Radiological protection for medical exposure to ionizing radiation : safety guide

CONTENTS 1. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Background (1.1–1.8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Objective (1.9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Scope (1.10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Structure (1.11–1.13) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2. REGULATORY PROGRAMME FOR RADIOLOGICAL PROTECTION FOR MEDICAL EXPOSURE . . . . . . . . . . . . . . . . . . . . 4 Introduction (2.1–2.4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 General aspects (2.5–2.9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 General responsibilities (2.10–2.11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Regulatory control (2.12–2.22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Specific responsibilities of registrants and licensees (2.23–2.36) . . . . . . . 8 Specific responsibilities of medical practitioners, qualified experts and other parties (2.37) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Specific responsibilities of manufacturers and suppliers (2.38–2.42) . . . . 12 Justification (2.43) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Optimization of protection for medical exposure (2.44–2.55) . . . . . . . . . 14 Dose constraints (2.56) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Guidance levels for medical exposure (2.57–2.62) . . . . . . . . . . . . . . . . . 18 Education, training and experience (2.63–2.71) . . . . . . . . . . . . . . . . . . . 18 3. SPECIFIC ASPECTS OF RADIOLOGICAL PROTECTION FOR MEDICAL EXPOSURE IN DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Introduction (3.1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Justification (3.2–3.3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Optimization of protection for medical exposure (3.4–3.26) . . . . . . . . . . 22 Guidance levels (3.27–3.28) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Dose constraints for persons holding patients during procedures (comforters) (3.29–3.30) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Training (3.31–3.33) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Investigation of accidental medical exposures (3.34–3.35) . . . . . . . . . . . 28 4. SPECIFIC ASPECTS OF RADIOLOGICAL PROTECTION FOR MEDICAL EXPOSURE IN NUCLEAR MEDICINE . . . . . . . . . . 29 Introduction (4.1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Justification (4.2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Optimization of protection for medical exposures (4.3–4.18) . . . . . . . . . 29 Guidance levels (4.19–4.21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Maximum activity at the time of discharge from hospital in patients undergoing treatment with unsealed sources (4.22) . . . . . . . . 34 Dose constraints for comforters and visitors (4.23) . . . . . . . . . . . . . . . . . 34 Training (4.24) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Investigation of accidental medical exposures (4.25) . . . . . . . . . . . . . . . 34 5. SPECIFIC ASPECTS OF RADIOLOGICAL PROTECTION FOR MEDICAL EXPOSURE IN RADIATION THERAPY . . . . . . . . . 35 Introduction (5.1–5.2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Justification (5.3–5.4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Optimization of protection for medical exposures (5.5–5.22) . . . . . . . . . 36 Training (5.23–5.25) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Investigation of accidental medical exposures (5.26–5.28) . . . . . . . . . . . 40 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 BIBLIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 ANNEX I: 1. GENERAL REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . 47 ANNEX II: APPENDIX II. MEDICAL EXPOSURE . . . . . . . . . . . . . . . . . . . 52 ANNEX III: SCHEDULE II. DOSE LIMITS. DOSE LIMITATION FOR COMFORTERS AND VISITORS OF PATIENTS . . . . . . . 64 ANNEX IV: SCHEDULE III. GUIDANCE LEVELS OF DOSE, DOSE RATE AND ACTIVITY FOR MEDICAL EXPOSURE . . 65 GLOSSARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 CONTRIBUTORS TO DRAFTING AND REVIEW . . . . . . . . . . . . . . . . . . . . 73 BODIES FOR THE ENDORSEMENT OF SAFETY STANDARDS . . . . . . . . 75