Radiation

Asystole RN · Oct 24, 2010

Don't know many nurses who do work with radiation...

SummitRN, BSN, RN · Oct 24, 2010

Most nurses do not wear film badge dosimeters because dealing with radiation emitting equipment and sources in generally not there job. Maybe avoid ortho, some ER/OR (flouroscopy), and oncology specialties.

X-rays and CAT are left to the radiological techs AFAIK.

If you would like to know more about radiation and what types and exposures constitute nonnegligable risks, I'd be happy to expound.

amy543 · Oct 24, 2010

So I would not be in the room when the radiation equipment is on? I don't mean using the equipment, but just being around it. Would I escort the patient to and from the room with the equipment off? Yes, I'd love to learn more about radiation and anything else you can inform me with. That would be really helpful. Thank you so much.

SummitRN, BSN, RN · Oct 25, 2010

So the vast majority of ionizing radiation sources you would encounter are electrically powered x-ray emitters and only on when exposing the patient.

Nuclear medicine (oncology) may have sealed gamma sources, but these are usually kept safely stored when not in use.

Suffice to say, the principle of ALARA (as low as reasonable achievable) apply to radiation exposure. Exposure is minimized by TDS (Time, Distance and Shielding). If your occupational exposure has any possibility of being significant, you will be issued a film badge dosimeter to measure you dose. Most people who are issued these still come back with zero exposure.

Most nurses are not going to have any occupational exposure to radiation. Regulations are quite strict and unless you are classified as a radiation worker under 10CFR20, your occupational exposure limit is 0.1mSV (25% of the annual dose you get from just living on Earth).

You will get MUCH more radiation exposure from being a flight attendant than being a nurse.

amy543 · Oct 27, 2010

So the vast majority of ionizing radiation sources you would encounter are electrically powered x-ray emitters and only on when exposing the patient.
Nuclear medicine (oncology) may have sealed gamma sources, but these are usually kept safely stored when not in use.
Suffice to say, the principle of ALARA (as low as reasonable achievable) apply to radiation exposure. Exposure is minimized by TDS (Time, Distance and Shielding). If your occupational exposure has any possibility of being significant, you will be issued a film badge dosimeter to measure you dose. Most people who are issued these still come back with zero exposure.
Most nurses are not going to have any occupational exposure to radiation. Regulations are quite strict and unless you are classified as a radiation worker under 10CFR20, your occupational exposure limit is 0.1mSV (25% of the annual dose you get from just living on Earth).
You will get MUCH more radiation exposure from being a flight attendant than being a nurse.

I'm kind of confused. Your first sentence looked like it was saying that there is occupational exposure...but the second part of your post says that there is no occupational exposure. Are you comparing significant exposure with insignificant exposure? Meaning that there is still exposure? I'm just trying to make sure that I understand correctly.

SummitRN, BSN, RN · Oct 27, 2010

Correction to the above post, 0.1mSv should read 1mSv (and that's still 25% of natural yearly exposure) for the exposure limit of a non-radiation worker (pretty much everyone but radiation nurses and x-ray techs).

You'd have to wear a badge to monitor your exposure if it was possible for you to receive 0.1mSv (ie if your occupational exposure would possibly be greater than 2.5% of the average dose you receive every year from normally occurring radiation exposure). If you apply for a job, ask if your job classifies you as a radiation worker or requires being issued a radiation monitor. If they say yes to either, you know that you won't be comfortable with it.

For most nursing positions, you should not be in any room where there is a radiation emitting machine (x-ray, CT, flouroscope etc) that is turned on and emitting radiation. The exceptions would be ER, OR, radiation oncology, and the like. There is NO reason to be! It's against the principles of minimizing exposure. Even the X-ray techs step out of the room or into a shielded cubby before turning on the X-ray except under the most unusual circumstances. Only flouroscopy in the ER or OR would have personnel in the room with an actively emitting radioimaging device.

You seem very nervous about occasional brief low (almost unmeasurable) exposures to radiation. Is the a reason for that apprehension something you'd care to discuss? Perhaps I can explain some things and put you at ease.

amy543 · Oct 28, 2010

Correction to the above post, 0.1mSv should read 1mSv (and that's still 25% of natural yearly exposure) for the exposure limit of a non-radiation worker (pretty much everyone but radiation nurses and x-ray techs).
You'd have to wear a badge to monitor your exposure if it was possible for you to receive 0.1mSv (ie if your occupational exposure would possibly be greater than 2.5% of the average dose you receive every year from normally occurring radiation exposure). If you apply for a job, ask if your job classifies you as a radiation worker or requires being issued a radiation monitor. If they say yes to either, you know that you won't be comfortable with it.
For most nursing positions, you should not be in any room where there is a radiation emitting machine (x-ray, CT, flouroscope etc) that is turned on and emitting radiation. The exceptions would be ER, OR, radiation oncology, and the like. There is NO reason to be! It's against the principles of minimizing exposure. Even the X-ray techs step out of the room or into a shielded cubby before turning on the X-ray except under the most unusual circumstances. Only flouroscopy in the ER or OR would have personnel in the room with an actively emitting radioimaging device.
You seem very nervous about occasional brief low (almost unmeasurable) exposures to radiation. Is the a reason for that apprehension something you'd care to discuss? Perhaps I can explain some things and put you at ease.

I've talked to friends, science professors and healthcare professionals who told me that any amount of radiation increases a person's risk for cancer. I have also done some reading about it. So even if there was a small amount of exposure, the chance increases.

A friend told me that there may be residual radiation coming from machines even when they are turned off and that I would be exposed to it as a nurse since I would be helping bring patients to and from the machines. I'm not sure if that is true though.

Editorial Team / Admin · Oct 29, 2010

There is radiation exposure when the xray machine is activated (turned on) for the xray exposure ONLY.

There is radiation exposure during flouroscopy (for example, standing in the room during an angiogram or upper GI procedure) -- when the fluoro is turned on.

There is radiation exposure from patients who have been injected with radioactive isotopes (for bone scan, lung scan, thyroid scan, cardiac MPI, etc), which diminishes in 24-48 hours as the dose decays.

There is radiation exposure from sunlight.

There is radiation exposure from flying.

Most nurses will not be exposed to much radiation during their career.

You will not be exposed to radiation if you wheel a patient down to Radiology or into the exam room.

Personnel who routinely work around radiation sources (technologists, Radiologists, Radiology Nurses) aim to reduce any unnecessary exposure by limiting time exposed to the active source, increasing distance from the source and using shielding (wearing lead aprons, lead thyroid shields, leaded glasses or standing behind a lead shield).

They also wear badges which collect any radiation exposure.

The badges are changed monthly, the last month's dose is measured and each person's cumulative dose is documented.

All exposure is reviewed monthly for personnel safety.

There are many areas a nurse may work that have little radiation exposure.

Good luck to you.

SummitRN, BSN, RN · Oct 29, 2010

Ah, I understand your concern now Amy. Let me clear some stuff up. Yes, low doses increase cancer risk, but only by very small amounts. It depends in what model you believe. Some believe that the tiniest dose results in the tiniest risk. Others believe that below certain levels, there is no risk increase. Some also believe that at low levels there is a health benefit, radiation hormesis: that extremely low doses (as with what you get normally every year just in every day life (from natural radiation source)) may be beneficial to health.

The data is in disagreement and there are arguments for each of the three models, but particularly, the worst case model is increasingly hard to support. But, say it is the worst case model: LNT (Linear [response] No Threshold [for risk]).

Under the worst case model, life is like the lottery where the winner gets cancer: you buy a lottery ticket for cancer from radiation every day by just living. 365 lottery tickets a year. If you are the average smoker, you get 1300 extra lottery tickets from radiation exposure alone (not the carcinogenic chemicals). The amount of radiation you can legally be exposed to on the job without being issued a radiation badge is 10 lottery tickets a year. That's about the same as the difference between someone living in Kansas City vs Austin (with respect to living 1500ft higher in altitude).

That should illustrate that the risk is very low. For a pure numbers approach with the worst case model, if every year you had the maximum dose before being required to wear a badge as a non-radiation worker, every year for 20 years, and 5,000 of you did it, the cause of death of those 5,000 people would eventually include:

1 would die of electrocution

1 would die of cancer caused by workplace radiation exposure

715 would die of cancer due to causes not related to workplace radiation exposure

1000 would die of heart disease

etc etc etc

Based on my readings, I really believe that there is a threshold to minimum effect and the response is nonlinear thereafter, so your safer than my above statistical exercise suggests under the worst case model!

That said, dianah's post is right on the money. So not only is it easy to avoid exposure as a nurse, if you didn't avoid exposure, the risk is incredibly low to he point of being negligible when compared to the health risk of having suboptimal diet or exercise patterns.