Basic Considerations of
Radiation Safety and Barrier Protection

Safety Regulations to Reduce Radiation Exposure In 1915, the British Röntgen Society organized an effort to provide protection to people from overexposure to x-rays. By 1922, American organizations adopted these protection guidelines as well. Radiation awareness and education continued to grow throughout the 1920s and 30s to address radiation protection in the United States. In 1970, Congress created the Environmental Protection Agency (EPA) and radiation protection became a part of the EPA's responsibility. Today, EPA's Radiation Protection Division (RPD) is responsible for protecting the environment and the health of the public from undue exposure to radiation. This is accomplished by setting safety standards and guidelines. Now, organizations that deal with ionizing radiation must meet these standards to comply with the law. Ionizing radiation includes x-rays, gamma rays, alpha particles, and beta particles. Non-ionizing radiation includes radio waves, microwaves, light, and heat. The term "radiation" as used in this educational program is generally assumed to mean ionizing radiation, unless otherwise specified. The Food and Drug Administration's (FDA) Center for Devices and Radiological Health is responsible for ensuring the safety and effectiveness of x-ray emitting medical devices. Their mission is to eliminate unnecessary human exposure to manmade radiation created by certain medical, occupational, and consumer products. Prompted by growing evidence of radiation-induced cancers and severe skin reactions, government agencies instituted regulations on the design and use of x-ray equipment. In 1992, the FDA began receiving reports of radiation-induced injuries to the skin of patients who had undergone extensive fluoroscopically guided interventional procedures. Injuries varied in severity from erythema to tissue necrosis requiring skin grafting. These injuries occurred after a variety of interventional procedures, including cardiac catheter ablation, catheter placement for chemotherapy, transjugular intrahepatic portosystemic shunt replacement, coronary angioplasty, renal angioplasty, multiple hepatic or biliary procedures (angioplasty), stent placement and biopsy, and percutaneous cholangiography followed by multiple embolization procedures.4,5 In 1994, as injury reports continued to rise, the FDA determined that many physicians performing these procedures might not fully realize the magnitude of the skin doses that can result from long, complicated interventional procedures. A public health advisory was issued to alert the radiologic community of this concern and to suggest actions designed to reduce the potential for radiationinduced skin injuries to patients. These actions included establishing standard protocols for screening and monitoring radiation dose rates, as well as modifying protocols and recording information on exposure. In 1995, the FDA recommended that all medical facilities record absorbed radiation doses in the records of all patients who received radiation procedures. This enabled the monitoring of patients to ensure their combined doses of absorbed radiation did not exceed 1 gray, the limit deemed safe by the FDA. In addition, the FDA also required the monitoring and recording of procedures with the potential for long exposure time, including cardiac ablation, vascular embolization, and percutaneous endovascular reconstruction.5

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