Assessing the Impact of Regulations on Radiation Safety Culture and Practices in Radiology Departments

Background: The need to establish a strong culture around radiation safety is derived from the assertion that medical practitioners, patients, and third parties should not be exposed to unnecessary radiation. Authorities have endeavored to enact policies to protect all employers and patients in radiology departments. Objectives: To assess the impact of radiation safety practices and regulations on the ongoing improvements in radiation safety culture and practices in radiology departments. This will be achieved through a subjective assessment of national and international rules and regulations by healthcare professionals. Materials and Methods: We conducted a questionnaire survey in the radiology departments of three JCI-accredited hospitals in the Riyadh region to identify and assess the impact of national radiation regulations and the accompanying processes on the improvement of radiation safety culture and practices in radiology departments. Results: There were statistically significant differences in the grading system results among various groups of respondents, based on their educational level. Also, there are statistically significant differences between the assessments of safety level results in the answers provided by various groups of respondents according to education level in favor of the master’s degree. Conclusion: The study concludes that technicians with a diploma degree require stricter regulation. Furthermore, the results of this study suggest that an exposure tracking system and a regulatory action supporting it may be useful in the ongoing task of improving patients’ radiation safety.

Nuclear power development and radiationsafety control in China

ＮｕｃｌｅａｒｐｏｗｅｒｄｅｖｅｌｏｐｍｅｎｔａｎｄｒａｄｉａｔｉｏｎｓａｆｅｔｙｃｏｎｔｒｏｌｉｎＣｈｉｎａＨｕＥｒｂａｎｇ（ＣｈｉｎａｉｎｓｔｉｔｕｔｅｆｏｒＲａｄｉａｔｉｏｎＰｒｏｔｅｃｔｉｏｎ，Ｔａｉｙｕａｎ０３０００６，Ｃｈｉｎａ）Ｎｕｃｌ...

Occupational Eye Lens Radiation Dose While Performing Interventional Procedures over 18 Months Using a Face-Shield Equipped Suspended Radiation Protection System

Background: Numerous studies have demonstrated increasing evidence for cataractogenesis at lower levels of ionizing radiation than previously believed, with some suggesting possible absence of a threshold. Genetic differences between individuals also result in increased susceptibility in some operators, who might not be aware. European occupational exposure limits have been reduced and operators are seeking protective measures. Objective: To evaluate the protective effect of a face-shield equipped suspended protection system (Zero-Gravity®, TIDI Products, Neenah, WI) along with adherence to safety practices against radiation dose to the eye lens for an interventional radiologist performing a wide variety of procedures. Materials and Methods: In this institutional review board-approved single-institution study, one interventional radiologist wore a highly sensitive personnel monitoring dosimeter badge on the cap near the left eye while performing 299 procedures (3690 fluoroscopy minutes) over 18 consecutive months while utilizing the suspended protection system along with adherence to other generally recommended safety practices and movement away from the field during angiographic power injections. Dosimetry reports and procedural information were retrospectively reviewed. Results: Total lens dose equivalent to the left eye over 18 months was 0.11 mSv (annualized dose = 0.073 mSv, or 7.3 mRem). The patient-dose-area product standardized dose of 0.00576 μSv/Gy⋅cm2 is well below reports of conventional lead aprons, shields, and protective eyewear. Conclusion: Eye exposures were kept to near-background levels using the materials and methods of this study while performing a wide variety of complex procedures from all positions around the patient.

Secondary and activated X(γ)radiation of SPHIC particle therapy facility

We report the secondary X(γ)radiation from the accelerator in a normal operating state and activated X(γ)radiation from the accelerator devices when the accelerator stops operating in the cancer treatment facility of the Shanghai Proton and Heavy Ion Center(SPHIC).These radiation measurements show us the structural radiation distribution along the beam lines and devices inside the accelerator room when the beam is on and off and can support the radiation protection design of the accelerator facility used for cancer treatment and help evaluate the accumulated radiation dose in the case of an emergency,such as a personal safety system failure or a radiation accident.The radiation dose rate measured in this facility shows that the facility is safe from the radiation protection point.After shooting the quality assurance(QA)beam,the radiation dose rate in the treatment room was also measured to investigate the radiation dose space distribution and decay time dependence.In addition,the time period before safely entering the treatment room after determining the shooting of the QA beam is recommended to be approximately 5 min.

Patient Safety Efforts in Tanzania: A Rapid Review of Two-Decades Efforts (2002-2022) to Inform Interventions towards Attainment of 2030 Targets

Introduction: The need to address the problem of patient safety has been a focus of World Health Assembly (WHA) meetings of 2002, 2019 and 2021. The 2019 WHA Resolution urged the Member States to take action on patient safety. We aimed to review patient safety efforts in Tanzania from 2002 to 2022 to inform improvement efforts towards the 2030 target. Methods: A rapid literature review was conducted between January 2002 and April 2022. We searched Google, PubMed and PubMed Central in April and May 2022 using the following search terms: PubMed—“patient safety Tanzania”, “blood safety in Tanzania”, “safe surgery Tanzania”, and “healthcare-associated infections Tanzania”;Google—“blood safety in Tanzania”, injection safety in Tanzania”, “infection prevention and control”, “radiation safety in health facilities in Tanzania”;and PubMed Central—“injection safety in Tanzania. Results: The search identified 4160 articles, of which 4053 were removed in initial screening;21 were duplicates, giving 86 relevant articles for full screening. Of the 86 articles, 04 were removed after the full screening, hence remaining with 82 articles. Among the 82 eligible articles, 27 are on IPC, 26 on safe surgery, 12 on blood safety, 07 on radiation safety, 06 on injection safety, and 02 on medication safety. One article was relevant to—blood safety, IPC and injection safety;and one article was relevant to—IPC and injection safety. Conclusion: Most of the eligible literature was on IPC and safe surgery, followed by blood safety, radiation safety, injection safety and medication safety. The literature on IPC has highlighted the need to strengthen efforts to address AMR. Findings from the implementation of the safe surgery 2020 intervention warrants for its scale-up to other zones. There is a need to strengthen hemovigilance and pharmacovigilance functions;and strengthen quality management and assurance systems and regulatory functions to ensure radiation safety.

Measurement of Gamma-Rays Using Smartphones

The CMOS (Complementary Metal Oxide Semiconductor) image sensor of a smartphone has been known for its sensitivity to gamma-rays. In this research, some smartphones were selected and tested for measurement of gamma-rays emitted from Cesium-137 and Iridium-192 sources. During measurements, the phones were set in video mode while the camera lenses were covered with black adhesive tape to prevent light exposure. Interaction of gamma-rays with the CMOS appeared as flashing bright spots on the image. The bright spots were then counted by using the freely available ImageJ software. Preliminary results indicated that the number of bright spots increased linearly with increase of gamma-ray dose rate. An in-house Android application software was then developed for real-time counting of the bright spots. The application software also allowed users to input a calibration equation so that the phones could simultaneously convert the count rate to display in dose rate. This research demonstrated that, after appropriate calibration, smartphones could be used as gamma-ray measuring devices for radiation safety control involving high activity sources such as in industrial radiography, gamma-ray irradiation facility and medical treatment.

Implementation of safety and security standards for high dose rate brachytherapy sealed radioactive source used in a medical radiation facility

Objective:To provide guidance on basic concepts and elements for radiation safety and security measures for a HDR brachytherapy sealed radioactive source in a medical radiation facility.Methods:Brachytherapy sources are Category 2(High risk-very dangerous)radioactive source and Security Level B applied to cover the range of security measures needed for the associated risk with remote afterloading HDR brachytherapy sources.These security measures were applied based on a risk informed graded approach.A series of in-build and operational safety measures were implemented for equipment and radiation installation.Results:The medical radiation facility equipped with adequate radiation protection,detection and monitoring equipment such as survey meter,digital contamination monitor,gamma zone monitor,digital radiation monitor,personnel dosimeter,pocket dosimeter,long handled forceps,shielding material and emergency source storage container etc.to deal with radiological incidences.The contingency plan with security objectives for incidents and procedures for action was prepared in order to implement response function to fulfill the goal of adequate security of radioactive source.The emergency response plan documented against emergency scenarios during transport,loss of radioactive source,theft,sabotage,natural calamities/disasters such as fire,flood and earthquake.Conculsions:The paper provides various radiation safety and security aspects for the HDR brachytherapy.The HDR brachytherapy radioactive sources are Type A packages.Transport of radioactive material is the responsibility of consignors,consignee and carriers under the legislation,supervision and control of regulatory authority.

Review of the 5·7 Nanjing^(192)Ir source radiological accident

This paper gives a detailed description of a radiological accident of ^(192)Ir source occurring on May 7,2014 in Nanjing,China(the 5⋅7 accident),encompassing a combination of accident overview,emergency response,investigation process and results,dose estimation,medical treatment,experience and lessons learnt.The investigation showed that the accident was mainly caused by insufficient attention to the radiation safety,non-compliance with licensing conditions and employment of untrained temporary radiographer without equipped with alarm dosimeters.Additionally,no area radiation survey meter was used to verify whether the source would have retracted to radiography camera after every exposure.It therefore is the important means to strengthen the management of radioactive source safety and put the strict management measures in place,implement the requirements for personnel qualification management,strengthen regulatory inspection and actively poster safety culture,which are necessary to avoid accidents.This paper aims to provide experience and reference for the emergency response and countermeasure of radiological accidents involving industrial radioactive sources.