Community Medical Center Annual Radiation Safety Training

1. Community Medical CenterAnnual Radiation Safety Training Basic Science Review Risk Perspective Biological Effects of Radiation Radiation Safety Program

2. Science Review: • Atoms: The elements that make up all matter are composed of atoms. Atoms have three basic particles: protons, neutrons, and electrons

3. STABLE ATOMS: Most atoms are stable and do not emit excess energy. • UNSTABLE ATOMS: Unstable atoms emit excess energy. This energy is called radiation.

4. Non-ionizing Radiation • Non-ionizing radiation does not have enough energy to remove an electron from an atom. • Types of non-ionizing radiation include: microwaves, radio waves, visible light, heat, and infrared radiation.

5. Ionizing Radiation • Ionizing radiation has enough energy to remove electrons from electrically neutral atoms • There are four basic types of ionizing radiation: alpha particles, beta particles, neutrons, and gamma rays. • We are exposed to ionizing radiation while taking x-rays, using fluoroscopy or in the presence of nuclear medicine patients.

6. Radioactive Contamination • Contamination is uncontained radioactive material in an unwanted location. • Exposure to radiation does NOT result in contamination of the worker. Only in the case of an individual coming in contact with radioactive contamination (e.g., urine from a bone scan patient) would there be a potential for the individual’s skin or clothing to become contaminated.

7. Sources of Radiation • People have always been exposed to radiation. Radiation, simply defined, is energy emitted through space and matter. We are exposed to radiation from naturally-occurring sources in our environment, man-made sources, and even from materials inside our bodies • The average annual radiation dose to a member of the general population is about 360 millirem/year. This amount is a combination of both natural background and man-made sources of radiation.

8. Natural background sources of radiation • Natural background radiation is by far the largest contributor (about 300 mRem/yr) to radiation doses.

9. Cosmic radiation: radiation from the sun and outer space, varies with altitude Radon: the principal source of background radiation exposure Terrestrial radiation: from naturally-occurring radioactive material found in the earth’s crust, such as uranium found in rocks ad soil Materials present in our bodies: These come from naturally-occurring radioactive material present in our food, such as potassium-40 Main sources of natural background radiation:

10. Man-made sources of radiation, where the radiation is either produced or enhanced by human activities, contribute to the remainder of the annual average radiation dose (about 60 mR/yr). Medical uses such as X-ray and nuclear medicine tests or treatments Tobacco products Building materials Man-made sources of radiation

11. Risks in Perspective • Radiation comes from background and man-made sources. We receive approximately 360 mR/yr. This is separate from occupational exposure. In addition, radiation dose may also be received on the job. The potential risks from this exposure can be compared to other risks we accept everyday.

12. Risk Perspective: • SOME ANNUAL RADIATION DOSES: • Cigarette smoking (1ppd) = 1300 • Radon = 200 • Medical exposures = 54 • Terrestrial radiation = 28 • Round trip US by air = 5 • Building materials = 7 • World wide fall out = <1 • Domestic water supply = 5 • Natural gas range = 0.2 • Smoke detectors = 0.001 • (Reported in mR/year)

13. Occupational Dose • The risks associated with occupational doses are very small and considered acceptable when compared to that of other occupational health risks (e.g. coal miner or construction worker) • The whole body radiation dose limit at CMC according to NRC regulations is 5000mR/yr.

14. Average annual radiation dose for various occupations • Airline flight crew member = 400 – 600 mR/yr • Nuclear power plant worker = 300mR/yr • Medical personnel = 70 mR/yr

15. Risk estimates: • Risk Estimates: The risk of working with or around sources of ionizing radiation can be compared to the risks we accept as a part of everyday life.

16. Estimated Days of Life Expectancy Lost: • Being unmarried male = 3500 • Smoking (1 pack/day) = 2250 • Being unmarried female = 1600 • Being a coal miner = 1100 • 15% overweight = 777 • Alcohol (US average) = 365 • Driving motor vehicle = 227 • Radiation 100 mR/yr (70 yr) = 10 • Coffee (US average ) = 6

17. Biological Effects of Radiation • Biological effects from exposure to radiation may occur in the exposed individual or in the future children of the exposed individual. • Exposed individual: There is scientific evidence for health effects (primarily cancer) from radiation doses well above the annual limit for occupational exposure (greater than 10,000 mR). The risks associated with occupational doses are very small and considered acceptable when compared to other occupational risks. • For very large doses received over a short period of time, prompt effects may result. These doses are received typically under accident conditions such as the firefighters responding to the Chernobyl accident. These effects may include reddening of the skin, vomiting, hair loss, or even death.

18. Future children of the exposed individual • Heritable effects (e.g. genetic changes to the parents sperm and/or eggs that results in an observed effect in their offspring) from ionizing radiation have been found in plants and animals, but have not been observed in human populations. The risk of heritable effects from ionizing radiation is considered to be very small when compared to other naturally-occurring heritable effects and difficult to detect over the natural background rate of birth defects.

19. Prenatal effects • A developing embryo/fetus is especially sensitive to ionizing radiation. Radiation is one of many agents that may cause harm to the embryo/fetus (e.g. chemicals, heat, etc). Significant radiation doses (>10,00mR) to the embryo/fetus may increase the chances that the child will develop conditions such as small head size, lower birth weight, and/or slower mental growth.

20. Prenatal Effects • The risk of these effects occurring is minimized by having special protective measures for the embryo/fetus of a declared pregnant woman. The limit for the embryo/fetus is 500mR for the period from conception to birth. • A worker may voluntarily notify her employer, in writing when she is pregnant. At this time, she may discuss with her supervisor alternative job duties that may reduce the exposure to her fetus. • Nuclear Medicine has the form to use. When the pregnancy is declared, in writing, a separate film badge is issued, to be worn at the abdominal level for the duration of the pregnancy.

21. ALARA: As Low As Reasonably Achievable • CMC has a formal Radiation Safety program in place. CMC has committed itself to the ALARA principle. This means that we strive to use, to the extent practical, procedures and engineering controls based upon sound radiation protection principles to achieve occupational doses (and doses to members of the public) that are as low as reasonably achievable (ALARA).

22. Radiation Safety Committee • Meets quarterly • Reports to Safety Committee • Reviews quarterly film badge reports, nuclear medicine reports, any unusual incidences or misadministrations.

23. Radiation Safety Officer • Our Radiation Safety Officer has agreed to help the Radiation Safety Committee implement and comply with the Radiation Safety Program. • Our RSO is Dr. Jim Brewer. Dr. Brewer can be reached at (406) 581-9867 or jbrewer@littleappletech.com

24. Radiation Protection • Time – reduce the amount of time spent near a source of radiation • Distance – stay as far away fro the source as possible • Shielding – shielding is placed between workers and the source • Radiation contamination is controlled using engineered ventilation, containments, decontamination and lastly PPE to minimize the potential for inhalation, ingestion, or absorption of radioactive material.

25. Dosimetry • Since radiation cannot be detected with the human senses, special detection devices must be used. • Dosimeters, “film badges,” should be worn at collar level outside of any lead garment with the ID window facing out. This location will monitor the “whole body” occupational dose. • The fetal dosimeter should be worn at waist level underneath the lead apron.

26. Exposure Reports • Exposures are reported on a monthly basis by Landauer, Inc. • Reports are reviewed monthly by nuclear medicine and the RSO. • The Radiation Safety Committee reviews reports quarterly. • Reports are posted monthly.

27. Notification and Reports to Workers • The NRC requires at least an annual report to the worker of the occupational dose received. (We provide this monthly. Each monthly report contains quarterly, year-to-date and lifetime exposures). • CMC must provide a report if worker requests one. • When employment is terminated, CMC must provide a summary of all doses received. • When beginning employment, CMC should request an exposure report from the previous employer.

28. Workers obligations • Must report unsafe conditions or practices that violate the ALARA program to the RSO. • Must follow applicable regulations and license conditions. • Exchange film badges each month. If the film badge is turned in late, the exposure reported is incorrect because the badge cannot be compared against the proper control.

29. Do you know where your applicable regulations, license conditions, information notices, bulletins and other pertinent paperwork can be found? • Most regulations, notices etc can be found at www.nrc.gov. • There is a copy of the RAM license and license application in Nuclear Medicine. This is where you find the conditions of our license, in other words, are we doing what we told the NRC we would do??