RISK ASSESSMENT FORM
USE OF OPEN SOURCES
DEPARTMENT / UNIT
BUILDING
PERSONS INVOLVED
PROCEDURE(S) COVERED BY THIS ASSESSMENT
The purpose of this risk assessment is to restrict exposure to Users of ionising radiations and those who by
association may be exposed, e.g. co-workers, students, maintenance and cleaning staff.
radionuclide
max activity
MBq
radionuclide
max activity
MBq
Could a non-radioactive marker be used?
select
Could a lower energy radionuclide be used?
select
The assessment of risks to personnel arising from ionising radiations should be based on the potential for dose before
Controls are put in place.
state the nature of the risks below e.g. finger dose, inhalation, contamination:
Make an assessment of the risks:
select
Consider, in turn, each component of the radioactive work and the Controls applicable to it, ticking any relevant
Control box. Where necessary please indicate in the space provided, other measures you have implemented to
control the risks arising from the work. The higher the risk the more stringent the Control Measure must be.
CONTROL MEASURES
Will any aspect of the work be carried out in a Controlled Area?
select
room no
Will any aspect of the work be carried out in a Supervised Area?
select
room no
See LR18 for guidance on Controlled and Supervised Areas
LOCAL RULES
I have read and will adhere to Local Rules and UCL Policy
select
WORK AREA
to minimise the spread of contamination, the work area will make use of:
delineated area / segregated from other work
work trays
benchcote
spill kit
other control:
THE RADIONUCLIDE
indicate which of the following will be used to minimise exposure:
the package will be inspected for damage and monitored for contamination before opening
Perspex shielding (beta emitters)
lead shielding (gamma emitters)
PPE, i.e. disposable gloves, labcoat, glasses (delete those not used)
remote handling e.g. tongs, tweezers, tube holders
fumecupboard
other control:
as a means of detecting exposure or contamination the following are used:
MONITORING AND
PERSONAL DOSIMETRY
a suitable and calibrated contamination monitor, used before, during and after the work procedure
wipe tests
film badges
TLDs
all monitoring is recorded
other control:
Open Sources
1
May 2010
DISPOSAL
indicate which of the following disposal routes will be used
designated sink
which is shielded
solid storage
which is shielded
contaminated organic liquid
which is shielded
scintillant
which is shielded
other control:
This Section should be completed by the RPS
PERMISSION
to ensure adequate storage and facilities
the department has the permission of the Licence Co-ordinator for Ionising Radiations to use this radionuclide
there is sufficient free allocation for holding this radionuclide activity on site
there is sufficient free allocation for disposal of this radionuclide activity
the RPS / Authorised Signatory has signed the order
other control:
THE PACKAGE
as a means of minimising leakage, spread of contamination and dose the following are
implemented:
the Supplier is reputable, e.g. has a quality standard
the delivery point for the radionuclide is secure
the delivery point for the radionuclide is adequately shielded
staff at the delivery point have received information and training in handling radionuclide packages
transfer between departments/organisations will be done to a standard that prevents spread of contamination
other control:
PERSONNEL
with regard to the people who may come into contact with the radionuclide:
those undertaking the work have attended Safety Services ‘HURS’ training course
those undertaking the work are registered with the Dosimetry Service
the work poses no risk to those who may be/are pregnant
the work poses no risk to maintenance workers
the work poses no risk to non radiation workers or other members of the public
other control:
STORAGE
the radioactive material is stored:
in a segregated box
in a shielded box
in a fridge / freezer which is lockable
in a freezer which is defrosted at least annually
in an area used by members of the public, e.g. corridor
other control:
Open Sources
which is marked with a trefoil
which is marked with a trefoil
which is marked with a trefoil
which is marked with a trefoil
which is marked with a trefoil
2
May 2010
DECLARATION
I the undersigned have assessed the activity and the associated risks and (delete as applicable) declare that
there is no significant risk/the risk will be controlled by the method(s) listed above. Those participating in the
work have read the assessment. The work will be reassessed whenever there is significant change and at
least annually.
NAME(S) OF USER(S)
SIGNATURE(S) OF USER(S)
DATE
REVIEW DATE
NAME OF RPS
DATE
SIGNATURE OF RPS
REVIEW DATE