Radiation Safety & Compliance

1. Radiation Safety & Compliance • External Beam • Electrons (linacs) • Photons (linacs, Gamma Knife) • Protons (Summer 2013) • Brachytherapy • Sealed Sources • Radiopharmaceuticals

2. Radiation Monitoring • Radiation Badges • Whole Body badges • Extremity badges

3. Radiation Monitors • Exchanged quarterly (10/15, 1/15, 4/15, 7/15) • Must wear monitors while operating or working near radiation producing machinery or isotopes • Ideally wear body monitors (badges) at waist level. If using lead apron, wear on the outside (collar) • Maintain them in a dry, ambient location. • Only wear the ones assigned to you by a facility at that facility. If working elsewhere, that facility must monitor you. Ensure records are being cross-transferred.

4. Radiation Monitors • If you lose your monitor alert Radiation Oncology Department’s Chief of Compliance or Compliance Coordinator ASAP. • If your monitor is irradiated off-body, try to be specific about location and duration. • When not working, maintain monitor in dependable location (use of monitor boards in Lounge and across from LL Conf Room). • Rings will be provided to those handling isotopes. • Supervisors: Please alert the Chief of Compliance about upcoming new employees.

5. Radiation Exposure Reduction – Occupational Dose Time – minimize the duration of your exposure Distance – maximize your distance from the source of radiation Shielding – use appropriate shielding

6. What are precautions for working with radioactive material? Caution Signs Gloves & Lab Coat Contamination Control Fume Hoods Shielding No Eating or Drinking Proper Radwaste Storage

7. Worker Classifications • Gamma Knife and Brachytherapy Nurses & Technicians will be classified as Radiation Workers. • All Radiation Workers are required to completed WU Radiation Safety Department Exam. • All Radiation Workers are required to wear radiation monitoring badges. • Rings will be provided to those handling isotopes. • Brachytherapy Radiation Workers may also be required to wear radiation monitoring ring badge dependent on job function.

8. What are our radiation worker’s annual dose limits? *Public limit for released radiation patient = 500 mrem

9. Dose Reduction A.L.A.R.A. • As Low As Reasonably Achievable. • Limits are the maximums allowable • Reduce radiation exposure as much as possible • Improvement/efficiency of procedures and techniques • Better Shielding

10. Radiation Safety • Linac Radiation Safety Practices • Anything out of the ordinary (sounds, odors, temperature) should be reported immediately to maintenance/physics. • When working on machine for 1st time, become familiar with Emergency Off locations. • Video and Audio must be functional. • Everyone is responsible for room clearance. • Door Interlocks and Beam-On indicators must be functional to treat.

11. Radiation Safety • Low energy X-ray Device Safety • Applies to CT Simulators, AND linac OBI x-ray sources • Requires Door interlock, and • X-ray on Indicator Light

12. Fetal Radiation Safety • Prenatal Exposure (Voluntary Disclosure) • Limit is 500 mrem over gestation period. • Further limit of 50 mrem per month. • Risk will increase above these limits. • Most sensitive time period: 8-15 weeks • Steps if you find that you are pregnant: • Encouraged to alert Radiation Oncology Department’s Chief of Compliance, in writing, in confidence, using declaration form. • Will be provided additional monthly monitor.

13. Regulatory Compliance • State of Missouri regulates radiation producing equipment such as the Linacs and CT SIM. • Require registration of each unit, • Set exposure limits, • Set training & monitoring requirements, inspection frequency, etc…

14. Regulatory Compliance • U.S. Nuclear Regulatory Commission regulates the radioactive material, radiopharmaceuticals and sealed sources ( i.e. Brachytherapy and Gamma Knife). • Some of the NRC requirements are: written procedures, QA, training, exposure monitoring, contamination monitoring, security of RAM and sealed sources, and the list goes on for miles. • NRC unannounced inspections

15. Written Policies & Procedures • They are located on the OCF website: http://ocf.wustl.edu/ (click on Clinical Applications, then Policies and Procedures) • Be familiar with them • A written policy or procedure documents how we will do things. • They may address regulatory agency requirements or in-house requirements. • Regardless of why they were generated they must be followed.

16. Written Policies & Procedures • If you are responsible for generating Policies & Procedures: • Review periodically or as required by regulatory agency • Why do we review? To ensure accuracy and completeness, to make sure everyone has the same understanding of the policy, process or situation To ensure effective communication which will lead to the desired outcome • Many problems with procedures once implemented can be traced to inadequate or no review • Ensure they are current and address changes when needed

17. Questions or issues with training? • Any questions you may have regarding this training please contact the Radiation Oncology Department’s Chief of Compliance through the Physics Division administrative staff.