Radiation Protection in Radiology—Large Facilities

1 Radiation Protection in Radiology Large Facilities Safety Procedures for the Installation, Use and Control of X-ray Equipment in Large Medical radiological Facilities Safety Code 35. Health Canada is the federal department responsible for helping the people of Canada maintain and improve their health. We assess the safety of drugs and many consumer products, help improve the safety of food, and provide information to Canadians to help them make healthy decisions. We provide health services to First Nations people and to Inuit communities. We work with the provinces to ensure our health care system serves the needs of Canadians. Published by authority of the Minister of Health galement disponible en fran ais sous le titre : Radioprotection en radiologie Grands tablissements Procedures de s curit pour l'installation, l'utilisation et le contr le des appareils rayons X.

2 Dans les grands tablissements radiologiques m dicaux Code de s curit 35. This publication can be made available on request on diskette, large print, audio-cassette and braille. Her Majesty the Queen in Right of Canada, represented by the Minister of Health, 2008. This publication may be reproduced without permission provided the source is fully acknowledged. HC Pub.: 4000. Cat.: H128-1/08-545E. ISBN: 978-1-100-10289-4. Guidelines for Reduction of Dose to Sensitive Tissues ..15. Table of Contents Diagnostic Reference Levels (DRLs) ..15. Introduction ..15. Explanatory Notes ..3. Application ..16. Recommended DRL Introduction ..5. Principal Objectives of the Safety Code ..6 Section B: Facility and Equipment Requirements.

3 18. Section A: Facility Requirements ..18. Responsibilities and General Responsibility of Personnel ..7 Design and Plan of X-ray Owner ..7 Preparation of Facility Plan ..18. Responsible Considerations for Room Design X-ray Equipment and Layout ..19. Medical Physicist/ Radiation Safety Determination of Parameters Governing Referring Physician/Practitioner ..9 Structural Shielding Information Systems Shielding Calculations ..21. Repair and Maintenance Radiographic Films ..21. Radiographic X-Ray Equipment and Procedures for Minimizing Radiation Dedicated Chest Radiographic Exposure to Personnel ..10 Radioscopic X-Ray Equipment and General Requirements and Recommendations ..10 Angiographic X-Ray Requirements and Recommendations for Computed Tomography Operation of Mobile Equipment.

4 11. Requirements and Recommendations for Medical X-ray Equipment Operation of Radiographic Equipment ..11 Regulatory Requirements for Requirements and Recommendations for Medical X-ray Operation of Radioscopic Equipment ..11 Equipment Purchasing ..22. Requirements and Recommendations Needs Analysis ..22. for Performing Equipment Specifications ..22. Analysis of Vendor Quotation and the Procedures for Minimizing Radiation Purchase Exposure to Patients ..12 Acceptance Guidelines for the Prescription of X-ray Existing Medical X-ray Equipment ..23. Retrofitting with Computed Radiography (CR). Guidelines for radiological Examinations of and Digital Radiography (DR) Systems ..23. Pregnant Women ..13 Equipment Specific Requirements.

5 23. Guidelines for Carrying out X-ray Examinations ..13 General Requirements ..23. General Requirements and Radiographic Equipment Recommendations ..13. Radioscopic Equipment Requirements and Recommendations for Computed Tomography Equipment Radiographic Requirements and Recommendations for Dose and Image Quality Information for Radioscopic Procedures ..14. Computed Tomography Requirements and Recommendations for Angiography ..14 Image Processing Systems ..29. Requirements and Recommendations for Film-Based Computed Tomography Procedures ..15 X-ray Film ..29. Cassette and Screen ..29. Safety Code 35 1. Film Processing ..30 Monthly Quality Control Testing ..46. Quality Control Tests Digital Imaging Monthly Quality Control Tests.

6 47. Computed Radiography Imaging Plates ..31 Monthly Quality Control Tests Equipment ..48. CR Cassette ..31 Quarterly Quality Control Testing ..48. Electronic Display ..31 Quality Control Tests Picture Archiving and Quarterly Quality Control Tests ..49. Communications system ..31 Quarterly Quality Control PACS Implementation ..32 Tests Equipment ..49. Teleradiology ..33 Semi-Annual Quality Control Testing ..50. Quality Control Tests Other Equipment ..34 Semi-Annual Quality Control Tests ..50. Protective Equipment ..35 Semi-annual Quality Control Test Equipment ..35 Tests Equipment ..51. Annual Quality Control Testing ..51. Radiation Protection Quality Control Tests General Procedures ..35 Annual Quality Control Tests.

7 51. Survey Annual Quality Control Tests Equipment ..55. Disposal of X-ray Appendix I: Dose Limits for Occupational Ionizing Section C: Radiation Exposures ..57. Quality Assurance Introduction ..38 Appendix II: Shielding Information Guides ..58. Goals of the Quality Assurance Costs-Benefits of the Quality Assurance Appendix III: NCRP #49 Methodology for Calculation of Shielding Requirements for Costs of Quality Assurance Diagnostic X-ray Installations ..61. Benefits of Quality Assurance Program ..38. Implementation of Quality Assurance Appendix IV: Shielding Guides for Storage of Policies and Guidelines Development ..39. Radiographic Film ..67. Establishment of Quality Control Procedures ..40. Appendix V: Federal/Provincial/Territorial Establishment of Radiation Safety Administrative Procedures.

8 40. Appendix VI: Radiation Emitting Devices Acceptance Regulations for Diagnostic X-ray Equipment ..70. Acceptance Testing Evaluation ..41. Appendix VII: Facility Radiation Protection Quality Control Testing Procedures ..81. and Equipment ..43. Daily Quality Control Testing ..43. Appendix VIII: Radiation Measurement Units ..85. Quality Control Tests Daily Quality Control References ..86. Daily Quality Control Test Weekly Quality Control Testing ..44. Quality Control Tests Weekly Quality Control Weekly Quality Control Test 2 Safety Code 35. This Safety Code does not address Radiation Protection for dental and mammography Facilities or small radiological Explanatory Notes Facilities such as chiropractic, podiatry, physical therapy and bone densitometry Facilities .

9 For these Facilities refer to Health This document is one of a series of Safety Codes prepared by Canada publications Safety Code 30, Radiation Protection Health Canada to set out requirements for the safe use of in Dentistry , Safety Code 33, Radiation Protection in Radiation -emitting equipment. Mammography, and the Safety Code for Small Medical radiological Facilities . This Safety Code has been prepared to provide specific guid- ance to large medical radiological Facilities where diagnostic In a field in which technology is advancing rapidly and where and interventional radiological procedures are routinely unexpected and unique problems continually occur, this performed using radiographic, radioscopic or computed to- Code cannot cover all possible situations.

10 Blind adherence to mography equipment. Large Facilities generally operate more rules cannot substitute for the exercise of sound judgement. than one type of radiological equipment, or have several suites Recommendations may be modified in unusual circumstances, of the same type of equipment. Most hospitals and computed but only upon the advice of experts in Radiation Protection . tomography Facilities fall within this category. This Code will be reviewed and revised from time to time, and a particular requirement may be reconsidered at any time, if The requirements and recommendations of this safety code do it becomes necessary to cover an unforeseen situation. Inter- not apply to Radiation therapy Facilities and the equipment used pretation or elaboration on any point can be obtained by in radiotherapy, including Radiation therapy simulators, for contacting the Consumer and Clinical Radiation Protection localization and treatment planning.