ‘dose indicator’ following an exposure which can be compared against a DRL. What is a dose indicator?

A
  • Number that relates to the radiation dose that the patient receives

BDS3 Dental Radiology (13 decks)

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