I. Rad 136 Radiation Protection and Biology

Alabama Department of Postsecondary Education

Representing Alabama’s Public Two-Year College System

(School Heading)

I. RAD 136 – RADIATION PROTECTION AND BIOLOGY

II. COURSE HOURS  Theory 2 credit hours  Lab 0 credit hour  Clinical 0 credit hour  Total 2 credit hours  Total Contact - 2 hours

I. CLASS MEETING DATES/TIMES/LOCATION

II. CLINICAL DATES/TIMES/LOCATION (None)

III. INSTRUCTOR, CONTACT INFORMATION, CONTACT POLICY, OFFICE HOURS/LOCATION

IV. COURSE DESCRIPTION:

This course provides the student with principles of radiation protection and biology. Topics include radiation protection responsibility of the radiographer to patients, personnel and the public, principles of cellular radiation interaction and factors affecting cell response. Upon completion the student will demonstrate knowledge of radiation protection practices and fundamentals of radiation biology.

V. PREREQUISITE(S)/CO-REQUISITE(S)

PREREQUISITE COURSES

CO-REQUISITE COURSES

VI. TEXTBOOK(S) AND OTHER LEARNING RESOURCES

VII. PROFESSIONAL COMPETENCIES/OBJECTIVES

MODULE A – INTRODUCTION TO RADIATION PROTECTION A1.0 Explain basic concepts related to radiation protection. A1.1 This competency is measured cognitively. A1.1.1 Define radiation and radioactivity units of measurement. A1.1.2 Explain the cardinal principles of radiation protection. A1.1.3 Identify ionizing radiation sources from natural and man-made sources. A1.1.4 Defend the need to minimize unproductive radiation exposure to humans. A1.1.5 Explain how time, distance and shielding can be manipulated to keep radiation exposures to a minimum. A1.1.6 Identify sources of electromagnetic and particulate ionizing radiations. A1.1.7 Identify sources of radiation exposure. A1.1.8 Identify methods to measure radiation response.

MODULE B – RADIATION PROTECTION PROCEDURES B1.0 Explain radiation protection procedures for patients and personnel. B1.1 This competency is measured cognitively. B1.1.1 Explain the objectives of a radiation protection program. B1.1.2 Describe the “as low as reasonably achievable” (ALARA) concept. B1.1.3 Identify the basis for occupational exposure limits. B1.1.4 Distinguish between perceived risk and comparable risk. B1.1.5 Describe the concept of “negligible individual risk level” (NIRL). B1.1.6 Explain the necessity to comply with legal and ethical radiation protection responsibilities of radiation workers. B1.1.6 Calculate dose equivalent limits (DEL) with reference to the latest National Council on Radiation Protection and Measurements (NCRP) reports. B1.1.7 Express the need and importance of personnel monitoring for radiation workers. B1.1.8 Describe personnel monitoring devices, including applications, advantages and limitations for each device. B1.1.9 Interpret personnel monitoring reports. B1.1.10 Compare values for dose equivalent limits for occupational radiation exposures (annual and lifetime). B1.1.11 Identify dose equivalent limits for the embryo and fetus in occupationally exposed women. B1.1.12 Identify performance standards for beam-directing, defining, and limiting devices. B1.1.13 Explain the relationship of beam-limiting devices to patient radiation protection. B1.1.14 Describe added and inherent filtration in terms of the effect on patient dosage. B1.1.15 Explain the purpose and importance of patient shielding. B1.1.16 Explain the relationship of exposure factors to patient dosage. B1.1.17 Identify the appropriate image receptor that will result in an optimum diagnostic image with the minimum radiation exposure to the patient. B1.1.18 Select the immobilization techniques used to eliminate voluntary motion. B1.1.19 State the minimum source-to-tabletop distances for fixed and mobile fluoroscopic devices. B1.1.20 Determine the appropriate method of shielding for a given radiographic procedure. B1.1.21 Determine safety factors for the patient (and others) in the room during mobile radiographic procedures. B1.1.22 Differentiate between effects of limited vs. total body exposure. B1.1.23 Describe risk estimates for radiation-induced malignancies.

MODULE C – DESIGNING FOR RADIATION PROTECTION C1.0 Explain the requirements for the design of a radiographic and fluoroscopic room. C1.1 This competency is measured cognitively. C1.1.1 Identify appropriate applications and limitations for each radiation detection device. C1.1.2 Identify conditions and locations evaluated in an area survey for radiation protection. C1.1.3 Distinguish between controlled and non-controlled areas and list acceptable exposure levels. C1.1.4 Describe “Radiation Area” signs and identify appropriate placement sites. C1.1.5 Describe the function of federal, state and local regulations governing radiation protection practices. C1.1.6 Describe the requirements and responsibilities of a radiation safety officer. C1.1.7 Describe the operation of various interlocking systems for equipment and indicate potential consequences of interlock system failure. C1.1.8 Distinguish between primary and secondary radiation barriers. C1.1.9 Describe how the operation of various x-ray and ancillary equipment influences radiation safety and describe the potential consequences of equipment failure. C1.1.10 Calculate exposure with varying time, distance and shielding. C1.1.11 Explain the relationship between HVL and shielding design. C1.1.12 Identify emergency procedures to be followed during failures of x-ray equipment. C1.1.13 Explain the purpose of the 1981 Consumer Patient Radiation Health and Safety Act. C1.1.14 Explain the purpose of the Consumer Assurance of Radiologic Excellence Bill. C1.1.15 Explain the functions of regulatory and advisory agencies.

MODULE D– FUNDAMENTAL PRINCIPLES OF RADIOBIOLOGY D1.0 Explain the fundamental principles of radiobiology. D1.1 This competency is measured cognitively. D1.1.1 Describe the characteristics of a molecule. D1.1.2 Describe principles of cellular biology. D1.1.3 Differentiate between direct and indirect forms of ionizing radiation. D1.1.4 Describe factors influencing radiobiologic/biophysical events at the cellular and subcellular level. D1.1.5 Describe physical, chemical and biologic factors influencing radiation response of cells and tissues. D1.1.6 Explain factors influencing radiosensitivity. D1.1.7 Explain the clinical significance of LD50/30 and LD30. D1.1.8 Explain the Law of Bergonie and Tribondeau. D1.1.9 Define the concepts of linear energy transfer (LET) oxygen enhancement ratio (OER), and relative biological effectiveness (RBE). D1.1.10 Differentiate between the various radiation dose response curves.

MODULE E – MOLECULAR AND CELLULAR RADIOBIOLOGY E1.0 Explain the fundamental principles of molecular and cellular radiobiology. E1.1 This competency is measured cognitively. E1.1.1 Identify dose equivalent limits (DEL) for occupational and non-occupational radiation exposure. E1.1.2 Describe how isoexposure curves are used for radiation protection. E1.1.3 Describe procedures used to verify performance standards for equipment and indicate potential consequences of performance standards failure. E1.1.4 Identify anatomical structures that are considered critical for potential late effects of whole body irradiation exposure. E1.1.5 Describe radiation-induced chemical reactions and potential biologic damage. E1.1.6 Relate short-term and long-term effects as a consequence of high and low radiation doses. E1.1.7Differentiate between somatic and genetic radiation effects and describe specific diseases or syndromes associated with them. E1.1.8Differentiate between stochastic and non-stochastic (deterministic) effects.

X. OUTLINE OF MODULES

MODULE A – UNITS, DETECTION AND MEASUREMENT  Radiation units  Exposure o Coulomb/kilogram (C/kg) o Roentgen (R)  Absorbed dose o Gray (Gy) o Rad  Dose equivalent o Sievert (Sv) o Rem  Radioactivity  Becquerel (Bq)  Curie (Ci)  Cardinal principles  Time  Distance  Shielding  Sources of radiation  Natural  Man-made (artificial)

MODULE B – RADIATION PROTECTION PROCEDURES  Objectives of a radiation protection program  Documentation  Occupational and non-occupational dose limits  ALARA concept  Comparable risk  NIRL  Legal and ethical responsibilities  Dose reporting according to current NCRP reports  Measurement devices: (principle, application and types)  Ion chambers  Proportional counters  Thermionic luminescent dosimeter (TLD)  Optically stimulated luminescent dosimeter (OSLD)  Personnel Monitoring  Historical perspective  Evolution of standards  Public Law 97-35 (The Patient Consumer Radiation Health and Safety Act of 1981)  Public awareness  NCRP recommendations  ICRP recommendations

 Requirements for personnel monitoring  Deep dose equivalent (DDE)  Shallow dose equivalent (SDE)  Eye dose equivalent (EDE)  Committed dose equivalent (CDE)  Committed effective dose equivalent (CEDE)  Total effective dose equivalent (TEDE)  Methods and types of personnel monitors  Film badge  TLD o Body badge o Ring badge  OSLD  Records of accumulated dose  Purpose  Content  Length of record-keeping  Retrieval from previous employers  Dose recommendations  Occupational  Non-occupational limits  Critical organ sites  Embryo-fetus  Cumulative dose formula  Radiation safety officer  Requirement  Responsibilities  Responsibilities for radiation protection  Radiographer  Radiation safety officer  Facility  Patient Protection  Beam-limiting devices  Filtration  Shielding  Exposure factors  Image receptor system  Immobilization  Fluoroscopic procedures  Mobile radiography  Special considerations  Pediatric patients  Pregnant patients

MODULE C – DESIGNING FOR RADIATION PROTECTION  General survey procedures  Qualified expert  Records  Equipment survey  Conditions  Radiographic and fluoroscopic equipment  Area survey  Controlled/uncontrolled areas  Conditions  Recommendations  “Radiation Area” sign posting  Regulatory/Advisory agencies  International Council on Radiation Protection and Measurements (ICRP)  NCRP  Nuclear Regulatory Commission (NRC)  The Consumer-Patient Radiation Health and Safety Act of 1981  CARE Bill (Consumer Assurance of Radiologic Excellence)  State agencies  Radiation safety officer  Design  Materials  Primary barrier  Secondary (scatter and leakage) barrier  HVL  Factors o Use (U) controlled and uncontrolled o Workload (W) o Occupancy (T) o Distance (D)  X-ray and ancillary equipment o Beam-defining devices o Exposure control devices o On and off switches o Interlocks o Visual/audio monitors o Emergency controls o Quality control . Calibration . Standards

MODULE D – FUNDAMENTAL PRINCIPLES  Molecule  Ionic bond  Covalent bond  Review of cell biology  Basic unit of life  Cell constituents o Protoplasm and metabolism o Organic and inorganic compounds o Basic cell chemistry  Cell structure  Cell membrane  Cytoplasm  Organelles  Nucleus  Cell growth  Mitosis  Meiosis  Cell cycle  Differentiation  Basic cell types  Somatic  Genetic  Molecular effects of radiation  Radiolysis of water  Target theory o Target molecules o Cell death  The deposition of radiant energy  Linear energy transfer (LET)  Relative biological effectiveness (RBE)  Factors influencing RBE o LET o Oxygen  Law of Bergonié and Tribondeau  Differentiation  Mitotic rate  Metabolic rate  Cell survival  Factors influencing survival o LET o Oxygen o Fractionation

 Systemic response to radiation  Hemopoietic system  Skin  Digestive  Urinary  Respiratory  Reproductive  Nervous  Other  Radiation dose-response curves  Linear, nonthreshold  Nonlinear, nonthreshold  Linear, threshold  Nonlinear, threshold

MODULE E- MOLECULAR AND CELLULAR RADIOBIOLOGY  Radiation Effects  Subcellular radiation effects o Radiation effects of DNA . Types of damage . Implications in humans o Radiation effects of chromosomes . Types of damage . Implications in humans  Cellular radiation effects  Types of cell death o Interphase death o Mitotic (genetic) death  Other effects o Mitotic delay o Reproductive failure o Interference of function  Individual radiation effects  Somatic effects o Short term o Long term o Stochastic effects  Genetic effects o Mutagenesis  Factors influencing radiation response

 Early effects of radiation  Total body irradiation o Acute radiation syndrome . Hemopoietic . Gastrointestinal . Central nervous system o Stages of response and dose levels o Factors influencing response o Medical interventions of response  Late effects of radiation  Somatic responses o Mutagenesis o Carcinogenesis  Stochastic effects  Non-stochastic (deterministic) effects  Genetic effects  Occupational risks for radiation workers  Carcinogenesis  Risk estimates

XI. EVALUATION AND ASSESSMENT

XII. ATTENDANCE a. Students are expected to attend all classes for which they are registered. Students who are unable to attend class regularly, regardless of the reason or circumstance, should withdraw from that class before poor attendance interferes with the student’s ability to achieve the objectives required in the course. Withdrawal from class can affect eligibility for federal financial aid. Withdrawal from class can prohibit progression in nursing and allied health programs.

b. Students are expected to attend all clinical rotations required for each course. Only excused absences will be considered for make up. However, due to limited clinical space and time, clinical make up days cannot be guaranteed. Failure to complete clinical rotations will prohibit progression in nursing and allied health programs.

XIII. STATEMENT ON DISCRIMINATION/HARASSMENT The College and the Alabama Board of Education are committed to providing both employment and educational environments free of harassment or discrimination related to an individual’s race, color, gender, religion, national origin, age, or disability. Such harassment is a violation of State Board of Education policy. Any practice or behavior that constitutes harassment is a violation of State Board of Education policy. Any practice or behavior that constitutes harassment or discrimination will not be tolerated.

XIV. AMERICANS WITH DISABILITIES The Rehabilitation Act of 1973 (Section 504) and the American with Disabilities Act of 1990 state that qualified students with disabilities who meet the essential functions and academic requirements are entitled to reasonable accommodations. It is the student’s responsibility to provide appropriate disability documentation to the College. Please contact the ADA representative.

XV. COURSE CALENDAR

XVI. STUDENT ACKNOWLEDGEMENT FORM