Safe work practices regarding radiation require considerable training. Before a health care worker begins to use radioactive material or a machine that produces radiation for patient care, proper supervision must be taken.
The must here refers to the health of both the worker and the patient being treated - and to OSHA compliance. If your health care practice - whether dentistry, veterinary, or medical - deals in radiation treatments of any kind, OSHA rules are strict. They’re strict for a reason: radiation exposure can be very damaging. As such, fines for non-compliance are strict, too.
Training is, in short, vital - and if your practice needs support, MedTrainer is here to help with online programs designed to specifically address safe work practices involving radiation.
So, first of all, what rules affect what workers, and what safety standards should be in place? Unless you’re Spiderman, getting a dose of radiation of any kind doesn’t result in super powers - it is a serious matter, and one that should be handled judiciously.
All staff, who in the course of a year’s employment, are likely to receive an occupational dose of radiation in excess of 100 mrem are considered radiation workers. Anyone who handles radioactive materials in the course of work must be trained in radiation safety, and carefully supervised while performing such work until their training has been completed. Yes, there’s a grey area as to whether or not all staff using radiation-producing machines are radiation workers, but it is always best to err on the side of caution when working with radioactive material or a radiation producing machine.
The bottom line: protection. Radiation protection consists of a variety of controls, including:
- Machine design and construction
- Administrative policy/procedures
- Personal protective equipment
Personal protective equipment must take into consideration time of exposure, distance from exposure, and shielding methods. It is considered the last form of defense in regard to reducing radiation exposure. Prior to this defense of course is the optimization of other controls in regard to the machines producing the radiation, and the time limits set in regard to exposure.
An employer, a supervisor, and the staff member handling the radiation all have certain areas to consider in regard to protective devices.
As an employer, a medical, dental, or veterinary practice must be all means ensure devices are in good shape, adequately provided, and used in the way they should be used. All of these areas lead back to the absolute necessity of training in order to be in OSHA compliance.
At the work place, the supervisor must make certain that the staff member subject to radiation exposure uses the protective garments or devices, handles materials safely, and follows safety measures.
And the staff member him or herself? He or she must use or wear protective devices, report defects, and understand the importance of protection through completion of OSHA required training.
The goal? To ensure radiation doses received by workers are as low as possible and meet limits in regard to safety.
OSHA requirements vary in regard to the particular position being regulated. For example, in regard to those staff members using X-ray equipment, the X-ray Safety requirement is for protective aprons and gloves that provide a shield of at least 0.5 mm of lead.
All workplaces must develop and use written measures and procedures about safe work practices in regard to radiation exposure. The use, maintenance, and care taken with radiation producing equipment, the care and wearing of protective garments, and criteria for staying up to date in regard to radiation safety and orientation are all key elements of proper OSHA compliance. Protective garments must be hung, not folded or wrinkled. This can damage them.
And here is another key element: employers are required to develop, and provide training and educational programs on the measures and procedures involved in radiation safety. So the health care employer’s responsibility for personal safety is not limited to providing the proper attire or equipment - it also must encompass the instruction and training of workers.
A staff member who must wear or use protective clothing, equipment, or devices must receive instruction on that protective gear’s wear and use before utilizing it.
OHSA also requires that risk assessment and control be set into place to assess staff members needs for protection and training. The selection of personal protective equipment, the roles and responsibilities of staff members in regard to obtaining this equipment and using it, and the establishment of control measures to minimize exposure to radiation must all be acted upon.
Care must also be taken, both that the personal protective equipment meets lead shielding requirements and is labeled to show that it does. There are specific areas that the PPE must accomplish: that it covers the parts of the body it is intended to protect in every posture your staff member may assume during a procedure, and that it allows full mobility. As well, it must fit properly, and be stored correctly by hanging or draping, and be regularly inspected and maintained to be sure no wear and tear has occurred, check for defects, and be properly cleaned.
Staff should also be appropriately trained regarding the selection of the PPE, its limitations, and proper storage, maintenance, and inspection. After all, the effectiveness of personal protective gear is completely reliant on the gear’s construction, fit, and how well they are used. If they are poorly made, fitted, or used, they cannot help in reducing exposure to leakage or scatter radiation.
And that’s not a scenario you want to have in place.
That’s a lot of information for staff members to take in. And of course it’s vitally important that PPE shielding is as great as a 0.5 mm thickness necessary for a particular radiation application.
Is your staff adequately trained to recognize the appropriate construction and fit of lead aprons, thyroid collars, leaded glasses, and gloves?
For example, wrap-around aprons should cover the entire front of the body to the posterior midline. A thyroid collar and apron should fit together with no gaps. Open backed aprons cannot be used in intensive radiation dose procedures such as angiography. Additional consideration should be made as to the ergonomics of the personal protective gear, too.
Remember ergonomics? We discussed the importance of proper ergonomics in the workplace in our last blog. But it comes into play with personal protective equipment and safe work practices too. After all, protective equipment can weight quite heavily on the body.
Lumbar support? Yes, weight belts and padded shoulders can improve comfort, and reduce the back strain and injury. Redistribution of weight can be helpful to avoid putting too much weight on parts of the body, specifically joins. Using separate skirts and tops can help.
Knowing the necessary use of leaded glasses and gloves, and labeling as to their effectiveness and thickness is also important. There is no point in providing gear if it is not effective!
Which leads to the next point regarding safe work practices and OSHA compliance: quality assurance testing. Every six months the PPE should be examine both visually and by touch for signs of tearing, separation from stitching, distortion, or puncture. And, at least annually, a fluoroscopic exam should be conducted. If the equipment shows any signs of visual defects, or through touch or x-ray exam, it must be replaced or repaired.
In summary, hospitals, veterinary clinics, radiology clinics, and dental clinics offering X-rays must be effectively monitored for compliance to protect the health of medical staff. Exposure to radiation can cause cancer, tissue or genetic damage, and defects in unborn children. Eye injuries can result from lasers and ultraviolet radiation.
Being proactive for the safety of your staff and to prevent non-compliance means monitoring of X-ray exposures, magnetic resonance imaging or MRI exposure, and laser sources, and inspection of personal protective equipment. A proactive approach to radiation orientation and safe work practices also means training in the safe use of lab materials and equipment, the safe use and storage of protective clothing, and protocols for operating radiation producing equipment. Safe handling, storage, and disposal of radioactive materials, producing and maintaining records, and establishing solid emergency procedures are all a necessary part of planning for staff health and safety - and OSHA compliance.
If you need assistance with developing proactive methods for radiation orientation and safe work situations, and training your staff for safety and compliance, MedTrainer is here to help.