GOVERNMENT OF INDIA
ATOMIC ENERGY REGULATORY BOARD
NIYAMAK BHAVAN, ANUSHAKTINAGAR, MUMBAI – 400 094
AERB/NM/Radiation Safety/02
ANNUAL REPORT ON STATUS OF RADIATION SAFETY IN NUCLEAR MEDICINE
INSTITUTIONS/ DEPARTMENTS
(This form, duly filled in must be dispatched in the month of January of each calendar year to
Head, Radiological Safety Division, Atomic Energy Regulatory Board, Niyamak Bhavan,
Anushaktinagar, Mumbai- 400 094. Hence sufficient number of copies of the form may please be
taken at your end. Please ensure that every entry is properly filled in)
A.
INSTITUTION AND STAFF
I
Name & address of the institution
:
Telephone No
Telex No
Fax No
E-Mail ID
II
III
IV
Name
:
:
:
:
Name and designation of the head of
the institution
:
Whether nuclear medicine unit
exists as an independent department?
If not, mention the department to
which it is attached.
:
Nuclear medicine physicians
Qualifications
Experience
1. (In-charge)
2.
3.
4.
1
Whether cleared by NMC?
(State yes or no) If yes, give
reference of clearance with
date.
Personnel
Monitoring
Service No.
V Nuclear medicine technologists:
Name
Qualifications
VI Radiation Safety Officer (RSO)
Experience
Personnel Monitoring
Service No.
:
Name & Qualification
:
Level of RSO
: Level I/II/III (delete whichever is not applicable)
Personnel Monitoring Service No.
:
Whether cleared by AERB
: Yes/No
If yes, give reference of AERB clearance
with date
:
B. WORK CARRIED OUT
:
I. Diagnosis
(a)Non-imaging procedures
Name of the
Radiopharmaceutical/radioisotope
diagnostic
used
procedure
Activity
administered per
patient (MBq)
(Attach separate sheet, in case the space is not sufficient)
2
No. of cases per
year
(b) Imaging procedures
Name of the
Radiopharmaceutcal/
procedure
Radioisotope used.
Avg. activity
administered per patient
(MBq)
3
Number of
cases per
year
(c) RIA Procedures
Name of the assay
No. of assays carried out per
year
No. of RIA kits
procured/purchased per year
If iodination is carried out, specify frequency of iodination (per month) and activity used per
iodination procedure.
II Therapy
Therapeutic
procedure
Radiopharmaceuticals/Radioisotope
used
Thyroid cancer
Thyrotoxicosis
Polycythemia vera
Bone metastasis
Any other (please
specify)
4
Average activity
administered per
patient (MBq)
No. of cases
treated per year
C. DETIALS OF RADIOISOTOPES PURCHASED FROM BRIT (Dept.of Atomic Energy)
Radioisotopes for
which authorisation
has been obtained
Activity of each of the
radioisotopes
authorised per year
(MBq)
Activity procured per
year (MBq)
Activity used per year
D. DETAILS OF NOCs OBTAINED.
Radioisotopes
specified in the
NOC
Activity of each of
the radioisotopes
specified in the
NOC (MBq)
And frequency of
import
Total activity of
each of the
radioisotopes
received during
the year (MBq)
Activity used
per year.
(MBq)
Name of the
person in whose
name the NOC
has been
obtained &
reference No. of
NOC with date
E. SEALED SOURCES PROCURED IN THE DEPT.
Sr. No.
Radio Isotope
Activity
5
Purpose
F. EQUIPMENT
I.
Nuclear Medicine equipment
Name of equipment
II.
Make & model
Date of installation
Whether in working
condition (Y/N)
Monitoring & Measuring instruments
Name of
instrument
Make & model
Measurement
range
Contamination
monitor
Survey meter
Isotope
calibrator
Any other
(please specify)
6
Whether in
working
condition (Y/N)
Date of last
calibration
G. RADIOACTIVE WASTE DISPOSAL
(a) Solid waste
Radioisotope
Details of waste
generated
Method of disposal
Activity disposed per
month
Details of waste
generated
Method of disposal
Activity disposed per
month
(b) Liquid waste
Radioisotope
7
H. RECORDS OF RECENT RADIATION PROTECTION SURVEY
I. Area monitoring (Date of survey-------------)
Name of the
instrument used
-------------------Exposure level
(mR/h) or (µSv/h)
.
a
b
Locations
(to be shown in the layout sketch)
c
d
e
f
g
h
Area monitoring should be conducted at least once every month
II. Measurement of contamination level
(Date of measurement------------------)
Name of the instrument used
Locations
----------------------------------1
2
3
4 5
6
Level of contamination
(Cpm)
Contamination levels should be checked at least once every week
7
8
9
10
III. Layout of the nuclear medicine laboratory (sketch showing locations of area monitoring
and contamination level measurements, as per the above tables)
8
IV.
Adequacy of facilities and availability of accessories
a. Number of fumehoods available and working properly---------------b. Shielding facility provided for the following purposes
(i)
Storage
(ii)
Handling
(iii) waste storage
c. Are polythene carbouys provided for collection of liquid waste?
d. Is there separate drainage system directly connected to main sewerage?
e. Are the following handling tools available?
1.Long forceps
2.Tongs
3.Propipetts
4.Bottle opener
f. Are foot-operated waste bins with polythene lining inside provided
for collection of solid waste ?.
g. Are the doors & walls painted with washable paint?
h. Is the floor covered with linoleum / PVC?
i. Are work surfaces made up of smooth, non-absorbing and non-porous
Material?
j. Are the worktables covered with polythene and absorbent sheets?
I.
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
ACCIDENTS
1. Whether any accident involving radioactive contamination of personnel or working areas
occurred during the last one year? If yes, give estimation of the activity and the action
taken for decontamination. Whether a report on the accident is prepared and sent to
AERB? If yes, give reference of the same.
2. Whether internal contamination of personnel occurred? If yes, give estimation of the
Activity and the action taken for decontamination. Whether a report on the accident is
prepared and sent to AERB ? If yes, give reference of the same.
J. Does the institution have a Radiation Safety Committee, for discussing radiation safety
status the department periodically? If yes, give the members of the Committee and the
number of meetings held by the committee during the year.
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K.
PERSONNEL MONITORING
a. Whether all persons working in the nuclear medicine laboratory are wearing
personnel monitoring badges while working in the laboratory? If not, give names
of persons who are not using badges and the reasons for the same.
b. Whether payments towards Personnel Monitoring Service is made upto date.
(Y/N)
L.
MAINTENANCE OF RECORDS
Whether inventory of the following items are maintained
1.
2.
3.
4.
5.
6.
7.
Inventory of radioisotopes received and used
Radioactive waste disposal
Personnel dose records
Area monitoring data
Radiation accidents/emergencies
Calibration of instruments
Quality assurance tests
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
Y/N
M. EXCESSIVE EXPOSURE
Give details of excessive exposures received, if any, by radiation workers during the year.
Attach details of investigations carried out by the RSO on the circumstances causing
excessive exposures and steps initiated to prevent recurrence of such mishaps. (attach report)
N. COMMENTS
Give your comments on radiation safety status in the institution.
The above information is true and complete to the best of my knowledge and belief.
Radiation Safety Officer
Signature:
Name:
Date:
Head of Department
Signature:
Name:
Date:
10