Appendix 4 MAGNETIC RESONANCE IMAGING AND NUCLEAR MAGNETIC RESONANCE Magnetic Resonance Imaging (MRI) and Nuclear Magnetic Resonance (NMR) is used extensively throughout the University in the analysis of chemicals, geological specimens and imaging biological tissues. The general principle of both MRI and NMR is the fact that certain nuclei possess a property called spin i.e. the net angular momentum of the constituent nucleons. This spin produces a magnetic moment which has random orientations, but will be aligned by an externally supplied magnetic field. By then applying radiofrequency energy, the nuclei undergo spin flips to generate a net moment in the x-y plane. Measurement of the resonant frequency of the resulting precessing magnetic moment or the spatial location of this phenomenon enables analysis of the tissue or substance. The various forms of EMF therefore pose differing risks, which must be risk assessed. The most significant occupational health risks relate to the Static Magnetic Field. Departments planning to use MRI or NMR equipment must inform the University Safety Office at the earliest opportunity prior to installation. In general, the use of the MRI is expected to conform to the Medicines and Healthcare Products Regulatory Agency’s ‘Safety Guidelines for Magnetic Resonance Imaging Equipment in Clinical Use’. 1 Static magnetic fields In the UK, the HPA has responsibility for providing advice on exposure restrictions for electromagnetic fields. In the case of static magnetic fields, current guidance is the adoption of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) exposure limits. These limits guard against the possible health effects of exposure to static magnetic fields, such as vertigo, nausea, cardiac arrhythmia and impaired mental function. The ICNIRP exposure limits for static magnetic fields, for occupational exposure, are: Quantity Exposure Limit (Tesla) Exposure of head and trunk 2 T1 Exposure of limbs 8T 1 Exposure up to 8 T can be permitted if the environment is controlled and appropriate work practices are implemented to control movement-induced effects Whole body exposure to static magnetic fields below 2.5 T is unlikely to have any adverse effect on health. However, static magnetic fields above 2.5 T must be accompanied by a risk assessment to assess potential exposure against these exposure limits. Risk assessments for potential whole body exposure to static magnetic fields above 4 T should be forwarded to the University Safety Office. The greatest risk associated with static magnetic fields is the potential effect on implants either in terms of ferromagnetic objects or medical electronic devices. Ferromagnetic implants are susceptible to forces and torques within the static magnetic fields. Static fields have also been shown to affect the operation of medical electronic devices, such as cardiac pacemakers. Again, ICNIRP advises that the possible effects on implants are unlikely at static magnetic fields below 0.5 mT (or 5 Gauss). Page 1 of 2 UPS S4/11(Appendix 4) October 2011 The other significant risk associated with static magnetic fields is the potential damage from projectile ferromagnetic items being drawn to the magnet bore. Not only does this have a very serious financial implication, it can result in serious injury to someone trapped or struck by the object. It can also result in a ‘quench’ and sudden release of the cryogenic gases. Therefore, equipment where individual exposure is above 0.5mT must: 2 Be notified to the University Safety Office. An outline plan of the static magnetic field must be produced and physically measured by the contracted installer. If the installer is unable to conduct these measurements, then the Safety Office must be consulted. The location of the 0.5mT line must be demarcated in all potential axes. Routine access into the 0.5mT area must be restricted to named and suitably trained individuals only. FMRIB annual training provides a suitable standard. Safe systems of work must be documented and implemented. These must outline the systems for screening individuals, entry restrictions for non-authorised persons, approval systems for magnetic safe/compatible equipment, emergency procedures for dealing with a projectile injury or quench. Appropriate warning signs must be displayed, indicating restricted access and the potential risk to implants or medical devices. Safety signs are available from the University Safety Office. Time-varying gradients In addition, to the static magnetic fields, MRI scanners use rapidly changing magnetic timevarying fields. This can induce electric currents that interfere with the normal function of that tissue, e.g. nerve tissue and muscle tissue. The risks are predominantly associated with patients undergoing an MRI scan and less so the operator. Significantly, the rapid changing of the magnetic field results in acoustic noise. Noise levels can be hazardous and so appropriate measures (e.g. hearing protection) should be implemented in line with University Policy Statement S1/06). 3 Radiofrequency The main risks associated with radiofrequency fields are thermal heating, leading to induced current burns and contact burns. At all frequencies, energy will be absorbed by the relevant tissue, which can cause eye lesions and cataracts, temporary sterility in men and foetal developmental problems. Again the risks are predominantly associated with patients undergoing an MRI scan. Indeed, manufacturers should be consulted about the potential exposure of radiofrequency fields to operators. However, operators must be aware of the risks when setting up equipment so as to avoid potential burns from equipment. Page 2 of 2 UPS S4/11(Appendix 4) October 2011