Controls Posting signs and regulations
Opening radioactive packages
Radiation Safety Rules when handling radioactive materials
Daily Surveys
Weekly Wipes
Cleaning Up A Radioactive Spill
Removing radioactive waste
Radiation Safety Officer (RSO)

 

• Areas where there are radioactive materials being stored must be secured at all times. If not under lock and key, then it must be under constant surveillance.  
• Caution, Radiation Area sign must be posted if the area contains radioactive materials emitting a dose equivalent in excess of 5 mrem per hour at 30 cm.  This sign is usually displayed on the main entrance into the nuclear medicine department.
• The hot lab and radionuclide decay/storage areas must display Caution, Radioactive Material or Danger, Radioactive Material warnings.
• If radioactive gases or aerosols are used then , a "Caution, Airborne Radioactivity" or "Danger, Airborne Radioactivity" must be posted.
• While highly unlikely if a nuclear medicine department has a source that emits an excess of 100 mrem per hour at 30 cm then a "Caution, High Radiation Area" or "Danger, High Radiation Area" sign must be posted.  Should the source of radioactive materials exceed 500 rads per hour at one meter then the sign must read Grave Danger, Very High Radiation Area.
• Waiting areas or patient's rooms do not require any signs posted unless a patient has than 30 mCi of radioactivity or if the measured dose rate is less then 5 mrem/hour at 1 meter.   

Packages that arrive in the nuclear medicine department must be inspected and specific data has to be recorded to insure that there are no removal radioactive materials. 

• During working hours a package must be inspected within3 hours.  However, it arrives after the department closes then the package has to be inspected within 3 hours after the department opens.
• The NRC or State Health Department and the final delivery carrier must be notified immediately if 0.001 μCi( 2,200 dpm) or is removed from the surface of a radioactive package.  able radioactive surface contamination exceeds 0.00l μCi (2,200 dpm per 100 square cm) or if the external radiation level exceed 200 mrem/hour on the external surface of the package and its transport index does not exceed 10.
• When a package arrive the following process must occur
  1. Put on gloves to prevent hand contamination.
  2. Visually inspect the package for any signs of damage.  Notify the RSO if there are any issues at any point during this procedure.
  3. Measure and record the exposure rates at surface and 1 meter.  Radioactive packages should have the following reading based on the label seen on the package.

     White I - <0.5 mr/hr at surface and background at 1 meter
     Yellow II - <50 mr/hr at surface and <0.1 mr/hr at 1 meter
     Yellow III - <200 mr/hr at surface and <10mr/hr at 1 meter

  4. Open the package with the following precautionary steps:
  1. remove the packing slip.
  2. open the outer package following the supplier's instructions, if provided.
  3. open the inner package and verify that the contents agree with the packing slip.
  4. check the integrity of the final source container. Look for broken seals or vials, loss of liquid, condensation, or discoloration of packing material.
  5. Check the user request to ensure that the material received is the material that was ordered.
  6. Once the package is empty monitor it to assure that there is no contamination and discard it.  Any radioactive labels must be defaced
  7. Record all the above data. 

• Wear laboratory coats and/or other protective clothing whenever in a radioactive area.
• Wear disposable gloves when handling radioactive materials.  
• Either after each procedure or before leaving the area, monitor your hands for contamination.
• Always use syringe shields when administering a radioactive dose.
• You are not allowed to eat, drink, smoke, or apply cosmetics in any area radioactive area.
• Do not store food, drink, or personal effects in areas where radioactive material is stored or used.  This includes the refrigerator in the hot lab.
• Wear personnel monitoring devices at all times usually this includes a whole body badge and a ring badge.
• Wear appropriate monitoring deceives pending the job being preformed, whole body, wrist, and/or finger.  NRC requires you to where a monitoring device if you are expected to receive 10% or more of the MDP.
• Dispose of radioactive waste only in designated, labeled, and properly shielded receptacles.
• Never pipette by mouth.
• Area surveys are done daily.  Weekly wipes must also be completed to determine if there is any removable by-product material.  Areas to be wiped and surveyed are, but not limited to:  hot lab, patient injection area, and imaging rooms.
• All radioactive material must have the following on their labels:  radioisotope, the name of the compound, and the date and time of preparation or administration (unit dose).  Likewise, any prepared radiopharmaceutical must be recorded and should have the following data:  total amount of activity, specific activity as mCi/mL, time and date of preparation, total volume prepared, total volume remaining, and the measured activity of each patient dosage.  All syringes and unit dosages must have the following data on the label:  the radiopharmaceutical name, the activity, the date and time for which the activity is estimated, the type of study, and the patient's name.
• Each dose must be assayed in the dose calibrator prior to injection.  The prescribed dose must be within plus/minus 20% and be approved by an authorized user (nuclear medicine physician).  Allows verify the patient prior to injection as well as the radiopharmaceutical being administered. 
• Anything radioactive must be shielded. 
• All radioactive material must be secured, either under constant surveillance or locked up when no authorized user, RSO or a designated nuclear medicine technologist is around.

  Area Survey Procedures  

Area surveys (ambient dose rate surveys): Radiation surveys will be performed with a survey meter sufficiently sensitive to detect 0.1 mR per hour:

1. Survey at the end of each day of use all radiopharmaceutical elution, preparation, assay and administration areas (except patient rooms, which will be surveyed at the end of the therapy instead of the day of administration) when using radiopharmaceuticals requiring a written directive (e.g. all therapy doses and any I-131 dose exceeding 30uCi).
2. Survey monthly all laboratory all laboratory areas where only small quantities of gamma-emitting radioactive material is used.
3. Survey weekly all radionuclide use, storage and waste storage areas. If diagnostic administrations are occasionally made in patients’ rooms, those rooms need not be surveyed.
4. Survey quarterly all sealed source storage areas.
5. Record the ambient dose rate results in the Area Radiation Survey Report.
6. Immediately notify the RSO if the ambient dose rate trigger level is exceeded, i.e., 0.1 mR/hr for an unrestricted area, or 5.0 mR/hr for a restricted area.

  Wipe Test (removable contamination surveys): Removable contamination surveys will be performed with equipment sufficiently sensitive to detect 200 dpm/100 sq cm.  

1.  Survey weekly all radiopharmaceutical elution, preparation, assay and administration areas. If diagnostic administrations are occasionally made in patients’ rooms, and care is taken to remove all paraphernalia, these rooms need not be surveyed
2. Survey monthly all laboratory areas where only small quantities of photon-emitting radioactive material is used (< 200 μCi at a time).
3. Survey weekly all areas used for radioactive storage and waste disposal.
4. Survey daily incoming and outgoing boxes that contain radioactive materials.
5. Wipe tests are done usually completed in a well counter.  Therefore, cpm must be converted to dpm and then recorded.
6. Note the following trigger levels for restricted and unrestricted areas.  Should the trigger level be reached contact the RSO immediately
7. Restricted areas and protective clothing used only in restricted areas: 2,000 dpm/100 sq cm for P-32, Co-60, Sr-85, Y-90, In-111, I-123, I-125, Au-198, or 20,000 dpm/ 100 sq cm for Cr-51, Co-57, Ga-67, Tc-99m, Tl-201.
8. Unrestricted areas: 200 dpm/100 sq cm for I-125, I-131, Sr-90, or, 1000 dpm/100 sq cm for other beta-gamma emitters.

  Radioactive Spill Procedures  

Should a radioactive spill occur, then the following procedures must be adhered to.   Minor spills of liquids and solids:

1. Notify persons in the area that a spill has occurred.
2. Prevent the spread of contamination by covering the spill with absorbent paper.
3. Clean up the spill using disposable gloves and absorbent paper. Carefully fold the absorbent paper with the clean side out and place in a plastic bag for transfer to a radioactive waste container. Also, put contaminated gloves and any other contaminated disposable material in the bag.
4. Survey the area with a low-range radiation detector survey meter. Check the area around the spill, also check your hands, clothing, and shoes for contamination.
5. Report the incident to the RSO.
6. The RSO will follow up on the cleanup of the spill and will complete the Radioactive Spill Report and the Radioactive Spill Contamination Survey (see below).

Major spills of liquids and solids:

1. Clear the area. Notify all persons not involved in the spill to vacate the room.
2. Prevent the spread of contamination by covering the spill with absorbent paper, but do not attempt to clean it up. To prevent the spread of contamination, limit the movement of all personnel who may be contaminated.
3. Shield the source if possible. This should be done only if it can be done without further contamination or a significant increase in radiation exposure. Close the room and lock or otherwise secure the area to prevent entry. Notify the RSO immediately.
4. Decontaminate personnel by removing the contaminated clothing and flushing contaminated skin with lukewarm water and then washing with mild soap. If contamination remains, induce perspiration by covering the area with plastic. Then wash the affected area again to remove any contamination that was released by perspiration.
5. The RSO will supervise the cleanup of the spill and will complete the Radioactive Spill Report and the Radioactive Spill Contamination Survey

• All radioactivity labels must be defaced or removed from containers and packages prior to disposal with routine trash.
• Occasionally monitor your regular waste containers to insure that NO radioactive trash is in the receptacle.  FYI - When trash arrives at dump/landfill it is monitored to assure there is no radioactive material.  If radioactivity is found, then the hospital is fined.
• Procedure for disposal by Decay-In-Storage (DIS):
  1. Short-lived material with a physical half-life of less than 65 days may be disposed of by DIS. Keep material separate according to half-life.  It is suggested that you group radioisotopes into similar half-lives as an example ^99mTc in receptacle,  ²⁰¹Tl/⁶⁷Ga/¹¹¹In in another container, and ¹³¹I be placed in a third storage container.
  2. When the container is full, seal it with string or tape and attach an identification tag that includes the date sealed, the longest-lived radioisotope in the container, and the initials of the person sealing the container. The container may then be transferred to the DIS area.
  3. Decay the radioactive material for at least 10 half-lives of the longest-lived radioisotope.
  4. Prior to disposal as in-house waste, monitor each container as follows. Record the results in the Radioactive Waste Disposal Record (see below):
  1. Using a GM meter monitor DIS material
  2. Identify that DIS is at background <0.5 mR/hr
  3. Record the disposal of material
  4. Discard as in-house waste

Radiation Safety Officer Duties and Responsibilities  

The radiation safety officer (RSO) is responsible for implementing the radiation protection program and for ensuring that radiation safety activities are performed in accordance with NRC, DOT and licensee-approved procedures   The RSO shall:

1. Ensure that radioactive material is used, stored and disposed of safely and in accordance with all applicable regulations and procedures. This includes review as necessary, of training programs, equipment, facilities, supplies and procedures.
2. Establish and supervise a radiation monitoring program for individuals requiring monitoring and to ensure that radiation exposures are maintained ALARA.
3. Ensure that personnel training are conducted and is commensurate with the individuals' duties regarding radioactive material. Conduct an audit of the radiation protection program at least annually and take corrective actions where necessary.
4. Maintain required records including radioactive materials license and related correspondence, training and experience documentation for authorized users, quality control records, medical event documentation, program audits and personnel monitoring records.

 

Material revised from Nuclear Medicine Procedure Manual, 2006-2008, W.C.Klingensmith III, et. al.