The Blue BookThe Blue Book 

P f Ji M l

Published, 1988, by predecessor of

Prof Jim MaloneRobert Boyle Prof of Medical Physics

Trinity College, DublinPublished, 1988, by predecessor of Radiological Protection Institute of Ireland (RPII)

y g ,

IAEA, Vienna

Problems with Blue BookProblems with Blue Book

• Changes in Legislation,  • OBJECTIVESg gTechnology, Clinical Practice, Building Style, Building Materials • Preference for 

h i l l• Changes in Dose Limits and Constraints

comprehensive local solution

• Use of Upper Floors• Need illustrated floor plans

• Not to innovate, but to produce a reliableNeed illustrated floor plans

• Advice on Ceilings, • Higher levels of walls

to produce a reliable practical manual or code.g

• Practical Tips and Solutions

Issues 1: EquipmentIssues, 1: Equipment

Issues 2: New ProblemsIssues 2: New Problems

W d ll t lid• Ward walls not solid• Theatre workloads not consistent with modern practice.

• Other – recovery rooms, endo suites lithotripsyendo suites, lithotripsy, cardiac pacing

• Radionuclides in Theatres• PET shielding

Issues 3: Dose Constraints

Category of P l

Dose C t i t

Dose C t i tPersonnel Constraint

1998mSv/year

Constraint 2001

mSv/year

Exposed 5 0 1 0Exposed Worker

5.0 1.0

All others 0.05 - 1.0 0.3

Issues 4: Medical PhysicsIssues 4: Medical Physics

Medical Physics SupportMedical Physics Support 

• Deficits in numbers, leadership and d i i l / i iacademic involvement/connectivity

• Often poor, or inadequate training, and narrow or inadequate experience

• Risk of litigation and difficulties with public accountabilityaccountability

Design Code (2nd edition)Design Code (2nd edition)

• About 100 pages incl. Appendices

1. Legal and Administrative Framework

2 Radiation Protection Projectpp 2. Radiation Protection, Project Management and Building Projects

3 R di l R D i d3. Radiology Room Design and Layout

4. Nuclear Medicine5. Shielding Calculations6. Some Practical Considerations

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

1. Statutory Framework1. Statutory Framework

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

E C iti (M di l I i i R di ti• European Communities (Medical Ionising Radiation 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 d ildi jManagement and Building Projects

• 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 Room Design and Layoutgy g y

• Radiology Room Types

• Fluoroscopy Rooms– General Fluoroscopyyp

• General Comments on Shielding

– Interventional Radiology and Cardiology

• Radiography Rooms– General

gy• CT• Shared Function

– Chest Room– Mammography

Rooms (A&E, Theatres, wards)

• Equipment in Trailers– DXA– Dental

• Equipment in Trailers

3 Radiolog Room Design and La o t3. Radiology Room Design and Layout

General RadiologyTwo-corridor DesignLarge enough for trolleys table andLarge enough for trolleys, table and chest radiologyTypical room sizes givenGenerally 2mm Lead – assess on individual basisPrimary Beam absorberStaff entrance behind protective screenTypical screen lengths presented Chest stand positioned to minimise

tt t i t ti lscatter entering protective consoleChanging cubicles

Specific Requirements for each type of facilityExamples of Good Layouts

3 Radiolog Room Design and La o t3. Radiology Room Design and Layout

Dental SurgeryNo shielding required if: < 20 exps/wk

CTSeparate staff area – Other staff present

and 2m between patient and all boundaries Need good view of door and patientScanner angled for access and visibility

MSCT: 3-4mm Pb

DXA and CTDXA and CT 

Design C ite iaDesign Criteria

orC

orrid

o

Corridor

CorridorCorridor

9/3/2009

Mobile X‐Ray Equipment

Equipment not in RoomsEquipment not in Rooms

Equipment not in RoomsEquipment not in Rooms

Equipment not even in BuildingEquipment not even in Building

• Re‐shielding often • TrailerRe shielding often means complete refit

• Hospital can’t do 

Trailer

pwithout equipment for 6 months

• Trailer arrives ‐‐‐‐‐

5 Shielding Calculations5. Shielding Calculations

X‐Ray• Review of two widely used 

Shielding MethodologiesShielding Methodologies– BIR, 2000– NCRP, 2004

• Variables– Distance from Barrier– Workload

• BIR: Workload is based  (ESD) and (DAP)

• NCRP: Workload based on “beam– Occupancy • NCRP: Workload based on  beam‐on” time. in mA min per week

Issue of New Build versus Conversion/Refit

WorkloadWorkload

WorkloadWorkload

• Either DAP (BIR) or mA‐min/week (NCRP)Either DAP (BIR) or mA min/week (NCRP)

• Try and base figures on real audit/projection

i i l bli h d d i l d• Historical or published data can mislead

• If no other option, use published data

• Transparency and accountability to the publicTransparency and accountability to the public

• Defendable legally (reasonable patient, not reasonable doctor)

Occupancy

OccupancyOccupancy

• Occupancy of adjoining areas to be assessedOccupancy of adjoining areas to be assessed

• Try and get real information

C id h id f id• Consider rooms on other side of corridor

• 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 publicTransparency 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 scatter only at 10 mGeneral Rm Window, scatter only, at 10 m

6. Practical Considerations

• Building Materials– Lead sheet and lead 

products

• Walls• Floors and Ceilings• Doorsproducts

– Concrete and concrete BlocksBarium Plaster

• Doors• Windows• Staff Areas– Barium Plaster

– Brick– Gypsum Wallboard

• Joints, Services, Openings and Perforations

• Assessment of Shielding– Lead Glass– Lead Acrylic

Assessment of Shielding• Nuclear Medicine

ALWAYS NEED TO VISIT AND SEE IMPLEMENTATION

9/3/2009

Lead CodesLead 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

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

• Also f room; Some Data Table C2Also 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 windows on upper ppfloors

• Transparent,

bl• Accountable 

• Defendable

CONCLUSIONCONCLUSION

www.rpii.ieRPII3 Cl k h S3 Clonskeagh Square,Dublin 14Ireland