Why the Management of Radiation is Important to Medicine
Radiation has an amazing range of uses that benefit humans, particularly in the way it is applied by medical professionals to help them ‘see’ areas of the body beneath the skin. X-rays use radiation to pass through our skin to cast shadows that can be detected on photographic film. This allows doctors, dentists, chiropractors and veterinarians to spot broken bones and dental problems.
Radiation also possesses the ability to kill cancerous tissue or reduce the size of a tumour. Although you will never see actual radiation, you may be familiar with X ray machines or having to go for a ‘CT scan’. These machines when combined with ingesting slightly radioactive substances, help doctors see the shapes and details of your internal organs such as the pancreas, kidney, thyroid, liver or brain, to diagnose clinical conditions.
However, radiation material and equipment can be also be put to more sinister uses making the management of radiation inventory critical.
The Management of Radiation material
Radiation material is required for both x-rays equipment that irradiates through the air, and to kill cancerous tissues using specific radioactive material. For example, radioactive iodine (specifically iodine-131) is commonly used to treat thyroid cancer while irradiating apparatus is required for almost any detailed dental diagnosis.
How Radiation is Currently Managed in New Zealand
Every person is required to hold a current radiation licence that covers them for a specific purpose from a permitted source. Some of the common licence purposes are:
Use of Nuclear Density Meters
Installation & Servicing
X Ray Security & Inspection
Sentinel Node Biopsy
This ensures that the radioactive material or irradiating apparatus is used for the purpose it has been licensed for. This is important, because radiation can accidentally penetrate the skin and damage the cells inside if not correctly handled and administered. Unsecured radioactive sources have caused deaths and serious injuries in many parts of the world.
New Zealand Radiation Safety
The Radiation Protection Act 1965 and Radiation Protection Regulations 1982 control the use of ionising radiation by medical professionals to ensure they hold a licence and comply with a code of safe practice. This helps avoid events involving radioactive sources that are beyond regulatory control and to prevent deliberate attempts to acquire radioactive sources for more sinister purposes. The International Atomic Energy Agency saves as the world’s central intergovernmental forum for scientific co-operation in the nuclear field, and they have released a 77 page implementation guide on the security of radioactive sources.
Radiation Material Risks
Keeping an accurate inventory of radiation materials is critical, as is being able to identify discrepancies in inventory data. Suspected or actual theft of a radioactive source is a notifiable event that must be able to be reported. Maintaining an accurate inventory is your last line of defence and will tell you whether your practice has lost control over a radioactive source whether material or equipment. Procedures must be in place for timely reporting of security events such as inventory discrepancies.
Of course, good radiation inventory record keeping through inventory management should be used in conjunction with security of your practice in particular the source storage area. Security systems are essential to the protection of radioactive sources.
Radiation Safety Plan for New Zealand Medical Practices.
A Radiation Safety plan should be prepared for each facility by its medical practice owner. Radiation Safety plans should take into account both stored sources, mobile and portable use sources and sources stored between periods of use. These plans are sensitive in nature and should be secured with strong encryption. The Radiation Safety Plan should also allow for a higher level of security in case of a wider security level alert increase.
A Radiation Safety Plan should include all information necessary to describe the security approach and system being used for protection of the radiation sources. The level of detail and depth of content should be commensurate with the security level of the sources covered by the plan. The following topics should typically be included:
1. A description of the source, its categorisation, and its use.
2. A description of the environment, building or facility where the
source is used or stored.
3. A diagram of the facility layout and security system.
4. The location of the building or facility relative to areas accessible to the
5. Local security procedures.
6. The objectives of the Radiation Safety Plan for the specific building or facility including:
— the specific concern to be addressed: unauthorised removal,destruction, or malevolent use.
— the kind of control needed to prevent undesired consequences including equipment that might be needed.
— the equipment or premises that will be secured.
7. The security measures to be used, including:
— the measures to secure, provide surveillance, provide access control, detect, delay, respond and communicate.
— the design features to evaluate the quality of the measures against the
8. The administrative measures to be used, including:
— the security roles and responsibilities of management, staff and others; routine and non-routine operations, including accounting for the source(s);
— maintenance and testing of equipment;
— determination of the trustworthiness of personnel;
— the application of information security;
— methods for access authorization;
— security-related aspects of the emergency plan, including event
reporting, training and key control procedures.
9. The procedures to address increased threat level.
10. The process for periodically evaluating the effectiveness of the plan and
updating it accordingly.
11. Any compensatory measures that may need to be used.
12. References to existing regulations or standards.
What Should I do First? A Vulnerability Assessment
A vulnerability assessment is a method for evaluation of radiation safety for licence owners, organisation managers and material controllers. This must answer the following questions at a minimum:
1. How is radioactive material currently maintained and stored?
2. Describe the materials, its categorisation and use at your organisation.
3. Description of the building and/or facility in which the material is located.
4. Areas (if any) of the building or facility that are accessible to the public.
5. What are the security arrangements currently in place?
6. Procedures to address increases in the national threat level?
7. What procedures are in place to ensure radiation sources aren’t abandoned?
8. What procedures are in place to notify the Ministry of Health of an incident?
9. For material in use or storage the security measures implemented to take all reasonable steps to prevent the unauthorised removal of the material.
10. Procedures for evaluation and testing of security plans including documented details of vulnerability assessments carried out.
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