Radiation Safety and Regulations (part 2)- Domain 2

unrestricted area

less than 0.02 mSv or 2 mrem in one hour

access is not limited by or under direct control of the license

caution: radiation area

signs used in areas that ann individual could receive more than 0.05 mSv (5 mrem) in 1 hour at 30 cm

-entrances of nuclear medicine labs

caution: high radiation area

signs used in areas where an individual could receive more than 1 mSv (100 mrem) in 1 hour at 30 cm

-where radiation therapy is performed

caution: very high radiation area (grave danger)

Area where individual could receive absorbed dose of more than 500 rad (5 Gy) in 1 hour at 1 m from the source

-not usually in hospital setting

caution: radioactive material

Where radiation is used or stored.

-hot lab, potential presence of radiation sources or contamination, food and drink strictly prohibited, no smoking or cosmetics

may exceed 5 mrem/hr

surveying

daily surveys must be done in any area radioactivity was used or stored

inventory

detailed, up-to-date list of all radioactive material, including how much you have, what type it is, when it was received, how much has been used, and where it is stored. a

also includes checking expiration dates and making sure all materials are accounted for according to regulatory and safety standards.

waste tracking

procedure for handling MINOR spills/contamination

1. Notify all people in mediate vicinity

2. Contain spill with absorbent material, limit movement

3. Remove clothing if contaminated, wash skin if contaminated

4. Wear PPE

5. Place all materials used to clean the pill into plastic bags and dispose as radioactive waste

6. Use survey & wipe until no contamination is detectable

7. Cover area with absorbent material and lead, label with caution: radioactive material if any remains

8. Report the spill

Procedure for handling wide areas of contamination or high radiation dose (MAJORR)

1. Clear the area

2. Use absorbent material to prevent spreading of material - but do not attempt to clean spill

3. Limit movement of contaminated personnel - remove clothing before leaving

4. Evacuate and close all doors - lock doors

5. Notify RSO immediately

6. Decontaminate personnel (treating serious injuries should take precedence)

MAJOR spills for Tc-99m and Tl-201

>100 mCi

MINOR spills for Tc-99m and Tl-201

<100 mCi

MAJOR spills for Ga-67, In-111, I-123

10 mCi

MINOR spills for Ga-67, In-111, I-123

<10 mCi

MAJOR spills for I-131

>1 mCi

MINOR spills for I-131

<1 mCi

recordable event: diagnostic

I-131 or I-125 : >30uCi, No Written Directive, No Record, & Dose Differs by 10%

recordable event: therapeutic

no written directive, no record, and dose differs by 10%

reportable event

all misadministrations

misadministration: diagnostic

for I-131 and I-123: >30 uCi, dose differs 20%, wrong pt, or wrong rpx

for all other rpx: wrong dose, wrong route, wrong rpx, and also must differ 20% of dose

misadministration: therapeutic

wrong pt, wrong, route, wrong rpx, wrong dose differing by 20%

The NRC refers to misadministration as a medical event and clearly defines them in terms of:

error & excess exposure (has to be both)

Radioactive materials with a half-life of less than ____ days can be retained in a shielded storage area until they decay to an activity that equals background. (General rule of thumb is 10 half-lives)

120

It is important to note that radioactive urine or feces are

Exempt from any NRC limitations and may be discarded through the sewer system

Regardless of the method of disposal used, __________ must be maintained to document compliance with regulations.

records of the disposal

record maintenance: receipt, storage, and disposal of radioactive material

3 years

record maintenance: radiation monitoring and reporting

3 years

record maintenance: equipment calibration and maintenance

3 years

record maintenance: staff, patient, occupational and public exposure

duration/indefinitely

record maintenance: nuclear medicine diagnostic and therapeutic procedures

diagnostic- 3 years

therapeutic- duration/indefinitely

record maintenance: leak test

3 years

written directive

is required for everyone who receives a therapeutic dose of radionuclide

keep for 3 years

what must be included on a written directive

must be dated and signed by an authorized user before the admin of I-131 >30 uCi, any therapeutic dose of unsealed byproduct material, or any therapeutic dose of radiation from byproduct material other than I-131

patient name, radioactive drug, dose, and route of administration

Type A packages are labeled according to

One of three categories based on measured dose rate in mR per hour

Transport Index (TI)

dose in mrem/hr at 1m from surface of package

What must be included on label for type A package?

Transport index

Radionuclide

Concentration

Total activity

Expiration date/ time

Assay date/ time

White I package limit (does not exceed)

0.5 mR/ hr (surface)

NDR (1 m)

Yellow II package limit (does not exceed)

50 mR hr (surface)

1 mR/ hr (1 m)

Yellow III package limit

200 mR/hr (surface) (also written as exceeds 50 mR/ hr)

10 mR/ hr (1 m) (also written as exceeds 1 mR/ hr)

type A package

Designed to survive normal transportation handling and minor accidents (adequate for normal transport)

type B package

Must be able to survive severe accidents, usually for large quantities of radiation

Radioactive material is DOT class:

7

Receipt of radioactive materials

-must display label

-check for removable contamination (wipe)

-inspect for damage

-inspect for wetness

-survey meter used to check exposure at surface and 1 m

Packages must be be monitored within:

3 hours of receipt (working hours)

3 hours of reopen (delivered after hours)

DOT

regulates transportation of radioactive material

Environmental Protection Agency- EPA

The US federal agency with a mission to protect human health and the environment.

sets regulatory limits and recommends emergency response guidelines well below 100 mSv/ 10 rem

Occupational Safety and Health Administration- OSHA

The federal regulatory compliance agency that develops, publishes, and enforces guidelines concerning safety in the workplace

radiation protection practices to protect workers from harmful effects of ionizing radiation (equipment registration, dosimetry, area monitoring, training, emergency procedures, record keeping, reporting)

Health Insurance Portability and Accountability Act- HIPPA

A federal act that protects health information of clients. Relates to data safeguarding

-protect patient rights and privacy

-maintaining patient records

-releasing information to authorized parties

Health and Human Services- HHS

primary federal agency responsible for protecting the health of all Americans and providing essential human services

Radiation Emergency Medical Management (REMM) program and other initiatives

Food and Drug Administration- FDA

a U.S. federal agency that regulates radiopharmaceuticals, which are radioactive drugs used in nuclear medicine for both diagnosis and treatment

USP 797

provides the standards for compounding sterile preparations in healthcare settings

USP 825

describes facilities and engineering controls, personnel training and qualifications, and procedural standards for processing radiopharmaceuticals in nuclear pharmacies, nuclear medicine areas in hospitals and clinics, and other healthcare settings that utilize radiopharmaceuticals.

The Joint Commission

A private, not-for-profit organization that evaluates and accredits hospitals and other healthcare organizations on the basis of predefined performance standards