March 3, 2014

Whether in the operating room, in the scan room, in Emergency or elsewhere in the institution, whether it is a fluoroscopy, an angiogram, an endoscopic retrograde cholangio-pancreatogram or another type of radiology examination, the healthcare professionals are at risk for exposure to ionizing radiation, such as X-rays, in the performance of their duties. Because radiation is highly energetic and able to ionize matter when it passes through, they can damage cells, in particular DNA in living matter. What’s more, X-rays can have harmful biological effects such as cancer or leukemia.

All employers are obliged to comply with the standards issued by the federal Department of Health, Radiation Protection Division, to ensure the safety of the healthcare professionals. The Health Canada Radiation Protection Bureau, whose mandate is to protect Canadians’ health, and to assess the risks associated with exposure to radiation in the workplaces, is responsible for managing the National Dose Registry (NDR), a centralized registry of the radioactive doses measured by the dosimeters worn by workers exposed to such radiation. In every workplace where radioactive elements are used, the employer must respect and apply the standards and the protocols in force, both in Canada and in Québec.

Among the many preventive measures is distance. Being as far away as possible from the source of radiation is actually the best protection from radiation. If that is not possible, it is crucial to minimize the time of exposure. In addition, wearing a lead apron is a mandatory personal radiation protection, a responsibility of every healthcare professional. In accordance with the standards, the lead apron must be at least 0.5mm thick. The thicker it is, the more effective it is, even though the discomfort linked to the weight of this protection must however be taken into account. Since it is known that the thyroid gland is extremely sensitive to radiation, particularly for people under age 25, it is also essential to wear thyroid protection. The mobile screens or leaded barriers available on the market can be additional protection, but not as substitutes for lead aprons.

As regards angiograms – an examination that uses X-rays and an iodine-based contrast medium –, the length and intensity of the radiation systematically requires the wearing of protective lead glasses in order to protect the lens and to avoid the early onset of cataracts. And, wearing a dosimeter is required, because an accumulation of radiation is harmful to health. Thus, the dosimeter enables a strict count of the quantity of radiation received by the healthcare professional and to better control the safe exposure limit.

Furthermore, the employer must ensure that every professional, exposed to radiation through her work, wears a dosimeter. If the personal dosimeter reveals exposure to excessive amounts of radiation, attributable to a defect or mal function of a piece of X-ray equipment, the employer must immediately make the necessary corrective measures.

Although an optimization of operational practices, a control of the quality of the X-ray equipment and using effective radiation protective equipment ensures that high doses of radiation are far from fatal, vigilance is still required. The healthcare professional must never minimize the risks linked to exposure to X-rays.

As a healthcare professional, you must remain demanding and uncompromising, In short, watch out for them!

Do you know ?

The employers can provide additional information on the subject, just like the joint Occupational Health and Safety Committee in the health institution or the local union team, as the case may be.

According to Health Canada, the dosimeter files must be kept on site for at least five years after a user has stopped working with the equipment.

The employer must give a copy of the federal report on her personal dosimeter to the healthcare professional exposed to radiation.

If the personal dosimeter reveals that the healthcare professional has received excessive doses, the employer must grant her a leave which can in no way affect her annual vacation or her bank of sick days. During this time, she receives a remuneration equivalent to that she would have received if she were at work.

Any blood anomaly attributable to radiation found in a healthcare professional must be immediately investigated by a hematologist or a physician who is an expert on the subject in order to discover the cause.

All healthcare professionals exposed to radiation because of their work, will have an annual chest X-ray while at work and without cost and a blood test (complete blood count) every three months and when exposed to excessive radiation, except if this is not advised by her attending physician.

The employer is responsible for setting up a maintenance programme for the radiation protection equipment. According to Health Canada, this equipment must be checked every year to guarantee the safest possible conditions. The results of this verification must be included in the quality control report. Any defective equipment must be banned from clinical use.

The pregnant or breast-feeding healthcare professional must never, under any circumstances, be exposed to radiation.