PEP Courses

PROFESSIONAL ENRICHMENT PROGRAM

In-Person PEPs will be taught in St. Louis, MO. All times shown below are Central Standard Time (CST). Virtual attendees must adjust for their local time.

If a PEP is given virtually you will be sent a link to watch the PEP virtually from home or your hotel room. There will NOT be a room on-site to watch the PEP.
If a PEP is given in person, you can participate in the course in person or virtually. If you are attending virtually, you will be sent a link to watch it LIVE through the SignalWire platform. If you are attending in person, the course will take place at the Union Station Hotel.

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.


Sunday, February 20, 8:00am – 10:00am CST

PEP 1A: VIRTUAL – ICRU/ICRP Recommendations Applied to Medical Radiation Protection

Cari Borras

The internationally acknowledged radiation protection quantities, advocated by the ICRP Recommendations 60 (1991) and 103 (2007) are absorbed dose, equivalent dose, and effective dose. The latter two magnitudes are to be used exclusively for stochastic effects. Equivalent dose depends on a factor termed wR that modifies the absorbed dose by taking into account the different qualities of the incident radiation. The effective dose includes, in addition, a factor, wT , which represents the relative contribution of that tissue or organ to the total detriment resulting from uniform irradiation of the body. Both wR and wT are judgmental values that have changed over time. Because of the way these quantities are defined, their measurement is impossible. The ICRU in its Reports 39 (1985) and 51 (1993) defined a set of operational quantities which determined equivalent and effectives doses by measuring physical radiation quantities and multiplying them by conversion coefficients that depend on the geometry and the quality of the radiation beams. There were quantities for radiation monitoring of areas (directional and ambient dose equivalent) and of individuals (personal dose equivalent). However, the measuring conditions and the conversion coefficients used differed significantly from those used in the determination of the protection quantities, causing significant errors and confusion. So, after ICRP published in Report 116 (2010) a new set of conversion coefficients for a wider range of particles and energies, and recognizing that radiation protection is not only concerned with the control of stochastic effects but also with the control of tissue injuries, the ICRU and the ICRP have recommended in a joint publication (ICRU Report 95, 2020) an alternative approach to the definition of operational quantities, which is based on the same phantoms as the definition of the protection quantities, and uses the same conversion coefficients as those of ICRP 116. The quantity for assessing potential effective doses in a given area is now named ambient dose H*; for personal monitoring, both personal doses Hp(3) (for eye lens) and HP(0.07) (for skin) are to be replaced by the operational quantities “personal absorbed dose to the lens of the eye” and “personal absorbed dose in local skin”, respectively. ICRU 95 describes the measurement conditions and the changes that will be needed in instrument fabrication and calibration should these new quantities be adopted by the radiation protection community. The course will provide an overview of the ICRU/ICRP dosimetry, a review of ICRU 95, and the potential impact that the new operational quantities may have in the medical practice, especially in interventional radiology.


PEP 1B: Assessment of Inhalation Doses and Effects of Particle Size Assumptions

Jason Davis

Whether during routine operations or an accident scenario, inhalation is regarded as the most likely pathway for internalization of radioactive materials. Deposition, distribution, dissolution, and excretion of inhaled contaminants are all influenced by the physiochemical properties of the material itself, along with the biochemical and physiological properties of the individual. In assessing intakes of materials at levels below regulatory limits, uncertainties in biokinetic parameters are often dwarfed by uncertainties in the risk of developing a stochastic effect. When intake levels approach or exceed the levels at which concerns over the development of a deterministic effect dominate, uncertainties in the location and characteristics of a contaminant can have a dramatic impact on the prediction or diagnosis of a clinically-relevant dose. These factors will be evaluated to determine their relative importance in the assessment of an individual dose. Determination of the amount and location of inhaled radioactive material can pose challenges in addition to those mentioned above. This lecture will also describe various methods for determining the magnitude of an intake with levels of precision spanning from the rough order of magnitude needed for screening in a mass casualty event through detailed analysis of an individual dose.


Sunday, February 20, 10:30am – 12:30pm CST

PEP 2A: Role of Radiation Safety Officer in Patient Safety

Thomas Morgan

The role of the Radiation Safety Officer (RSO) is to prevent unnecessary exposure to ionizing radiation and maintain necessary exposures as low as reasonably achievable (ALARA). The RSO is delegated broad authority throughout the organization by senior management. This authority includes permission to stop unsafe practices and identifying radiation protection problems, initiating, recommending, or providing corrective actions and verifying implementation of these actions. For the most part, these efforts are focused on maintaining radiation doses to employees and the public ALARA. Regulations do not address a role for the RSO in reducing radiation exposure to patients, except when unnecessary exposure is suspected due to equipment malfunction or human error. There is increasing concern about the risks of cancer and other effects from the use of medical imaging procedures. This workshop will discuss the tools and resources available to the RSO to educate members of the medical community and senior management on the need to manage radiation doses to patients so that the physician is able to obtain information necessary to properly diagnose and treat patients while avoiding unnecessary exposure.


PEP 2B: Where Did This Come From? Lessons Learned from High-Routine Bioassay Investigations

Eugene Carbaugh

This PEP class provides actual case studies of high-routine bioassay measurements and discusses the investigation process, resolution, and lessons learned from each. High routine bioassay results can come from several sources, including normal statistical fluctuation of the measurement process, interference from non-occupational sources, and previous occupational intakes, as well as new intakes. A good worker monitoring program will include an investigation process that addresses these alternatives and comes to a reasonable conclusion regarding which is most likely. A subtle nuance to these investigations is the possibility that a newly detected high-routine measurement might represent an old intake that has only now become detectable. This can result from the worker being placed on a different bioassay measurement protocol, a change in analytical sensitivity, unusual biokinetics, or lack of a clear work history. When sites are closed the detailed dosimetry records of specific worker exposures are archived, often becoming relatively inaccessible, with only summary dose information available. Likewise, the “tribal knowledge” of the site becomes lost or seriously diluted as knowledgeable employees retire or move on. Therefore, it is incumbent upon the site performing a potential intake investigation to thoroughly address the possible alternatives or face the consequence of accepting responsibility for a new intake. The important lessons learned include, 1) have good measurement verification protocols, 2) confirm intakes by more than one bioassay measurement, 3) conduct interviews with workers concerning their specific circumstances and recollections, 4) have good retrievable site records for work history reviews, 5) exercise good professional judgment in putting the pieces together to form a conclusion, and 6) clearly communicate the conclusions to the worker, the employer, and the regulatory agency.


PEP 2C: VIRTUAL – The Case Against The LNT

Alan Fellman

Radiation safety programs must establish compliance with radiation regulations which continue to be based on the linear no-threshold (LNT) hypothesis and the ALARA principle, despite overwhelming sound, peer-reviewed science that demonstrates the existence of a carcinogenic threshold and/or hormesis at low doses. LNT and ALARA insist that when we make changes that lower worker dose by as little as one µSv, we are making the workplace safer. Public health authorities and many radiation safety professionals have convinced most members of the public that when we evacuate 150,000 persons following Fukushima to keep them from receiving tens of mSv, we are improving public health despite the fact that this decision has resulted in more than 2,000 fatalities among evacuees. Yet despite compelling evidence revealing LNT to be fraudulent, the consistent response taken by regulatory agencies and scientific bodies whose recommendations are cited as the basis of regulatory actions is to deflect or rationalize away the science at best or simply pretend it doesn’t exist at worst so as to maintain allegiance to a worldview of radiation safety built on ALARA and LNT. A sample of relevant findings supporting this allegation will be presented.


Sunday, February 20, 1:00pm – 3:00pm CST

PEP 3A: Integration of Health Physics into Emergency Response

Steve Sugarman

In the event of a radiation incident it is essential that the radiological situation is properly, yet rapidly, assessed so that a proper response can be planned. Various techniques can be employed to help gather the necessary information needed. There are many groups of responders that need to be considered such as law enforcement, EMS, fire, and healthcare providers. Most, if not all, of these groups have relatively little understanding of the realistic hazards associated with radiation. It is not always necessary to incorporate wholesale changes to the way things may usually be done in the absence of radioactive materials. For instance, law enforcement officers routinely incorporate stand-off distances when approaching a suspect or other dangerous situation. Firefighters are familiar with the use of protective clothing and respiratory protection. EMS and healthcare providers routinely incorporate contamination control practices – universal precautions and proper patient handling techniques – into their everyday jobs. Coupled with a good event history and other data, health physicists can help to develop a strategy for safely and effectively responding to a radiological event. Support duties can also include assessment of dose responders or patients and assistance with communication issues affecting incident response, medical care, or with external entities such as regulators and the media. As time goes on and more information, such as bioassay or biological dosimetry data, plume data, and other additional data is received the health physicist will be called upon to interpret that data and communicate its meaning to the decision-makers and otherwise advise incident command. It is, therefore, essential that health physicists are able to seamlessly integrate themselves into the response environment and effectively communicate their findings to a wide variety of people.


PEP 3B: VIRTUAL – How to Perform Internal Dose Calculations for Nuclear Medicine Applications

Michael Stabin

Internal dose calculations for nuclear medicine applications are based on the well-established concepts and units, as defined by the RAdiation Dose Assessment Resource (RADAR) Committee of the Society of Nuclear Medicine and Molecular Imaging. The RADAR method harmonized the defining equations and units employed to provide quantitative analysis for both nuclear medicine and occupational internal dose calculations. This program will show, from a practical standpoint, how data are gathered and dose calculations performed in nuclear medicine applications, showing practical examples to solve different problems. An overview will be given of the current state of the art and promise for future improvements to provide more patient specificity in calculations (in therapeutic applications) and better ability to predict biological effects from calculated doses. Current developments in radiation biology that are challenging our interpretation of internal dose calculations in nuclear medicine will also be presented.!


PEP 3C: Statistics, Uncertainty, and Detection Decisions - A Practical Review for Health Physics Practitioners

Doug Van Cleef

This course presents a quick but thorough review of the basic elements of counting statistics, uncertainty, and detection decisions and their application to radiation detection. In the course of the review, we will review basic procedures for estimating and propagating uncertainty, appropriate sources of reference information for detection system performance, and consensus standards guidance for these practices. The course will include ample time for Q&A to allow attendees to address specific application considerations.


Sunday, February, 3:30pm – 5:30pm CST

PEP 4A: Radiation in Flight

Joseph Shonka

In 2012, measurements of an extreme solar flare that missed earth by 7 days, along with analysis that showed such an event had a 12% probability of occurrence per decade led the US and UK science and technology advisors to recommend a course of action should such an event occur. Unlike the US, carriers in the EU and UK are regulated, and the doses that would have been received exceeded allowable limits. There are no radiation dose limits for US aircrew and passengers. This PEP will summarize the conclusions of those meetings and address both routine and extreme events from radiation that occur in flight. The PEP will also address methods that are being considered to control that radiation routinely and during space weather events. Efforts by the ISO to develop standards for measurement of radiation in flight will also be summarized. A detailed summary of the differences in approach to radiation safety in the EU and UK in contrast to the US will be given. The US has no traditional radiation safety program for aircrew and relies on advisory circulars to inform US air carriers of elements that can be considered in development of a program.


PEP 4B: VIRTUAL – Radon Physics

Robert Hayes

This work will review the basic physics which give rise to operational health physics related considerations for radon and it's progeny at nuclear facilities.