Employee Exposure to Ionizing Radiation

The safe use of ionizing radiation is a highly technical topic that requires expertise beyond the scope of most risk managers. The individual charged by the NRC with this responsibility—the radiation safety officer (RSO)—is required to meet strict standards for training, experience, and formal education (10 CFR § 35.50).

While the RSO has primary responsibility for the safe use of radiation, risk managers often attend radiation safety committee meetings and are concerned with overall patient safety matters, which, in the case of ionizing radiation, are closely connected to occupational safety. Moreover, occupational exposure issues, as well as general public exposure issues, can raise liability concerns for hospitals. Therefore risk managers should understand what ionizing radiation is and how it is used in healthcare and should be familiar with basic radiation safety principles and occupational groups at risk.

Radiation is the general term used to describe energy moving through space in the form of subatomic particles or waves. Ionizing radiation is a type of radiation that has enough energy to force an electron out of its orbit, creating an ion. Ionizing radiation is what people typically think about when they use the word "radiation"; in this guidance article, "radiation" will be synonymous with "ionizing radiation." Four forms of radiation are relevant to healthcare: alpha particles; beta particles; gamma rays; and x-rays.

Alpha and beta particles. Alpha and beta particles are both energized subatomic particles that are emitted when an atom with an unstable nucleus changes its structure; they are the byproducts of a process known as radioactive decay.

Alpha particles consist of two protons and two neutrons and are heavy, move slowly, and only travel a few inches in air. They can be stopped by a piece of paper or human skin, and thus external exposure is not a major concern; however, they can cause severe damage to cells and DNA if they are inhaled, ingested, or otherwise enter the body.

Beta particles are either an electron or a positron and are much lighter than alpha particles and can travel several feet in air. They can penetrate human skin to the layer where new skin cells are produced and cause internal damage similar to that caused by alpha particles; external exposure to beta particles can produce severe skin burns. Patients treated with beta-particle-emitting substances may themselves be radioactive; that...