CEL Courses

AAHP is evaluating the number of Continuing Education Credits awarded for each of the PEP (and CEL) courses based on technical content. Course instructors will be able to provide this information at the time of the presentation. This information will also be made available on the AAHP recertification site after data entry is completed.

Tuesday, July 9, 7:45am – 8:45am

CEL-1: How to Reduce Radiation Exposure to Fluoroscopy Operators

Jacob Kamen

Radiation Safety Officers have to review the exposure level to Fluoroscopy operators and implement ALARA threshold according to the regulations. In most medical centers, almost all of the exposures that exceed these thresholds are from Fluoroscopy operators. In this one hour CEL course, we will teach Radiation Safety Officers, not only how to comply with regulations more effectively, but also how to reduce the radiation exposure to the patients and staff, ultimately leading to a more effective radiation safety program.

Mandatory regulatory requirements for Fluoroscopy operators are reviewed, including minimum lead equivalent for lead aprons, radiation badges to monitor operator exposure, and minimum training needed for the operators. We will also discuss the annual regulatory radiation exposure limits to Fluoroscopy operators.  We will review some cases of patient’s radiation skin injuries to describe the level of damage correlated to length of Fluoro time. We will also discuss how to train your operators to use Fluoroscopy machines more effectively.

Since the main source of radiation exposure is the scatter from the patient, we will discuss how to reduce the patient skin dose based on recommendations stated in NCRP 168. The primary concern for reducing radiation skin exposures is Fluoroscopy time, which we will put in perspective by reviewing the expected severity of radiation injuries with relation to Fluoro time. We will also discuss the new NCRP efforts to modify operator-training requirements.

Finally, we will discuss how to best minimize fluoroscopy operator’s exposure and staying in compliance with regulations without too much burden. There have been publications stating that operators are suffering from back pain from wearing lead aprons all day, which makes them less motivated to wear them. There has also been an economic study supported by ORSIF claiming that the annual economic cost of radiation exposure associated with interventional fluoroscopy was approximately $60M in the US alone. This cost is associated with treatment of cancer and orthopedic injuries. This figure does not factor the precursor to cataracts, cognitive decline and risk to reproductive health. According to Michael Seymour, the director of ORSIF “this economic study draws attention to alarming annual cost resulting from adverse health effects associated with long-term exposure to interventional fluoroscopy in the US”.   The use of available radiation shielding to minimize lead thickness in aprons to ease the operators’ physical pain will be reviewed. Additionally, since there are many products available in the market to reduce the radiation exposure to staff in the Fluoroscopy room, we will review some of these products with their advantages and disadvantages and how to use them to reduce exposure to the staff in the Fluoroscopy room. As a result, there will be fewer ALARA level exposures to investigate by the Radiation Safety Officers and more effective radiation safety programs.

Wednesday, July 10, 7:45am – 8:45am

CEL-2: Achieving Laser Safety in the University Setting

Ken Barat

The most challenging environment to achieve laser safety is in the research setting, especially in the academic setting. Compared to other environments in research we actively manipulate laser beams, and the user population is made up of individuals with a wide range of experience. While the ANSI standard both Z136.1 Safe Use of Lasers and Z136.8 Laser Safety in the Research, Development and Testing Environment  call out controls and procedures to follow, compliance is no guarantee of laser safety. The goal of this presentation is to help the Laser Safety Officer or any individual who has laser safety responsibilities by reviewing a number of proven techniques and approaches that work to provide a laser safety culture. In addition a number of control measures and products you might not have thought of will be discussed. Look forward to seeing you.

Thursday, July 11, 7:45am – 8:45am

CEL-3: Radiobiological Studies Using X and Gamma Rays

Charles Potter

In 2008, the U.S. National Academies of Science released Radiation Source Use and Replacement that identified the risk presented by the use of high-radioactivity radioactive sources.  This led to programs in several countries to replace such sources with other technologies including, in many cases, replacement of beta/gamma-emitting sources with X-ray technologies.  In support of such efforts, Sandia National Laboratories partnered with Lovelace Biomedical on two studies comparing irradiations of near-identical specimens by 137Cs source and 320 kVp X-ray.  The studies resulted in five papers published in open-source journals, providing researchers with examples showing that with the proper consideration of relative biological effectiveness, the lower energy X-ray technology was adequate, and in some cases more effective, at providing the dose needed for medical research.  This continuing education lecture will describe the studies and papers documenting this body of work.

Friday, July 12, 7:45am – 8:45am

CEL-4: Three Mile Island: Past, Present & Future

David Allard

State and federal Radiation Control agencies implement regulatory radiation protection programs in the functional areas that include: X rays, accelerators, radioactive materials, radon, nuclear power plant (NPP) emergency response (ER), facility decommissioning, site cleanups, environmental surveillance (ES), and radioactive waste.  The primary goal of these programs is to protect the environment and prevent unnecessary exposure of the public, patients, and workers to radiation exposure from controllable sources of radiation - while allowing for their beneficial use.  In this framework the U.S. Nuclear Regulatory Commission (NRC) regulates the operations of NPPs, Federal Emergency Management Agency (FEMA) oversees ER around the NPPs, and the states perform their respective ER and ES functions.  With Three Mile Island Units 1 & 2 as a case study, this presentation will explore: the international and national radiation protection standards that provide the foundation for federal and state radiation protection regulations; the TMI U2 accident response and recovery; offsite public dose and public health impact; radioactive waste generated by operations, cleanup and decommissioning at TMI; the concerns related to spent nuclear fuel storage and transport; radiological environmental surveillance; and other related issues. Given the economics of construction and operation of a NPP versus a natural gas plant for baseload electric power, TMI U1 and several other NPPs in the U.S. have recently ceased operation, while others may shut-down before the end of their NRC-approved licensed or extended operating period. This aspect will no doubt have a significant impact on states’ and our nation’s ability to meet carbon emission reduction goals, to [ultimately] slow the rate of climate change. These issues will be discussed, and an overview and update for the ongoing and planned decommissioning of TMI U2 will be provided.