RADIATION PROTECTION IN CENTRAL RADIOPHARMACY

BY AMIT NAUTIYAL.MASTER IN NUCLEAR MEDICINE,MANIPAL UNIVERSITY,MANIPAL

CONTENT
Introduction Precautions for radiation safety in central radiopharmacy:1-Keep personal exposure as low as possible. It should be done by, a- Review exposure limit & control radiation exposure. b-Monitor radiation exposure.

2-Receipt of radioactive packages 3-Elution of Mo99-Tc99m generator 4-Compounding,Dispensing and quality control of radioactive materials. 5-Transportation of radioactive material 6-Radioactive waste storage and disposal.

 Recommendation for personnel exposure monitoring and quality control Recommendation for minimizing radiation exposure handling PET radiopharmaceutical. References

INTRODUCTION
Present time there is increasing number of new radiopharmaceuticals and NM centers so there is also require more radiation safety. Approximately 200 central radiopharmacies in US serving multiple NM centers. Increases in the need of NM community and the number of studies performed so

increasing awareness to keep radiation exposure in lab as low as possible. The central radiopharmacies deal with large generators, compounds and delivery of many radioactive materials. According NRC (nuclear regulatory commision) each license is responsible for development and documentation of radiation safety program to maintain the

dose as low as reasonably achievable (ALARA) Under this ALARA concept, isotope handling techniques, monitoring & calibrating the equipment, review the personnel exposure are more strictly monitored.

 Parallel to these tighter regulation & concept (NRC,ALARA), there is rapid growth of average patient dose per study because higher dose achieve better diagnostic study and decrease acquisition time, but high dose increases in the dose burden in the nuclear medicine department.

PRECAUTIONS IN CENTRAL RADIOPHARMACY

1. Keep personal exposure as low as possible:

Review exposure limit and control radiation exposure :-

The exposure limits have been developed by ICRP. According ICRP-not only keeping exposure below recommended levels but also maintaining all exposures as low as reasonable achievable (ALARA)

The annual occupational dose limits are described below:The total effective dose equivalent(whole body) of 5Rem (AERB Limit-2Rem). Sum of deep dose equivalent to any individual organ other than the lens of eye being equal to 50Rem(AERB Limit-50Rem) Dose in lens of eye-15Rem(AERB-15REM) Dose in skin equivalent to 50Rem(AERB limit-50Rem)

Dose for embryo/fetus during pregnancy is 0.5Rem(AERB Limit-0.2Rem) The whole body dose limit to non radiation worker and public member should not exceed 0.1Rem/yr(acording both ICRP And AERB). Monitor radiation exposure:Radiation exposure can be monitored by film badge, TLD, self reading dosimeters. 1. Film badge: Most common method of monitoring external exposure.

 The film clips to users cloths. Consist of plastic sheet covered with a thin gelatin matrix, covered by plastic holder. Capable of covering a range of exposure from 10MR to 10R. Also contain various filters such as : aluminum, lead and plastic and an open window to determine the energy of incoming radiation. Advantage is that it gives

exposure because film developed and also able to estimate the exposure to beta radiation. Disadvantage are: sensitive to temperature and humidity changes. 2.TLD: Consist of small crystal chips usually lithium fluoride (LiF) ,which is capable to trap the excited state of radiation. Heated to 250degree Celsius to release the trapped state in form of light photon.

 These light photons measured by TLD reader consist of heater, PMT, digital readout. Crystal is reusable after heating to a temp. of 400 degree Celsius. TLD badge used over the range of 10MR to 1000R.

POCKET DOSIMETER-

Useful for measure exposure over short period of time (hours or day).

 Worn in special situation such as- In high dose operations. Able to measured radiation level from 10R to 1000MR. Expensive and insensitive for beta radiation. DIGITAL DOSIMETER Generally the size of cigarette pack. Worn in pocket or clipped to a belt. Consist of GM tube, which display radiation exposure in 1MR increment.

2.Receipt of radioactive packages: Also need precaution during receipt of radioactive packages because each incoming package containing small amount of radionuclide. Must be monitored during receipt. Test should be performed within 3hrs. after receipt of the

 If package is arriving after normal working hour, then test should be performed within 3hr of begaining of next working day. External exposure should not exceed 10mrem/hr(0.1msv/hr) at one meter distance. Exposure should not exceed 200mrem/hr(2mSv/hr) Wipe test are done for removal of contamination on the external surface of the package. Using absorbent material ,such as alcohol swabs, an area of >300 centimeter square is wiped.

3.Elution of Mo99/Tc99m generator: During elution of radionuclide generator there is many opportunities for person to become exposed. High exposure and contamination during handling the unshielded elution vials. Generators are supplied according the size of radiopharmacy lab. For medium size NM radiopharmacy generators are ranges upto 3Ci(111GBq)

 For larger size NM Radiopharmacy lab generators are ranges upto 16.6Ci(613GBq) In the generators of medium size radiopharmacy 2.5Ci(92GBq) may be eluted in 10ml vial, but in larger size radiopharmacy lab this elution is more concentrated.

 The elution vial should always be transferred using 9 inch forceps, increasing the distance from vial to the fingers about 7inch. By this distance the dose rate to fingers about 315mrem/min(3.15mSv/min) If we will used 2sec to transfer the vial, then there is resulted finger dose about10mrem(0.1mSv)

 There is exposure mainly results from removing the eluate vial shield cap when fingers are within 3inch of the eluate. So that in central radiopharmacy this type exposure reduces by two devices:-CapMac and prototype shield. In the CapMac ,the lead canister is transferred to the dose calibrator by a lifting device.

 By this CapMac device the surface exposure rates from 15mR/hr are reduced to less than 0.5mR/hr.

CapMac remote assay device

4-Compounding, Dispensing and quality control of radioactive materials: In central radiopharmacy many

chance for person to become exposed to radiation or contaminated during compounding/dispensing radioactive material and performance of quality control test. These all procedures done with doses of Tc99m ranging from 50500mci. Performed behind the lead lined Lshield.

Syringe shields: According NRC, the use of syringe shield also important part of radiation protection during kit preparation. By this reduction of hand exposure when drawing a dose from shielded vial. 3mm thick lead glass disk is used for shielding. This thickness is able to attanuate exposure of Tc99m 98% to 99%.

 Many time radiopharmacist may prefer to not use syringe shield but the dose reduction is significant and it is strongly recommended that dose drawing shield always be used.

I-131 Bioassay-

Preparation of I-131 capsule from unsealed source is a radiopharmacist duty.

 Chances of internal dose to radiopharmacist due to inhalation, skin absorption etc. According NRC, there is requires a specific program of bioassay measurements (urine analysis and thyroid uptake) for detecting the extent of internal dose of an employees when handling unsealed quantities of I-131.

5-Transportation of radioactive materials: Many chance to radiopharmacist to become exposed when transporting radioactive materials, so before transporting following thing must be consider : Use strong, tight packages that will not leak. Use appropriate container (syringe shields, lead pigs, moly generators) with a

sign that reads radioactive material attach to each. Radiation level at external surface <0.5mR/hr. Marking are design to provide an explanation of the content of package.

 The three labels are commonly used:Label surface radiation radiation level level at 1met distance White1 <0.5millirem/hr not applicable Yellow2 <50millirem/hr not exceed 1 mrem/hr Yellow3 >50mrem/hr exceed 1mrem/h

6-Radioactive waste storage

and disposal: Radioactive waste generated in radiopharmacy generally consist of syringes, needles, vials and contaminated tissue and papers. All radioactive waste is disposed by the decay-in-storage method. This method is limited to radionuclide with half life less than 65 days. Before routine disposal all radioactive waste must be stored for 10 half lives.

Storage of radioactive waste product

Recommendations for personnel exposure monitoring and quality control:Placement of badges: As a rule all radiopharmacy employee shall wear a film or TLD badge for monitoring external radiation exposure .

The badge should be exchanged for processing at least monthly.

 Whole body badges and dosimeters should be placed near the location to received the highest dose. If lead apron is worn, then dosimeter should place outside the apron. If ring badge are worn, the ring should be worn on hand receiving highest dose.

Visitors: All visitors and nonradiopharmacy employee entering in restricted areas, so for this a self reading pocket dosimeter is must be issue for all visitors. At the end of visit, the dosimeter is read and any exposure exceeding an action level of 2mR/hr should be should b issue a monitoring device. immediately reported to RSO.

Recommendation for survey: All elution, preparation, radiopharmaceutical manipulation areas should be surveyed daily with a GM survey meter. Radioactive waste storage areas should be surveyed weekly.

Radioactive spills: A decontamination kit should readily available that consist of at least following:-protective gloves, liquid and foam decontamination solution, forceps, absorbent paper, disposable pads. If minor spill (from 1mCi of Tc99m) should occur then: Cover the spread of radioactive contamination by covering with

absorbent paper or disposable pads. Clean with absorbent paper using gloves and if possible forceps. Use decontamination solution and water Avoid stepping in contaminated areas and avoid entering & leaving the area. Perform wipe test to ensure no removable activity.

 If major spill, such as from I-131 or activity greater than 1mCi of Tc99m,then : Prevent spread by covering with absorbent paper or disposable pads. Shield the source if possible. Avoid stepping in contaminated area.

Recommendations for minimizing radiation exposure handling PET radiopharmaceutical:-

Withdraw all doses into a syringe with a plastic syringe holder to minimizing bremsstrahlung radiation. All F-18 radiopharmaceuticals and positron radioactive wastes (syringe and gauge) should be stored in radiopharmay hot lab behind 0.5inch thick lead. (because it is equivalent to tenth value thickness for 511kev photon)

 To minimizing exposure, a patient intravenous line should be started before the dose is transported. Recommended that pregnant technologists not work with PET radiopharmaceuticals.

General layout of central radiopharmacy lab