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Re: X-Rays at Podiatrist Office



Since the exposure is to an extremity, your estimated

doses, based on the "BERT," is too high.  From

http://www.doseinfo-radar.com/RADARDoseRiskCalc.html

the effective dose for an extremity exposure is about

0.5 mrem.  Again, there are no critical organs in the

foot.



I am not sure if the giving the patient a leaded apron

is a good idea.  It probably reinforces patient fears.



--- David Englehart <davee@med-phys.com> wrote:

> Entrance skin exposure from various general x-ray

> units that I see are

> anywhere from 10 mR to 30 mR, based on their typical

> technique.  That's

> about 8 to 25 days of background equivalent

> radiation time (BERT, background

> @ 300 mR/year via John Cameron).  I survey only one

> true podiatry unit per

> year, and ESE for that unit is a little higher for

> their typical technique

> at 64 mR due to a source to image distance less than

> 40 inches.  Still, only

> about 52 days worth of background.  Our state does

> require that the exposure

> switch extend to at least 6 feet from the source. 

> Regardless of the low

> exposure for extremity work, the "techs" should be

> trained to always reduce

> their exposure whenever possible.  Somebody

> should've explained the

> difference between occupational exposure and patient

> exposure, and told them

> to stand at least 6 feet away when shooting a film.

> 

> Given the public's fear of radiation an apron should

> have been offered, even

> though it wasn't necessary.  This simple practice

> can alay fear in patients

> and prevent a lot of trouble for the x-ray provider

> in the future.

> 

> The geometry of the machine I see is such that the

> tube head can move from

> 90 degrees perpendicular to the floor to only about

> 50 degrees.  So the

> primary beam is, for the most part, pointed toward

> the floor.  If the unit

> you saw is restricted to this type of movement,

> shielding in the walls is

> not likely necessary.

> 

> Regards,

> David Englehart B.S.

> Diagnostic Imaging Specialist

> Medical Physics Services Ltd.

> Department of Radiation Oncology

> 6150 Oakland Ave.

> St. Louis, Mo.63139

> tel. (314)768-3608

> fax (314)768-5646

> ----- Original Message -----

> From: "Thomas M Lashley" <lashleyt@DTEENERGY.COM>

> To: "Parry, Don (CIS)" <dparry@michigan.gov>

> Cc: <radsafe@list.vanderbilt.edu>;

> <sloanpb@BELLSOUTH.NET>

> Sent: Wednesday, March 10, 2004 6:34 AM

> Subject: Re: X-Rays at Podiatrist Office

> 

> 

> > Were the technicians wearing dosimetry?  Most

> states require the operator

> of x-ray machines to wear dosimetry.  However, after

> talking to a dental

> student here in Michigan, the school doesn't monitor

> their students.

> >

> > Tom Lashley

> > mailto:LashleyT@DTEenergy.com

> >

> >

> > "Parry, Don (CIS)" wrote:

> >

> > > While the risk is low, the practice described is

> not good health physics

> and in most states would be contrary to their

> regulations.  Most states

> would require operators to stand at least 6 feet

> away or behind an

> appropriate shield.  The apron is likely not

> required by regulation since

> the primary beam is not in the gonadal region,

> however some states recommend

> their use in both podiatry and dentistry.  Shielding

> is another issue

> dependent on the particular state regulations.  If

> the primary beam is

> directed towards an interior occupied area, I

> believe most states would

> require some shielding in that wall.

> > >

> > > This machine would be regulated by the state

> government, if you have

> concerns I would contact them.  links to various

> state programs can be found

> at www.CRCPD.org or at our web site below

> > >

> > > Don

> > >

> > > Donald E. Parry, CHP

> > > Health Physicist

> > > Radiation Safety Section

> > > Michigan Department of Community Health

> > > Phone : 517-241-1989  Fax: 517-241-1981

> > > mailto:dparry@michigan.gov

> > > Web Site:  www.michigan.gov/rss

> > >

> > > -----Original Message-----

> > > From: owner-radsafe@list.vanderbilt.edu

> > > [mailto:owner-radsafe@list.vanderbilt.edu]On

> Behalf Of John Jacobus

> > > Sent: Tuesday, March 09, 2004 1:54 PM

> > > To: radsafe@list.vanderbilt.edu;

> sloanpb@BELLSOUTH.NET

> > > Subject: Re: X-Rays at Podiatrist Office

> > >

> > > I would suggest that you submit this question to

> the

> > > Health Physics Society's "Ask the Expert" Web

> site at

> > >

> http://hps.org/publicinformation/asktheexperts.cfm

> > >

> > > The short answer is that there is little if any

> risk,

> > > but I think you would like a more than that.

> > >

> > > --- iradi8 <sloanpb@BELLSOUTH.NET> wrote:

> > > > I recently had a series of foot x-rays done in

> a

> > > > podiatrist's office. The person doing the

> x-rays was

> > > > training a brand new assisstant. Neither

> seemed to

> > > > have any knowledge whatsoever about what they

> were

> > > > doing. I was not asked if I was pregnant -- I

> am a

> > > > woman of childbearing age. I was not offered

> an

> > > > apron which they do at the dentist (not that I

> feel

> > > > that I really needed it). They stood right

> next to

> > > > the head of the x-ray machine while taking all

> three

> > > > films. Actually, the head of the machine was

> within

> > > > 6 inches of her pelvis. The new assisstant was

> told

> > > > that they could stay in the room for all

> x-rays --

> > > > that the dose is so low that it is safe. That

> is

> > > > what the "x-ray guy who works on the machine"

> said.

> > > > I was taken aback by all of this! Could

> someone

> > > > please enlighten me as to whether this is

> okay? I am

> > > > sure it is not! Also, the machine is not in an

> > > > enclosed room -- the restroom door is within 6

> feet

> > > > of it and an exam room on the other side of

> the

> > > > wall. Shouldn't there be shielding -- I wonder

> if

> > > > there is?

> > > >

> > > > Thanks so much.

> 

> 

>

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=====

+++++++++++++++++++

""A fanatic is one who cannot change his mind and won't change the subject."  Winston Churchill



-- John

John Jacobus, MS

Certified Health Physicist

e-mail:  crispy_bird@yahoo.com



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