DOS 525 Brachytherapy for Medical Dosimetrist

Week 2: Discussion 2 - Group 2

10 CFR Part 20 – Standards for Protection Against Radiation

SUBPART B - RADIATION PROTECTION PROGRAMS

20.1101 Radiation protection programs (Hieu Tran)
Subpart B discusses the radiation protection program and the conduct required of a
license holder. There are 4 conditions; to have a protection program, practice ALARA,
maintain testing, and minimize airborne radiation.
 Protection program - Development and implementation of radiation protection
program shall meet compliance provisions and recordkeeping requirements. All
radiation activity that the licensee undertakes must be able to adhere to the radiation
protection measures.
 Practice ALARA - Protocols, procedures, controls, and good practice to ensure
radiation protection principles are applied to personnel and the public.
 Testing - Annual review and testing of radiation protection program is performed to
ensure compliance.
 Minimize airborne radiation - Each licensee must establish a dose constraint of no
more than 10 mrem (0.1 mSv) per year from radioactive air emissions. Radon-222
and its daughters are not expected to receive a total effective dose equivalent in the
dose determination. Failure to meet this requirement must be reported and action
taken to prevent recurrence.

SUBPART C – OCCUPATIONAL DOSE LIMITS

20.1201 Occupational dose limits for adults (Kearla Bentz)
A. Total effective dose equivalent annual limit 5rem or sum of deep-dose and committed
dose equivalent to any organ (other than lens) 50rem limit/year.
B. Lens dose equivalent annual limit 15rem, shallow-dose equivalent annual limit to skin
50rem.
C. Excess dose beyond annual occupational limits (emergencies/accidents) subtracted
from planned special exposures limit for the individual that year and his/her lifetime.
D. With an external personal monitoring device use the deep-dose equivalent unless
effective dose equivalent found by NRC-approved dosimetry method.
1. Use the deep dose from the body region receiving the highest dose
2. Shallow dose averaged over 10cm2 of skin receiving the highest dose
 3. If monitoring device not in highest dose region or no measurement-use the deep
dose, lens dose, and shallow-dose equivalent from surveys or measurements
E. Derived air concentration (DAC) and annual limit on intake (ALI) tables may help
determine individual’s dose.
F. Limit soluble uranium intake of occupational individual to 10mG in a week.
G. Individual occupational dose of current year reduced from dose received at previous
occupation.
20.1202 Compliance with requirements for summation of external and internal doses. (Kearla
Bentz)
A. Occupational individual must show sum of external and internal doses unless not
subject to 20.1502(a) and (b) requirements.
1. Individual licensee is compliant with summation requirements by meeting one
condition from intake inhalation and the intake by oral ingestion and intake
through wounds/skin conditions (sections B, C, D of this subpart).
2. The dose equivalents of the lens, skin, and extremities are subject to separate
limits and are not included in the summation.
B. Intake by Inhalation- if sum of deep-dose equivalent divided by the total effective dose
equivalent limit, and one of the following, < unity than total effective dose equivalent
limit is not exceeded.
1. Total fractions of inhalation ALI for each radionuclide
2. Total DAC hours for all radionuclides divided by 2,000
3. The sum of committed effective dose equivalents to all irradiated organs (T)
calculated from bioassay data using biological models, expressed as a fraction of
the annual limit.
C. Intake by oral ingestion- intake >10% of applicable oral ALI requires the licensee to
include it in demonstrating compliance with limits.
D. Intake through wounds or absorption through skin-licensee must evaluate and account
for intake through wounds/skin.
20.1203 Determination of external dose from airborne radioactive material (Jenn DeWeese)
Licensees must include the contribution of external exposure to the deep-dose equivalent,
lens dose equivalent and shallow-dose equivalent when determining the dose from the
airborne radioactive material.
20.1204 Determination of internal exposure (Allison Wright)
When assessing dose, it is suitable to take note of concentration of radioactive materials
in air in work areas, quantities of radionuclides in the body, quantities of radionuclides
excreted from the body, or the combination of these. It is assumed that an individual has
inhaled radioactive material unless respiratory protective equipment is used. If the
 specific radionuclide is known, the exposed individual can report the calculated effective
dose based on known values. There are calculations for assessing dose to assist with
assumptions. This is applied to brachytherapy when an individual is unnecessarily
exposed to the live source.
20.1205 (Reserved)
20.1206 Planned special exposures (Jenn DeWeese)
 Planned special exposures may be authorized under specific conditions.
 Conditions include written authorization, informing individuals of risks, prior dose
evaluation and dose limits.
20.1207 Occupational dose limits for minors (Madeleine Booth)
The annual occupational dose limits for minors is 10% or the annual dose for adult
workers. For example, the annual dose limit to the lens for adults is 15 rems (0.15 Sv).
The limit for a minor would be 10% of that, making the annual dose limit to the lens 1.5
rems (0.015 Sv).
20.1208 Dose equivalent to an embryo/fetus (Madeleine Booth)
The dose equivalent to an embryo/fetus must not exceed 0.5 rem (5mSv) during the entire
pregnancy due to the occupational exposure of a declared pregnant woman. The dose
equivalent to the fetus is the sum of the deep-dose equivalent to the pregnant woman and
the dose equivalent from radionuclides in the fetus or woman. If the dose equivalent has
been exceeded or is within 0.05 rem of the limit by the time the pregnancy is declared,
the worker is still in compliance with this section. However, additional measures must be
taken to ensure the dose equivalent does not exceed 0.5 rem for the remainder of the
pregnancy.

SUBPART D – RADIATION DOSE LIMITS FOR INDIVIDUAL MEMBERS OF THE

PUBLIC
20.1031 Dose limits for individual members of the public (Katelyn Knoepke)
Subpart D pertains to radiation dose limits for individual members of the public. It is
intended to protect the public from radiation exposure. The following list summarizes the
main requirements of subpart D:
 The total effective dose equivalent to individual members of the public must not
exceed 0.1 rem (1 mSv) per year.
 The dose in unrestricted areas must not exceed 0.002 rem (0.02 mSv) per hour.
 These dose limits apply to members of the public if they are allowed access to
controlled areas.
 Visitors to individuals containing byproducts who cannot be released may receive a
dose greater than 0.1rem (1mSV), if the dose does not exceed 0.5 rem (5mSv) and the
authorized user has deemed the visit appropriate.
  An application is required to allow up to an annual dose limit of 0.5rem (5mSv) for
an individual member of the public. The application must include a need and
expected duration, a program to assess and control dose, and procedures to maintain
ALARA.
 EPA environmental radiation standards must also be followed, and additional
restrictions may be imposed to limit dose to the public.
20.1302 Compliance with dose limits for individual members of the public (Joshua Dutton)
Section 20.1302 of Subpart D pertains to demonstrating and maintaining dose limit
compliance for individual members of the public. To show compliance with this Nuclear
Regulatory Commission (NRC) code, a measurement or calculation must be performed
indicating that annual dose limits will not be exceeded by the performance of any
operation. The dose to unrestricted areas must remain in compliance with the NRC code
and dose in this area must not exceed .002 rem (.02 mSv) in an hour and .05 rem (.05
mSv) in a year.

SUBPART F – SURVEYS AND MONITORING

20.1501 General (Stacey Song)
General is about how each licensee shall ensure that surveys are made. These surveys
include the subsurface and helps the licensee to comply with regulations, are reasonable
under the circumstances which allows the evaluation of the magnitude and extent of the
radiation levels, the concentration or qualities of the residual radioactivity and the
potential radiological hazards of the radiation levels.
Records from the surveys describe the residual radioactivity’s location and amount that
which are identified at the site. These records must be retained in accordance with §
30.35(g), 40.36(f), 50.75(g), 70.25(g), or 72.30(d).
The licensee will ensure that the quantitative radiation measurement equipment and
instruments are calibrated periodically for the measured radiation.
All personal dosimeters used by licensees are to comply with § 20.1201, and with
associated provisions of 20.1501, or with the conditions as specified in a license must be
processed and evaluated by a dosimetry processor.
These dosimetry processors must hold current personnel dosimetry accreditation from the
NVLAP of the National Institute of Standards and Technology (NIST), and approved for
this type of radiation(s) included in the NVLAP program and must be of the type of
radiation(s) for which the individual wearing the dosimeter is monitored.

20.1502 Conditions requiring individual monitoring of external and internal occupational dose
(Carlos Torres Teran)
 Ten CFR Part 20 subpart F has two parts: general and conditions requiring individual
monitoring of external and internal occupational dose. The latter, as the name suggests,
addresses the scenarios that mandate individual monitoring of external and internal
occupational dose by a licensed individual. It communicates this in two parts, the first
addresses the responsibility of each licensed individual to monitor occupational exposure
from both licensed and unlicensed sources under the control of a licensed individual. As
well as provide and require the usage of individual monitoring devices if specific
conditions are met.
This specifically applies to adults with a high probability of receiving an external dose
greater than 10% of the limits in § 20.1201(a) in a year, as well as children with the high
probability of receiving a deep dose equal to 0.1 rem (1 mSv), lens dose greater than 0.15
rem (1.5 mSv), or shallow dose to skin or extremities greater than 0.5 rem (5 mSv) in a
year. This also applies to those that go into areas recognized for having high or very high
levels of radiation as well as pregnant women (with declared pregnancies) with the high
probability of receiving a deep dose equivalent greater than 0.1 rem (1 mSv) during the
pregnancy.
Lastly, it addresses that each licensed individual has the responsibility of monitoring the
occupational uptake of radioactive material by and access the effective dose equivalent
applying to the following groups. First, this apples to adults with the probability of
receiving a radioactive uptake greater than 10% of the annual limits on intake (ALIs)
outlined in the first table of appendix B, specifically in the first two columns, in one year.
It also applies to children with the probability of receiving an effective dose greater than
0.1 rem (1 mSv) and pregnant women (who chose to declare) with the probability of
receiving an effective dose greater than 0.1 rem (1 mSv).

SUBPART G – CONTROL OF EXPOSURE FROM EXTERNAL SOURCES IN

RESTRICTED AREAS
20.1601 Control of access to high radiation areas (Kristen Eberhard)
When high levels of radiation exist in a controlled environment, regulations exist to keep
both the public and workers safe from radiation harm. High radiation areas are more
stringent in regulations because higher exposure causes more harm. Therefore, strict
regulations apply. The Nuclear Regulatory Committee (NRC) has set regulations in the
CFR 10 Part 20 subpart G to address control standards in a Restricted area. As entry into
the areas is of the greatest importance, at no time should an exit be blocked from usage.
One or more of three distinct features must be present to control access in a restricted
high radiation area that is used to store the external radiation source. The first option is a
control device that lowers the radiation dose received to a dose under a level the person,
upon entry, receives a deep dose equivalent to 0.1 rem (1 mSv) in an hour at 30 cm from
the radioactive source or from surfaces being penetrated by radiation. This can be
 replaced by video surveillance maintaining continuous direct or electronic surveillance.
The surveillance equipment must be able to prevent entry by unauthorized persons to the
high radiation area.
20.1602 Control of access to very high radiation areas (Kristen Eberhard)
The second option is a controlled device that will sound an alarm or be visible to the
person entering the high radiation area. Or the final option is that all entryways are locked
except when access is required. Positive control over each entryway must be maintained
on an individual basis. If a facility wishes to alter the NRC regulations in controlling a
high radiation area, approval may be requested from the Commission.
If a radioactive material is packaged awaiting transport, and is being stored while waiting
for said transport, then differences in the monitoring and control applies. Control is not
required for each entry/access point as long as the package is removed within 3 days and
the dose rate at 1 meter from the external surface of any package does not exceed 0.01
rem, or 0.1 mSv, per hour. Both conditions must be met.
Sometimes a patient becomes the radioactive source while receiving treatment. In this
instance, the hospital does not need to control the entrance. However, there must be staff
on site to limit radiation exposure to others and maintain ALARA principles.
If very high radiation exposure is possible (levels of 500 rads, or 5 Gray, in 1 hour at 1
meter), added protection is required so that unauthorized access is not permitted into the
very high radiation area.