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Personnel Radiation Protection
Published in Robert J. Parelli, Principles of Fluoroscopic Image Intensification and Television Systems, 2020
ALARA is an acronym for “As Low As Reasonably Achievable.” ALARA is the philosophy for maintaining: occupational radiation exposures as low as reasonably achieved. It must be assumed that there is no minimum threshold of radiation exposure necessary to achieve a biological effect. Even the lowest radiation exposure is assumed to result in some effect, though the effect may be too slight to measure. It stresses the fact that all radiation exposures to the operator, the staff, and the patient be kept as far below legal limits as possible.
Concomitant Exposures and Legal Frameworks
Published in Mike Kirby, Kerrie-Anne Calder, On-treatment Verification Imaging, 2019
Mike Kirby, Kerrie-Anne Calder
Since ionising radiation always has clinical consequences for a patient no matter how small the quantity, one must be careful in its use for diagnosis and treatment; always ensure there is a net benefit to the patient whenever it is used. As such, there are tight legal frameworks for ensuring ionising radiation is used wisely and that the risks of its use are suitably understood. In general terms, this means that keeping all doses As Low as Reasonably Achievable (ALARA) or Practicable (ALARP) are highly important considerations and are the basis of international guidance governing the use of radiation and protection from its use; e.g. through the International Commission on Radiological Protection (ICRP). Each country has its own legal framework within which the safe use of ionising radiation is governed, particularly for medical exposure. In the UK, this comes under the Ionising Radiations (Medical Exposure) Legislation 2017 (IRMER 2017), the legislation that governs both diagnostic and therapeutic use. Once the clinical team (in the UK, within the multidisciplinary team, or MDT) has decided to treat a patient with radiotherapy, one must be aware of all the exposures of radiation needed to plan and verify the treatment course; this can be numerous in a radiotherapy clinical pathway. In this chapter, we discuss the types of radiation exposure anticipated, which are not part of the treatment itself, the principles involved in minimising such doses, and the legal frameworks that operate to ensure these aspects that protect the patient.
The principles of risk assessment
Published in Alan Martin, Sam Harbison, Karen Beach, Peter Cole, An Introduction to Radiation Protection, 2018
Alan Martin, Sam Harbison, Karen Beach, Peter Cole
Any work with radioactive materials or ionizing radiation needs to be assessed to demonstrate that the radiation exposures of workers and members of the public are as low as reasonably practicable (ALARP). This process, known as safety assessment, considers all the potential risks associated with the work activity (identified by appropriate risk assessments) and then addresses the wider issue of managing the risks so as to ensure the optimum ALARP result. In practice this distinction between safety assessment and risk assessment is most important for large, complex facilities such as nuclear reactors, where there are numerous sources of risk, requiring a detailed, comprehensive safety management approach. For many small users who only deal with one or a very few sources of radiation, the distinction is less important because the safety management needed is relatively straightforward.
Approaches for the setting of occupational exposure limits (OELs) for carcinogens
Published in Critical Reviews in Toxicology, 2023
The Committee on Carcinogenicity of Chemicals in Food, Consumer Products and the Environment (COC) is an advisory committee whose remit is to advise on all aspects of the carcinogenicity of chemicals, at the request of government departments and agencies and the devolved administrations. If a putative carcinogen is found to be potentially genotoxic, the COC recommends a non‐threshold approach to risk assessment and that the approach of ALARP (as low as reasonably practicable) should always be adopted by risk managers, where possible, for exposure recommendations. In addition, the MoE approach could be used for risk characterisation, to aid risk communication and prioritise risk management when there are adequate carcinogenicity and exposure data. This could be supplemented in specific situations by the setting of a minimal risk level based on expert judgement.
Novel diagnostic and imaging techniques in endovascular iliac artery procedures
Published in Expert Review of Cardiovascular Therapy, 2020
Sanne W. De Boer, Stefan G.H. Heinen, Seline R. Goudeketting, Michiel W. De Haan, Barend M. Mees, Daniel A. F. Van Den Heuvel, Jean-Paul P. M. De Vries
Radiation exposure during endovascular procedures is an invisible threat, and attention to protection can be easily forgotten, especially in complex procedures. Body mass index and lesion complexity are associated with significantly higher radiation exposures during the procedure [83,84]. With an increase in procedure numbers, an increase in patient obesity and multimorbidity, and more complex lesions, the cumulative lifetime dose of the endovascular staff will increase. The ALARA (as low as reasonably achievable) principle is important to maintain. For the first time, radiation has been shown to cause DNA damage in endovascular specialists [85]. However, in light of the growing evidence that the use of image fusion can reduce the radiation dose for both the patient and endovascular team, the observation that image fusion has not been adapted in international scientific guidelines or clinical workflows is remarkable but we expect that this will be amended in coming updates of various international guidelines.
Looking for solutions: vision and a call-for-attention for radiation research scientists
Published in International Journal of Radiation Biology, 2019
The above discussion helps one to further explore analogy between a pill of a medicine and the radiation exposure. The author first took the analogy of some medications that one takes on regular basis like for keeping the lipid levels, blood pressure, gastric reflex in control. This provided situation where the medicine has benefits without easy reach to a level where detrimental effects can be perceived. These medications are taken for achieving benefit and can be increased in dose or frequency to achieve optimal benefit without thinking too much about the risks, even though the mindset of so-called “as low as reasonably achievable, ALARA” may remain here also. Actually, this is quite similar to radiographic examinations with small radiation doses in the range of 0.01 to 3 mSv of effective dose, but the approach has not been taken in the same way.