Radiation Safety 1

Module details

Title

Radiation Safety 1

Type

Specialist

Module code

SPE155

Credits

20

Requirement

Compulsory

Aim of this module

Radiation Governance Framework

To understand the management of radiation safety in a healthcare organisation.

Patient Dose Assessment and Optimisation

 To enable the trainee to undertake the assessment of patient dose and implement interventions to optimise imaging systems.

Diagnostic Radiology: Equipment Performance

To enable the trainee to manage the testing and performance of a wide range of diagnostic X-ray systems.

Laser and Ultraviolet Equipment

The trainee can participate in measurements to characterise a range of non-ionising (non-imaging) radiation sources.

Submodules

Learning outcomes

1. Critically appraise the legislation and guidance that applies to ionising radiation safety.
2. Discuss the physical processes behind image formation in diagnostic radiology.
3. Explain the normal and pathological appearances of images and identify common imaging artefacts.
4. Discuss the physical principles and operation of radiographic equipment.
5. Explain the factors that affect system performance.
6. Explain the principles of operational radiation protection.

Indicative content

Fundamentals

• Mathematical and physical principles behind the formation of the image:
  • radiographic images (film, CR, DR, fluoroscopy)
  • transaxial imaging CT
  • mammography
• The physics of radiation interactions with matter in diagnostic radiology
• The key parameters that define optimal image quality for a range of clinical/research applications

Legislation and Guidance

• Quantities and units (including dosimetry underlying regulatory quantities)
• Basis of radiation protection standards (e.g. epidemiology, linear hypothesis for stochastic effects, deterministic effects)
• International Commission on Radiological Protection (ICRP) principles:
  • justification
  • optimisation
  • dose limitation
• Practices and interventions (including natural radiation, especially radon)
• Legal and regulatory basis:
  • international recommendations/conventions
  • European Union legislation
  • Ionising Radiations Regulations 1999
  • Ionising Radiations (Medical Exposure) Regulations 2000
  • Approved Code of Practice and Guidance Notes
  • Environmental Permitting Regulations 2010, High Activity Sealed Sources (HASS) Regulations 2006 and other relevant Health and Safety Regulations. NaTsCo security requirements
  • Ionising Radiation (Medical Exposure) Regulations 2000, Amended 2006
  • The Carriage of Dangerous Goods and Use of Transportable Pressure Equipment Regulations 2004
  • Exemption Orders
  • other relevant legislation
  • detailed knowledge and understanding of other key documents (ARSAC/MARS, MHRA/GMP, GCP/GLP, etc.), national and local SOPs, policies and procedures
  • competent authorities

Operational Radiation Protection

• Types of sources (sealed, unsealed, X-ray units, accelerators)
• Hazard and risk assessment (including environmental impact)
• Minimisation of risk
• Control of releases
• Monitoring: area, personal dosimetry (external, real time and internal), biological
• Critical dose concept/dose calculation for critical group
• Ergonomics (e.g. user-friendly design and layout of instrumentation)
• Operating rules and contingency planning
• Emergency procedures
• Remedial action/decontamination
• Dealing with radiation incidents and incident reporting
• Analysis of past incidents, including experience feedback
• Record keeping
• Security
• Accumulation of waste
• Wipe testing
• Instrumentation and limitations

Clinical

• The appearance of the radiographic image
• Common imaging artefacts
• Results from analyses (e.g. qualitative, quantitative) and the context in which they were acquired
• Radiation risk and communication of that risk to patients, staff and members of the public

Technical

• Design principles and operation of radiographic imaging equipment
• Assessment of system performance and perform comparative evaluations
• Quality assurance and quality control
• Dosemeters and contamination monitors, equipment for measuring patient dose
• Radiation protection for diagnostic X-rays, radiotherapy and nuclear medicine, including:
  • biological effects
  • protection quantity and units
  • risk factors and dose limits
  • risk-benefit, cost benefit analysis
  • ALARA, ALARP
  • radiation working areas
  • protection instrumentation
  • engineering control

Activities

Radiation Governance Framework 

• The trainee should attend the radiation safety committee and/or medical exposures committee, with a view to observing how the management of radiation protection takes place in practice. They should be able to contribute to some of the discussions, as appropriate, and reflect on the sometimes contentious issues discussed.
• The trainee should prepare an audit of radiation areas using existing audit tools (which the trainee should critically appraise as part of the process) or by developing new tools. The trainee will need to understand relevant legislation and guidance and the processes that are being undertaken in the areas being audited. The audit should address areas of significance for patient care and the future practice in the area being audited. The trainee should use the above audit tool to assess a radiation area and issue a written report giving appropriate advice and recommended actions.
• The trainee should participate in the investigation of a radiation incident where a patient has been given a greater than intended dose or a member of staff has accidentally received a radiation dose. The trainee should be involved in determining why the incident occurred, the dose received and the steps taken to reduce the likelihood of recurrence. They should also reflect on the patient’s experience.
• The trainee should review radiation incident plans at organisation level and specific department plans. The trainee should critically appraise the plans, including a review of the contents of the radiation incident kit (equipment, documentation, guidance publications).

Patient Dose Assessment and Optimisation 

• Assess clinical image quality using appropriate parameters with a multidisciplinary team. This may also include optimisation of the images and calculation of the patient doses involved.
• Critically appraise parameters measured for image quality and patient dose for one modality, with respect to previous results and clinical impact.

Diagnostic Radiology: Equipment Performance

• In addition to working within the host department, the trainee should visit another diagnostic radiology physics department and compare test equipment, protocols and frequencies. This would enable the trainee to reflect on the procedures and test equipment in the host department, looking at best/poor practice in quality assurance.
• The trainee should compare and contrast available test equipment with regard to specifications and ease of use. This may also include a review of available calibration facilities and the procedures performed on calibration.
• The trainee should attend some multidisciplinary sessions with regard to expanding their clinical knowledge about the uses of ionising imaging.

Laser and Ultraviolet Equipment

• The trainee should perform a literature review of the clinical uses of non-ionising radiation. This may include blue light therapy, Ultraviolet, lasers, short-wave diathermy, therapeutic ultrasound, e.g. lithotripsy, physiotherapy ultrasound and high-intensity focused ultrasound (HIFU).
• Attend an Ultraviolet or laser treatment session.