6 - Radiation Protection

Measures for radiation safety of students and patients are presented in many forums to ensure this information is comprehended by the student so needed competencies become instinctive and reflexive in daily clinical practice. Within this section are Departmental radiation safety rules, procedures for personnel monitoring, and the pregnancy policy. Students will be promptly notified of any new rules or changes in existing regulations administered by the OUHSC Radiation Safety Office, the Oklahoma Department of Environmental Quality, the Department of Health, and/or the Nuclear Regulatory Commission.

The concepts and application of minimizing radiation exposure to you, your patients and the public is imperative.  Students will be educated in both didactic and clinical environments regarding radioactive materials and/or radiation emitting devices. Such education includes the practice of ALARA (as low as reasonably achievable); annual radiation safety training; additional related trainings and personal radiation safety monitoring. As part of these responsibilities, students should not hold patients during imaging or therapy procedures or imaging receptors during any procedure that uses ionizing radiation. Failure to apply the principles of radiation safety is considered unprofessional and may result in disciplinary action.

The goal of monitoring personal radiation exposure is to obtain an accurate record of accumulated occupational radiation exposure.  This record is of utmost importance; therefore, improper use of personal dosimeters and/or a lack of responsibility with radiation safety is considered unprofessional behavior and may result in disciplinary action. 

The Departmental Radiation Safety Liaison is Professor Vesper Grantham, AHB 3032. She coordinates all radiation safety procedures and personnel monitoring in the Department with the campus Radiation Safety Officer, Mr. George MacDurmon. The OUHSC Radiation Safety Office is located in the Biomedical Sciences Building, BMSB-127, and is open Monday through Friday from 8:00 a.m. to 5:00 p.m. (405-271-6121).

Radiation Safety Office 

To meet federal, state and programmatic accreditation requirements, personal dosimeters are distributed to students quarterly and must be worn by students at all times while working in the clinic or laboratory setting where ionizing radiation is used. A radiation dosimeter is worn clipped to the collar of the uniform, lab coat or shirt and should be outside any lead apron to accurately record whole body exposure.

Since nuclear medicine students prepare and administer radiopharmaceuticals, they are also issued a ring dosimeter. Students are required to wear the ring dosimeter on a finger of their dominant hand with the label facing the palm of the hand. This ensures accurate hand exposure measurements.

New dosimeters will be distributed to students just prior to the beginning of a quarter.  Students must exchange their dosimeters by the first clinic day of each new quarter in January, April, July and October.  In addition, at the end of the fall semester, students will turn in their dosimeters to the department prior to the completion of the last final exam of the semester. Students will be required to pick up their new dosimeter before the first day of clinic of the spring semester.

Students who have not picked up their new dosimeter by the first clinic day of the new quarter or semester will receive a Zerograde. Old dosimeters must be turned in to the Clinical Coordinator the last day of the quarter through the fourth day of the new quarter, whichever is later, or the last day of the semester in December, May and July. Any badges not turned in by this date will be considered “late”. Any student who turns in a “late” badge will receive a Zerograde.

Lost dosimeters must be reported immediately to a student’s Clinical Coordinator and the Radiation Safety Office so a replacement can be issued. There may be a fee for any lost badges. Under no circumstances may a student continue activities involving ionizing radiation until a replacement dosimeter has been issued. Clinic time missed due to lost badges will have to be made up.  Any student who goes to clinic without a dosimeter at any time will receive a Zerograde. All student dosimeters must be returned to the Department prior to graduation. 

Failure to practice the following guidelines will render a radiation dosimeter useless in accurately measuring the exposure that a particular student receives in the clinic or laboratory setting. Failure to follow these guidelines may result in a Zerograde penalty.

• Do not immerse the dosimeter in liquids, expose it to bright light or extreme heat, or a microwave oven. Should any of the above happen to a student’s dosimeter, it should not be worn.  It must be immediately exchanged at the Radiation Safety Office.  
• Never exchange or wear a dosimeter issued to another person since each is issued to a specific person and is presumed to record that person’s exposure. 
• Students are responsible for maintaining and exchanging their own dosimeters. 
• If a student is employed as a radiation worker while in a departmental program, he/she must not wear dosimeters provided by the Department during work hours. The employer must provide a badge in this instance.  

Each quarter, faculty will provide a dosimeter report for students to review, date and sign to be kept on file for programmatic accreditation requirements.  

The Radiation Safety Officer will contact any student and the Department in writing if an exposure reading exceeds established trigger levels. These trigger levels are set by the OUHSC RSO. 

See OUHSC RSO trigger levels in Table below, from the OUHSC Radiation Safety Manual.  When a student’s exposure reading exceeds the trigger level, his/her Clinical Coordinator will meet with the student.  

From experience, Department faculty know it is a rare occurrence for a student to exceed the trigger level. Radiation safety policies and practices taught in courses and mandated and monitored in the clinic and laboratory environment strive to instill in students the ongoing need to keep radiation exposure as low as reasonably achievable (ALARA).  

Any student who wants to discuss his/her individual dosimetry readings or who has a question regarding radiation safety should contact their Clinical Coordinator, Professor Grantham, or the Radiation Safety Officer promptly. 

Records of accumulated exposure are maintained throughout a person’s professional career. It is a radiation worker’s responsibility to carefully maintain these records. Upon entering the Department, students are required to notify the Radiation Safety Liaison if they are currently employed as a radiation worker. Since annual occupational limits are accumulated for the person in the year, students who work as a radiation worker outside OU Health will be required to provide their quarterly dosimetry records for the year entering the program until graduation to the Department so the individual’s accurate accumulated dose can be calculated by the Radiation Safety Office.  

Upon graduation, a student’s employer may require a copy of his/her exposure records.   Students should contact the Department to receive a copy of their accumulated exposure record, Form 5.  

Special monitoring may be considered when a student is exposed to ionizing radiation during pregnancy. A developing embryo/fetus, particularly for the first six weeks after conception, is more sensitive to the effects of radiation than an adult. Because of this radiosensitivity, the National Council on Radiation Protection and Measurements (NCRP) recommends that “during an entire gestation period, the maximum permissible dose equivalent to the fetus from occupational exposure to the expectant mother should not exceed 0.5 rem.”   

Since it is possible for a student to exceed the recommended 0.5 rem over the course of her pregnancy, students are asked to discuss with their Clinical Coordinator and/or Program Director if they do become pregnant.    

Declaration of Pregnancy

Students may choose to “Declare their Pregnancy,” see the OUHSC Radiation Safety Office template letter.

A declared pregnant woman is defined in 10 CFR 10.1003 as a woman who has voluntarily informed her school/employer, in writing, of her pregnancy and estimated date of conception.  This declaration is made in order to notify the OUHSC Radiation Safety Office so a fetal radiation dosimeter may be issued and worn at the level of the waist during the pregnancy.    

Faculty in all programs, regardless of ionizing radiation, will discuss the options available to students who have declared they are pregnant, including programmatic curriculum plan impact, requesting reasonable accommodations, and voluntarily reporting the suspected pregnancy.  
 
Academic options for the student may include the following:

• Continue in all aspects of the program; 
• Withdraw from clinic courses during the pregnancy but continue in didactic courses.  An “I” grade would be assigned for the clinic course, which must be completed after the birth of the baby.  Graduation would most likely be delayed; 
• Withdraw from the entire program immediately.  No credit would be lost and “I” grades would be assigned to all courses in progress.  The student would arrange with her Program Director to resume programmatic work after the birth of the baby.  Graduation would most likely be delayed. 
• Programmatic accommodations are subject to approval through the OU Accessibility and Disability Resource Center.  

 
Clinic education experiences have physical requirements; refer to policy on Technical Standards, when working with equipment and patients.  Faculty may request students obtain a physician’s note ensuring the student is allowed to continue with all aspects of clinic or request reasonable accommodations through the OU Accessibility and Disability Resource Center. 

Withdrawal of Declaration

After a “Declaration of Pregnancy” has been made, it can be voluntarily withdrawn at any time.  The student must indicate in writing that she wishes to withdraw her declaration of pregnancy.  No penalty of any kind will be given to the student due to the withdrawal.

The nuclear medicine laboratories include the imaging lab in AHB-1038.  These laboratories are in compliance with federal and state regulations, a copy of the mini-license is posted in each lab and audit records are maintained in the department and Radiation Safety Office. 

The following guidelines specific to activities in the nuclear medicine lab must be followed: 

• Eating, drinking, smoking, and other forms of tobacco use are prohibited. 
• Students must obtain authorization from a nuclear medicine faculty member to utilize radioactivity or any equipment within the lab. 
• No student may enter the lab without a badge and ring dosimeter properly worn when working with ionizing radiation. 
• Excessive handling of radioactive materials should be avoided. 
• All contaminated items or those that are potentially contaminated should be discarded in the designated disposal storage area. Do not place these items in regular trash receptacles. 
• Protective gloves and a lab coat must be worn at all times when handling radioactive materials. 
• Students must report any contamination to the supervising faculty member immediately.  
• Procedure for handling a spill includes: 
  • Containment of liquid spills with absorbent material 
  • Evacuation of the area and prevention of unauthorized entry 
  • Removal of contaminated clothing 
  • Cleaning of contaminated skin with warm water, mild soap and a soft brush
  • Reporting of the spill to the Radiation Safety Office

The radiography laboratories include an energized lab (AHB-1032) and CT simulation laboratory (AHB-1036). These labs are in compliance with all federal and state regulations; the appropriate documentation is posted in the lab and records are maintained in the Department office. 

The following guidelines specific to activities in the radiography labs must be followed: 

• Eating, drinking, smoking, and other forms of tobacco use are prohibited. 
• All radiographic exposures must be part of a specific laboratory exercise and under the supervision of a faculty member. 
• No student shall work in any of the labs without wearing a radiation dosimeter. 
• Holding of radiographic phantoms during exposure is not permitted and no one should be in the imaging lab while exposures are being made. 
• Doors to all lab areas must be closed during radiographic exposures and the outer door must be locked. 
• Students are not permitted to utilize lab equipment to make radiographs of any human subject. Failure to comply with this rule may result in immediate dismissal from the program. 
• At no time are exposures to be made that exceed the maximum allowable energy indicated by the x-ray tube manufacturer. Students should refer to the tube rating chart as necessary. 
• All accidents occurring in any of the labs must be reported to the supervising faculty member immediately and use of equipment discontinued until the problem is corrected. 

Students may be exposed to magnetic resonance imaging (MRI) during their clinic rotations. It is imperative to understand and comply with safety and screening protocols that reflect current American College of Radiology (ACR) MRI safety guidelines. Completion of the MRI orientation and screening tool is required prior to starting clinic rotations.  If the student has a status change after initial completion of the screening tool (any surgeries, body modifications, injury involving metal; refer to MRI screening form for a more complete list), they are required to notify the program by contacting their clinical coordinator or program director immediately.