ALYSSA OLSON

Alyssa Olson
DOS 516-Radiation Safety
October 19, 2015
Easing Anxieties on Radiation Exposure
Will I lose my hair? Can I be around my grandkids this weekend? Will I get sick
like the people did in Chernobyl? These are all periodic questions patients ask radiation
therapists. To those well-educated on the subject of radiation, these questions may seem
excessive. Realistically, however, radiation is typically publicized in the media with negative
connotations: cancer, radiation overdose, and atomic bomb. Radiation is especially daunting to
many, because it is intangible, invisible, and potentially lethal. Fear escalates when details are
unknown or cannot be completely comprehended. Even though radiation has potential to
provide health benefits, many patients still view radiation therapy as an unsettling situation.
What most of the general public may not realize, is that radiation is present in our
everyday lives. Background radiation, which can amount to an average of 300 mrem per year, is
found inside our own bodies, soil, building materials, and during air travel.1 Since the discovery
of x-rays in 1895 by Wilhelm Roentgen, radiation has been carefully scrutinized for its practical
uses in society and adverse biological effects on the human body.2 Notable adversities include
effects on ones genetics, lifespan, and development, along with the risk of carcinogenesis.1
Because of these effects, the National Council on Radiation Protection and Measurements
(NCRP) developed safe radiation exposure guidelines for both the general public and
occupational worker.2 The goal of these guidelines was to reduce the risk of carcinogenesis
through unsafe radiation exposure. Through research, exposure limits have changed over the
years. In the 1920s, for example, various advisory committees recommended a maximum
occupational limit of 0.2 rem per day. Overtime, it was evident that many who were exposed at
these unsafe levels developed cancer. In 1947, NCRP added general public tolerance limits after
much concern regarding nuclear weapon testing and public safety. Currently, the NCRP
recommends a maximum annual occupational and general public exposure limit of 5 rem and 0.1
rem respectively. To put this into perspective, general public exposure limits are 3 times less
than the annual background radiation exposures already received. Radiation should be deemed

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safe when used appropriately. It must be understood, however, that medical imaging, treatment,
and background radiation are not accounted for in the annual exposure limit recommendations.1
While radiation therapy has been proven to be instrumental in the treatment of cancer,
safety measures must be implemented to ensure the well-being of both the staff and patients
present on the premises. These safety measures are put into practice through monitoring and
appropriate shielding. According to recommendations from NCRP, facilities are carefully
designed based on several factors including occupancy rates, workload, use factor, and distance.1
With these factors in mind, walls of treatment rooms are built with specific materials and
thicknesses to protect against primary, secondary and leakage radiation. In addition, patient
safety is addressed though special shielding devices located inside the linear accelerator. The
primary and secondary jaws and multileaf collimator (MLC) are strategically designed to treat
desired areas while shielding healthy structures. The ultimate goal of linear accelerator shielding
is to minimize the risk of secondary cancer development to patients.
Patients are often anxious about the accuracy of the radiation treatment delivered. These
fears should be put aside for reasons including quality assurance programs, record and verify
systems, and qualified professionals. Amols3 discusses the extensive quality assurance (QA)
programs recommended for implementation in facilities by the American Association of
Physicists in Medicine (AAPM). Frequent calibrations and QA testing provides safe assurance
that the planned radiation dose matches the patient delivered dose. To uphold quality safety
standards, all QA programs must be periodically updated to adapt to the increasing technology
complexity demands. Record and verify systems have become a standard in radiation therapy.
Designed to perform secondary checks prior to radiation administration, this process has
significantly lowered the likelihood of human and computer-based errors. Finally, to
accommodate these complexities, it is important to have qualified and professionally-trained
staff. With the proper training and skills, the radiation oncology team will provide a safe
environment for patients through careful treatment preparation and assessment of potential
treatment hazards.
Radiation can be a scary situation for both patients undergoing radiation treatment and
the general public. Although it can be harmful, the benefits for cancer treatment and medical
imaging should outweigh public concerns. Strict guidelines and recommendations have been
implemented to ensure public and occupational safety. With the help of advanced computer

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systems, QA programs, and professionally-trained staff, the risk for hazardous errors have
drastically decreased. Radiation is a foreign topic. For that reason, it is the responsibility of the
radiation oncology team to provide a safe and professional environment for their patients and
families.

References
1. Kahn FM, Gibbons JP. Kahns The Physics of Radiation Therapy. 5th ed. Philadelphia, PA:
Lippincott Williams & Wilkins; 2014:348-369.
2. Jones CG. A review of the history of U.S. radiation protection regulations,
recommendations, and standards. Health Phys. 2005;88(2):105-124.
doi:http://dx.doi.org/10.1097/01.HP.0000146629.45823.da
3. Amols HI. New technologies in radiation therapy: ensuring patient safety, radiation safety
and regulation issues in radiation oncology. Health Phys. 2008;95(5):658-665.
doi:http://dx.doi.org/10.1097/01.HP.0000326334.64242.46