Regulatory Framework Tutorial Flashcards
Distinguish between justification of radiation practices and individual justification of a patient exposure giving examples of each.
- Justification of radiation practices (e.g. industrial radiography) requires generic justification to show net benefit.
- Use of medical x-ray equipment on human subjects (e.g. radiology) requires individual justification to account for the patient condition.
Why is it difficult to determine the shape of the radiation health effects response at low doses? What measures could improve knowledge in the future?
- Effects are low radiation dose are small and, therefore, are masked by natural background cancer rates. Latency periods are also long and their are many confounding factors.
- Large studies on the back of reliable CT doses may provide further insight.
Distinguish between ICRP, ICRU and IAEA.
- International Commission on Radiological Protection (ICRP): Determines international consensus on the science of radiation and its effects. Its recommendations form the basis for radiological protection policy, regulations and guidance worldwide.
- International Commission on Radiation Units and Measurement (ICRU): Determines measurement quantities and their units for ionising radiation and provides concepts, definitions and recommendations for their use.
- International Atomic Energy Agency (IAEA): Has roles that include training, research and inspection. It is an intergovernmental forum encouraging safe the development of peaceful application of radiological science and technology. It provides international safeguards against the misuses of radioactive materials. It promotes radiological protection and security standards. It conducts research and provides technical support and training in radiation technology worldwide.
Does any involvement with ionising radiation by an employer fall under IRR2017?
Yes, apart from some very low activity radioactive materials.
What is the difference between notification, registration and consenting and under what conditions would a hospital need all three?
- These are the three levels of informing the HSE, as per IRR17, for intended work with ionising radiation. They are levelled depending on the risk associated with the practice with notification being the least and consenting being the highest level. A larger quantity of information must be provided to HSE for a higher level.
- Notification: e.g. radon levels above actions levels.
- Registration: e.g. radiography/use or storage of radioactive materials.
- Consent: Nuclear medicine/radiotherapy practices.
What is the hierarchy of radiation controls and why is it important?
Refers to the different levels of control measures for radiation protection. These are ordered in terms of most effective to least effective to allow for determination the order in which control measures should be considered. Ordered from most effective to least effective, these are: Elimination, substitution, engineering controls, systems of work, PPE.
Why are the dose limits specified over a calendar year while risk may accumulate over a working lifetime and why is the public whole-body dose limit much less?
- Annual dose limits are preferred as they lead to more equitable dose management.
- Public dose limits are lower as they are not trained professionals. There is no direct benefit associated with there exposure, as opposed to radiation workers who have the benefit of employment.
Under what circumstances would a contingency plan be required (illustrate this with an example)?
- Contingency plans are the actions required to limit dose in the case of reasonably foreseeable incidents.
- e.g. An agreed method for terminating an exposure when an x-ray set fails to terminate normally.
Distinguish between the limits for a controlled area and those for a classified individual. Why might a hospital have the several controlled areas but few classified individuals?
- An area must be designated as controlled if there is potential to exceed the relevant limit.
- An individual is classified on the likelihood of exceeding the relevant limit.
- Administrative measures and PPE usually ensure usually ensure the likelihood of overexposure is reduced significantly compared to the potential.
Why was Reg 33 of IRR2017 revoked and how did it differ from regulation 32 which remains in force?
- IR(ME)R regulations assumed responsibility for regular quality testing of medical x-ray facilities.
- Regulation 32 covers the critical examinations required of all new facilities.
How does the exposure of a comforter or carer differ from any exposure received occupationally?
Exposure to a comforter or carer (typically a friend or relative) is part of the medical exposure and is subject to dose constraints but not dose limits.
What types of procedure require special attention and why?
- Pregnant patients and paediatrics as they have increased associated risks.
- Patients within a screening programme may not have a conditions.
- Research exposures need ethics approval.
How does a DRL differ from dose constraint?
- Both provide an upper bound for a procedure.
- A DRL, in some cases (e.g. large patient), may be exceeded. A dose constraint would not usually be exceeded.
How can a practitioner retain responsibility for justification while delegating the duty to others? How are these actions recorded?
- A practitioner (often a radiologist) will establish and support evidence based local schemes of work for individual justification. Often, the actual authorisation of the exposure will be performed by the operator (e.g. radiographer).
- The names of the both practitioner and authoriser will be recorded.
What is clinical audit and how does it differ from other forms of audit? Give examples.
- A clinical audit is measured against a clinical outcome (e.g. correct radiological diagnosis).
- Other audits aim to measure compliance against non-clinical measures (e.g. correct recording of patient ID).
