ACVR’s Radiation Safety Statement

Authors: Monica Jensen, Monique Mayer, Connie Fazio, Elissa Randall

The ACVR supports sustained and conscientious attention to safe practices regarding veterinary radiologic imaging and therapy as they relate to personnel, patients, and equipment. Exposure to radiation should always be As Low As Reasonably Achievable (ALARA) while maximizing the quality of the procedure.

The use of radiation to diagnose and treat animal diseases has significantly advanced the field of veterinary medicine and improved patient care. The equipment and techniques used to perform imaging and therapy procedures, whether they generate ionizing radiation (such as radiography, fluoroscopy, computed tomography, therapeutic radiation generators, and radioisotopes) or they do not generate ionizing radiation (such as ultrasonography and magnetic resonance imaging) are associated with potential risks to patients and personnel. Individuals with significantly less formal training than ACVR Diplomates in the safety, physics, and biology of ionizing radiation* are routinely involved with these procedures. It is essential that these individuals be adequately trained in the appropriate function and use of the equipment and in the procedural techniques used to minimize unnecessary radiation exposure to themselves, staff, patients, and the public. ACVR Diplomates should encourage the continued education of those in general practice by referring them to the ACVR website for video tutorials and educational articles on radiation safety.

Facilities employing ionizing radiation as a diagnostic or therapeutic tool must establish policies, put standard operating procedures in place, and be familiar with current standards and techniques. This includes developing examination protocols for radiography, fluoroscopy, computed tomography, and radioisotope procedures that take into account patient body parameters (size, weight, composition) and maximizing the distance and shielding of workers and the public. Equipment quality control must be included in these protocols, including monitoring all personal protective equipment (PPE) at least once yearly for evidence of cracking or leaks.

Unless absolutely necessary for patient well-being, individuals should leave the room while a radiographic exposure is made. This may be facilitated through the use of sedation and/or manual positioning devices such as troughs, sandbags, and tape. If veterinary medical personnel must be in the room with the patient, dosimetry badges should be worn at all times to monitor radiation exposure. Badge measurements should be evaluated regularly. If individual doses are reported to be high, measures should be taken to reduce further exposure to that individual (e.g. minimizing exposure time, maximizing distance, wearing appropriate shielding). PPE including a lead (or equivalent) apron, thyroid collar, fully enclosing gloves (worn on the hands, not draped over them), and lead glasses should be worn at all times while remaining in the room with a patient for a procedure involving ionizing radiation. If they must remain in the room with the patient, individuals should also step as far away from the primary beam and patient while an exposure is made to reduce scatter radiation exposure. A human body part within a primary x-ray beam is a failure in safety protocol.

ACVR Diplomates, including teleradiologists, often encounter insufficiencies in personnel performance, poor equipment performance, and lapses in proper radiation safety practices. The ACVR Diplomate should comment on visibly unsafe practices occurring in the radiographs they are interpreting. These practices include but are not limited to human body parts in the primary beam, incorrect use of PPE, or inappropriate collimation. Appropriate written communication to the requesting party (private clinician or corporate or academic agency) should immediately address the safety infraction with the primary goal of alerting the submitting party to prompt appropriate corrective measures. Avoidance of infractions should be considered as important as the imaging component of the radiology submission and delivery of patient-centric care.

As an industry, we are, and must be dedicated to safety and safety event reporting. Progress in our field and in animal patient care depends on practice, habit, and operations improvement.

ACVR Diplomates should be leaders in radiation safety to help keep human and animal exposure to radiation as low as possible.

*Ionizing radiation refers to any electromagnetic or particulate radiation capable of producing ion pairs by interaction with matter. Common examples used in medicine include x-rays, electrons, gamma rays, and other products of radioactive decay.

• U.S. Nuclear Regulatory Commission – Occupational dose limits for adults.
• National Council on Radiation Protection and Measurements (NCRP) – NCRP Report No. 148, “Radiation Protection in Veterinary Medicine” (ISBN 0-929600-85-1) was published in 2004. This report can be purchased ($50 hardcopy; $40 PDF) from the NCRP web site.
• Health Canada – Environmental and Workplace Health – Radiation Protection In Veterinary Medicine – Recommended Safety Procedures For Installation And Use Of Veterinary X-ray Equipment – Safety Code28.
• Health Canada – Environmental and Workplace Health – X-rays.
• Hands-Free X-Rays– Created to promote radiation safety awareness in the veterinary workplace

This video describes how to use radiation shielding if you must manually restrain an animal during a radiography examination. Federal guidelines in the United States and Canada recommend that individuals should avoid regular manual restraint of animals for radiographs, but if you must do so, it’s important to follow these guidelines that are designed to protect your health.

The video is the focus of a manuscript by the University of Saskatchewan titled “A 7-minute video training intervention improves worker short-term radiation safety behavior during small animal diagnostic radiography”, published in Veterinary Radiology & Ultrasound.

The ACVR partners with the Hands-Free X-Ray initiative, created to promote radiation safety awareness in the veterinary workplace.

The ACVR partners with IDEXX and the National Association of Veterinary Technicians in America (NAVTA) in Lower the Dose, a new initiative to help raise awareness of radiation safety best practices. There is a need for more radiation safety education to make people aware of the As Low as Reasonably Achievable (ALARA) principle to help create a safer work space. Visit the new Lower the Dose website for timely and relevant radiation resources, news, safety information, and state guidelines. This initiative complements the ACVR’s Position Statement on Radiation Safety.