Discuss about the Radiation Protection Awareness and Knowledge.
In the clinical set up especially the radiography department, there are risks associated with ionization radiations. The risks of these radiations are severe since they are associated with different types of malignancies .Ionizing radiation can basically be defined as a form of energy whose source is different atom sand it moves from one place to another as electromagnetic waves which take the form of either gamma or x-rays or particles otherwise the neutrons, beta and alpha. Radioactivity is the process whereby different atoms disintegrate spontaneously and the excess energy from this process is released as ionizing radiation. Radionuclides are the unstable elements that break down to release the ionizing radiation. Radionuclides are basically identified through three criteria which include the type of radiation they emit, the energy of the radiation and finally their half-life.
Activity is the term used to express the quantity of a radionuclide present and it is expressed as Becquerel (Mothersill et al., 2018). Half-life on the other hand is the time needed for the radionuclide to disintegrate half to its original value. Half-life can range from either a fraction up to million years.
Ionizing radiation are used in hospitals on a daily basis to perform x-rays on the human body. Despite having medical benefits, they are harmful or can be defined as occupational hazards (Kraft & Howells, 2017). This therefore calls for a management plan to reduce its harm to the human body. Some of the management plans include shielding, dosimeter, signage as well labelling
The workplace in this case is a hospital in the department of radiography. Hospitals have different departments, one of them is the department of radiography. The core function or rather role of this department is to carry out x-rays and fluoroscopy on patients to diagnose deformities inside the human body .This is achieved by the use of different medical appliances. This workplace is prone to the ionization radiation hazard. There are usually around eight workers at the radiography department with five men and three women.
There are two types of ionization sources. The human and the natural sources. The natural sources include exposure to different radioactive materials that can be found in the soil, water as well as air .It basically happens as a result of exposure to more than 60 naturally occurring radioactive substances. The most common radioactive substance is Radon whose source is the rocks and soil and individuals ingest this elements from air and food or even water.
Besides inhalation and ingestion, the other natural way is through exposure from the cosmic rays especially those people who are located at high altitude localities (Corbett, 2013). According to studies, approximately 80% of the dose an individual receives is as a result of the cosmic sources.
Human sources or exposure on the other hand is as a result of human made appliances such as the nuclear power plants to those diagnostic appliances that are used in the hospitals. This is now the center of interest in this case since the workplace in question is the Hospital environment. According to recent studies, the leading source of human made sources of the ionizing radiations are the medical appliances such as the X-ray machines.
At the hospital, exposure to ionization radiations can either be internal or external. Internal exposure takes place when the radionuclide goes into the bloodstream and this can be either be through injection or through wounds (Hricak & Dauer, 2017). Internal exposure however cease when the radionuclide is expelled from the body either by excreta or through treatment as well.
External exposure on the other hand takes place when radionuclides are either deposited on the skin or clothes. The radionuclides in this case however can be eliminated through washing (Dauer et al., 2015). In this case at the hospital, exposure to the ionization radiations is due to irradiation from different external sources like the medical radiation exposure from the X-rays (Burns, Taragin, & Markowitz, 2017). External irradiation however cease through shielding the source of the radiation or when someone moves out of the focus of the radiation field.
People get exposed to ionization radiation under different conditions such as home, public places or workplace like in this case the medical setting where patients, caregivers and volunteers are exposed. Currently, there are three exposure situations to ionizing radiations: planned exposure situations, existing exposures and finally the emergency exposure situations (Akahane et al., 2015). Emergency exposure occurs due to unexpected situation that need quick response like nuclear accidents as well as malicious acts (Paolicchi et al., 2016).Planned exposure is the deliberate introduction of the ionization radiations to achieve particular objectives (Bärenfänger, Rohde, & Block, 2017). One such exposure is treatment and this holds for this case. Existing exposure on the other hand refers to already existing exposure but now there is need for control.
Of all the artificial sources of radiations, medical use accounts for a junk of the population dose currently at 80% and this further represents 20% of the whole population exposure (“NCRP 52nd Annual Meeting, Meeting The Needs of the Nation for Radiation Protection,” 2017). According to studies, it is estimated that in excess of 3600 million diagnostic radiology examinations are carried out.
The effects of radiation are numerous. Radiation results to damage of tissues and this depends on the dose rate. The amount of radiation absorbed is expressed as gray (Gy).The extent of damage however depends on the nature of radiation and the sensitivity nature of tissues and organs (Kroger, 2015). Effective dose is the qualitative estimation of the ionizing radiations and the potential to cause damage. This is measured by a unit known as the Sievert.
Exposure to radiations beyond certain thresholds results impairment in the functioning of tissues and organs and the end results might be acute effects like reddening of the skin, loss of hair, burns and finally the acute radiation syndrome (Xu, 2014). A t higher doses however, the effects become more severe. If the dose rate is low and delivered for a long time over an extended period of time, the risks are reduced since there is greater chance of repairing the damage over time. However, the risk of long term effects like cancer can happen years or decades later. However, the chance of this effects occurring is minimal and their occurrences is directly proportional to the dose rate. The risks are however high in children and adolescents since their cells are actively dividing and due to the fact that their bodies are highly sensitive to radiations as opposed to adults.
According to epidemiological research like the atomic bomb survivors, it was found out that doses above 100mSv are likely to cause cancer. However, the same study did find out that exposure during infancy or childhood is likely to cause cancer with exposures to dose rate between 50-100mSv (M’Garrech & Ncib, 2009).Incase a pregnant woman is exposed to radiations, brain damage is likely to develop in the fetus as long as the dose is above 100mSv.This is likely to happen between the 8-15 weeks of pregnancy as well as a dose rate of 200mSv between weeks 16-25.Prior to week 8 of pregnancy however, studies have shown no significant risks associated with radiations.
Since time immemorial, many people including the patients and workers at the department have been exposed to ionizing radiation with the risk of developing cancer. This therefore necessitates change which should reduce the harm of the ionizing radiations.
The management plan to reduce the effects of radiations in the X-rays departments include setting up clear guidelines on the disposal of radioactive substances, signage, labelling, shielding and security concerning radioactive substances and dosimetry.
Personal dosimetry is one of the management plan that should be implemented at the radiography department in the hospital. This is through ensuring that all users of the radiation wear a dosimeter.
A dosimeter is simply a badge that is used to indicate the dose rate of the radiation. This is a good management plan since it will indicate the dose rate when it exceeds the threshold and will enable the concerned individual to take the necessary step to avoid harm. Another management is shielding. Shielding is simply protecting or barring radiations from going into the body. This can be implemented by the use of lead wears since lead does not allow radiations to go through it. Another effective management plan is the security of the room with radiation appliances. The place should have total security. This is implemented by restricting unauthorized access to the room and only allow designated staff who have protected themselves go in the room. This will reduce on the emergency exposure of radiations to different people. The use of signage is another good management plan to reduce the potential harm of radiations. This can be implemented through including the word HAZARD to the entrance of the radiation room so that anyone entering the room is adequately prepared before they go inside.
The management plan will be monitored and evaluated by estimating the extent of the harm caused by the radiations such as cancer. With time, the incidences of cancer and damage to the brains of the fetus inpatients and workers exposed to radiations should reduce considerably. This might however take time since the effects of radiation are not instant. They take some time to be felt. This management plan therefore needs a long timeframe to be effectively evaluated.
According to the law, each one has a right to be protected from any form of harm. Based on this case of radiation, each worker should therefore be protected from potential damage of the radiations. The objectives of this management therefore are in line with the requirements of the law.
The objective of the management plan is to reduce the harm or effects associated with radiations. The desired outcomes in this management is to minimize the dose rate that is subjected to the radiography workers so as to reduce the risks of cancer and brain damage to the fetus. It is my desire that this outcome is attained within the shortest time possible.
Since this a medical management plan, ethical dilemmas are likely to occur. One such ethical dilemma is whether to avoid exposing radiations to pregnant women or not. Apparently, the protocol of radiation bar pregnant women from being exposed to radiations as this may affect the brain of the fetus.It is the sole decision of the patient however to choose whatever they deem suitable to them and this is called the principle of autonomy. This management plan will therefore take into account this principle by ensuring there is balance between autonomy and non-maleficence.
In the past years, the management of radiations basically did focus only on the reduction in the time of exposure. This therefore necessitates the need for change to focus on other management options such as shielding, signage, the use of dosimeter and finally security.
Conclusion
Since workers are likely to be exposed to hazards while at their workplaces, there is need to have a management plan to reduce on the likelihood of such harm. Such risky environment include the X-ray department in the hospital whereby exposure to radiations can lead of risks such as development of cancer or brain damage in the fetus. Management plan is simply a strategy that can be put in place to reduce potential harm to the workers. Example of management plan in X-rays department include the implementation of the dosimeter, signage, dietary management, shielding, labelling and disposal of radioactive substances. The management plan needs ethical and legal considerations before they are implemented. The ethical consideration includes the chances of the plan going against the patients wish while the legal requirements dictates that the plan should be implemented within the jurisdiction of the constitution or the law. Every workplace where there is potential harm should therefore consider setting up management plans to bar the workers from the harmful effects of different hazards.
References
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Burns, K., Taragin, B., & Markowitz, M. (2017). Presence of lead on the external surface of lenses in radiation protection eyewear. Journal of Vascular and Interventional Radiology, 28(2), S22-S23. doi:10.1016/j.jvir.2016.12.634
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