The average annual dose of radiation that people who do not work with x-ray equipment receives is about 620 millirem.  Approximately 30 millirem comes from food and beverages you consume.  For common sources of radiation and the doses associated with it, you can visit the website of the United States Nuclear Regulatory Agency (U.S. NRC) to easily find this information.  You will be able to find anything from dental x-rays, CT scans, and even bananas. 

X-rays have allowed for amazing advances in medicine by allowing healthcare professionals to look inside teeth and other bones in the body without any invasive procedures.  It has allowed doctors to assess a situation and determine which of many different forms of treatment is best for their patient.  Along with this amazing technology comes some risk for both the patient and the users of these devices due to the ionizing radiation that x-ray units produce to generate an image. 

Safe Work Practices

In order to keep yourself and your patients safe, it is important to follow safe practices.  We always encourage people to remember the acronym ALARA which stands for As Low As Reasonably Achievable.  The idea behind ALARA is to use the lowest amount of radiation you can to get a usable image.  Doing so reduces the amount of radiation you are exposed to, as well as the amount your patient is exposed to.  It is also important to remember the three radiation safety principles while you work with your x-ray equipment throughout the day.

• Time: the least amount of time spent in the room during x-rays decreases your exposure
• Distance: the further from the source you are, the less radiation you get. Radiation is directed in a cone pattern by the machine and therefore only the person being imaged should be in that area
• Shielding: includes barriers like radiation blocking walls, lead shields, lead-lined glass, and lead aprons/thyroid shields. Aprons and thyroid shields must be worn whenever you are in the room while the x-ray is being taken

Radiation Dosimetry

Radiation dosimetry is done in order to make sure that staff at your office are not being exposed to more radiation than normal.  High results from dosimetry can indicate either malfunction of your x-ray equipment, or user error of the equipment/badges and can help determine which corrective action needs to be taken.  Dosimetry requirements vary from state to state, ranging from needing to be done once and not again without special considerations, periodically, to continuously.

Dosimetry should always be offered to a pregnant employee.  Pregnant women should declare their pregnancy along with the estimated date of conception to their employer.  If the pregnant woman would like to do radiation dosimetry during the pregnancy, the employer should provide a radiation dosimetry badge. This badge will be worn for the duration of the pregnancy at the belly line underneath a lead apron.

Handheld X-Ray

Handheld x-ray devices can be a convenient way to cover multiple exam rooms with a single x-ray unit rather than installing a unit in every single room.  The use of handheld devices can be highly restricted in some states like Alabama, where a special exemption has to be filed with the state radiological health department in order to use them.  Like all x-ray equipment, handheld devices must be registered with the state department of radiologic health.  The majority of states that allow the use of handheld x-ray units, including California and Nevada, follow along these lines of requirements:

• The operator must be specifically trained by the manufacturer of the unit to operate the equipment
• A written security policy must be established (we provide this for you in your Radiation Safety Plan when you inform us of the use of handheld x-ray devices)
• The operator must wear a lead apron (long enough to cover reproductive organs), a lead thyroid shield, collar dosimetry monitor, and ring dosimetry monitor when operating the device
• If the device is on a stand, the operator must be behind the device at the end of the exposure button, at a distance of at least 6 feet. The requirements for lead aprons/thyroid shields and dosimeters are not necessary when used on the stand.
• The handheld unit must be stored in a locked cabinet or drawer with restricted access when not in use