Who Is Responsible For Radiation Safety In Hospitals?
After completing a radiation safety training program or learning about the risks of exposure while using equipment like C-arms, fluoroscopy, or X-rays, it’s common to wonder if your facility is doing everything it can to achieve radiation safety in healthcare.
Who is responsible for radiation safety in hospitals? We have the information you need here to understand the responsibilities of each team member, federal and state regulations, and best practices that can help.
Introduction: Why Radiation Safety Matters In Hospitals
Radiation safety for healthcare workers is crucial due to the adverse health effects that can result from long-term exposure.
The World Health Organization (WHO) stresses that long-term exposure is harmful even in low doses. Ongoing low-dose exposure can increase the risk of cancer and cause tissue and organ damage. Exposure to very high doses can result in severe effects such as skin burns or acute radiation syndrome.
Fortunately, with adequate protection and adherence to safety protocols, hospitals can significantly reduce occupational radiation exposure and keep healthcare staff safe.
Shielding, such as lead aprons and thyroid collars, can slow and absorb radiation before it reaches the wearer’s body. A study from the Journal of Clinical Orthopedic Trauma found that 0.5 mm lead aprons could attenuate up to 99% of gamma radiation, offering critical protection during radiological procedures.
Who Is Responsible For Radiation Safety In A Hospital?
Radiation safety responsibilities are shared amongst administrators, departments, and staff members throughout hospitals. It requires everyone to follow hospital protocols and make educated decisions to remain safe.
OSHA states that a qualified expert known as a radiation safety officer (RSO) should take a lead role in assessing and managing safety policies. The RSO may work as an individual or take a lead role as part of a radiation safety committee comprised of staff members throughout a hospital.
Once policies are set, it's up to department leaders, clinicians, and support staff to uphold them and prevent unnecessary radiation exposure. Each team member plays a critical role in minimizing radiation hazard. Any issues should be reported immediately so the RSO and radiation safety committee can make adjustments to keep everyone safe.
Who Is The Radiation Safety Officer For The Hospital?
The RSO is a qualified expert, such as a health physicist, who has completed rigorous training and gained experience to effectively create and manage safety policies. Their responsibilities include monitoring radiation doses, overseeing equipment maintenance, and conducting safety audits.
The U.S. Nuclear Regulatory Commission (NRC) has established requirements for RSOs that include health and medical physics education, 1-2 years of full-time practical on-the-job training, and 200 hours of classroom and laboratory training. These requirements ensure that RSOs are well-qualified and prepared before taking a lead role.
Whose Responsibility Is It To Maintain Safe Radiation Practices?
After the RSO and radiation safety committee establish policies, it’s recommended that hospitals take a team-based approach to ensure they’re enforced and followed. That includes:
Department leaders: Manage the radiation protection program in the department, ensure radiation safety precautions are followed, and correct any problems that arise.
Physicians: The International Atomic Energy Agency (IAEA) states that physicians and radiologists must justify that all procedures involving radiation are necessary based on patient needs, optimize imaging procedures, and use the minimum dose needed to capture a high-quality image.
Technologists: The IAEA states that technologists and radiographers are responsible for informing patients of safety protocols, preparing equipment to emit the lowest possible radiation dose, recording patient doses, and performing regular quality control checks on equipment.
RSO: In addition to establishing policies, the RSO will continue to monitor the hospital’s practices. This includes reviewing the hospital’s resources, performing acceptance testing, supervising quality control, overseeing equipment maintenance, and continuing to optimize equipment specifications and protocols to further reduce exposure.
Who Is Responsible For Radiation Safety Training At Your Facility?
The radiation safety officer RSO typically oversees safety training programs. These sessions cover radiation risks, protection strategies, emergency procedures, and how to manage radiation measurement systems. Training records must be updated regularly for compliance and employee safety.
OSHA also provides support for radiation safety training. OSHA’s guidelines state that all healthcare facilities must provide appropriate safety training to healthcare workers. They encourage all healthcare workers to report issues if they feel they aren’t provided the necessary training or safety measures.
Radiation Safety Precautions: 3 Basic Principles Every Hospital Should Follow
The 3 basic principles of radiation protection are: time, distance, and shielding. They fall under the guidelines of ALARA (as low as reasonably achievable) recommended by the CDC, FDA, and other governing bodies. The 3 principles go as follows:
Time: Teams should work to complete procedures as quickly as possible and immediately leave the area when the procedure is finished. However, some procedures, such as intensive interventional surgery using C-arm-guided fluoroscopy, may last for extended amounts of time, so other safety precautions are still necessary.
Distance: Remain a safe distance from the equipment emitting radiation when possible. AORN recommends standing at least 6 feet from the radiation source to reduce exposure, but notes that it isn’t always possible during procedures where the physician needs to operate right next to the radiograph tube.
Shielding: Wearing protective garments or using mobile barriers that contain dense materials, like lead, to shield clinicians from radiation. Radiation safety equipment lists for shielding may include lead aprons, thyroid collars, glasses, vests, or skirts. Shielding is a crucial component of radiation safety because it can provide protection when limiting time or increasing distance isn’t possible.
Key Equipment And Inspection: The Role Of RCS In Supporting Compliance
At Radiological Care Services (RCS), we strive to support medical facilities in the shielding component of the ALARA principle. We can help you source protective garments from top manufacturers and provide several maintenance services, including deep cleaning, inspections, and repairs, to increase their lifespan and ensure they remain as safe and effective as possible.
Integrity inspections for protective garments are crucial. We recommend performing annual inspections using radiographic scanning to identify damage that can reduce a garment’s effectiveness. A study in the Journal of Health Physics found that small tears in lead aprons can progress by up to 270% in 10 months, so lead apron inspections to identify damage early are essential.
Additionally, garments like lead aprons and thyroid shields should be cleaned and disinfected regularly. Dr. Jaber of Wayne State conducted an analysis of lead aprons in a medical facility, finding that:
84% were contaminated with Tinea species (ringworm) and Staphylococcus aureus
12% were contaminated with MRSA
AORN recommends quarterly deep cleaning and sanitization of high-touch objects in medical settings to effectively remove harmful microorganisms. Because protective garments like lead aprons are frequently handled and worn in sterile environments, they should be treated with the same level of care. Routine wipe-downs are not enough. Only deep cleaning can fully eliminate biofilm and other contaminants that pose infection risks to staff and patients.
Conclusion: Building A Culture Of Radiation Safety Together
Every member of a healthcare team can play a role in radiation safety precautions. It’s important to assess the risk of each procedure, develop optimal protocols to reduce doses, wear appropriate shielding, and consult with your RSO for safety recommendations.
Facilities wanting to enhance shielding can rely on our services at RCS. We can help you source protective garments and develop a regular maintenance schedule.
We offer deep cleaning and disinfection, annual radiographic inspections, garment repairs, and garment disposal services that make the process easy. Everything is tracked and managed in our RADCOMPLY™ software to ensure you have all the data you need for compliance.
Contact us today to learn more about how RCS can help.