Radiation Safety

Nurses General Nursing

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Hello Nurses,

I have learned that shielding,time, and distance can reduce your risk of radiation exposure in hospitals. Just curious, what health problems can radiation cause and how ?

Thank you in advance.

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Before I became a nurse I used to work in a Cardiologist. I did Nuclear Stress testing with the doctor. I went for my pap smear and my cells came back abnormal. For the life of me I can't remember what they were called. But my gyno told me that the cause of the change is radiation exposure. I stopped doing the Nuclear Stress Testing and went back a couple months later for another Pap and the cells were back to normal. My gyno said that these cells changed from being exposed to the nuclear medicine that the patients were injected. Needless to say, I never did the Nuclear stress testing again.

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I doubt if many nurses are radiation experts. I don't even know exactly what "radiation" means. People get more exposure to "radiation" from one cross country airplane flight (the sun puts out "radiation") than 100's of exposures to x-rays at a dentists or other routine x-rays.

Even saying that. Every hospital I have worked in requires nurses who might work around x-ray equipment to wear a badge that is exchanged every two months and tested for how much exposure that nurse received.

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Specializes in ICU + Infection Prevention.
Hello Nurses,

I have learned that shielding,time, and distance can reduce your risk of radiation exposure in hospitals. Just curious, what health problems can radiation cause and how ?

Thank you in advance.

Not a nurse yet. I start school in two weeks. However, this is an area I know a lot about since I studied Nuclear Engineering until I decided that wasn't what I wanted to be.

Hospital Radiation Risks:

In the hospital setting, for the most part, you are looking at multiple very low dose exposures, unless something goes terribly wrong. That's why you learned time, shielding, and distance to keep those exposures as low as possible over time. The human body is very good at repairing radiation damage from very low doses. Occupational exposure limits are set accordingly and why you wear a film badge dosimeter to monitor your exposure levels. Therefor, as a hospital worker, over a career, the only problem you might see is a negligible increase in cancer risk, but no more than living at altitude. Of course, if there is an unusual exposure incident, the story could be different. Anyways, read below to see how radiation works.

When radiation is absorbed it can cause two possible reactions:

1. Ionization Radiation and Types of Interaction:

When ionizing radiation interacts with matter, it breaks a chemical bond or creates a free radical by directly knocking free an electron. You need a LOT of energy to do this directly in most materials.

1a Photoelectric Effect Ionization: In some materials in certain states you need photons with as little as a couple of hundred electron volts (e.g. UV-A) to cause Photoelectric Effect ionization, e.g. hydroxyl group ions (free radicals) production in human cells. You need radiation with more energy (higher frequency) than visible light.

1b Compton Effect Ionization: In most materials most of the time, you need several 1000 electron volts (X-ray/gamma) to cause ionization via the Compton Effect. Sometimes these can cause "chain reactions" of multiple ionizations, such as soft X-ray bombardment of Aluminum (or especially when dealing with particle radiation, but that's another topic).

Ionizing Radiation Effects on Living Cells

Ionizing radiation causes damage the cells either indirectly through free radicals (1a) or directly (1b), both of which disrupt chemical bonds within molecules that do important jobs in a cell, destroying the cellular machinery and causing aptosis (programmed cell death) or damaging DNA causing cell death, mutation, perhaps a cancerous reproduction mutation. Generally, to get that type of mutation, a lot of other ionization damage also occurred in the cell so often the cell is killed anyway.

Ionizing Radiation Effects on Humans

Cells that reproduce most often have the least time to repair and are therefor the most sensitive to radiation damage: the lining of your intestines replace itself every 3-5 days. New RBCs and leukocytes are constantly forming in your bone marrow. That is why we see WBC countl changes and GI problems as the first signs of ionized radiation exposure (and the ONLY acute signs in lower doses where any sign at all is created) and why radiation therapy patients are more prone to infection.

2. Non-ionizing Radiation

When radiation doesn't have the energy to knock off electrons and break bonds, it is known as non-ionizing. THIS ENCOMPASSES ALL RADIATION FROM:

VISIBLE LIGHT (200-300 electron volts)

INFRARED (200 eV down to 0.001 eV)

MICROWAVE RADIO (0.001eV to 0.000001eV) and weaker. Cell phones again are putting out about 0.0000035 eV photons (versus say a 50,000 eV photon from an X-ray machine).

Non-ionizing interactions

When these low energy non-ionizing radiation interacts with matter, they cause molecules to vibrate, to gain speed. To speak properly, HEAT IS TRANSFERRED TO THE AFFECTED MOLECULE. What happens next depends on how much heat you apply:

Non-Ionizing Radiation Effects on Living Cells

2A Critical Heating: If you apply a LOT of low energy radiation, you can raise the temperature high enough to deform complex molecular structures (like quaternary structure of proteins at ~120-160F) or even high enough to cause state changes (melting/boiling) or chemical reactions (fire!). You are heating the substances.

2B Minor Heating: If you apply anything less than enough energy to do what is mentioned in 2A, nothing happens to the chemical structures. It gets warmer. Heat is conducted away to surrounding materials.

Non-Ionizing Radiation Effects on Humans

2A applied: If you stand in front of a 10,000 watt directional microwave repeater antenna, you will receive enough thermal energy to denature your proteins at about 120F, which causes burns. If you don't move fast, it could boil water in your cells! It's like standing in a microwave oven!

2B applied: If you stand next to a cellphone, only a TINY amount of heat energy is delivered by RF... a negligible amount. Because of your bodies thermoregulation abilities, the worst cellphone would be able to theoretically raise local tissue temperatures by a fraction of a degree. The heat just conducts away through your tissues and blood. Repeated low level heating is no more worrysome than taking hot showers every day.

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summitAP I should have said, I doubt many nurses, except SummitAP, are radiation experts. Thanks for the information.

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Well, I think a bit of confusion stems from the concept of "radiation." Simply put, radiation is a nebulous description of matter waves moving about. This can be anything from visible light to the relatively massive alpha particle and all other types including radio waves, x-rays, and gamma rays.

Radiation in basic terms is simply a way of moving energy about. When that energy hits the human body, many things can occur. Often, weakly interacting particles such as billions of neutrinos pass through us as if we were empty space without any ill effect. However other types of radiation or energy transfer will impact atoms in our cells and deliver that energy to the various atoms and molecules. The results will typically vary according to how much energy is transferred.

Ionizing radiation delivers such high amounts of energy, it can literally knock electrons off atoms to put it into simple terms. Since much of organic and bio chemistry stems from electron interactions, this typically alters molecules and atom structure. Sometimes this damage can be repaired, sometimes not.

Again, radiation is basically a way of transporting energy in the form of a matter wave. It may sound strange but all matter behaves like a particle and wave. That's another story however.

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Specializes in ICU + Infection Prevention.

OP, you can also contact your hospital's RSO (Radiation Safety Officer) with additional questions. This person is usually a Health Physicist.

Brownbrook, thanks for the compliment, but again, I am not yet a nurse. :) 2 years!

Simply put, radiation is a nebulous description of matter waves moving about. This can be anything from visible light to the relatively massive alpha particle and all other types including radio waves, x-rays, and gamma rays.

You are listing ELECTROMAGNETIC waves (AKA light). Matter waves (de Broglie waves) are another concept from quantum mechanics not worth worrying about here. Also, you can have particle radiation: alpha, beta, neutron, neutrino, positron, and a whole host of others we don't normally worry about like anti-protons and pi-mesons. Particle radiation, in general terms, is easier to shield against (except neutrons) but can be more dangerous because the higher q factor (one particle causing multiple ionizations) and neutron radiation causing neutron activation (actually making a substance radioactive that was not so before).

In the hospital setting, we are mostly concerned with direct ionizations from x-ray and gamma radiation (very high energy light).

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Right, we are still talking about light, just very high energies. I do think things like alpha particles and so on (stuff with mass) do apply to this discussion. I was trying to say that radiation is a rather vague term that explains a variety of things.

You have two years left? Did you look into the prior degree RN programmes? You may be able to finish in a year.

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I know that nurses are not radiation experts, but you don't need to be an expert to know a few things about radiation. I don't know much and I was wondering if any of you could help. We are exposed to radiation everyday and we don't think about it. Why is it a big deal when working with hospital equipment?I know the definition of radiation but how dangerous can radiation be? What health problems can it cause?

Anyway...I just want to thank all of you for your responses. Anything can help.

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I know that nurses are not radiation experts, but you don't need to be an expert to know a few things about radiation. I don't know much and I was wondering if any of you could help. We are exposed to radiation everyday and we don't think about it. Why is it a big deal when working with hospital equipment?I know the definition of radiation but how dangerous can radiation be? What health problems can it cause?

Anyway...I just want to thank all of you for your responses. Anything can help.

Summit summed the effects up pretty effectively. If you remember back to chemistry, the atoms that make up our cells and complex molecules rely on the interaction of electrons. Basically, atoms can share, gain and loose electrons to form bonds. Of course, other concepts such as dipole interactions and noncovalent bonds other than ionic play a role, but we can all agree that electron interactions are very important.

When ionizing radiation smashes into our cells and disrupts the very interactions that make biology possible, it is easy to understand why we need to worry about problems such as cancer. Additionally, we can appreciate the effects of "regular" (nonionizing) heat and conventional burns quite easily.

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Specializes in ICU + Infection Prevention.

Gila: 'fraid I didn't quite finish the BSNE, otherwise an ABSN would be a good plan. When I finish by BSN, I'll have over 200 credits!

I know that nurses are not radiation experts, but you don't need to be an expert to know a few things about radiation. I don't know much and I was wondering if any of you could help. We are exposed to radiation everyday and we don't think about it. Why is it a big deal when working with hospital equipment?I know the definition of radiation but how dangerous can radiation be? What health problems can it cause?

Anyway...I just want to thank all of you for your responses. Anything can help.

I thought we had answered your question quite thoroughly. I don't know what else to tell you other than to summarize: normal occupation radiation exposure in hospitals leads to negligible increases in cancer risk over a lifetime. Exposure limits are not normally reached. Even at the limits, the risk extremely low. If you are pregnant, effects are magnified (radiation is a teratogen).

I could throw a bunch of numbers out, but I'm not sure they'd be very helpful. If you really want to get into the subject, here is some light reading:

If that http://ec.europa.eu/energy/nuclear/radiation_protection/doc/publication/125.pdf

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Gila: 'fraid I didn't quite finish the BSNE, otherwise an ABSN would be a good plan. When I finish by BSN, I'll have over 200 credits!

That sucks. Is it possible to at least get a minor or two out of it? I know some of the people in my area of the world are able to minor in optics and general chemistry with enough credits. I also know a Bachelor of independent study and applies studies programmes exist where students with enough credits can essentially consolidate said credits into a four year degree.

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