Radiation safety principles and governance
1. Principles of radiation safety
The three key principles are time, distance and shielding.
Time: Fluoroscopy should be used to reduce the duration of exposure.
Distance: Radiation intensity decreases inversely with the square of the distance from the source. Standing double the distance away results in a four-fold reduction in dose.
Shielding: Personal protective equipment (PPE) should include thyroid guard and well-fitting lead (or equivalent) gowns, with appropriate coverage for the individual.
2. UK legislation and governance
The safety of individuals who may be exposed to radiation at work is covered by the Ionising Radiation Regulations 2017 (IRR17), which are enforced by the Health and Safety Executive (HSE).
Radiation exposure should comply with the ALARA principle = 'as low as reasonably achievable'. This should be achieved using the principles of radiation safety, engineering and design to reduce exposure, and adequate PPE.
Radiation protection advisors (RPAs) are external bodies, regulated by HSE. They must be consulted by hospitals for advice on ensuring working conditions comply with IRR17.
Radiation Protection Supervisors (RPSs) are appointed by hospitals to ensure local rules are followed. RPSs are typically hospital employees, commonly based in the radiology department. They are the first port of call for any work-related radiation concerns.
Reporting of Injuries, Diseases and Dangerous Occurrences (RIDDOR) places a duty on an employer to report workplace-related illness. This includes disease related to ionising radiation exposure, including occupational cancers.