Radiological protection of healthcare staff

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The principles for the protection of workers from ionising radiation are discussed fully in ICRP Publication 75 General Principles for the Radiation Protection of Workers. These principles apply to healthcare staff working in diagnostic radiology, interventional procedures, nuclear medicine, and radiation therapy facilities (ICRP Publication 105 Radiological Protection in Medicine). ICRP has recently published recommendations on occupational radiological protection in interventional procedures (ICRP Publication 139 Occupational Radiological Protection in Interventional Procedures).

The control of occupational radiological exposure in healthcare can be simplified and made more effective by the designation of workplaces into two types: controlled areas and supervised areas. In a controlled area, normal working conditions, including the possible occurrence of minor mishaps, require workers to follow well-established procedures and practices aimed specifically at controlling radiation exposures. A supervised area is one in which the working conditions are kept under review, but special procedures are not normally needed.

Individual monitoring for external radiation is simple and does not require a heavy commitment of resources. In medicine, it should be used for all those who work in controlled areas.

In several areas of healthcare, the control of occupational exposure is of particular importance, including nursing of brachytherapy patients when the sources have been implanted, palpation of patients during procedures utilising fluoroscopy, fluoroscopically guided Interventional procedures such as in heart catheterisation, or radiopharmaceutical preparation by staff in nuclear medicine. In all these procedures, careful shielding and time limits are needed. Individual monitoring with careful scrutiny of the results is also important. In brachytherapy, frequent and careful accounting of sources is essential.

Protecting pregnant workers: The basis for the control of occupational exposure of women who are not pregnant is the same as that for men. However, if a female worker declares to her employer that she is pregnant, additional controls have to be considered in order to attain a level of protection for the embryo/fetus broadly similar to that provided for members of the public. The working conditions of the pregnant worker, after the declaration of pregnancy, should be such as to make it unlikely that the additional equivalent dose to the embryo/fetus will exceed approximately 1 mSv during the remainder of the pregnancy. The part of a pregnancy prior to declaration of the pregnancy is covered by the normal protection of workers, which is essentially the same for females and males.

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