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X-ray Training Manual

Complied By
Shahzad Arain
Cell: 92-334-9564004

In the early 1970s in Pennsylvania, 1.8% of all X-ray users worked

with analytical X-ray (definition) instruments (rather than medical,
dental, or industrial X-ray). This relatively small number of users was
involved in 76% of the serious radiation accidents. Why are analytical
X-ray users such a high-risk group?
There are a number of factors involved in risk, but the most
significant can probably be categorized into equipment and training.
By its nature, the equipment produces an intense, highly collimated
beam of high-energy radiation that cannot be sensed physically at the
time of exposure. Consequently, a number of protective devices and
features are required on instruments currently being marketed to
reduce the hazards, greatly reducing the accident rate among users.
The other factor, traiing, includes knowing proper procedures for
using the machine, hazard awareness, and in some cases, safety
attitude adjustments.


The goals of analytical X-ray safety training can be simply stated as:
creating and maintaining a safe work environment and
developing proper work procedures, habits and attitudes


The purpose of this training is to help you minimize occupational

X-ray exposure (definition) while still gathering useful data about
your samples.

Safety Parameters

Given that some workers have a propensity to overlook or ignore

safety issues (thus contributing to hazardous attitudes), and that
analytical X-ray users belong to a high risk group, several areas need
to be considered to ensure the safe use of analytical X-ray instruments.
These are:

o Attitudes
o Training
o Equipment
o Site
o Procedures
o Monitoring (inspections and audits)


Very briefly, high risk or hazardous attitudes may include:

o believing that accidents happen only to others

o attempting to prove one's abilities are superior
o resentment of having to submit to another's authority,
considering rules and procedures as unnecessary
o a perceived need to respond immediately in a given situation
before considering alternatives
o resignation to the circumstances

Hazardous attitudes can lead to poor decision-making and actions,

which greatly increase risk of accident and injury. Each individual must
understand his or her own personal limitations at every moment and
must make decisions carefully to ensure he or she has not been
influenced by a hazardous attitude. Those whose actions put
themselves and others at risk may be removed from the X-ray lab.
Production of X-
Production of X-
Assuming the reader has
already studied the
production of X-rays in detail
through some other source, a
brief summary will be
provided here.
Generation of
Figure 1 shows the generation of broad spectrum bremsstrahlung as
an incident electron penetrates the electron cloud of the atom and
passes close to

Statistically a large number of incident electrons will produce a broad

distribution of bremsstrahlung photons, as shown in Figure 2 on the 50
kV curve (tungsten target).
Characteristic X-Ray Spectra

If the incident electron energy is high enough, it may interact with

an (inner) orbital electron, ejecting it from its orbit. As the vacancy is
occupied by an electron from a higher orbit, the (quantized) excess
energy is emitted as a characteristic photon (definition) (Figure 3).
X-Ray Producing Machines

The ensemble of the target atoms consists of a small "block" of the

target material, usually mounted on a heat removing substrate, and
sometimes immersed in oil. The electrons come from a heated filament
of ~10-50 mA current. The incident electrons acquire a high incident
energy by being accelerated by the high voltage supply of tens of kV,
connected across the target block and the filament. The resulting X-
rays scatter away from the target, and pass through a window in the X-
ray tube housing. Further collimation produces a narrow beam suitable
for studying crystal samples. (See Figure 5).

Diagnostic and some analytical X-ray machines mount the target on a

rotating anode and use an annular target ring, as in Figure 6. This
results in increased heat dissipation and longer tube life.
-Ray Absorption in Human Tissue

When X-ray photons interact with matter -- human tissue in this

discussion -- some of the photons are absorbed by the tissue. Figure 7
shows the absorption characteristics for bone, muscle, and fat, as a
function of the gamma (or X-ray) energy. Many analytical x-ray
machines produce X-rays up to 50 or 60 kV. Over this energy range,
the plot shows that bone absorbs roughly five times the energy that
muscle absorbs and about ten times that of fat. This is significant since
the hands are mainly muscle and bone. They are therefore more
susceptible to X-ray injury.

Injuries are generally characterized by the clinical symptoms

manifested (burns, swelling, and so on), and the estimated dose. There
are short-term and long-term injuries.

Short-Term Injuries

Short-term injuries are generally manifested by soreness, reddening

of the skin, swelling, inflammation, ad tissue breakdown characteristic
of second and third degree burns. Most often these signs do not begin
until several days after the accident.

Figure 8 shows the fingers of an accident victim about 1 month after

his exposure, and Figure 9 was taken 3½ months after exposure.
Long-Term Injuries

Many long term injuries are due to the progression of short-term

damage. Despite initial treatment of the injury, the tissue may be
damaged beyond recovery, sometimes necessitating the removal of
the damaged tissue (such as a finger). Cancer and cataracts
(definition), in the case of eye exposure, are also considered potential
(latent (definition)) long-term injuries.

Dose Definitions

"Absorbed dose" of any ionizing radiation is the energy imparted to

matter by ionizing particles per unit mass of irradiated material at the
place of interest. The unit of radiation absorbed dose is the "rad." 1 rad
is 100 erg/gram.
"RBE dose" is equal numerically to the product of the absorbed dose
in rads and an agreed factor RBE (relative biological effectiveness)
whose values for ICRP (International Commission on Radiological
Protection). The "rem" (roentgen equivalent [in] man) is the unit of RBE

Dose Limits

Maximum Permissible Dose Equivalent for Occupational Exposure

5 rem
Dose to whole body
per year
50 rem
Skin of whole body
per year
50 rem
per year
0.5 rems
Pregnant women (with respect to fetus)
n period

[Note that average background radiation in U.S. is 0.36 rem

per year.]

Sample Dose Calculation

Using a Mo X-ray tube at 50 kV and 40 mA, and assuming:

Most of the energy radiated is at the Mo Ka1 spike of 17 kV, and that
the bremsstrahlung is small by comparison,
1 amp = 6.3 E18 e-/sec (then 40 mA = 2.52 E17 e-/sec)
1 eV = 1.6 E-12 erg/e- (then 17 kV = 2.72 E-8 erg/e- (Mo Ka1))
The total Mo Ka1 X-ray power radiated (17 kV, 40 mA) is 6.8 E9
The X-ray tube is 65 mm diameter with four 16 mm diameter
windows. The area of one window is 201 mm2. The area of a 65 mm
diameter sphere, centered on the X-ray focal spot, is 3,318 mm2.
The ratio of the area of half of one window to the area of the sphere
is 0.031 to 1. (Depending on the target orientation, it is presumed
that only 50% of the X-rays generated exit the window.)

The total MoKa1 X-ray power exiting through one window is:

(6.8 E9 erg/sec) X 0.031 - 2.1 E8 erg/sec

If a hand were covering that window and the X-rays were totally
absorbed in the hand in a column of flesh and bones 30 mm tall and
101 mm2 in cross-section area, then 3.0 cm3 or ~3.0 gram would
receive the dose.
The dose received by the irradiated portion of the hand would be
(2.1 x E8 erg/sec)/(3.0 gram) or 7.1 E7 erg/gram or about 7.1 E5 rems
for every second of exposure!
Compared to 75 rems per year maximum allowed occupational
exposure to the hands, this is about 9500 times the annual dose limit
to the hand every second!

Protection and Regulations

Standards for Protection Against Radiation

Following are excerpts from the State of North Carolina Regulations

for Protection against radiation.

.1601 Purpose and Scope

(a.) The rules in this section establish standards for protection
against ionizing radiation resulting from activities conducted
under licenses and registrations issued by the agency pursuant
to the rules in this chapter.
.1603 Radiation Protection Programs
(b.) The licensee or registrant shall use procedures and
engineering controls based upon sound radiation protection
principles to achieve occupational doses and doses to the
members of the public and releases of radioactive material, in
effluents to unrestricted areas that are as low as is reasonably
achievable (ALARA).

Minimizing Exposure

How can exposure to radiation be minimized? There are four

physical factors that affect the exposure level in a "radiation field"

1. Distance
2. Time
3. Shielding
4. Output factors (kV, mA)

o Exposure varies as the inverse square of the distance (assuming

a point source, as from scattering)
o Exposure increases linearly with time
o Exposure is inversely exponential with the thickness of shielding.
o Exposure increases linearly with current (mA) and as the square
of the potential (kV).

An operator of analytical x-ray equipment may be provided with an

extremity monitoring device and any person coming in contact with
equipment capable of exposing a major portion of the body shall be
required to wear a whole-body monitoring device. Such devices are
referred to as dosimeters. These portable devices are capable of
measuring and registering the total accumulated exposure to ionizing
At the University of North Carolina, thermoluminescent dosimeters
(TLDs) in the form of ring badges and optically stimulated
luminescence (OSL) whole-body badges may be issued to operators of
analytical x-ray equipment. Thermoluminescent dosimeters contain
crystalline materials (for example, CaF2 with a Mn impurity or LF) that
emit light if they are heated after having been exposed to radiation.
The whole body badges contain a thin layer of aluminum oxide. After
use, the aluminum oxide is stimulated with a laser light and the
luminescence is measured. The amount of luminescence is
proportional to the amount of radiation exposure.
Remember that dosimetry badges are to be worn only by the
person to whom they are assigned and are not to be shared. They are
to be worn only for work related to research and not for "checking"
dental or medical doses.
The badges are to be worn at all times when operating, or in the
vicinity of, the analytical x-ray equipment. They should be stored in a
location away from the equipment (and heat sources) to avoid
exposure to the badges when they are not being worn. These badges
are issued by, and returned to, the UNC Radiation Safety Office via the
authorized user who supervises the worker

Radiation Fields Around Equipment

Figure 10 shows how the exposure rates vary around the

equipment. Note that the "fields" range from 500,000 R/min to 50
R/min between the aperture and the sample. After scattering from the
sample, typical exposure rates diminish to less than several hundred
mR/hr, a reduction of 5 to 6 orders of magnitude.

The X-ray equipment manufactured today is much safer than that

made before the 1970s. Major advances have been in the areas of:

o interlocks
o enclosures
o shutters
o failsafe warning lights
o remote and computer controls

The sealed X-ray tubes and the mechanical goniometers are

basically unchanged.
Equipment - Interlocks

Interlocks are a set of switches in a series, where EVERY switch must

be closed in order for the X-rays to be generated and/or for a shutter to
be opened. These switches are connected to doors, panels, and
collimators, which if opened or removed, would create a radiation
hazard for the user. If any switch is opened while the X-rays are on or
the shutter is open, the X-ray generator will immediately shut off
and/or the shutter will close.

Equipment - Enclosures

Enclosures are boxes, some having a transparent window, which

contain the X-ray instruments so that stray or scattered X-rays do not
escape into the room. Enclosures, along with interlocks, also prevent
people from encountering the direct X-ray beam.

Equipment - Shutters

Shutters open and close a path for the X-ray beam. When a shutter
is properly functioning and closed, no X-rays can pass beyond the

Equipment - Warning Lights, Failsafe

Lights are used to indicate that the X-ray generator is turned on and
that a shutter is open. These lights are 'failsafe' so that in the event of
a lamp failure (e.g., broken filament) the X-ray generator will NOT turn
on and the shutter will NOT open (and, in fact, if on or open, will shut
off or close in the event of a lamp failure). Also, the X-ray generator will
not turn back on nor the shutter open again without the user first
taking action to do so.

Equipment - Remote and Computer Controls

Remote and computer controls of X-ray instruments are major

safety advances in that the user need not be anywhere near the
instrument to operate it. Enclosures, interlocks and warning lights
serve to prevent possible radiation exposure to anyone in the vicinity
of the instrument.

Equipment - Safety Over-Rides

Any mechanical or electrical system can, by deliberate action, be

made unsafe (e.g., using a key to over-ride the interlock system, using
jumper wires to bridge an open switch, and/or mechanically opening or
removing something). Such actions are reserved for service personnel
in the repair or alignment of the instrument. Such actions should
NEVER be done by users.

Equipment - Repairs

Users are NEVER to attempt repairs or make non-trivial adjustments

to instruments. If there is a problem, inform the instrument supervisor.
Depending on the severity of the problem, in the absence of the
supervisor, users should label the instrument as "down" and power it
off. For lesser problems, if deemed safe to do so, label it and walk
If users encounter an instrument being repaired, stay back and do
not touch it!

Normal Operating Procedures

'Normal Operating Procedures' mean operating procedures for

conducting suitable for analytical purposes with shielding and barriers
in place. These do not include maintenance but do include routine
alignment procedures. Routine and emergency radiation safety
considerations are part of these procedures.
Normal operating procedures shall be written and available to all
analytical x-ray equipment workers.

One of the major causes of X-ray accidents has been taking short
cuts in attempts to complete work more quickly. Most of these involved
defeating interlocks, or modifications to the instruments, but still one
must think through every task and procedure to recognize and avoid
hazards. If contemplating an improvisation, talk it over with the
instrument supervisor first and notify the UNC Radiation Safety Office.
Work smart!

Monitoring (Inspections and Audits)

The UNC Radiation Safety Office regularly conducts surveys and

inspections of every X-ray instrument on campus, and will also inspect
X-ray instruments at other times as requested (any concern about
safety, after major repairs or any modifications have been made, etc.).
If you have concerns, it would be best to express them to the
instrument supervisor first, but the UNC Radiation Safety Office will
also hear and act on your concerns.
In addition to inspections by the UNC Radiation Safety Office, the
State of North Carolina also inspects the X-ray instruments on a
random schedule along with inspecting our records (e.g. user training
logs). They watch for user compliance with rules (e.g. use of
dosimeters, unreasonable over-riding of interlocks, no food in the lab,
etc.), and they are strict.
The UNC Radiation Safety Office, instrument supervisors, or
individual users can make surveys of the instruments. This consists of
using a radiation detector (Geiger counter or other such device) to
measure radiation levels all around the instrument, paying special
attention to sites such as joints in collimators. These surveys must be
documented. Make a drawing of the instrument, record the radiation
levels at different locations, and file the survey results in the
instrument records.

The state agency that governs the use of radiation machines is the
Radiation Protection Section of the North Carolina Department of
Environment and Natural Resources.
The official procedure of the Radiation Protection Section to follow in
the event of a radiation accident is:

1. go to the hospital
2. file a report within 30 days

The Radiation Protection Section monitors TLD finger ring and OSL
badge reports for about 5 years; any excess exposure requires a report
- failure to do so results in a citation
The UNC Radiation Safety Office should be involved in preparing the
report (and would likely be who alerted the laboratory personnel to the
problem in the first place).


The response at a hospital emergency room for the victim of a

radiation accident would include:

1. treatment of the symptoms (combat swelling, avoid infection,

and other steps in severe burn treatment)
2. take a baseline CBC (a blood test to tell whether future blood test
show changes in any parameter)

The injury cannot be undone - hospital workers can only lessen the
effects of the injury as the body attempts to repair itself.

Let us close this session with a brief summary and some
recommendations for safe practices when using the analytical x-ray

Analytical x-rays provide useful information about materials, but
their use is accompanied by risk of injury. The objective is to maximize
the information gathered and minimize the risk.
Analytical x-rays are machine generated and are designed to
produce an intense, highly collimated beam, which is accompanied by
less intense, un-collimated scatter from the sample.
The energy from the beam can be absorbed by bone, muscle, fat,
skin and organ tissues. Significant absorption results in severe burns
and long term effects, like cancer and/or cataracts (eye exposure).
Risk of injury can be estimated by dose calculations and controlled
by proper equipment, procedures and attitudes. Accidents are treated
symptomatically, an reports are to be filed.

This concludes the tutorial part of your on-line analytical X-ray safety
training. If you have any questions, please feel free to contact the UNC
Office of Radiation Safety at 2-5507 or radiation safety
This portion is followed by a quiz, which must be successfully
completed (score of 75% or better) to receive your dosimeters and
authorization to use the analytical X-ray instruments.

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understand any part of this training I will direct my questions to the
UNC Radiation Safety Office for clarification. I will not begin working
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