Occupational exposures of Chinese medical radiation workers in 1986-2000

Data on occupational exposures from medical uses of radiation in China during 1986-2000 are presented. Individual dose monitoring results in the reports of monitoring centres in different provinces in China during 1986-2000 were collected as the basic data. These data were summarised and then analysed. From 1986 to 2000, in diagnostic radiology, nuclear medicine and radiotherapy, the annual collective effective doses varied within the range 122.4-206.6, 5.4-9.3 and 4.1-10.3 man Sv, respectively; the average annual effective dose in these categories varied within the range 1.5-2.2, 1.2-1.6 and 1.0-1.5 mSv, respectively. Almost all the average annual effective doses in medical uses of radiation were <3 mSv in 1986-2000, and no monitored workers were found to have received an occupational exposure >50 mSv in a single year or >100 mSv in a 5-y period. After 1990, the protection status of medical radiation workers in China was sufficient.     

Assessment of annual whole-body occupational radiation exposure in medical practice in Ghana (2000-09)

Occupational exposure to radiation in medical practice in Ghana has been analysed for a 10-y period between 2000 and 2009. Monitored dose data in the medical institution in Ghana from the Radiation Protection Institute's database were extracted and analysed in terms of three categories: diagnostic radiology, radiotherapy and nuclear medicine. One hundred and eighty medical facilities were monitored for the 10-y period, out of which ~98% were diagnostic radiology facilities. Only one nuclear medicine and two radiotherapy facilities have been operational in the country since 2000. During the 10-y study period, monitored medical facilities increased by 18.8%, while the exposed workers decreased by 23.0%. Average exposed worker per entire medical institution for the 10-y study period was 4.3. Annual collective dose received by all the exposed workers reduced by a factor of 4 between 2000 and 2009. This is seen as reduction in annual collective doses in diagnostic radiology, radiotherapy and nuclear medicine facilities by ~76, ~72 and ~55%, respectively, for the 10-y period. Highest annual collective dose of 601.2 man mSv was recorded in 2002 and the least of 142.6 man mSv was recorded in 2009. Annual average values for dose per institution and dose per exposed worker decreased by 79 and 67.6%, respectively between 2000 and 2009. Average dose per exposed worker for the 10-y period was least in radiotherapy and highest in diagnostic radiology with values 0.14 and 1.05 mSv, respectively. Nuclear medicine however recorded average dose per worker of 0.72 mSv. Correspondingly, range of average effective doses within the diagnostic radiology, radiotherapy and nuclear medicine facilities were 0.328-2.614, 0.383-0.728 and 0.448-0.695 mSv, respectively. Throughout the study period, an average dose per medical institution of 3 mSv and an average dose per exposed worker of 0.69 mSv were realised. Exposed workers in diagnostic radiology primarily received most of the individual annual doses >1 mSv. The entire study period had 705 instances in which exposed workers received individual annual doses >1 mSv. On thermoluminescent dosemeter (TLD) return rates, facilities in Volta and Eastern Regions recorded highest return rates of 94.3% each. Ashanti Region recorded the least TLD return rate with 76.7%.     

Occupational radiation protection dosimetry in Nigeria

The general features of occupational radiation protection dosimetry in Nigeria within the period 1990-1999 have been summarised. About 640 personnel, representing about 25% of the estimated number of radiation workers in Nigeria, were monitored by the TL dosimetry technique during the period, with the majority being the personnel of the teaching hospitals across the country. Most private establishments, especially the X ray diagnostic centres, operate without dosimetry coverage or supervision by a regulatory authority. The weighted mean of the annual effective dose ranged between 0 and 28.97 mSv with the upper limit of collective effective dose being 18.47 man.Sv per year. The individual risk estimate due to this is about 1.5 x 10(-3) per year and this was among the medical personnel. The value could be more if all radiation workers in the country were monitored.     

Transition in occupational radiation exposure monitoring methods in diagnostic and interventional radiology

Radiation exposure monitoring is a traditional keystone of occupational radiation safety measures in medical imaging. The aim of this study was to review the data on occupational exposures in a large central university hospital radiology organisation and propose changes in the radiation worker categories and methods of exposure monitoring. An additional objective was to evaluate the development of electronic personal dosimeters and their potential in the digitised radiology environment. The personal equivalent dose of 267 radiation workers (116 radiologists and 151 radiographers) was monitored using personal dosimeters during the years 2006-2010. Accumulated exposure monitoring results exceeding the registration threshold were observed in the personal dosimeters of 73 workers (59 radiologists' doses ranged from 0.1 to 45.1 mSv; 14 radiographers' doses ranged from 0.1 to 1.3 mSv). The accumulated personal equivalent doses are generally very small, only a few angiography radiologists have doses >10 mSv per 5 y. The typical effective doses are <10 μSv y(-1) and the highest value was 0.3 mSv (single interventional radiologist). A revised categorisation of radiation workers based on the working profile of the radiologist and observed accumulated doses is justified. Occupational monitoring can be implemented mostly with group dosimeters. An active real-time dosimetry system is warranted to support radiation protection strategy where optimisation aspects, including improving working methods, are essential.     

Dose level of occupational exposure in China

This paper discusses the dose level of Chinese occupational exposures during 1986-2000. Data on occupational exposures from the main categories in nuclear fuel cycle (uranium enrichment and conversion, fuel fabrication, reactor operation, waste management and research activity, except for uranium mining and milling because of the lack of data), medical uses of radiation (diagnostic radiation, nuclear medicine and radiotherapy) and industrial uses of radiation (industrial radiography and radioisotope production) are presented and summarised in detail. These are the main components of occupational exposures in China. In general, the average annual effective doses show a steady decreasing trend over periods: from 2.16 to 1.16 mSv in medical uses of radiation during 1990-2000; from 1.92 to 1.18 mSv in industrial radiography during 1990-2000; from 8.79 to 2.05 mSv in radioisotope production during the period 1980-2000. Almost all the average annual effective doses in discussed occupations were lower than 5 mSv in recent years (except for well-logging: 6.86 mSv in 1999) and no monitored workers were found to have received the occupational exposure exceeding 50 mSv in a single year or 100 mSv in a five-year period. So the Chinese protection status of occupation exposure has been improved in recent years. However, the average annual effective doses in some occupations, such as diagnostic radiology and coal mining, were still much higher than that of the whole world. There are still needs for further improvement and careful monitoring of occupational exposure to protect every worker from excessive occupational exposure, especially for the workers who were neglected before.     

Optimization of radiation protection for the control of occupational exposure in Ghana

Investigation of the optimization of protection of occupational exposed workers (OEWs) in Ghana had been carried out on the three practices in the country, namely medical applications, industrial radioisotope applications and research and education from 2002 to 2007. Mean annual effective dose and collective effective dose were estimated from dosimetry records from the Radiation Protection Institute of those occupationally exposed from 2002 to 2007. The mean annual effective dose estimated for about 650 OEWs per year ranged from 0.42 to 0.68 mSv compared with a global value of 0.5 mSv estimated by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR 2008 Report). This implies that efforts should still be made to institute as low as reasonably achievable culture in most practices in Ghana even though trend of doses incurred was low. The collective effective dose for this same period estimated ranged from 0.26 to 0.47 man Sv. A reference monetary value of the man sievert was estimated using the human capital approach for each year from 2002 to 2009; it ranged from 172 to 22 US $ per man Sv, which provided a basis for estimating the cost of averting a unit collective effective dose of 1 man Sv. This value could not be used for quantitative optimization since the range of mean annual effective dose estimated was below 1 mSv.     

Occupational exposure in nuclear medicine in Portugal in the 1999-2003 period

The annual doses received by the staff of nuclear medicine departments from public hospitals and private clinics and evaluated by the Individual Monitoring Service of the Radiological Protection and Nuclear Safety Department (DPRSN) of the Nuclear and Technological Institute (ITN) in Portugal, in the 5 y period from 1999 to 2003, are analysed and presented in this paper. In the 1999-2003 period, ITN-DPRSN monitored on an average 462 workers from nuclear medicine departments, which represents 6% of the 8000 workers of the medical field (approximately). The medical sector represents 80-85% of all the monitored population in Portugal. The professions of the monitored workers at nuclear medicine departments were identified by the respective departments as administrative, auxiliary, medical doctor, nuclear medicine technician, nurse, pharmacist and physicist. This information was collected at the onset of the monitoring and was updated over the last 3 y. The annual whole-body doses evaluated in the period 1999-2003 were used to derive the distribution of workers by dose intervals for every profession. The respective annual average doses and annual collective doses, as well as, the total average and total collective doses for the nuclear medicine sector were also determined and are presented. Internal radiation hasn't been monitored.     

A review of the scientific basis for radiation protection of the patient

The use of ionising radiation in medicine is the single largest man-made source of population exposure. Individual and collective doses to patients arising from the medical use of ionising radiations continue to rise significantly year on year. This is due to the increasing use of medical imaging procedures in modern healthcare systems as well as the continued development of new high dose techniques. This paper reviews the scientific basis for the principles of radiation protection as defined by the International Commission on Radiological Protection. These principles attempt to include exposures arising from both medical and non-medical applications within a common framework and have evolved over many years and changing socio-economic considerations. In particular, the concepts of justification and ALARA (doses should be as low as reasonably achievable), which underpin the principles for medical exposures are assessed in terms of their applicability to the scientific process and relevance to a rapidly changing technologically-led healthcare system. Radiation protection is an integral component of patient safety in medical practices and needs to be evidence based and amenable to the scientific process. The limitations imposed by the existing philosophy of radiation protection to the development of a quantitative framework for adequately assessing the performance of medical imaging systems are highlighted. In particular, medical practitioners will require quantitative guidance as to the risk-benefits arising from modern X-ray imaging methods if they are to make rational judgements as to the applicability of modern high-dose techniques to particular diagnostic and therapeutic tasks. At present such guidance is variable due to the lack of a rational framework for assessing the clinical impact of medical imaging techniques. The possible integration of radiation protection concepts into fundamental bio-medical imaging research activities is discussed.     

Problems with film processing in medical X-ray imaging in Lithuania

Optimisation in X-ray imaging in order to reduce patient doses during diagnostic X-ray examinations is a complex process given the high level of image quality required. When quality systems are implemented as a basis for optimisation, attention should be paid to the qualifications of the staff and quality control of the equipment and of the X-ray imaging procedures, as well as to the methods used to evaluate the quality of these procedures. Until recently, quality control procedures at health care institutions in Lithuania were limited to the testing of X-ray units. Since film processing is one of the most important factors influencing patient doses and image quality during X-ray examinations, in 2003 the Kaunas department of the Radiation Protection Centre organised inspections of film processing laboratories in 11 health care institutions-hospitals and outpatient departments-in the Kaunas region. Problems of non-compliance with requirements identified during these inspections are discussed in this paper. Most of the health care institutions inspected already had quality assurance programmes. However, the implementation of these programmes was sometimes erratic because of the insufficient attention paid to the film developing processes. The worst situation was found in 4 institutions where the films were developed manually. Only 3 of the 11 departments inspected had sensitometers and densitometers for quality control of the processing. In many cases there was no control of chemicals, film sensitivity and density, or else control was irregular. In only a few departments were the effects of repeated controls investigated and discussed. Despite the current problems occurring in medical X-ray diagnostic departments in Lithuania, the situation is rapidly improving. New equipment is being installed, new devices for quality control are being used and, last but not least, the view of hospital administrators, radiologists and laboratory workers towards quality assurance and quality control is changing.     

Current status of radiological protection at Swiss NPPS

Occupational exposure in nuclear power plants has been reduced significantly within the last two decades. Dose distribution of workers shows that 80 % have a dose <1 mSv y(-1). Discharges have always been low, resulting in hypothetical doses of a few micro Sieverts per year to the most affected persons. Dose distribution owing to natural and medical exposure does not change for the majority of workers by adding their occupational dose distribution. Doses from discharges do not have any impact on the dose distribution of the public. Nuclear power implicates no additional radiation risks to the public and tiny risks for a few of the workers. Nuclear power contributes positively to the environment and to public health with tremendous savings of greenhouse gas emissions. Comparing the public benefits, tiny doses for workers are easily justified. Further reductions of discharge limits or occupational exposure constraints are without a real gain in public health.     

Assessment of medical occupational radiation doses in Costa Rica

Participation of the University of Costa Rica (UCR) in activities in an IAEA Regional Project RLA/9/066 through training, equipment and expert missions, has enabled to setting up of a national personal monitoring laboratory. Since 2007, the UCR has been in charge of monitoring around 1800 medical radiation workers of the Social Security System. Individual external doses are measured with thermoluminescent dosemeter using a Harshaw 6600 Plus reader. The service has accreditation with ISO/IEC 17025:2005. Distribution of monitored medical personnel is as follows: 83 % in diagnostic radiology, 6 % in nuclear medicine and 6 % in radiotherapy. Preliminary values for the 75 percentile of annual H(p)(10) in mSv are: radiology 0.37; interventional radiology 0.41; radiotherapy 0.53 and nuclear medicine 1.55. The service provided by the UCR in a steady and reliable way can help to implement actions to limit the doses received by the medical workers and optimise their radiation protection programs.     

An assessment of annual whole-body occupational radiation exposure in Ireland (1996-2005)

Whole-body occupational exposure to artificial radiation sources in Ireland for the years 1996-2005 has been reviewed. Dose data have been extracted from the database of the Radiological Protection Institute of Ireland, which contains data on >95% of monitored workers. The data have been divided into three sectors: medical, industrial and education/research. Data on exposure to radon in underground mines and show caves for the years 2001-05 are also presented. There has been a continuous increase in the number of exposed workers from 5980 in 1996 to 9892 in 2005. Over the same time period, the number of exposed workers receiving measurable doses has decreased from 676 in 1996 to 189 in 2005 and the collective dose has also decreased from 227.1 to 110.3 man millisievert (man mSv). The collective dose to workers in the medical sector has consistently declined over the 10-y period of the study while that attributable to the industrial sector has remained reasonably static. In the education/research sector, the collective dose typically represents 5% or less of the total collective dose from all practices. Over the 10 y of the study, a total of 77 914 annual dose records have been accumulated, but only 4040 (<6%) of these represent measurable radiation doses in any given year. Over the same time period, there were 283 instances in which exposed workers received individual annual doses >1 mSv and 21 of these exceeded 5 mSv. Most of the doses >1 mSv were received by individuals working in diagnostic radiology (which also includes interventional radiology) in hospitals and site industrial radiography. There has been only one instance of a dose above the annual dose limit of 20 mSv. Evaluating the data for the period 2001-05 separately, the average annual collective dose from the medical, industrial and educational/research sectors are approximately 60, 70 and 2 man mSv with the average dose per exposed worker who received a measurable dose being 0.32, 0.79 and 0.24 mSv, respectively. Diagnostic radiology and site industrial radiography each represents >60% of the collective dose in their respective sectors. Available data on radon exposure in one underground mine and in three show caves indicate an annual collective dose of 75 man mSv from these work activities. By comparison, previous estimates of exposure of Irish air crew to cosmic radiation have given rise to an estimated collective dose of 12 000 man mSv. It can be concluded therefore that the natural radioactivity sources account for well >90% of all occupational exposure in Ireland. This evaluation does not include an estimate of exposure to radon in above-ground workplaces-these data are currently being evaluated and their inclusion will increase both the total occupational collective dose as well as the percentage of that dose due to natural radiation.     

Assessment of annual whole-body occupational radiation exposure in education, research and industrial sectors in Ghana (2000-09)

Institutions in the education, research and industrial sectors in Ghana are quite few in comparison to the medical sector. Occupational exposure to radiation in the education, research and industrial sectors in Ghana have been analysed for a 10 y period between 2000 and 2009, by extracting dose data from the database of the Radiation Protection Institute, Ghana Atomic Energy Commission. Thirty-four institutions belonging to the three sectors were monitored out of which ～65% were in the industrial sector. During the 10 y study period, monitored institutions ranged from 18 to 23 while the exposed workers ranged from 246 to 156 between 2000 and 2009. Annual collective doses received by all the exposed workers reduced by a factor of 2 between 2000 and 2009. This is seen as a reduction in annual collective doses in education/research and industrial sectors by ～39 and ～62%, respectively, for the 10 y period. Highest and least annual collective doses of 182.0 man mSv and 68.5 man mSv were all recorded in the industrial sector in 2000 and 2009, respectively. Annual average values for dose per institution and dose per exposed worker decreased by 49 and 42.9%, respectively, between 2000 and 2009. Average dose per exposed worker for the 10 y period was least in the industrial sector and highest in the education/research sector with values 0.6 and 3.7 mSv, respectively. The mean of the ratio of annual occupationally exposed worker (OEW) doses for the industrial sector to the annual OEW doses for the education/research sector was 0.67, a suggestion that radiation protection practices are better in the industrial sector than they are in the education/research sector. Range of institutional average effective doses within the education/research and industrial sectors were 0.059-6.029, and 0.110-2.945 mSv, respectively. An average dose per all three sectors of 11.87 mSv and an average dose per exposed worker of 1.12 mSv were realised for the entire study period. The entire study period had 187 instances in which exposed workers received individual annual doses >1 mSv, with exposed workers in the education/research sector primarily receiving most of this individual dose.     

Patient exposure in medical X-ray imaging in Europe

Patients are exposed to X rays when undergoing medical examinations in diagnostic radiology. Exposure data acquired and assessed in Germany for the year 1997 resulted in a mean annual effective dose of 2 +/- 0.5 mSv per head of the population, thereby reaching or exceeding the average level of environmental radiation in many cases. The underlying frequency of medical X-ray examinations was approximately 136 million, i.e. approximately 1.7 examinations annually per head of the population. For comparison, corresponding data of other countries were extracted from the UNSCEAR 2000 report or originate from the literature. Data analysis shows significant differences in national radiological practices and a very uneven distribution of patient doses amongst the world population. The mean annual effective dose per head of the population varies by up to a factor of 60 between health care level I and IV countries, and still by a factor of approximately 6 within health care level I countries. While projection radiography has succeeded in reducing dose consumption, computed tomography and radiological interventions have given rise to a significant growth of patient exposure, and interventional radiology can even exceed thresholds for deterministic radiation effects. Patient exposure is further shown to result from misadministration and retakes of X-ray examinations, usually not registered, as well as from technical failures of X-ray facilities, which can cause significantly enhanced exposure times. Corresponding data are presented and comments are made on the international situation of non-harmonised data collection on patient exposure as well as of parameters affecting the assessment of exposure and risk.     

Current status of personal dosimetry in industry, research and medicine in Lithuania

The personal dosimetry service of the Radiation Protection Centre performs individual monitoring for all the industrial, medical and research radiation workers. The RADOS and DTU TLD systems are used for monitoring of doses. The DTU TLD system is used for measurements of doses to extremities and for measurements of public external exposure. Finger ring TLDs are used in therapy which uses radiopharmaceuticals. The RADOS system is also used for evaluation of patients' doses in selected hospitals. The dosimetry service recently provided individual monitoring of approximately 3000 workers. The average occupational dose was about 1.06 mSv for medical workers and 3.2 mSv for industrial radiography workers in 1999. Detailed analysis of doses received by different categories of workers is performed. A system for the urgent review of work conditions in the case of increased dose has been set up.     

Scan region and organ doses in computed tomography

The purpose of this study was to investigate how the choice of the scanned region affects organ doses in CT. ImPACT CT Patient Dosimetry Calculator (version 1.0) was used to compute absorbed doses to eight organs of interest in medical radiation dosimetry. For 13 dosimetry data sets, the authors calculated the maximum organ dose (D(max)) as well as the corresponding organ dose for a scan with selected length D(L). These data permitted the relative dose (D(r) = D(L)/D(max)) to be determined for varying scan lengths. Computations were performed for a nominal X-ray tube current of 100 mA, a rotation time of 1 s and a CT pitch of 1. The authors also determined values of D(max)/CTDI(vol), where CTDI(vol) is obtained in a 32-cm diameter CT dosimetry phantom using the same radiographic techniques. For each organ, D(r) was independent of the type of scanner, and increased monotonically to unity with increasing scan length. Relative doses for a scan restricted to the organ length ranged from 0.65 D(max) for the bladder to 0.86 D(max) for the lungs. There was good correlation (r = 0.64) between relative organ dose and the corresponding organ length. At 120 kV, the lowest value of D(max)/CTDI(vol) was 1.23 for the breast and the highest was 2.22 for the thyroid. Varying the X-ray tube voltage between 100 and 130 kV results in changes in D(max)/CTDI(vol) of no more than 4 %. CT scans limited to the direct irradiation of an average-sized organ results in an absorbed dose of ~0.75 D(max).     

The effect of copper implantation on the mechanical, structural properties and residual stress of polycrystalline alumina

The effect of copper implantation on the mechanical properties, such as hardness, fracture toughness, and residual stress of alumina is addressed herein. The implantation conditions are conducted at room temperature on the polycrystalline alumina with doses ranged from 3 × 10¹⁶ to 10¹⁷ Cu cm⁻² (110 keV). The ion profile distribution was examined by Rutherford backscattering spectroscopy. Surface morphology was observed directly using scanning electron microscopy. Using the X-ray diffraction, we determined the crystallographic nature of the precipitates formed after heat treatment. The residual surface compressive stresses produced by these implantations, as determined by an indentation technique, ranged from 950 to 1720 MPa. Implantation caused a modification in the mechanical properties and an increase in the residual stress. The average residual compressive stress in the implanted region increases with fluence.     

Occupational exposure in Greek industrial radiography laboratories (1996-2003)

More than 40 industrial radiography laboratories are operating in Greece using X-ray or gamma-ray sources and more than 250 workers occupationally exposed to ionising radiation in these facilities are monitored on a regular basis. This study presents the evolution of individual doses received by radiographers during the past years. The mean annual dose (MAD) of all workers as well as of exposed workers is estimated, and correlated to the types of laboratories and practices applied. The MAD of the exposed workers in industrial radiography is compared with the doses of workers in other specialties and with the doses of radiographers in other countries. Furthermore, the study attempts to propose dose constraints for the practices in industrial radiography, according to the BSS European directive and the relevant Greek radiation protection legislation. The proposed value was defined as the dose below which the annual doses of 75% of the exposed radiographers are expected to be included.     

A comparison of dose savings of lead and lightweight aprons for shielding of 99m-Technetium radiation

Nuclear medicine technologists (NMTs) have the highest effective doses of radiation among medical workers. With increase in the use of lightweight materials in diagnostic radiography, the aim was to compare the effectiveness of lead and lightweight aprons in shielding from 99m-Technetium ((99m)Tc) gamma rays. The doses received from a scattering phantom to the entrance, 9cm depth and exit of a phantom were measured with LiF:Mg, Cu, P thermoluminescent dosemeters (TLDs). Doses and spectra were assessed without no shielding, with 0.5-mm lead and lightweight aprons. The lead and lightweight aprons decreased entrance surface doses by 76 and 59%, respectively. The spectral analysis showed that the lightweight apron provided better dose reduction at energies <95 keV, though lead was 35% more efficient at higher energies. While lead apron demonstrated better shielding, the additional savings should be considered with the weight differential. It is concluded that the lightweight apron is suitable to be worn by NMTs interacting with patients injected with a (99m)Tc labelled radiopharmaceutical.     

Occupational exposures of nuclear power plant workers in Finland

In Finland, the Radiation and Nuclear Safety Authority (STUK) maintains a central dose register where all occupational doses of radiation workers are recorded. The computerised register enables easy control of personal doses, including annual, 5 year and lifetime doses. The type of radiation work is also recorded in the dose register. Finland was one of the first countries in the world to introduce dose limits based on the recommendations of ICRP 60. In this article, the radiation dose data of the Finnish nuclear power plant workers are analysed. The majority of the radiation doses are received during the maintenance outages. The trend of the 5 year doses and their distribution are presented. Doses received during different work assignments were averaged over the years 1996-1999 and they are also discussed in this article.