Personal Radiation Exposure Monitoring (PREM)
Okay, before you tune out to this necessary but, frankly, rather dull topic – please consider the following…
- Do you know what your current annual ‘running-balance’ of exposure to radiation from X-ray sources is? No? You should do, you’re entitled to and it is definitely in your best Health & Safety interests!
- Do you know what your responsibilities and rights are regarding PREM? No? Read on!
HEALTH & SAFETY
Are you aware that self-employed persons are responsible for making their own arrangements with an Approved Dosimetry Service for dose assessment and dose recording under Ionising Radiations Regulations 1999 (IRR99)?
Radiation doses-assessment and recording: http://www.hse.gov.uk/pubns/irp2.pdf
Best practice is for all information to be passed from practice to practice when a nurse moves location. This is necessary because we should be monitoring our rolling twelve-month exposure for reasons of health, safety and action as required – RPS: Radiation Protection Supervisor (on-site supervisor)
Confessions of a slightly naughty nurse:
Also known as the episode where only half a ‘t’ got crossed & no ‘i’ was dotted!
Many locums are not aware of their responsibilities for dose assessment and recording under IRR99 and travel from practice to practice undertaking x-rays in happy ignorance of the law. Potentially jeopardizing their health and safety by remaining unaware of any accumulated, and potentially excessive, radiation exposure within the last twelve-months.
Using the practice’s own dosimeter badge – or other device – certainly appears to fulfil the criteria of a self-employed person ‘making their own arrangements with an ADS for dose assessment and dose recording under IRR99’. That is, so long as you are recording your rolling twelve-months’ exposure total.
Let’s think about this process. The badge is eventually sent off by the practice within their usual reporting time-frame, be that on a monthly or quarterly basis. It is read and a report is prepared for the exposure that this particular badge has recorded. Any issues identified are then passed to the practice to deal with…
What if there is a radiation exposure identified?
- To whom does this exposure belong? It may be difficult to identify this as a ‘general-use’ or ‘spare’ badge has very likely to have been used by multiple people within the reporting period.
- When did the exposure occur? Near impossible to tell to the exact day/date as the report is at best a monthly one and more generally a three-monthly one.
Why is this relevant to a locum?
- You need to know what your rolling twelve-month exposure is.
- Due to the peripatetic nature of locum-working, you are normally long-gone before the report appears. Does the practice get in contact with you after you have left?
- The practice should get in contact with you to advise of the identified issue – even if they cannot be certain it was you that was exposed. It is sensible to show the exposure in your records, just in case.
- You need to know what do you do with the information.
- You need to know who is responsible to you for on-going information and assistance.
As a matter of routine, you should receive a copy of your dose assessment and recording report from every practice you work at – issues or no issues. If you do not already, then request these reports as you are entitled to them.
- Similarly, for a permanent employee, who has changed employers within any one twelve-month period, it is sensible to obtain your own dose summary and termination records. You are fully entitled to do so under regulation 21 (6) IRR99. You can then pass the information onto your new RPS.
- Some employers do pass the information on to the next practice or obtain it from the previous one(s); but check!
TIP: You can also request a copy of your full dose record from the ADS (record-keeping) within a reasonable period of any such request.
1. Practice-provided dosimeter badge. Is usually the ‘spare’ or ‘general use’, un-named, badge. No one person’s activities can be accurately identified.
2. The exposure report from the un-named badge is not specific; it could record activities of anyone at any time within the reporting period (one month’s or usually a three months’ period). The badge could be even be worn by a different person on the same day! The information is useless for individual monitoring purposes.
3. Unless you provide a report to each practice of your ‘running balance’ exposure total, and they provide you with theirs, your annualised total exposure undoubtedly cannot be assessed and therefore any issues cannot be addressed.
***This method clearly cannot accurately monitor an individual’s radiation exposure. You need to set up a different arrangement for yourself***.
Buy your own dosimeter badge!
Take charge of your own safety and obtain a dosimeter badge for yourself, with access to your very own RPS and RPA. It is, I believe, by far the easiest method and is also very reasonable on the purse (around £15 per annum).
The personal preference of my RVN Alison is to apply for an account with ‘JAK Marketing’ (other providers available)
- 01347 878697
From JAK Marketing:
You will receive a quarterly monitoring kit, consisting of:
- A location-badge to place in-situ, to monitor background radiation, whilst working at the practice,
- A body-badge to wear
- A return envelope.
- Send the two badges off every quarter and receive an official exposure report, to keep
- Make every practice aware you have your own badges.
This has been wholly accepted wherever Alison, my RVN, went. When she returned to permanent work she continued to use her own badge until the (paid for) year expired and then went onto the practice’s own system. She gave the practice copies of her exposure reports throughout.