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Chapter 16: Radiation Protection and Safety in Radiotherapy

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Chapter 16: Radiation Protection and Safety in Radiotherapy Chapter 16: Radiation Protection and Safety in Radiotherapy Set of 236 slides based on the chapter authored by P. Ortiz- Lopez, G. Rajan, and E.B. Podgorsak of the IAEA publication: Radiation Oncology Physics: A Handbook for Teachers and Students Objective: To familiarize the student with the basic principles of radiation protection and safety in radiotherapy. Slide set prepared in 2006 by E.B. Podgorsak (Montreal, McGill University) Comments to S. Vatnitsky: [email protected] IAEA International Atomic Energy Agency CHAPTER 16. TABLE OF CONTENTS 16.1. Introduction 16.2. Radiation effects 16.3. International consensus and radiation safety standards 16.4. Types of radiation exposure 16.5. Quantities and units used in radiation protection 16.6. Basic framework of radiation protection 16.7. Governmental regulation and national infrastructure 16.8. Scope of the basic safety standards 16.9. Responsibilities for implementation of basic safety standards 16.10. Safety in the design of radiation sources and equipment 16.11. Safety of acceptance tests, commissioning and operation 16.12. Security of source IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16. CHAPTER 16. TABLE OF CONTENTS (continued) 16.13. Occupational exposure 16.14. Medical exposure 16.15. Public exposure 16.16. Potential exposure and emergency plans 16.17. General shielding calculations 16.18. Typical linac installation 16.19. Shielding design for brachytherapy IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16. 16.1 INTRODUCTION Soon after Roentgen discovered x rays in 1895 and Becquerel discovered natural radioactivity in 1896 it became apparent that ionizing radiation was not only useful for the diagnosis and treatment of disease but was also harmful to human tissue through: • Direct clinical effects at very high doses. • Potential for delayed effects such as induction of malignancies. • Potential for genetic effects. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.1 Slide 1 16.1 INTRODUCTION Risks associated with radiation exposure can only be restricted but cannot be eliminated entirely because: • Radioactive substances producing ionizing radiation occur naturally and are permanent features of the environment. • Man-made radiation sources are now widespread. • Sources of ionizing radiation are essential to modern life, in health care, industry, and agriculture. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.1 Slide 2 16.1 INTRODUCTION Health care: • Disposable medical supplies sterilized by radiation are central in combating disease. • Radiology and nuclear medicine are a vital diagnostic tool • Radiotherapy is commonly used in treatment of cancer. Agriculture: • Irradiation is used to preserve foodstuff and reduce wastage. • Irradiation-based sterilization techniques are used to eradicate disease carrying insects and pests. Industry: • Industrial radiography is in routine use to examine welds. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.1 Slide 3 16.2 RADIATION EFFECTS Exposure to radiation can cause detrimental health effects that fall into one of two categories: • Deterministic • Stochastic In addition to deterministic and stochastic effects in adults, other health effects may occur in infants due to exposure of the embryo or foetus to radiation, such as: • Greater likelihood of leukaemia (stochastic effect). • Severe mental retardation and congenital malformations (deterministic effects). IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.2 Slide 1 16.2 RADIATION EFFECTS 16.2.1. Deterministic effects Deterministic effects occur at relatively large doses and are called deterministic because they are certain to occur, if the dose exceeds a threshold level. Deterministic effects are the result of various processes, mainly cell death and delayed cell division, caused by exposure to large radiation doses. The severity of a particular deterministic effect in an exposed individual increases with the dose above the threshold for the occurrence of the effect. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.2.1 Slide 1 16.2 RADIATION EFFECTS 16.2.1. Stochastic effects Radiation exposure can also induce delayed effects such as malignancies and hereditary effects, which: • Are expressed after a latency period. • May be epidemiologically detectable in a population. • Are called stochastic effects because of their random nature. This cancer induction is assumed to take place over the entire range of doses without a threshold level: • The probability of occurrence of cancer is higher for higher doses. • The severity of cancer that may result from irradiation is independent of dose. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.2.1 Slide 2 16.2 RADIATION EFFECTS 16.2.1. Stochastic effects Stochastic effects may ensue if an irradiated cell is modified rather than killed, since modified cells may develop into a cancer after a prolonged delay. If a cell damaged by radiation exposure is a germ cell whose function is to transmit genetic information to progeny, it is conceivable that hereditary effects of various types may develop in the descendants of the exposed individual. The likelihood of stochastic effects is presumed to be proportional to the dose received without a dose threshold. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.2.1 Slide 3 16.3 INTERNATIONAL CONCENSUS AND RADIATION SAFETY STANDARDS Radiation safety standards are based on knowledge of radiation effects and on established principles of radiation protection. The United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) was set up by the United Nations in 1955 to compile, assess and disseminate information on: • Health effects of radiation. • Levels of radiation exposure due to various sources. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.3 Slide 1 16.3 INTERNATIONAL CONCENSUS AND RADIATION SAFETY STANDARDS Purely scientific considerations are only part of the basis for decisions on protection and safety; an important component is also value judgment on the relative risks of different kinds and on the balancing of risks and benefits. General acceptance of risk is a matter of consensus and the international safety standards should provide a desirable international consensus for the purpose of radiation protection. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.3 Slide 2 16.3 INTERNATIONAL CONCENSUS AND RADIATION SAFETY STANDARDS International consensus is basic to the IAEA radiation safety standards, which are prepared with the wide participation of and approval by its Member States as well as relevant international organizations. The current version of the safety standard was issued in 1996 and is entitled “International Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources”, in short Basic Safety Standard (BSS). IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.3 Slide 3 16.4 TYPES OF RADIATION EXPOSURE The BBS defines two types of exposures: Normal exposure results from certain industrial or medical practices and is of predictable magnitude albeit with some degree of uncertainty. Potential exposure is an unexpected but feasible exposure that can become actual exposure, if the unexpected situation does occur, for example, as a consequence of equipment failure, design problems or operating errors. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.4 Slide 1 16.4 TYPES OF RADIATION EXPOSURE The BBS specifies means for controlling normal and potential exposures: Normal exposures are controlled by restricting the dose delivered. For example, exposure of patients is controlled through delivering only the doses that are necessary to achieve the diagnostic or therapeutic objective. Potential exposures are controlled by optimizing the design of installations, equipment and operating procedures. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.4 Slide 2 16.4 TYPES OF RADIATION EXPOSURE The radiation exposures covered by the BBS encompass normal and potential exposures of three distinct groups: • Workers pursuing their occupations (occupational exposures). • Patients in diagnosis or treatment (medical exposures). • Members of the public. Radiation exposures are thus divided into three categories: • Occupational exposure. • Medical exposure. • Public exposure. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.4 Slide 3 16.4 TYPES OF RADIATION EXPOSURE Occupational exposure is defined as all exposures of workers incurred in the course of their work. Medical exposure is defined as the exposure incurred: • By patients as part of their medical diagnosis or treatment. • By individuals, other than those occupationally exposed, while voluntarily helping in the support and comfort of patients. • By volunteers in a programme of research involving their exposure. Public exposure is defined as exposure incurred by members of the public from radiation sources, excluding any occupational or medical exposure. IAEA Radiation Oncology Physics: A Handbook for Teachers and Students - 16.4 Slide 5 16.5 QUANTITIES AND UNITS IN RADIATION PROTECTION 16.5.1. Physical quantities Most of the requirements of the BBS are qualitative, yet they also establish
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