What Radiation Safety Precautions Should Healthcare Workers Be Aware Of?

Healthcare workers conducting X-rays, interventional surgery, and radiation therapy are frequently exposed to ionizing radiation from the equipment involved, resulting in occupational radiation exposure for many frontline radiation workers. Much of this energy comes in the form of gamma radiation emitted by X-ray tubes and fluoroscopy units, or from handling radioactive material in departments such as nuclear medicine and during procedures like external beam radiation therapy. For example, C-arm–guided fluoroscopy is a common imaging solution used during interventional surgery, and AORN states that the average C-arm emits 2 rem (20 mSv) of radiation per minute. 

Those levels of exposure can become harmful if precautions for radiation safety in healthcare aren’t used. The World Health Organization (WHO) states that frequent exposure to ionizing radiation without preventative measures can cause serious health risks like cancer, cataracts, infertility, birth defects, and blood and skin damage. 

How can healthcare workers remain safe while working in high-dose environments? Read on as we discuss everything you should know. 

What Precautions Should Healthcare Workers Take When Working With Radiation? 

The CDC recommends following ALARA (As Low As Reasonably Achievable) during procedures that emit high doses of radiation to avoid unnecessary radiation exposure and to keep both the internal radiation dose and external radiation dose well below regulatory limits.  ALARA uses 3 basic principles of radiation protection: time, distance, and shielding. 

Here’s how each ALARA principle contributes to safety: 

• Time: Minimizing time spent near the radiation source reduces exposure. The CDC recommends finishing work as quickly as possible and leaving the area as soon as you can to help reduce exposure time. However, some extensive procedures can inevitably extend exposure, so taking other safety measures is crucial too. 

• Distance: Standing a greater distance away from the radiation source reduces exposure. AORN recommends standing at least 6 feet away from the source when possible, but notes that some procedures require physicians to be right next to the equipment. Additional preventative measures, like lead aprons, are necessary in those cases. 

• Shielding: Wearing personal protective equipment (PPE) helps shield vital organs when healthcare workers are operating in high-dose environments. Radiation safety equipment lists often include lead aprons, thyroid shields, and protective eyewear. 

Research shows that wearable radiation protection devices in radiology are highly effective. A study in 2018 showed that 0.5 mm lead aprons could attenuate up to 99% of ionizing radiation, another showed that 0.5-0.75 mm thyroid shields could attenuate 95% of radiation, and one in 2022 showed that 0.75 mm lead glasses can reduce doses to the eyes by 1.6 times. 

What Precautions Should Nurses Take During Radiation Therapy? 

Radiation therapy is highly beneficial to treat cancer, but it can lead to exposure for nurses administering treatment. The American Cancer Society recommends that everyone in the treatment area follow the principles of ALARA, including time, distance, and shielding. 

Nurses routinely wear lead aprons, thyroid collars, gloves, and glasses; mobile lead barriers add an extra layer of safety. Wearing a dosimeter beneath PPE tracks occupational radiation doses accurately, and standardized protocols emphasize continuous radiation safety education for staff.

Another one of the nurse precautions is wearing a dosimeter under PPE to track exposure levels. The National Institutes of Health states that hospital staff members should wear personal dosimeters during all planned radiation exposure to monitor doses received and accurately report any safety incidents. 

Lastly, communication and training are essential to minimize radiation doses. A recent study in February 2025 emphasized the need for standardized healthcare worker training before administering radiation therapy due to the risks for both staff and patients from ionizing radiation exposure. 

What Are The Radiation Safety Precautions For Patients? 

It’s common to wonder about patient protection and how to use ALARA for patients during high-dose procedures. The International Atomic Energy Agency (IAEA) lists several tips for minimizing exposure to patients during X-rays and fluoroscopy, many of which align with the principles of ALARA. Those tips include: 

• Know your equipment and ensure all staff members involved are trained to use it safely. 

• Keep detailed records to track patient doses and exposure time. 

• Keep X-ray tubes as far away from patients as possible while still being able to obtain a quality image. 

• Use the lowest frame rates possible while ensuring they can still capture a consistent image. 

• Remain aware that lateral views and oblique projections can increase patient doses. 

• Vary the X-ray beam’s position to prevent irritation to the same part of the skin. 

• Avoid using a large field of view or magnification. 

Additionally, the IAEA stresses that healthcare teams must justify procedures that emit radiation to prevent any unnecessary patient exposure. That includes evaluating whether the procedures have been done already, are needed and urgent, and are the best option to solve a clinical problem. 

Should Patients Wear PPE? 

Using PPE and shielding devices isn’t always possible for patients during radiology procedures. One of the main problems is that PPE can get in the way during procedures or disrupt the X-ray’s field of view. For example, a study in the Journal of Medical Imaging and Radiation Sciences showed that wearing lead garments in an X-ray’s field of view reduced image quality. 

A study in the British Journal of Radiology also mentions a growing body of research that suggests using patient shielding can become unsafe with modern imaging equipment. Modern equipment often uses automatic controls that adjust exposure levels based on factors like patient weight. Wearing dense PPE in the field of view would automatically increase exposure substantially, affecting the safety of everyone in the room. 

What Are The Safety Precautions When Handling Radiation? 

OSHA provides several regulations for radiation handling, control, and prevention in medical facilities. Key precautions include: 

• Following the principles of ALARA with an emphasis on wearing PPE, such as lead aprons, thyroid collars, glasses, and gloves. 

• Implementing thorough worker safety training and emergency response procedures. 

• Creating clear warning signs for any highly radioactive areas. 

• Monitoring radiation doses and limiting exposure for the whole body to 12.5 mSv per quarter or 50 mSv in a year. 

Additionally, governing bodies are putting a greater emphasis on radiation equipment maintenance, quality assurance, and infection control. 

One of the primary concerns is that high-touch objects like lead aprons and other PPE can harbor harmful microorganisms that lead to infections and other adverse health effects if they aren’t properly cleaned. A study by Dr. Jaber of Wayne State found that 84% of lead aprons analyzed were contaminated with Staphylococcus aureus and Tinea species (ringworm), and 12% were contaminated with MRSA. 

AORN recommends quarterly deep cleaning for high-touch objects to reduce the risk of hospital-acquired infections. 

It’s also important to regularly inspect PPE for any damage, such as cracks, holes, or tears that could reduce shielding capabilities. A study by the Journal of Health Physics showed that small defects could increase by up to 270% in 10 months, so identifying them early is crucial. We recommend annual PPE integrity inspections using X-ray scanning to accurately identify defects. 

How We Can Help At Radiological Care Services (RCS) 

We offer several services at RCS to help busy healthcare facilities manage maintenance needs for PPE. Our services include: 

• Deep cleaning and disinfection

• Inspections using X-ray scanning

• Garment repairs

• Garment disposal

• Inventory management with our RADCOMPLY™ software

We make the process easy and ensure your PPE stays cleaned and inspected while following regulations from governing bodies like the CDC and AORN. 

Contact us today to learn how RCS can make a difference for you.