Radiology: Legalities
Legislations:
• Two sets of legislation govern use of radiation in dental practice in the UK:
• Ionising Radiations Regulations (2017)
– Concerned with the safety of the workplace, the workers and the
general public
– Also covers the equipment aspects of patient protection.
– Enforced by the HSE
• Ionising Radiation (Medical Exposures) Regulations (2017)
– Concerned with the safety of patients.
– Enforced by the CQC (or equivalent body outside England).
The expectation is that the documentation required to satisfy the two sets of
regulations would be in one place and form the dental practices Radiation Protection
File - CQC
IRR 2017:
• The use of Ionising Radiation must be registered with the HSE. The main
change in 2017 was the way in which this is done.
- notify (low risk procedures)
- register (intermediate risk procedures - dentistry)
- consent (high risk procedures)
• A Radiation Protection Advisor (RPA) must be appointed to advise on all
aspects of radiation protection.
,• A Radiation Protection Supervisor (RPS) should be appointed to ensure
compliance with IRR 2017.
• All equipment must be critically examined and (acceptance) tested before
being put into clinical use.
• Radiographic equipment must be maintained correctly.
• Radiographic equipment must be regularly tested as part of a QA programme.
Best practice is annually.
• In previous legislation, the HSE must be notified of the routine use of dental x-
ray equipment.
• RPA – a suitably trained medical physics expert
• Staff should be divided into classified and non-classified workers and the dose
limits for these divisions must be adhered to. (It is very rare to be a classified
worker in general dental practice).
• Appropriate information, instruction and training must be provided for all
persons involved with dental radiology.
• Radiation doses to staff and other persons should be As Low As Reasonably
Practicable (ALARP).
• A risk assessment should be carried out and be reviewed regularly.
• equipment supply company/maintenance company; private companies
contract
- formally appointed in writing
- a radiation ‘consultant’ to the practice
- suitably trained; specific radiation protection qualifications
• Radiation Protection Supervisor: normally a dentist at the practice but a
suitably qualified dental nurse/hygienist/therapist can fulfil this role. Training is
required.
• The Radiation Protection Supervisor is appointed by the employer to oversee
the work and make sure local rules are followed.
, • Examples of duties.
Duties will vary between Departments depending on the type and scale of
work involved and the availability of additional local competent staff and
support.
• Provide support and advice to assist staff in the day to day control of
activities using ionising radiation.
• Assist in carrying out risk assessments for work involving radioactive
sources and assist in writing Local Rules.
• Make sure staff are provided with information, instruction and training on
safe working with substances and equipment capable of emitting ionising
radiation.
• Supervise keeping of source records for radioactive sources.
• Undertake physical stock checks of radioactive sources.
• For their area of responsibility, set up a regular scheme for monitoring and
recording of contamination levels and/or radiation dose rates.
• Arrange for the immediate repair of any defective safety or warning system
associated with equipment which emits ionising radiation.
• Co-ordinate the periodic testing of radiation monitoring equipment.
• Co-ordinate the periodic leak testing of sealed radioactive sources
• Make sure that contingency plans exist in the event of an accident or
incident, particularly if a person is accidentally exposed to ionising radiation or
there is damage, theft or loss of a radioactive source.
IRR 2017: Local Rules
• All practices should have a set of written Local Rules applying to all
employees.
• These should be provided by the employer (legally responsible person)
• These should include:
• The name of the RPS
• Summary of working instructions including the names of adequately
qualified staff
Legislations:
• Two sets of legislation govern use of radiation in dental practice in the UK:
• Ionising Radiations Regulations (2017)
– Concerned with the safety of the workplace, the workers and the
general public
– Also covers the equipment aspects of patient protection.
– Enforced by the HSE
• Ionising Radiation (Medical Exposures) Regulations (2017)
– Concerned with the safety of patients.
– Enforced by the CQC (or equivalent body outside England).
The expectation is that the documentation required to satisfy the two sets of
regulations would be in one place and form the dental practices Radiation Protection
File - CQC
IRR 2017:
• The use of Ionising Radiation must be registered with the HSE. The main
change in 2017 was the way in which this is done.
- notify (low risk procedures)
- register (intermediate risk procedures - dentistry)
- consent (high risk procedures)
• A Radiation Protection Advisor (RPA) must be appointed to advise on all
aspects of radiation protection.
,• A Radiation Protection Supervisor (RPS) should be appointed to ensure
compliance with IRR 2017.
• All equipment must be critically examined and (acceptance) tested before
being put into clinical use.
• Radiographic equipment must be maintained correctly.
• Radiographic equipment must be regularly tested as part of a QA programme.
Best practice is annually.
• In previous legislation, the HSE must be notified of the routine use of dental x-
ray equipment.
• RPA – a suitably trained medical physics expert
• Staff should be divided into classified and non-classified workers and the dose
limits for these divisions must be adhered to. (It is very rare to be a classified
worker in general dental practice).
• Appropriate information, instruction and training must be provided for all
persons involved with dental radiology.
• Radiation doses to staff and other persons should be As Low As Reasonably
Practicable (ALARP).
• A risk assessment should be carried out and be reviewed regularly.
• equipment supply company/maintenance company; private companies
contract
- formally appointed in writing
- a radiation ‘consultant’ to the practice
- suitably trained; specific radiation protection qualifications
• Radiation Protection Supervisor: normally a dentist at the practice but a
suitably qualified dental nurse/hygienist/therapist can fulfil this role. Training is
required.
• The Radiation Protection Supervisor is appointed by the employer to oversee
the work and make sure local rules are followed.
, • Examples of duties.
Duties will vary between Departments depending on the type and scale of
work involved and the availability of additional local competent staff and
support.
• Provide support and advice to assist staff in the day to day control of
activities using ionising radiation.
• Assist in carrying out risk assessments for work involving radioactive
sources and assist in writing Local Rules.
• Make sure staff are provided with information, instruction and training on
safe working with substances and equipment capable of emitting ionising
radiation.
• Supervise keeping of source records for radioactive sources.
• Undertake physical stock checks of radioactive sources.
• For their area of responsibility, set up a regular scheme for monitoring and
recording of contamination levels and/or radiation dose rates.
• Arrange for the immediate repair of any defective safety or warning system
associated with equipment which emits ionising radiation.
• Co-ordinate the periodic testing of radiation monitoring equipment.
• Co-ordinate the periodic leak testing of sealed radioactive sources
• Make sure that contingency plans exist in the event of an accident or
incident, particularly if a person is accidentally exposed to ionising radiation or
there is damage, theft or loss of a radioactive source.
IRR 2017: Local Rules
• All practices should have a set of written Local Rules applying to all
employees.
• These should be provided by the employer (legally responsible person)
• These should include:
• The name of the RPS
• Summary of working instructions including the names of adequately
qualified staff
