The Blue Book

The Blue Book 

P f Ji M l
Prof Jim Malone
Robert Boyle Prof of Medical Physics
Published, 1988, by predecessor of 
Published, 1988, by predecessor of Trinity College, Dublin
y g ,
Radiological Protection Institute of  IAEA, Vienna
Ireland (RPII)
 Problems with Blue Book
Problems with Blue Book
• Changes in Legislation, 
g g • OBJECTIVES
Technology, Clinical Practice, 
Building Style, Building 
Materials • Preference for 
comprehensive local 
h i l l
• Changes in Dose Limits and  solution
Constraints

• Use of Upper Floors • Not to innovate, but 
• Need illustrated floor plans
Need illustrated floor plans to produce a reliable
to produce a reliable 
• Advice on Ceilings,  practical manual or 
code.
• Higher levels of walls
g
• Practical Tips and Solutions
Issues 1: Equipment
Issues, 1: Equipment
 Issues 2: New Problems
Issues 2: New Problems

• W
Ward walls not solid
d ll t lid
• Theatre workloads not 
consistent with modern 
practice.
• Other – recovery rooms, 
endo suites lithotripsy
endo suites, lithotripsy, 
cardiac pacing
• Radionuclides in Theatres
• PET shielding
 Issues 3: Dose Constraints
Category of Dose Dose
P
Personnel
l C t i t
Constraint C t i t
Constraint
1998 2001
mSv/year mSv/year

Exposed 50
5.0 10
1.0
Worker

All others 0.05 - 1.0 0.3

 Issues 4: Medical Physics
Issues 4: Medical Physics
Medical Physics Support 
Medical Physics Support
• Deficits in numbers, leadership and 
academic involvement/connectivity
d i i l / i i
• Often poor, or inadequate training, and 
narrow or inadequate experience

• Risk of litigation and difficulties with public 
accountability
 Design Code (2nd edition)

• About 100  1. Legal and Administrative 
pages incl.  Framework
Appendices
pp 2 Radiation Protection, Project 
2. Radiation Protection Project
Management and Building 
Projects
3 Radiology Room Design and 
3. R di l R D i d
Layout
4. Nuclear Medicine
5. Shielding Calculations
6. Some Practical Considerations

www.rpii.ie RPII, 3 Clonskeagh Square, Dublin 14, Ireland

 1. Statutory Framework
1. Statutory Framework

• The Radiological Protection Act, 1991 (Ionising 
Radiation) Order 2000 (SI No. 125 of 2000)

• EEuropean Communities (Medical Ionising Radiation 
C iti (M di l I i i R di ti
Protection) Regulations 2002, 2007 (SI. No. 478 of 
2002 & SI. No. 303 of 2007)

• RPII Licensing System and Requirements

• Related EU Directives
 2. Radiation Protection, Project 
Management and Building Projects
d ildi j

• The Radiation Safety Committee
• The Radiation Protection Advisor
• Project Teams, New Building Design Cycle, 
Refitting Buildings
• Dose Limits and Dose Constraints
• Risk Assessments
• Site visits essential

Issue of New Build versus Conversion/Refit
 Radiology
gy Room Design
g and Layout
y

• Radiology Room • Fluoroscopy Rooms

Types
yp – General Fluoroscopy
– Interventional
• General Comments on Radiology and
Shielding Cardiology
gy
• Radiography Rooms • CT
– General • Shared Function
– Chest Room Rooms (A&E, Theatres,
– Mammography wards)
– DXA • Equipment in Trailers
– Dental
3 Radiolog
3. Radiology Room Design and La
Layout
o t

General Radiology
„ Two-corridor Design
„ Large enough for trolleys,
trolleys table and
chest radiology
„ Typical room sizes given
„ Generally 2mm Lead – assess on
individual basis
„ Primary Beam absorber
„ Staff entrance behind protective screen
„ Typical screen lengths presented
„ Chest stand positioned to minimise
scatter
tt entering
t i protective
t ti console l
„ Changing cubicles

Specific Requirements for each type of facility

Examples of Good Layouts
 3 Radiolog
3. Radiology Room Design and La
Layout
o t

Dental Surgery
No shielding required if: < 20 exps/wk
and 2m between patient and all boundaries
CT
Separate staff area – Other staff present
Need good view of door and patient
Scanner angled for access and visibility
MSCT: 3-4mm Pb
DXA and CT
DXA and CT 
 Design Criteria
C ite ia

or
Corrido

Corridor

Corridor
9/3/2009
Mobile X‐Ray Equipment
Equipment not in Rooms
Equipment not in Rooms
Equipment not in Rooms
Equipment not in Rooms
 Equipment not even in Building
Equipment not even in Building
• Re‐shielding
Re shielding often 
often • Trailer
means complete refit
• Hospital can’t do 
p
without equipment for 
6 months
• Trailer arrives ‐‐‐‐‐
 5 Shielding Calculations
5. Shielding Calculations

X‐Ray
• Review of two widely used 
Shielding Methodologies
Shielding Methodologies
– BIR, 2000
– NCRP, 2004

• Variables
– Distance from Barrier • BIR: Workload is based  (ESD) and 
– Workload (DAP)
– Occupancy • NCRP: Workload based on “beam
NCRP: Workload based on  beam‐
on” time. in mA min per week

Issue of New Build versus Conversion/Refit

Workload
 Workload
• Either DAP (BIR) or mA
Either DAP (BIR) or mA‐min/week
min/week (NCRP)
(NCRP)
• Try and base figures on real audit/projection
• Historical or published data can mislead
i i l bli h d d il d
• If no other option, use published data

• Transparency and accountability to the public
Transparency and accountability to the public
• Defendable legally (reasonable patient, not reasonable doctor)
Occupancy
 Occupancy
• Occupancy of adjoining areas to be assessed
Occupancy of adjoining areas to be assessed
• Try and get real information
• C id
Consider rooms on other side of corridor
h id f id
• Extremes: Office, 100%;   Unattended car‐
park, 2.5 to 5 %
• Reservation about NCRP door value in new 
builds, and Remember:
• Transparency and accountability to the public
Transparency and accountability to the public
• Defendable legally (reasonable patient, not reasonable doctor)
General Radiographic Room 
Ceiling (BIR method)
General Radiographic Room 
Ceiling (NCRP method)
General Rm Window
Window, scatter only,
only at 10 m
 6. Practical Considerations

• Building Materials • Walls
– Lead sheet and lead  • Floors and Ceilings
products • Doors
– Concrete and concrete  • Windows
Blocks
• Staff Areas
– Barium Plaster
Barium Plaster
– Brick
• Joints, Services, Openings 
and Perforations
– Gypsum Wallboard
• Assessment of Shielding
Assessment of Shielding
– Lead Glass
– Lead Acrylic • Nuclear Medicine

ALWAYS NEED TO VISIT AND SEE IMPLEMENTATION

9/3/2009
 Lead Codes
Lead Codes

Code No. 3 4 5 6 7 8
Nominal Thickness (mm)
Nominal Thickness (mm)
1.32 1.80 2.24 2.65 3.15 3.55

(kgm‐2)
Weight (kgm
Weight 14 6
14.6 19 5
19.5 24 4
24.4 29 3
29.3 34 2
34.2 39 1
39.1

Cost (Relative)

• When installed as part of a new build, lead is not 
very dear relative to other costs
Some Data 2:
Some Data 2: 
 Some Data Figure C 6
Some Data Figure C 6
• Also
Also f room; Some Data Table C2 
f room; Some Data Table C2
and C3,4,or Fig C6 and page 101
 Issues
• Advice for imaging 
facilities located on 
upper floors
• Advice for shielding of 
pp
windows on upper 
floors

• Transparent,
• Accountable 
bl
• Defendable
CONCLUSION

www.rpii.ie
RPII
3 Cl k h S
3 Clonskeagh Square,
Dublin 14
Ireland