Workers in Medical Institutions (Medicine, Dental, Veterinary)

Many people working in medical institutions are occupationally exposed to radiation. Therefore, it is important to understand what types of exposures can occur, what your responsibilities are, and what your employers’ responsibilities are when dealing with radiation in medical workplaces. The Information System on Occupational Exposure in Medicine, Industry, and Research (ISEMIR) has a specific branch to serve as a tool for interventional cardiology facilities to improve their implementation of optimization of occupational radiation protection (ISEMIR-IC).

What do I need to know?

There are many types of medical treatments that expose both the patient and medical worker to ionizing radiation. However, for routine procedures, this amount of radiation is perfectly safe for the patient. For the medical worker however, repeated exposures during these procedures can be of concern. Therefore, there should be regulations and controls on the ways and types of repeated exposures allowed for medical workers.

Protections, dose monitoring, and medical records should be kept for all workers in medical institutions that deal with ionizing radiation sources. These sources can range from X-rays, nuclear medicine therapy, radiation oncology, and interventional cardiology. Each of these procedures comes with its own exposure risks to the staff performing the task. 

How much radiation do medical workers vs. patients receive?

3.0 mSv is an average radiation dose per year received by a person from all sources of radiation including medical treatment. Roughly half of the 3.0 mSv is attributed to normal medical treatment for a person may receive over the course of their life.

Workers in the medical section who deal with radiation sources as a part of their job can receive much higher doses if the proper protections and control methods are not in place. However, averages for workers in medical institutions range from 1.0-3.0 mSv/year depending on the job performed. This falls below the 20 mSv/year dose limit for people who are occupationally exposed to radiation during their work.

What do the IAEA Safety Standards say?

According to the General Safety Requirements Part 3: Radiation Protection and Safety of Radiation Sources: International Basic Standards, the dose limit for workers occupationally exposed to radiation is set at 20 mSv per year. Additionally, this document sets forth the responsibilities of the government, employers, and employees when dealing with the occupational exposure of radiation.  

Employer Responsibilities

“Employers, registrants and licensees shall be responsible for the protection of workers against occupational exposure. Employers, registrants and licensees shall ensure that protection and safety is optimized and that the dose limits for occupational exposure are not exceeded.” – GSR Part 3 Requirement 21

For workers who are engaged in activities in which they are or could be subject to occupational exposure in planned exposure situations, employers, registrants and licensees shall be responsible for:

1. Protection of workers against occupational exposure.
2. Compliance with other relevant requirements of these Standards.

Organisations/employers are responsible for:

• devising, implementing, and regularly reviewing their Radiation Protection Programme.
• regulatory compliance.
• development a training programme that provides the appropriate level of training and information specific to the worker`s job assignments and also general radiation protection information.
• induction and ongoing training of workers, including contractors.
• appropriate dosimetry arragements;

Employee Responsibilities

“Workers shall fulfil their obligations and carry out their duties for protection and safety.” – GSR Part 3 Requirement 22.

This means that workers:

1. Shall follow any applicable rules and procedures for protection and safety as specified by the employer, registrant or licensee.
2. Shall use properly the monitoring equipment and personal protective equipment provided.
3. Shall cooperate with the employer, registrant or licensee with regard to protection and safety, and programmes for workers’ health surveillance and programmes for dose assessment.
4. Shall provide to the employer, registrant or licensee such information on their past and present work that is relevant for ensuring effective and comprehensive protection and safety for themselves and others.
5. Shall abstain from any willful action that could put themselves or others in situations that would not be in accordance with the requirements of these Standards.
6. Shall accept such information, instruction and training in protection and safety as will enable them to conduct their work in accordance with the requirements of these Standards.

A worker who identifies circumstances that could adversely affect protection and safety shall report such circumstances to the employer, registrant or licensee as soon as possible.

References

• Fundamental Safety Principles, IAEA Safety Standards Series No. SF-1, IAEA, Vienna (2006) 
• Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards, IAEA Safety Standards Series No. GSR Part 3, IAEA, Vienna (2014) 
• Occupational Radiation Protection, IAEA Safety Standards Series No. GSG-7, IAEA, Vienna (2018)