Radiation Protection

What is Radiation protection?

Radiation is energy. It can come from unstable atoms or it can be produced by
machines. Radiation travels from its source in the form of energy waves or energized
particles. There are actually two kinds of radiation, and one is more energetic than the other.
It has so much energy it can knock electrons out of atoms, a process known as ionization.
This ionizing radiation can affect the atoms in living things, so it poses a health risk by
damaging tissue and DNA in genes. While there are other, less energetic, types of
nonionizing radiation (including radio waves, microwaves—and visible light), this booklet is
about ionizing radiation. In the late 1800s, Marie and Pierre Curie were among the first to
study certain elements that gave off radiation. They described these elements as radio-actif,
the property that is now called “radioactivity.” As scientists studied radioactivity more
closely, they discovered that radioactive atoms are naturally unstable. In order to become
stable, radioactive atoms emit particles and/or energy waves. This process came to be known
as radioactive decay. The major types of ionizing radiation emitted during radioactive decay
are alpha particles, beta particles and gamma rays. Other types, such as x-rays, can occur
naturally or be machine-produced.
Radiation protection, also known as radiological protection, is defined by
the International Atomic Energy Agency (IAEA) as "The protection of people from harmful
effects of exposure to ionizing radiation. Exposure can be from a radiation source external to
the human body or due to the bodily intake of a radioactive material. Ionizing radiation is
widely used in industry and medicine, and can present a significant health hazard by causing
microscopic damage to living tissue. This can result in skin burns and radiation sickness at
high exposures and statistically elevated risks of cancer at low exposures. Radiation
protection is the reduction of expected dose and the measurement of dose uptake. Radiation
protection instruments are used to indicate radiation hazards, and personal dosimeters and
bioassay techniques are used to measure personal dose uptake. Radiation protection,
sometimes referred to as radiological protection, is a general term applied to the protection of
people and the environment from the harmful effects of ionizing radiation. Radiation
protection can be divided into occupational radiation protection , which is the protection of
workers in situations where their exposure is directly related to or required by their work;
medical radiation protection, which is the protection of patients exposed to radiation as part
of their diagnosis or treatment; and public radiation protection, which is the protection of
individual members of the public and of the population in general.
History of Radiation Protection
Health physics is concerned with protecting people from the harmful effects of
ionizing radiation while allowing its beneficial use in medicine, science, and industry. Since
the discovery of radiation and radioactivity over 100 years ago, radiation protection standards
and the philosophy governing those standards have evolved in somewhat discrete intervals.
The changes have been driven by two factors—new information on the effects of radiation on
biological systems and changing attitudes toward acceptable risk. The earliest limits were
based on preventing the onset of obvious effects such as skin ulcerations that appeared after
intense exposure to radiation fields. Later limits were based on preventing delayed effects,
such as cancer, that had been observed in populations of people receiving high doses,
particularly from medical exposures and from the atomic bomb exposures in Hiroshima and
 Radiation Protection

Nagasaki. During the evolution of standards, the general approach has been to rely on risk
estimates that have little chance of underestimating the consequences of radiation exposure. It
is important to realize that most of the effects observed in human populations have occurred
at high doses and high dose rates. The information gathered from those populations must be
scaled down to low doses and low dose rates to estimate the risks that occur in occupational
settings. According to the Environmental Protection Agency’s history of radiation protection:
By 1915, the British Roentgen Society adopted a resolution to protect people from
overexposure to X-rays. This was probably the first organized effort at Radiation Protection.
By 1922, American organizations had adopted the British protection rules. Awareness and
education grew, and throughout the 1920s and 30s, more guidelines were developed and
various organizations were 8 SP001-1 Radiation and Risk: Expert Perspectives, revised 2017
formed to address radiation protection in the United States and overseas. Radiation protection
was primarily a non-governmental function until the late 1940s. After World War II, the
development of the atomic bomb, and nuclear reactors caused the federal government to
establish policies dealing with human exposure to radiation. In 1959, the Federal Radiation
Council was established. The Council was responsible for three things:
1. advising the President of the United States on radiological issues that affected
public health
2. providing guidance to all federal agencies in setting radiation protection standards
3. working with the States on radiation issues.
Following World War II, nuclear regulation was the responsibility of the Atomic Energy
Commission, which Congress established in the Atomic Energy Act of 1946 (amended in
1954). The act also made the development of commercial nuclear power possible for the first
time in history. The U.S. Congress chartered the National Council on Radiation Protection
and Measurements (NCRP) in 1964 as follows: To: 1. collect, analyze, develop and
disseminate in the public interest information and recommendations about (a) protection
against radiation . . . and (b) radiation measurements, quantities and units . . . ; 2. provide a
means by which organizations concerned with the scientific and related aspects of radiation
protection . . . may cooperate . . . ; 3. develop basic concepts about radiation . . .
measurements . . . and about radiation protection; 4. cooperate with the International
Commission on Radiological Protection, the Federal Radiation Council, the International
Commission on Radiation Units and Measurements, and other national and international
organizations, governmental and private, 2
http://www.epa.gov/rpdweb00/understand/history.html 9 SP001-1 Radiation and Risk: Expert
Perspectives, revised 2017 concerned with radiation . . . measurements and with radiation
protection.3 The Energy Reorganization Act of 1974 created the U.S. Nuclear Regulatory
Commission (NRC). Today, the NRC’s regulatory activities are focused on reactor safety
oversight and reactor license renewal of existing plants, materials safety oversight and
materials licensing for a variety of purposes, and waste management of both high-level waste
and low-level waste. The NRC also relinquishes to the states portions of its regulatory
authority to license and regulate byproduct materials (radioisotopes), source materials
(uranium and thorium), and certain quantities of special nuclear materials. Thirty-seven states
have entered into agreements with NRC, and others are being evaluated. In addition, the NRC
evaluates new applications for nuclear plants. In 1970 Congress created the Environmental
 Radiation Protection

Protection Agency (EPA) and radiation protection became a part of EPA’s responsibility.
Today, EPA’s Radiation Protection Division is responsible for protecting the public’s health
and the environment from undue exposure to radiation. This is accomplished by setting safety
standards and guidelines. Current radiation dose limits protect workers and the public. Our
radiation protection standards embody the extensive knowledge on radiation effects gained
through radiobiological and epidemiological research of the last century. Collectively, more
is known and understood about the biological effects of radiation than any other toxin or
carcinogen. This knowledge applies to animals and the human species of various ages, organs
and tissues of differing radiosensitivities, and a wide range of biological endpoints, including
cell death, mutations, chromosome aberrations, and carcinogenic transformation. While
questions remain on the precise shape of dose-response functions for specific biological
effects over a broad spectrum of doses and dose rates for radiations of varying qualities, our
understanding is sufficient to establish strong scientific bases for current radiation protection
standards. No single hypothesis explains all combinations or mitigating circumstances in
radiation toxicology. Further research will enable a greater understanding of natural factors
that influence adaptive response and cellular repair of radiation damage
Early radiation dangers
The dangers of radioactivity and radiation were not immediately recognized. The discovery
of x-rays in 1895 led to widespread experimentation by scientists, physicians, and inventors.
Many people began recounting stories of burns, hair loss and worse in technical journals as
early as 1896. In February of that year, Professor Daniel and Dr. Dudley of Vanderbilt
University performed an experiment involving x-raying Dudley's head that resulted in his
hair loss. A report by Dr. H.D. Hawks, a graduate of Columbia College, of his suffering
severe hand and chest burns in an x-ray demonstration, was the first of many other reports
in Electrical Review. Many experimenters including Elihu Thomson at Thomas Edison's
lab, William J. Morton, and Nikola Tesla also reported burns. Elihu Thomson deliberately
exposed a finger to an x-ray tube over a period of time and suffered pain, swelling, and
blistering.[29] Other effects, including ultraviolet rays and ozone were sometimes blamed for
the damage.[30] Many physicians claimed that there were no effects from x-ray exposure at all.
As early as 1902 William Herbert Rollins wrote almost despairingly that his warnings about
the dangers involved in careless use of x-rays was not being heeded, either by industry or by
his colleagues. By this time Rollins had proved that x-rays could kill experimental animals,
could cause a pregnant guinea pig to abort, and that they could kill a fetus.[31] He also stressed
that "animals vary in susceptibility to the external action of X-light" and warned that these
differences be considered when patients were treated by means of x-rays. Before the
biological effects of radiation were known, many physicians and corporations began
marketing radioactive substances as patent medicine in the form of glow-in-the-dark
pigments. Examples were radium enema treatments, and radium-containing waters to be
drunk as tonics. Marie Curie protested against this sort of treatment, warning that the effects
of radiation on the human body were not well understood. Curie later died from aplastic
anaemia, likely caused by exposure to ionizing radiation. By the 1930s, after a number of
cases of bone necrosis and death of radium treatment enthusiasts, radium-containing
medicinal products had been largely removed from the market (radioactive quackery).
Principle: The ICRP recommends, develops and maintains the International System of
Radiological Protection, based on evaluation of the large body of scientific studies available
 Radiation Protection

to equate risk to received dose levels. The system's health objectives are "to manage and
control exposures to ionising radiation so that deterministic effects are prevented, and the
risks of stochastic effects are reduced to the extent reasonably achievable". The ICRP's
recommendations flow down to national and regional regulators, which have the opportunity
to incorporate them into their own law; this process is shown in the accompanying block
diagram. In most countries a national regulatory authority works towards ensuring a secure
radiation environment in society by setting dose limitation requirements that are generally
based on the recommendations of the ICRP.
Planned exposure situations: A planned exposure situation arises from the planned
operation of a source or from a planned activity that results in an exposure from a source. The
primary means of controlling exposure in planned exposure situations is by good design of
installations, equipment and operating procedures. Those exposed can include workers,
patients and the public. In the case of workers and the public, dose limits are set and must be
complied with in order to ensure there is an adequate level of radiation protection. This
differs from medical radiation protection, where the prime consideration in determining the
dose that needs to be delivered is the need to ensure that diagnosis and treatment are
effective.
Emergency exposure situations: An emergency exposure situation arises as a result
of an accident, a malicious act, or any other unexpected event, and requires prompt action in
order to avoid or reduce adverse consequences. Exposures can be to the public and to
workers, such as those who may be exposed while taking actions to respond to
the emergency.
Existing exposure situations:An existing exposure situation is a situation of
exposure which already exists when a decision on the need for control needs to be taken.
Examples of an existing exposure situation are exposure to natural background radiation and
exposure to residual radioactive material from a nuclear or radiological emergency after the
emergency exposure situation has been declared ended. When considering the need for
control, factors to be taken into account include the range of doses received and the size of
the population exposed. Social and economic factors also need to be taken into account and,
in some cases, the exposure may not be amenable to control. Regulatory control restricts the
release of radionuclides to and their accumulation in the environment. There is an increasing
awareness of the vulnerability of the environment and society places greater emphasis than in
the past on environmental protection. It is therefore important to be able to explicitly
demonstrate that flora and fauna are appropriately protected against radiation risks arising
from discharges of radionuclides into the environment. Whereas radiation protection of
humans aims to avoid deterministic and to limit stochastic effects for individuals, radiation
protection of the environment is focused on the conservation of species, the maintenance of
biodiversity and the protection of habitats and ecosystems. The methods and criteria for these
radiological assessments are being developed and will continue to evolve.
RADIATION-INDUCED SKIN INJURIES FROM FLUOROSCOPY
The United States Food & Drug Administration (FDA) has received a number of
reports of serious radiation-induced skin injuries resulting from prolonged fluoroscopic
imaging during interventional therapeutic procedures. Such procedures include angioplasty
and radio-frequency cardiac catheter ablation, among others. In some of the reported injuries,
 Radiation Protection

the physicians performing the procedures appear to have been unaware that the radiation
doses exceeded the expected threshold for injury, or were unaware of the intensity of the
fluoroscopic beam. It is important to note that the onset of these injuries is usually delayed, so
that the physician cannot discern the damage by observing the patient immediately after the
treatment. The radiation dose required to cause skin injury depends on a number of factors,
including the type of injury, the area of skin exposed, the age of the patients (and other
patient-specific characteristics), and the circumstances of the exposure - single exposure or
fractionation. In addition to acute effects, very large doses can lead to an increased risk of
delayed effects (e.g. cancer). Physicians should know that radiation-induced injuries are not
immediately apparent. Other than the mildest symptoms, such as transient erythema, the
effect of the radiation may not appear until weeks following the exposure. Physicians
performing these procedures may not be in direct contact with the patients following the
procedures and may not observe the milder symptoms when they occur. Only when
symptoms of serious injury occur do the physicians become aware of the magnitude of the
radiation doses associated with the procedures. For this reason, facilities should record
information from the procedure in the patient's medical record; to facilitate subsequent
assessment of the radiation dose should the need arise.
RADIATION PROTECTION DURING ORTHOPAEDIC PROCEDURES WITH
MINI C-ARM UNITS
This RIN contains information and recommendations concerning radiation protection
in the use of mini C-Arm xray units for orthopaedic procedures involving the upper and
lower extremities. It provides owners, operators and other personnel with guidance on the
conditions that would warrant the use by staff of lead aprons and personal monitoring badges,
and on room shielding. Operating Features The mini C-arm differs from the conventional or
full-size C-arm in certain features which impact on the radiation protection needs for this
equipment. These features are: lower kVp range (40-70); smaller beam size, significantly
lower beam current (20-60 µA), shorter source-to-image distance (SID) of 40 cm (16"), and
closer proximity of the operator to the x-ray unit.
RADIATION PROTECTION GUIDELINES FOR WORKERS ASSISTING DURING
MEDICAL X-RAY PROCEDURES
This RIN provides guidance for workers [nurses, respiratory technologies, etc] who
assist in medical procedures that involve the use of x-ray equipment. The purpose is to help
employers and employees take appropriate actions to ensure such workers are aware of and
are effectively protected against radiation exposure during these procedures. Employers need
to be aware of their obligations to protect these workers in accordance with the requirements
for ionizing radiation as specified in the WorkSafeBC Occupational Health and Safety
Regulation (see Part 7, Div 3).
General Recommendations  All workers involved with medical x-ray procedures must be
aware of the radiation hazards involved and adhere to workplace safety protocols.  Except
when the worker is required to assist directly during an x-ray procedure, the worker should
maximize the distance between themselves and the x-ray equipment during its use to help
minimize their radiation exposure.  All persons required to be present during an x-ray
procedure must take advantage of available protective devices (i.e. lead apron).  Holding
 Radiation Protection

devices should be used to support patients whenever practicable. If workers are asked to
assist, they must be provided with lead aprons and gloves, and be positioned so as to avoid
the x-ray beam. No worker should regularly perform these duties.  X-ray equipment must be
operated only by individuals who are properly trained for the equipment and the procedures
being performed.  A female worker should immediately notify her employer upon
knowledge that she is pregnant in order that appropriate steps may be taken to ensure that her
work duties during the remainder of the pregnancy do not exceed the dose limits for a
pregnant worker as given in the OH&S Regulation.  A pregnant worker or a worker
considering starting a family is entitled to counselling and further education on radiation
protection issues and concerns regarding reproduction
X-Ray Procedures  Portable x-ray units must be used only if the condition of the patient is
such as to make it impossible for the x-ray procedure to be performed in the x-ray
department. During the xray procedure, the x-ray beam should be directed away from
occupied areas if possible, and every effort must be made to ensure the x-ray beam does not
irradiate any other persons close by. Patient support devices should be used.  During general
fluoroscopic procedures, all workers required to be in the room during the fluoroscopy
procedure should wear protective clothing, lead aprons. When workers are to be at the side of
the patient during fluoroscopy, appropriate protective clothing must be worn by these
workers.  For guidance on mini “C”-arm procedures, please refer to our RIN 14 - Protection
During Orthopaedic Uses of Mini C-arm Units for Imaging Upper and Lower Extremities. 
During angiographic and interventional procedures, all workers assisting during the x-ray
procedure must wear protective clothing and personal dosimeters (TLD badges). X-ray
protective glasses should also be worn. As the patient is the largest source of scatter radiation,
this scatter can be reduced by using the tube under the patient. If the tube is horizontal, stand
on the side of the image receptor/digital plate. Full use must be made of the protective
devices provided with x-ray equipment (shielded panels, drapes, covers, ceiling-suspended
lead acrylic screens, etc). All workers who are not required to be next to the patient during
these procedures must stand back as far as possible from the patient and, if at all possible,
should stand behind a protective shield. (
Radiation Safety After a century of developing man-made, radiation-producing devices—
many of which help support human life—there was a heightened awareness that risks
associated with related materials and radiation-based activities had to be evaluated and
managed to ensure the safety of the general public. Thus, the multidisciplinary field of health
physics was born to fulfill the need to better evaluate and manage radiation safety, and the
Health Physics Society was formed shortly after to support all aspects of the profession. The
middle of the 20th century marked the time that the U.S. government began responding to the
prevalence of man-made radiation with regulatory bodies focused on ensuring public and
environmental safety. Three fundamental radiation protection principles apply to radiation
sources and to exposed individuals, in all cases where the exposure is controllable. In general,
exposure to natural sources of radiation is controllable only to the limited extent that
individuals can choose the location in which they live. 1. The principle of justification: Any
decision that alters the radiation exposure situation should do more good than harm. This
means that by introducing a new radiation source or by reducing existing exposure, one
should achieve an individual or societal benefit that is higher than the detriment it causes. 2.
The principle of optimization: The likelihood of incurring exposures, the number of people
 Radiation Protection

exposed, and the magnitude of their individual doses should all be kept as low as reasonably
achievable, taking into account economic and societal factors. This means that the level of
protection should be the best under the prevailing circumstances, maximizing the margin of
benefit over harm. The third radiation protection principle is related to individuals and applies
only in planned exposure situations. 3. The principle of application of dose limits: The total
dose to any individual from all planned exposure situations, other than medical exposure of
patients, should not exceed the appropriate limits specified by a regulatory body. Dose limits
are determined by a national regulatory authority, such as the Nuclear Regulatory
Commission, on the basis of international recommendations and apply to workers and to
members of the public in planned exposure situations. Dose limits do not apply to medical
exposure of patients or to public exposures in emergency situations
Radiation Shielding
Almost any material can act as a shield from gamma or x-rays if used in sufficient amounts.
Different types of ionizing radiation interact in different ways with shielding material. The
effectiveness of shielding is dependent on the Stopping power of radiation particles, which
varies with the type and energy of radiation and the shielding material used. Different
shielding techniques are therefore used dependent on the application and the type and energy
of the radiation. Shielding reduces the intensity of radiation depending on the thickness. This
is an exponential relationship with gradually diminishing effect as equal slices of shielding
material are added. A quantity known as the halving-thicknesses is used to calculate this. For
example, a practical shield in a fallout shelter with ten halving-thicknesses of packed dirt,
which is roughly 115 cm (3 ft 9 in) reduces gamma rays to 1/1024 of their original intensity
(i.e. 1/210). The effectiveness of a shielding material in general increases with its atomic
number, called Z, except for neutron shielding which is more readily shielded by the likes
of neutron absorbers and moderators such as compounds of boron e.g. boric acid,
cadmium, carbon and hydrogen respectively.