Any use of ionizing radiation, either from radioactive materials (RAM) or equipment that produces ionizing radiation when energized (i.e. an x-ray tube or accelerator) by a facility must have a program to oversee that it is used properly and safely. As a diagnostic medical physicist, I can provide physics support to a department that uses one of these sources of ionizing radiation. My services comes in several forms: doing quarterly and/or annual audits of a RAM program, providing services as a Radiation Safety Officer (RSO) or an agent/spokesperson for the RSO, and as a contact in case of a radiological emergency.

Every medical program that uses RAM for the purpose of imaging or treatment must have either a meeting or a review of their paperwork every quarter, depending upon what the facility promised to their regulators when they applied for a RAM license. Most smaller programs (e.g. cardiac imaging clinics) may only need to have a review of their program and verify quarterly QC tests. Quality control tests like dose calibrator linearity, well counter efficincy, personal dosimeter exposure levels, sealed source inventory & leak checks should be performed and documented quarterly. Larger programs that use therapeutic level doses need to review their Written Directives every quarter to ensure they have been completed properly and are compliant with the license conditions. These programs will have a meeting of the Radiation Safety Committee, and the RSO or designee must present a summary of these to the committee. As a physicist, I will review the paperwork and generate a summary report that includes all general compliance requirements for the RSO and the RSC if there is one. I will often present the report, highlighting points of interest and recommendations as needed. I also note any changes to the regulatory environment to the committee as they arise, with assessment and recommendations for any course of action, if needed. Also, if some QC tests have not been completed, of if the program is just being started, I can perform them and provide documentation to provide proof of compliance. Of course, my level of involvement is based upon the specific needs and license conditions of the facility - what matters is that the facility stays compliant with all laws and license conditions.

Another basic role I have provided in the past is Radiation Safety Officer. I have overseen a program that has included nuclear medicine with a PET/CT scanner and Iodine-131, Yttrium-90, Radium-223 therapies; a therapy program that included HDR (Irridium-192) and LDR (Iodine-123 prostate seed inplants and Cesium-137 manual sources), Yttrium-90 calibration check source, and a dedicated breast imaging unit with Cerium-139 check sources. I can manage a program on a short-term basis while a facility looks for a more long-term placement, or at least I can provide services on behalf of an RSO as needed. This can include the preparing and presentation of the RSO's annual report. This must be completed by the RSO or a designee every year and be submitted to licensee (i.e. administration).

An often-overlooked requirement is the need to have a plan of action in case of a radiological event. Events from a spill to handling a dirty bomb are all possible scenarios that must be addressed in the emergency planning of the facility. Once again, the input of a physicist can help alleviate some uncertainty, and I can be "on-call" in case of an event that requires immediate attention for consultation. I have also performed calculations to estimate radiation exposure to workers, patients and pregnancies as the situation warrants, and can provide both a written report and presentation of results to interested parties. In general, diagnostic procedures do not generate enough radiation dose to jepardize the viability of a pregnancy, but this must be verified on a case-by-case basis.

If your facility uses x-rays or RAM for medical use, be sure you have a Radiation Safety Program that can address all concerns and legal responsibilities. If there is any question or concern, please consider having a physicist review the program to ensure that compliance is maintained. Staying compliant protects more than just your workers and the public - they protect the facility and the license owner from liability should anything unexpected happen.