Answer to Question #872 Submitted to "Ask the Experts"

I can only speak for institutions for which I serve. They include a major metropolitan tertiary-care hospital with level-1 trauma center, a county hospital, and multiple clinics. My remarks are confined to diagnostic and fluoroscopic x-ray technologists. At every facility, no technologist has received an occupational dose that approaches the maximum allowed. In fact, most technologists except those who work with fluoroscopy receive doses far less than 10% of the maximum permitted by regulation. Some technologists have collar-badge readings that approach, and in some cases exceed, 10% of the allowable eye dose. This only occurs with emergency-room technologists and those who work in angiography suites. Since the badges are worn outside their aprons, their effective doses are lower. The issue of whether we should be required by regulation to monitor our technologists who perform general radiography in well-shielded rooms is unimportant and, to me, irrelevant. The important issue is whether or not the radiation safety practices at my facility are better than adequate. I cannot responsibly answer that question unless I have a substantive radiation monitoring program in place. I therefore require that any technologist who actively participates in the radiologic acquisition of x-ray images wear a radiation monitor at all times while on duty. Every once in a while I will find an unusually high reading on a badge and I will call that technologist to find out why it was unusually high. Even though the unusual reading is very acceptable regulation wise, I am still concerned about why the unusual reading occurred. After a discussion I make some conclusions as to the likely reason and advise the individual to adjust their working habits, if I think that is in order. This has always resulted in more acceptable readings in the future. So, the answer is "Yes, monitoring of technologists is necessary to ensure a safe working environment. By monitoring, we can ensure that good working habits are maintained and that there are no lapses or drifting into bad habits. Without monitoring, we cannot know what is happening and we cannot correct digressions into bad behavior."

Louis K. Wagner, Ph.D. Medical Physicist