Protective radiation-shielding devices

AORN Journal, July, 2008 by Denise Maxwell-Downing

QUESTION: Staff members at the health care facility where I work do not know when the protective radiation-shielding devices were last examined. Who is responsible for monitoring the examination of shielding devices? Do protective radiation-shielding devices need to be examined annually?

ANSWER: The US Nuclear Regulatory Commission (NRC) states that

   executive management of the licensed facility
   assumes ultimate responsibility for the safe
   use of radiation products and equipment, and
   is required to implement an effective radiation
   safety program to achieve this goal. (1)

Within health care facilities, the executive management team, the radiation safety committee, and the radiation safety officer (RSO) are responsible for providing effective management of the radiation safety program. Reducing exposure to radiation requires an integrated program with day-to-day operations controlled by an RSO. The RSO for the facility should have copies of the

* personal radiation exposure reports;

* radioisotope inventory, if applicable;

* receipt and disposition logs for radioactive materials, by-products, and equipment; and

* radiation survey reports and equipment maintenance reports.

To meet the recommendations of the NRC for dose-equivalent levels, the facility's radiation safety program goals should include measures to keep the radiation exposure dose limits low. The guidelines for ensuring radiation exposures are maintained as low as is reasonably achievable. (1)

Radiation-emitting equipment used infrequently by a facility still has the potential to cause radiation exposure beyond the recommended dose-equivalent levels. Radiation exposure can occur when unprotected workers are near a radiation-emitting machine in operation. The degree of exposure depends on several considerations including the

* amount of radiation emitted,

* duration of exposure,

* distance from the source, and

* type of shielding in place. (2)

Surgical team members who may stand with their backs to a radiation source should wear wraparound protective shielding devices to decrease the risk of exposure. At least annually, licensed medical facilities should record exposure to ionizing radiation doses received during planned exposures, accidents, and emergency conditions for all individuals who are required to be monitored. (3)

According to AORN's "Recommended practices for reducing radiological exposure in the perioperative setting," "all leaded protective devices should be checked for defects and wear at least annually or whenever damage is suspected." (4(p529)) The National Institute of Occupational Safety and Health standard 5.2.3.7.3 affirms this recommendation. (5) A facility may decide to perform protective radiation-shielding device examinations more frequently based on their usage and method of storage. AORN recommends that all radiation aprons, gloves, and thyroid shields be stored flat or hung vertically to protect the devices from cracking, which reduces the effectiveness of the shielding barrier. When new radiation protection equipment is received, the facility should examine it for holes, tears, or cracks that may have occurred during transport. New radiation protection equipment also should be tagged or labeled for identification during future examinations.

Radiation can be either beneficial or harmful, depending on its use and how well it is controlled. Regulation of radioactive sources, byproducts, and certain materials are needed so that people are protected from unnecessary or excessive exposures. State rules and regulations differ, so one facility may implement a radiation safety program differently from another facility. Following the facility's radiation safety program, the state's governing agency's rules and regulations, and AORN's "Recommended practices for reducing radiological exposure in the perioperative setting" will help ensure radiation safety for patients and health care workers.

REFERENCES

(1.) Management of radioactive material safety programs at medical facilities (NUREG-1516)-Final Report. US Nuclear Regulatory Commission. http://www.nrc.gov/reading-rm/doc-collections /nuregs/staff/sr1516/#abs. April 24, 2008.

(2.) Occupational exposure to ionizing radiation. Occupational Safety and Health Administration. Federal Register. 2005;70(84):22828-22835

(3.) 10 CFR [section] 20.2106--Records of individual monitoring results. US Nuclear Regulatory Commission. http://www.nrc.gov/reading-rm/doc-collections/cfr /part020/part020-2106.html. Accessed April 24, 2008.

(4.) Recommended practices for reducing radiological exposure in the perioperative setting. Perioperatire Standards and Recommended Practices. Denver, CO: AORN, Inc; 2008:525-536.

(5.) Guidelines for protecting the safety and health of health care workers. Chapter 5-Recommended guidelines for controlling noninfectious health hazards in hospitals. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. http://www.cdc.gov/niosh /hcwold5d.html. Accessed April 24, 2008.