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Limited Exposure

Minimizing your staff's radiation exposure requires planning.

Limiting Radiation Exposure

Radiology workers are at risk of radiation exposure with each image they take, and that risk is increasing for those working in specific areas of radiology, namely fluoroscopy and nuclear medicine, says Cari Kitahara, PhD, an investigator within the National Cancer Institute's radiation epidemiology branch, in the division of cancer epidemiology and genetics. These professionals are filling an increased demand, according to Kitahara, who is reviewing background information provided by professionals in these fields to help determine the accuracy of current dose limits.

"For these workers, especially those performing interventional procedures, there is wide variability in the level of exposure received that reflects the potential for considerable improvement through more effective radiation protection equipment and practices and more rigorous radiation safety training," Kitahara says.

That's good advice for anyone working in radiology. But what other steps can help a radiation safety program reduce staff dose exposure? Radiology Today speaks with some experts to find out.

Have a purposeful occupational dosimetry program.

At Duke University Medical Center in Durham, North Carolina, the radiation safety division's goal is to maintain the occupational exposure for most workers below 10% of the occupational limits, explains Robert Reiman, MSPH, MD, DABNM, the associate professor of radiology in the radiation safety division. An occupational dosimetry program is fundamental to reaching that goal.

"A robust occupational dosimetry program helps maintain ALARA," Reiman says. "The key component to a dosimetry program is the personal dosimeter."

One of the newer types of personal dosimetry badges is a digital on-demand dosimeter that allows wearers to check their dose at any time, according to Melody Pierson, RT(R), CRA, manager of imaging services at UCHealth Greeley Hospital in Greeley, Colorado. Speaking from her experience setting up the radiology department as manager of imaging services at UCHealth Longs Peak Hospital in Longmont, Colorado, she recommends dosimeters that allow users to get daily or cumulative readings on demand using an app downloaded on their smartphone or mobile device. Dose readings can also be wirelessly processed and transmitted using an onsite badge reader and accessed online via a computer. Dose is monitored on a monthly basis at Longs Peak Hospital, and individuals are alerted when dose levels are high. The radiation safety officer reserves the right to temporarily restrict a staff member's work with fluoroscopy if dose levels are too high.

"With immediate, on-demand access to current dose data comes the opportunity to alter behavior and mitigate exposure risks—enabling an unprecedented level of administrative control and safety for our staff," Pierson says.

At Longs Peak Hospital, nuclear medicine technologists wear a radiation monitoring badge as well as a ring dosimeter that monitors the dose exposure to their skin, since these professionals use their hands to work with radioisotopes, she explains. Ring dosimeters are sent to the manufacturer for readings on a monthly or quarterly basis.

To monitor surfaces within nuclear medicine, the staff at Duke routinely use Geiger-Mueller detectors to detect any residual contamination at the end of the day and after therapeutic administrations of iodine-131 or lutetium-177.

"The Radiation Safety Division assists them in ensuring that facility surfaces are free of contamination and all employees, monitored or not, do not ingest radioactive material," Reiman explains. "Thyroid probes are used to ensure that undetected ingestion of iodine-131 does not occur for our nuclear medicine technologists and radiopharmacy staff."

Reward staff for timely dosimetry badge return.

It's challenging to get staff to turn in traditional film dosimetry badges. "We expend a lot of effort to get our monitored employees, which is more than 2,000, to wear the monitors properly and to return them for analysis in a timely manner," Reiman notes. "A sound educational program for dosimeter wearers is a must. We require our personnel to complete an online training module annually and work with our dosimetry vendor