4.11 Radiation Protection - AH

Radiation Protection
Alison Hand
alison.hand@christie.nhs.uk
© 2018 The Christie NHS Foundation Trust

All rights reserved
The Christie NHS Foundation Trust

Overview
• Basic principles of radiation protection
• Radiation protection regulations and
legislation and their application
• IRR17
• Coffee break!
• IR(ME)R2017
• Room design for radiation therapy
• Monitoring

Key principles
• Distance
o The further from a source, the lower the
dose (inverse square law).
• Time
o Limit time spent near sources of radiation.
• Shielding
o Appropriate shielding will attenuate
radiation and reduce dose.
• Technique
o Well-practiced techniques will be safer
and reduce time required

Definitions of Radiation Dose for RP
Absorbed dose Unit = Gray
Radiation weighting
Equivalent dose Unit = Sievert
Tissue weighting
Effective dose Unit = Sievert

Absorbed Dose
(dose to a particular place in the body)
• Energy deposited per kilogram
• Units:
Joules (unit of energy) per kg (unit of mass)
• Special unit:
Gray (Gy)
• Typical doses:
o 60 Gy dose to radiotherapy target
o 50 mGy liver dose from CT abdomen scan

Equivalent Dose
(considering different types of radiation)
• Different types of ionising radiation differ in the way they
interact with biological material:
o Equal absorbed dose does not mean equal biological damage
o For example, alpha particles are heavily charged -> deposit their energy
densely in their path through tissue -> many double strand breaks in DNA
• Equivalent dose = Absorbed dose  Radiation weighting factor

(reflecting relative biological harm)
• Unit = Sievert (Sv)
• 1Sv of x-rays gives the same risk of inducing cancer as 1Sv of

alpha radiation (if delivered to the same tissue)

Radiation Weighting Factors
(also known as quality factors)
Type of radiation Radiation weighting factor
X-rays, Gamma rays,

1
betas
Protons 2
Alphas 20
Depends on Neutron energy

Neutrons
(approximately 2 – 20)

Effective Dose
(averaged over whole body)
• Different organs in the body are more radiosensitive (more
likely to develop a radiation-induced cancer) than others
o For example, breast tissue is more sensitive than the gonads or skin
• To calculate effective dose:

o Multiply the equivalent dose to each organ by the relevant tissue
weighting factor
o Sum the results for each organ to obtain whole body effective dose
• Unit = Sievert (Sv)

o Same as for equivalent dose, so care is required
• Gives a broad indication of the detriment to health from

exposure to ionising radiation - allows us to estimate risks

Tissue
Tissue weighting factors
Weighting Factors
Tissue or organ Tissue weighting Tissue weighting
factor factor
(ICRP 60, 1990) (ICRP 103, 2007)
Gonads 0.2 0.08
Red bone marrow, 0.12 0.12
Colon, Lung, Now includes Breast
Stomach
Bladder, Breast, Liver, 0.05 0.04
Oesophagus, No longer includes
Thyroid Breast
Skin, Bone surface 0.01 0.01
Now includes brain,
salivary glands
Remainder 0.05 0.12
Whole Body Total 1.00 1.00

Types of damage from radiation
exposure
Deterministic effects:
• acute damage – days to months after exposure
• threshold dose for effect to be seen
• e.g. skin burn, loss of saliva production, bone
marrow suppression, sterility
Stochastic effects:
• long term damage - manifests years after exposure
• assumed that there is no threshold dose
• e.g. hereditary defects, cancer induction

Deterministic Effects
• Skin damage - 2 Sv
• Cataracts – 2 to 10 Sv
• Hair loss – 3 Sv
• Sterility – 2.5 to 3.5 Sv
• Radiation sickness – 1Sv

Deterministic Effects
• Example of skin damage:

Question
• Which is the most appropriate quantity for

assessing the risk from exposure to ionising
radiation?
a) Equivalent dose
b) Effective dose
c) Absorbed dose
d) Deterministic effect threshold

What radiation sources are you
exposed to?

Sources of Radiation Dose
• Radon in air • Food
• Discharge from nuclear • Return flight from London

industry to New York
• CT scan of chest • Building materials & rocks
• Smoke detectors • Cosmic radiation
• Occupational dose of • Single chest X-ray

Interventional Radiologist (plain film)
Put them in order of dose (per year unless stated otherwise)

In order
• CT scan of chest (8mSv) • Food (0.25mSv)
• Radon in air (1.2mSv) • Return flight from London to

New York (0.1mSv)
• Occupational dose of
Interventional Radiologist • Single chest X-ray (plain film)
(0.35mSv) (0.02mSv)
• Building materials & • Discharges from nuclear

rocks (0.35mSv) industry (0.00007mSv)
• Cosmic radiation • Smoke detectors

(0.33mSv) (0.00006mSv)

Background radiation
Average effective dose in UK
 2.2mSv from natural sources
Radionuclides in air (Radon and Thoron) 1.3 mSv
Building materials and rocks 0.35 mSv
Cosmic radiation 0.33 mSv
Food 0.25 mSv
HPA-RPD-001 2005
Variation across country
Cornwall
Derbyshire
Northamptonshire
Greater Manchester
Isle of Wight
0 1 2 3 4 5 6
Effective Dose mSv pa
HPA-RPD-001 2005
Occupational exposure
Average effective dose pa mSv

0 0.5 1 1.5 2 2.5
Fuel reprocessing
Power stations
Defence
General Industry
Coal miners
Non-coal miners
Aircrew
HPA-RPD-001 2005
Medical occupational exposures
Radiographers
Diagnostic Radiologists
Cardiologists
Interventional Radiologists
Nuc Medicine Radiographers
0 0.2 0.4 0.6 0.8

Average annual dose mSv
HPA-RPD-001 2005
Statutory Framework for Radiation
Protection

Where is the legislation from?
ICRP
International
Commission for
Radiological
Protection BSSD 2013
2007
1991
2007
UK Legislation
2000
2017

Updated UK Legislation
Ionising Radiation Ionising Regulations

(Medical Exposures)
Regulations Regulations
(IRR99) IR(ME)R 2000
Medical
Administration of
Radioactive
Substances (MARS)
1978


(Medical Exposures)
From 1st Jan 2018 From 6th Feb 2018
Medical
Administration of
Radioactive
Substances (MARS)
1978

The Ionising Radiations Regulations 2017
(IRR17)
IRR17 covers:
• Protection of employees
• Protection of members of the public
Under the Health and Safety at Work Act

Responsibilities
Legal person responsible
for compliance with regs
e.g. C.E. of Trust
Employer
RPA RPC Manager

Radiation protection Radiation protection
adviser committee
RPS
Appointed in writing Radiation protection
Meets competency criteria supervisor
defined by HSE Some authority
ADVISE only Appointed in writing
Employee Ensures compliance
with local rules
Under IRR17
Every employer must ... take

all necessary steps to restrict
so far as is reasonably practicable the extent
to which its employees and other persons
are exposed to ionising radiation

Hierarchy of protection methods
• Engineering controls and design features Must be

• Safety features and warning devices tested
• Systems of work
• Training
• Personal protective equipment Must be looked after

Dose limits
• It is insufficient for employee doses to be below the limit if
they are not ALARP - limits are like a back-up timer.
• Dose limits have changed in IRR17 compared to IRR99
mSv p.a. Effective Extremities, Eye lens

dose skin (averaged
over 1cm3)
Employees & trainees (>18) 20 500 150 20*
Trainees (<18) 6 150 50 15
Others 1 50 15
* If requested, an effective dose of 100mSv in any period of five consecutive
calendar years subject to a maximum equivalent dose of 50mSv in any single
calendar year may be approved by the Health and Safety Executive

Dose levels
• Classification – an employee must be designated
as a classified worker if they are likely to receive:
o Effective dose greater than 6 mSv per year
o Equivalent dose greater than 15 mSv per year for the lens of
the eye
o Equivalent dose greater than 150 mSv per year for the skin or
the extremities
• Formal Investigation Level

o Employer must investigate if effective dose above a
pre-agreed level is received by an employee
o Level must be no higher than 15mSv
o Usually between 1 and 4 mSv in health service

Classification of Staff
• Prior risk assessment should identify staff who will
need to be classified
o Alternatively may be identified when high doses are picked up by
personal dose monitoring
• An appointed doctor should assess suitability before

classification and then perform annual health checks
• Appropriate personal monitoring may include

extremity monitors and electronic (instant) dose
readouts

Risk assessment and hazard identification
• Prior risk assessment
o before a new activity using IR
o suitable and sufficient estimate of the risk
o includes estimation of maximum doses likely to be received by
staff and public
o regular review
• Hazard identification
o identify hazards with potential to cause accident
o assess risks associated with likely accident scenarios
• Contingency plans
o how to deal with hazards

Designation of Areas
• Controlled area
o if special procedures are needed to limit dose
o if effective dose likely to be >6 mSv per year
o if equivalent dose likely to be >15 mSv per year for the lens
o if equivalent dose likely to be >150 mSv per year for skin / extremities
• Supervised area
o if area needs to be kept under review
o if effective dose likely to be >1 mSv per year
o if equivalent dose likely to be >5 mSv per year for the lens
o if equivalent dose likely to be >50 mSv per year for skin / extremities

Requirements for Controlled Areas
• Demarcation
• Suitable signs

Controlled area signs
Radiation Do not enter

Controlled without
Area permission

Requirements for Controlled Areas
• Demarcation
• Suitable signs
• Procedures for restriction of entry
• Written arrangements for entry of non-classified
staff
• Demonstrate that non-classified staff dose is
being restricted (e.g. by personal monitoring)
• Designated RPS
• Local rules

Local Rules
Written local rules to identify the key working instructions intended
to restrict any exposure in that controlled or supervised area.
• Must contain: • Should be:

o details of management & o brief and clear
supervision of work o focused on key work
o description of areas covered instructions that will keep
by the rules & designation doses low
o written arrangements for o ‘local’ (i.e. refer directly to
restricting access for work at a specific location
non-classified persons taking into account the
o summary of relevant work working environment)
instructions o reflective of actual working
o dose investigation levels practice, not an unattainable
o contingency plans ideal
o details of training procedures o reviewed regularly (< 3y)

Special Considerations for Unsealed Sources
• Controlled area not needed if the only "sources" present are

diagnostic patients
• Controlled area needed:

o if patient has a therapeutic dose of a  emitter and
E > 150 MBq.MeV
o if there is significant risk of spread of contamination
• Supervised area needed:

o if there is a possibility of build up or spread of
contamination
o If the area needs to be monitored to see whether there is a
need to change the designation to controlled

Training
• All employees working with ionising radiation should
know
o risks to health
o precautions to be taken to reduce dose
o importance of complying with the regulations
• Other employees involved

o adequate info to ensure their health and safety
• Information to female employees must include

informing employer of pregnancy

Incidents (staff)
• If suspected dose > local investigation level
o investigation needed – involve RPA
• If suspected dose > 6mSv (or 3/10 of any limit)

o must carry out dose assessment
• If suspected dose > dose limit

o investigate
o keep record for 2 years
o inform HSE
o inform an appointed doctor
o tell person involved
• If dose confirmed as likely to have been > dose limit

o further investigate and assess dose
o keep records for 30 years
Appointing RPAs
An RPA must be consulted for:
• requirements for • designation of areas
controlled areas • investigations into
• planning new overexposure
installations • contingency plans
• checking monitoring • dose assessment and
equipment recording
• checking safety features • quality assurance
and systems of work programme
• prior risk assessment

Employee’s Responsibilities
• Take reasonable care not expose themselves or
others to a greater extent than is necessary
• Tell employer if they suspect an overexposure
incident has occurred
• Not to tamper with or recklessly misuse equipment
• Wear and return dosemeters, if issued
• Use PPE
o report defects in PPE
o return to appropriate storage after use
• Those members of staff who do not comply
may be prosecuted under criminal law


(Medical Exposures)
Medical
Administration of
Radioactive
Substances (MARS)
1978

Medical exposure principles
Justification: any decision that alters the existing
radiation exposure situation (e.g. by introducing a
new radiation source or by reducing existing
exposure) should do more good than harm.
Optimisation: the likelihood of incurring exposures,

the number of people exposed, and the magnitude of
their individual doses should all be kept as low as
reasonably achievable, taking into account economic
and societal factors.

IRMER Duty Holders
• Referrer
• Practitioner
• Operator
• Employer

Referrer
Who:
• registered healthcare professional
• local decision
Responsibilities:
• responsible for providing “sufficient medical data”
to the practitioner to enable justification
o Patient identification
o Clinical details
• employer must provide referral criteria

Practitioner
Who:
• registered healthcare professional
• local decision
• must have “adequate training”
Responsibilities:
• justification of each exam
• ensure target volumes are individually planned
• doses to non-target volumes ALARP
• comply with employer’s procedures

Justification
The Practitioner must take into account the
information supplied by the Referrer and consider:
• the specific objectives of the exposure and the characteristics

of the individual involved
• the total potential or therapeutic benefits, including the direct

health benefits to the individual and society
• the individual detriment, as well as any detriment to an

unborn / breastfeeding child
• the efficacy, benefits and risks of available alternative

techniques

Justification
2 stage process: justify and authorise as justified
• Directly:
o Practitioner reviews referral card / patient, justifies
and authorises
• Indirectly:
o Practitioner lays down criteria for acceptance of
referrals and the operator authorises that the
referral complies with these criteria

Justification
2 stage process: justify and authorise as justified
• Christie therapy solution:

o First clinician to see patient at hospital acts as
referrer
o Justified at two stages: pre-treatment preparation
and prescription by clinical oncologist
o authorised by clinician signing forms

Who is an operator?
Anyone carrying out practical aspects of optimisation
of a patient’s dose:
Operator Not operator
Loading
Transporting
Checking
Checking patient
Informing
QC patient
of
Calculation
Checking
Administering
patient
patient images
treatment
delivery
patient
around
of MU/of into
plan
chemotherapy
into
ID hospital
department
for treatment
Checking
Creation
Assessing sidepregnancy
ofeffects
treatment status
plan NHS Foundation Trust
of treatment
The Christie
planning
measurement system
appointments
equipment
Operator
Who:
• any person who is entitled to carry out practical
aspects, including those to whom practical aspects
have been allocated
• includes people participating in practical aspects as part
of practical training, unless directly supervised
Responsibilities:
• select equipment and methods to ensure dose ALARP
• must not perform exposure unless authorised as justified
• if performing exposure must ensure that patient has
been asked if pregnant (when appropriate)
• must follow employer’s procedures
Employer
In order to provide a framework to ensure efficient,
effective and safe delivery of radiotherapy services, the
employer must:
• provide written procedures (and ensure compliance)

• establish written protocols for every type of standard radiological
practice (including non-medical imaging)
• establish referral criteria for medical exposures and ensure that
these are available to the referrer
• ensure adequate training for practitioner and operator
• ensure continuing education and training of practitioners and
operators (including radiation protection requirements)

Employer
employer must:
• regularly review and make available diagnostic reference levels

(DRLs) for radiological procedures
• conduct incident investigations for unintended exposures
• collect population dose estimates from medical exposures for
radiodiagnostic and interventional procedures, taking into
consideration age and gender
• ensure all research is REC approved and set dose constraints
• establish appropriate dose constraints and guidance for exposure
of carers and comforters

Employer
employer must:
• establish QA programmes / risk assessments / clinical audits

• appoint and involve a suitable medical physics expert (MPE)
• maintain an inventory of equipment and specify acceptable
performance criteria and corrective actions for defects
• take measures to raise awareness of the effects of ionising
radiation amongst individuals capable of childbearing or
breastfeeding

Procedures
Legally binding on practitioners and operators
• Patient identification
• Who can act as referrer, practitioner, operator
• Asking pregnancy question
• Clinical evaluation
• Research
• QA of IRMER procedures and protocols
• Assessment of patient dose
• Reducing accidents
• +

Protocols
• For every standard radiological/therapy

practice for each equipment:
o Equipment settings
o Standard projections
o Guidelines on standard practice in Department
o Allow room for professional judgement
o Equipment specific

Training
• Practitioners and Operators must be “adequately

trained”:
o Training includes theoretical knowledge and practical experience
o Syllabus defined in Regs
o Part 1 of FRCR should cover all theory basics
• Employer must ensure that Practitioners / Operators

undertake relevant continuing training and education
• Employer must keep up-to-date records of training

Medical Physics Expert
“A person with a science degree and experience in application of
physics to medical diagnosis and therapy”
– IR(ME)R2000
“An individual or a group of individuals, having the knowledge,

training and experience to act or give advice on matters relating
to radiation physics applied to exposure, whose competence in
this respect is recognised by the Secretary of State”
– IR(ME)R17

Medical Physics Expert –
IR(ME)R2000
A Medical Physics Expert (MPE) must be:
• Closely involved for all radiotherapy practices

• Available for standardised nuclear medicine
practices
• Involved as appropriate for consultation on
optimisation, including patient dosimetry and QA,
for all other radiological practices

IR(ME)R17
A Medical Physics Expert (MPE) must be:
• Closely involved for all radiotherapy practices
• Involved in standardised nuclear medicine practices and high
dose interventional radiology and high dose CT
• Involved as appropriate for consultation on optimisation for all
other radiological practices
An MPE must give advice on:

• dosimetry & QA matters relating to radiation protection
concerning exposures
• physical measurements for dose evaluation
• medical radiological equipment
IR(ME)R17
An MPE must contribute to:

• optimisation of the radiation protection of patients and other
individuals subject to exposures, including the use of DRLs
• the definition and performance of quality assurance and
acceptance testing of equipment
• the preparation of technical specifications for equipment and
installation design and the surveillance of the medical
radiological installations

IR(ME)R17
An MPE must contribute to:

• the analysis of events involving, or potentially involving,
accidental or unintended exposures
• the selection of equipment required to perform radiation
protection measurements
• the training of practitioners and other staff in relevant aspects of
radiation protection
• provision of advice to the employer on IR(ME)R compliance


(Medical Exposures)
Medical
Administration of
Radioactive
Substances (MARS)
1978

The Medicines (Administration of Radioactive
Substances) Regulations 1978 (MARS)
& Amendment Regulations 1995
ARSAC: Administration of Radioactive Substances Advisory Committee
• An ARSAC Certificate is required for any administration of
a radioactive substance for diagnosis, therapy or research
• Certificates are specific to a person, a site, and the purpose

(e.g. diagnosis), and list the types of investigation/treatment
which have been authorised
• Other persons may act under the directions of a certificate

holder (e.g. other radiologists, radiographers).
• Must be renewed every 5 years
REVOKED BY IR(ME)R17
FROM 6TH FEB 2018
Licensing Requirements –
IR(ME)R17
Employer
• Must hold a licence at each radiological installation where radioactive
substances will be administered
• For the specific purpose of diagnosis, treatment or research
• This will define the scope of the service at the site
Practitioner
• Must hold a licence to justify exposures involving the administration of

radioactive substances
• For the specific purpose of diagnosis, treatment or research
• The scope of the licence will reflect the individual’s training and
experience

IR(ME)R17
• No person can carry out an exposure involving the
administration of radioactive substances unless
both the practitioner and the employer are licenced
• Operators may authorise exposures in accordance

with guidelines issued by the licensed practitioner
• Research involving the administration of

radioactive substances must be approved by an
expert committee (ARSAC)

IR(ME)R17
Any current ARSAC certificate after 6th Feb
2018 is deemed:
• To be equivalent to a practitioner licence for the

same scope and purpose for which it was issued
until its expiry date
• To licence the employer at the medical radiological

installation for the same scope and purpose

Unintended exposures –
IR(ME)R2000
• Exposures "much greater than intended" (MGTI) must be
reported to the Care Quality Commission (CQC).
• Details of what constitutes an MGTI exposure can be found in
guidance published on the Department of Health website:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/
583637/MGTI_guidance_Jan_17.pdf
• Notification is not required where the exposure is:

(i) less than intended, or
(ii) greater than intended, but less than the relevant
guideline factor

IR(ME)R2000
Unintended exposures to be reported include:
• Incorrect patient exposed / Unintended planning or
verification exposures
• Failure to follow procedure regarding pregnancy enquiries
resulting in an unintended exposure to the foetus
• Unintended foetal exposure where there was no failure to
follow procedure regarding pregnancy enquiries when the
foetal dose is >10mGy
• When the delivered dose to the planned treatment volume
and/or OAR is 1.1 times (whole course) or 1.2 times (any
fraction) the intended dose

IR(ME)R2000
Unintended exposures to be reported include:
• Total geographical miss
• Partial geographical miss that exceeds the locally defined
error margin AND the guideline dose factor above for the
exposed tissue
• Imaging doses >2.5x intended dose due to repeated or
high dose scans
• Five repeat imaging exposures for a single patient over a
course of treatment due to human or procedural error

Incident Reporting
• Classification system for
radiotherapy errors and
near misses outlined in
Towards Safer
Radiotherapy
• Provides information to the
radiotherapy community
about most common near
misses
• Multiple near misses are
often a prelude to a more
serious event

Incident Reporting
TSR Classification of radiotherapy Errors
Radiotherapy Error
Radiation Incident? Potential for radiation incident?
Reportable?
Correctable radiation incident?
Potentially or actually clinically

Significant?
Level 1 Level 2 Level 3 Level 4 Level 5

Reportable radiation incident Non reportable radiation incident Minor radiation incident Near Miss Other non conformance

Reportable doses
• Equipment – Previously
reportable to HSE, now to CQC
• Procedural – Reportable to
CQC

Radiotherapy Incidents Best Practice
• Near misses and incidents recorded
• Reported via line manager
• If in doubt report it!

o No blame/fair blame cultures
• Incidents reviewed by trust committees

7
Question
• Who ensures compliance with the local rules

in their department?
a) RPA
b) Operator
c) RPS
d) Practitioner

Radiotherapy Room Design

Room Design Overview
Aim is to ensure set dose limits are not exceeded for
staff & public (based on IRR17)
• Bunkers will be controlled areas:

o Access will be restricted
o Design should still aim to minimise doses in surrounding areas
• Dose reduction mostly achieved using highly

attenuating bunker walls (shielding)
o Thickness and design must be carefully calculated
o Higher energy -> more penetrating radiation -> more attenuation
required

External Beam - Sources of
Radiation
Primary (or clinically useful) Radiation
• Highly collimated beam directed at the patient
Leakage Radiation
• Unwanted radiation generated from
structures within the equipment (i.e.
not exiting via the collimation system)
• Specified level checked at installation:
o 0.1% for MV
o 2.0% for kV

External Beam - Sources of
Radiation
Scattered Radiation
• Unwanted radiation scattered from the patient,
structures within the room etc.
• Lower average energy compared to primary beam,
however use max energy in calculations
• Intensity dependent upon field size used
o Larger field -> more scatter

• In the design of treatment rooms both

the leakage and primary radiation must
be considered
• Fundamental principles :
o Distance
o Shielding
o Time

Distance: Inverse Square Law
Inverse square fall-off with distance from radiation source
5
4.5
Relative dose rate (normalised at 100cm)
3.5
2.5
1.5
0.5
0
0 50 100 150 200 250 300
Distance (cm)

1. A room must be set apart for the purpose,

which will provide appropriate shielding
2. Consider function/occupancy of adjoining

rooms, floor space and ceilings. Work to
annual dose limits of occupants.
3. Special attention to adjacent areas in the

primary beam (high energy & intensity)
4. Consider the dose-rate of the machine

5. Consider distance from the machine

(the larger the room the better)
6. Consider attenuation of the wall material
7. Consider classification of areas

(controlled / supervised according to IRR)
8. Consider time allowances (occupancy,

machine orientation, duty cycle)

Primary and Secondary Barriers
Primary barrier:
• The section of treatment
room shielding in the direct •1o
path of the treatment beam
Secondary barrier:
•2o
• The section of room
shielding not in direct path
of the treatment beam, but
required to protect against
scatter and leakage

Typical Room Design – MV Equipment
• Thick walls, fixed beam directions:
o Option 1: thicker maze walls to prevent penetration
into maze
o Option 2: more maze scatter.
Option 1 Option 2
Typical Room Design – kV Equipment
• Machine in middle
of room
Tube support
HT transformer
• Can point in any
x-ray tube
direction Treatment couch
• Walls usually have

3mm lead lining
• Lead-lined doors viewing
window
sliding door
• Lead glass windows

control area
• CCTV

Other Treatment Machines
Images ref.: http://www.tomotherapy.com/ and http://www.cyberknife.com/

Attenuation of radiation
As a radiation beam passes through matter, intensity is
attenuated exponentially:
 mx
I = I 0e
Where:
m = linear attenuation co-efficient (dependent upon
material and energy)
I = resulting intensity
I0 = initial intensity without attenuating material
x = thickness of attenuating material
e = natural exponential
Attenuation of Radiation
Attenuation
100
90
80
70
Relative Intensity
60
50 High μ
40
Medium μ
Low μ
30
20
10
0
0 5 10 15 20 25 30
Depth (m)

Attenuation of radiation
 mx
I = I 0e
I 
ln   =  mx
 I0 
I
= Fractional decrease in intensity
I0

Attenuation parameters
I 5 1
= =
I 0 10 2
X = Half-Value
thickness (HVT)
I0 = 10mSv/hr I = 5mSv/hr
or
Half-Value layer
x (HVL)

Attenuation parameters
I0 = 10mSv/hr I = 2.5mSv/hr
1 HVL 1 HVL

Half-Value Thickness (HVT)
HVT is amount of material required to reduce
radiation intensity by half:
I 1 1
= ln  =  m  HVT
I0 2 2
ln 2 = m  HVT
ln 2
HVT =
m
Typical Barrier Thicknesses
Radiation Attenuation Thickness (mm) Thickness of Pb
Quality Factor of Concrete (mm)
(2350 Kg m-3)
Orthovoltage
X-rays
100kV 10-3 165 2.4
300kV 460 17
Megavoltage X- Thickness of
rays steel (mm)
Cobalt 60 10-6 1380 408
4 MV 1640 510
6 MV 2030 564
10 MV 2320 630
20 MV 2740 630

Other Room Design Considerations
• Maze:
o Ensure no direct path for scattered radiation out of the room
o Consider total pathlength, cross-sectional area and number
of turns in maze
• Neutrons:
o Photon energy >10MeV leads to neutron production in target
and collimators
o Neutrons can easily escape maze, therefore:
• walls should be lined with “thermalising” materials
• door should be placed at maze entrance
• Roof:
o Level of shielding depends on access requirements
o Need to account for “sky-shine”

Maze Entrance

Treatment Room Door
(only necessary for short mazes / high energies)

Room Design – Other Safety Features
• Controlled Area signs:

o Any controlled area must be clearly identified as such,
using standard signs
• Warning lamps / audible alarm:

o Warning lamps both inside & outside room should
be illuminated when radiation beam is on
o Audible alarm should also sound when beam is on
o Both of these should be interlocked to machine – if
warning systems fail, machine should not function

Room Design – Other Safety Features
• Emergency Stop buttons:

o Used to cut power to the equipment in case of
emergency (fire/malfunction)
o Clearly identifiable and accessible (one on each wall /
on couch / at control desk)
• Interlock access to room:

o “Last person out” system
o Either light gate or door at entrance used to monitor
access whilst beam is on
o Terminates beam if interlock broken

Question
• Which has the highest average energy?

a) Primary beam
b) Leakage radiation
c) Scattered radiation
d) All the same

Question
• If the HVT is 5cm, what thickness of barrier is

needed to reduce the dose rate from
24mSv/hr to 3mSv/hr?
a) 3cm
b) 10cm
c) 15cm
d) 20cm

Personal Monitoring

Requirements for monitoring
• All classified staff must be monitored

• Must be able to prove non-classified staff
receive < classification limits
• Should monitor if annual dose likely to be:

o Whole body >1mSv
o Eye > 15mSv i.e. public dose limit
o Hand > 50mSv

Monitoring Personnel
Whole body badge
• An approved dosimetry body
will provide film / TLD badge
• Should be worn under apron,
front mid trunk
• Should be exchanged at end
of wear period
• Results should be available
on notice board and reviewed
locally by Manager or RPS
• Any unusual dose should be
reported and investigated

Thermoluminescent Dosemeter
X-ray photon in light photon out
Energy stored in
crystal lattice
• Doped lithium fluoride (LiF:Mg,Cu,P)

• Light out  dose in
•  20% energy variation only

Electronic Personal Dosimeter
• Solid state detector – silicon diodes
• Relatively energy insensitive (factor of 1.5)
• No image or permanent record
• Range 1 mSv – few Sv
• Need to consider if will measure correctly in pulsed
radiation field i.e. LINAC beams
Images ref.: http://www.biodex.com/

Extremity monitoring
• Greater importance as eye dose limit reduced
• Extremity badges – e.g TLD ring dosimeters
• Measure at a depth of:
o 0.07 mm for skin o 3 mm for lens of the eye

Practice Exam Question
What change will most reduce the dose to an exposed
individual from a point source of radioactivity?
a) Reduce the activity of the source by half

b) Reduce the time for which the individual is exposed by one-third
c) Double the distance from the source
d) Increase the thickness of the protective barrier between the
source and the individual by 1.5 HVL
e) Reduce the intensity of radiation transmitted by the protective
barrier between the source and the individual by one half

Any questions?
alison.hand@christie.nhs.uk
© 2018 The Christie NHS Foundation Trust


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Radiation Protection

© 2018 The Christie NHS Foundation Trust

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Absorbed dose Unit = Gray

Equivalent dose Unit = Sievert

Effective dose Unit = Sievert

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• Energy deposited per kilogram

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• Equivalent dose = Absorbed dose  Radiation weighting factor

• Unit = Sievert (Sv)

• 1Sv of x-rays gives the same risk of inducing cancer as 1Sv of

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Type of radiation Radiation weighting factor

X-rays, Gamma rays,

Depends on Neutron energy

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• To calculate effective dose:

• Unit = Sievert (Sv)

• Gives a broad indication of the detriment to health from

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• Which is the most appropriate quantity for

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• Discharge from nuclear • Return flight from London

• CT scan of chest • Building materials & rocks

• Smoke detectors • Cosmic radiation

• Occupational dose of • Single chest X-ray

Put them in order of dose (per year unless stated otherwise)

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• Radon in air (1.2mSv) • Return flight from London to

• Building materials & • Discharges from nuclear

• Cosmic radiation • Smoke detectors

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Radionuclides in air (Radon and Thoron) 1.3 mSv

Building materials and rocks 0.35 mSv

Cosmic radiation 0.33 mSv

Food 0.25 mSv

Average effective dose pa mSv

Nuc Medicine Radiographers

0 0.2 0.4 0.6 0.8

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Ionising Radiation Ionising Regulations

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Ionising Radiation Ionising Regulations

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Under the Health and Safety at Work Act

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RPA RPC Manager

Every employer must ... take

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• Engineering controls and design features Must be

• Personal protective equipment Must be looked after

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mSv p.a. Effective Extremities, Eye lens

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• Formal Investigation Level