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Instructions on labor protection for personnel of radiation therapy departments. Full document

Occupational Safety and Health / Standard instructions for labor protection

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Introduction

This instruction was developed in accordance with the requirements of the current "Radiation Safety Standards NRB-99" SP 2.6.1.758-99 (recognized as not requiring state registration, letter of the Ministry of Justice of Russia dated July 29.07.99, 6014 No. 99-ER), "Basic Sanitary Rules for Ensuring Radiation Safety OSPORB-2.6.1.799" SP 99-01.06.00 (recognized as not requiring state registration, letter of the Ministry of Justice of Russia dated 4214 No. 09.01.96-ER), Federal Law dated 3 No. 17.01.96-FZ "On Radiation Safety of the Population" (published in "Rossiyskaya Gazeta" 31.07.00/298/XNUMX), Order of the Ministry of Health of Russia dated XNUMX/XNUMX/XNUMX No. XNUMX "On approval

Regulations on the unified state system for monitoring and accounting for individual exposure doses of citizens" (recognized as not requiring state registration, letter of the Ministry of Justice of Russia dated 15.08.00 No. 6948-YuD).

The instruction contains the main provisions on labor protection for the staff of radiation therapy departments.

On the basis of this instruction, in each institution that has a department or cabinet of radiation therapy, internal and job descriptions for labor protection should be developed, taking into account specific working conditions.

1. General safety requirements

1.1. Individuals at least 18 years of age who have undergone special training and are assigned by order of the institution to category A personnel in accordance with the requirements of the "Basic Sanitary Rules for Ensuring Radiation Safety OSPORB-99" SP 2.6.1.799-99 are allowed to work independently in radiation therapy departments.

1.2. When conducting radiation therapy, two categories of irradiated persons are distinguished: A and B.

Category A includes department employees directly involved in radiation therapy. Category B includes employees of the department who are in the field of ionizing radiation.

1.3. Personnel of groups A and B must know and comply with the maximum allowable doses per year. For group A personnel, the effective dose should not exceed 0,02 Sv per year on average for any consecutive 5 years, but not more than 0,05 Sv per year. The effective dose for personnel should not exceed 50 Sv for the period of employment (1,0 years). For group B personnel, the basic dose limits are equal to 1/4 of the effective dose values ​​for group A personnel in accordance with the "Radiation Safety Standards. NRB-99".

1.4. Female staff should be exempt from direct work in the department for the entire period of pregnancy from the moment of its medical confirmation.

1.5. In accordance with the order of the Ministry of Health and Medical Industry of Russia No. 405 of December 10.12.96, 31.12.96 "On conducting preliminary and periodic medical examinations of employees" (registered with the Ministry of Justice of Russia on December 1224, XNUMX No. XNUMX), in order to prevent the occurrence of diseases and accidents, the department staff must undergo a mandatory medical examination upon admission to work and periodic medical examinations at least once a year. Persons who do not have medical contraindications are allowed to work with ionizing radiation.

1.6. Persons with the I qualification group for electrical safety are allowed to work in the departments of radiation therapy. Assignment of group I is issued in the prescribed manner.

1.7. Newly admitted, as well as persons temporarily assigned to work in the department, must undergo an introductory briefing by an engineer for labor protection and safety or a person responsible for labor protection and appointed by order of the institution. The results of the briefing should be recorded in the introductory briefing log. Based on the results of the briefing, the person responsible for working with personnel makes the final registration of the newly arriving employee and sends him to the place of work.

1.8. Each newly hired employee in the department must undergo an initial briefing on labor protection at the workplace. Re-briefing of personnel must take place at the workplace at least twice a year, and unscheduled - in case of changes in the technological process, violations of labor protection rules and accidents. These briefings should be conducted by the head of the department or a person appointed by him. The results of the briefing are recorded in the appropriate journal, personal card of the instructed, work permit or other documentation authorizing the production of work.

1.9. Department staff must:

• be guided by job descriptions;
• comply with the internal labor regulations;
• avoid deviations from the established technological process of working with radiation sources;
• comply with the requirements of the main regulatory documents listed above, technical descriptions, operating instructions for the equipment installed in the department, as well as these instructions;
• own the principles of operation and operating conditions of the technological equipment of the office;
• know how to provide first aid;
• report to the immediate supervisor on each equipment malfunction or accident;
• keep the department in order and cleanliness, do not allow the department to be cluttered with unused equipment and furniture.

1.10. The staff of the department is obliged to comply with the requirements for compliance with work and rest regimes.

1.11. The staff of the department must know the rules of protection against the effects of hazardous and harmful production factors:

• increased level of ionizing radiation in the working area, including radiation due to induced activity in structural materials and neutron radiation; electromagnetic radiation of high frequency during the operation of accelerators;
• increased concentration of radionuclides on working surfaces and in the air of working rooms with open sources of radiation;
• increased concentration of toxic components of protective materials on working surfaces and in the air of working premises;
• increased concentration of ozone, nitrogen oxides and from air electrical discharges in high-voltage devices;
• dangerous level of voltage in electrical circuits;
• increased noise level generated by electric drives, air fans;
• open moving elements of equipment, machines, mechanisms.

1.12. With simultaneous exposure of a person to sources of external and internal exposure, the annual effective dose should not exceed the dose limits specified in clause 1.3 of this Instruction.

1.13. The staff of the department should be provided with personal protective equipment, depending on the purpose of the office.

1.14. The department is subject to general safety requirements for sources of electricity and household electrical appliances.

1.15. In the event of an accident or malfunction of equipment, devices and tools, the personnel must turn off the main power switch, notify the head of the department and act, depending on the situation:

1.16. Department staff must:

• if a person gets under moving elements of apparatus or equipment, release the victim, evacuate him from the office and provide first aid;
• in the event of a fire, call the fire brigade and the police and take measures to extinguish the fire with primary fire extinguishing means;
• in other emergency situations (short circuit, open circuit, damage to the radiation protection of the device, breakdown of communication systems for water supply, sewerage, heating and ventilation), stop work and call the appropriate emergency repair services.

1.17. The staff of the department must be proficient in first aid.

1.18. The staff of the department must observe the rules of personal hygiene.

1.19. Department personnel are prohibited from:

• work without the established overalls and protective devices;
• work without personal protective equipment;
• use damaged or expired personal protective equipment;
• work with disconnected water supply, sewerage, ventilation systems;
• eat and smoke in work areas.

1.20. Store food, home clothes and other items that are not related to work should only be stored in specially designated places.

1.21. Signs of radiation hazard should be posted on the doors of the offices of the departments.

1.22. The head of the institution must ensure that the instructions on labor protection are studied by each employee.

1.23. If necessary, persons who have violated the instructions are subject to an extraordinary knowledge test and unscheduled briefing on labor protection.

1.24. This instruction is accepted for a period of five years, the validity of which can be extended for no more than two terms.

2. Safety requirements before starting work

2.1. Before starting work, the staff of the department should put on medical gowns and caps, change shoes, and check the availability of individual dosimeters.

Persons working with open radionuclide sources should put on overalls: an apron with oversleeves or film semi-overalls and surgical gloves.

2.2. Personnel must check the health of ventilation, water supply, sewerage and electric lighting systems. Report any defects to the head of the department.

2.3. Those responsible for the storage of sealed and open radionuclide sources must check the integrity of the seals on the storage doors, open them and issue the required radiation source. During the working day, the vault must be closed with a key.

2.4. The staff of the department must prepare apparatus, instruments and auxiliary equipment for work, check the safety of radiation protection equipment.

2.5. The engineer is obliged to turn on the radiation monitoring and alarm systems, check the readiness of the devices for operation, the operation of the blocking devices, and the integrity of the ground wires.

2.6. During shift work of the radiotherapy department, the procedure for handing over and receiving a shift is determined by the internal instruction developed by the head of the department, taking into account the functional features of each room.

3. Safety requirements during work

3.1. The staff of the department must follow the optimal technological process of working with radiation sources from the moment they enter the department to their delivery for disposal and disposal of radioactive waste after storage in accordance with the internal instructions developed by the head of the department.

3.2. The staff of the department must know how to work safely with radiation sources;

3.3. The person responsible for radiation safety and appointed as the head of the department must control the storage, consumption and movement of radioactive sources within the department (office), the timely replacement of radioactive sources, and the timely delivery of radioactive waste.

3.4. During the laying of the patient in the rooms of X-ray therapy, megavoltage and gamma therapy, a radiologist and a nurse must be present.

3.5. During the irradiation session, the nurse should not leave the apparatus unattended and entrust supervision to persons who do not have the right to work on the apparatus.

3.6. The nurse must inform the engineer of the department or senior officer about all the malfunctions that occur.

4. Safety requirements in emergency situations

4.1. In the event of a radiation accident, the personnel must notify the head of the department and the person responsible for radiation monitoring.

4.2. In the event of failure of the gamma-therapy apparatus, fallout or loss of a radionuclide source, the personnel must evacuate the patient from the room, close the protective door, seal it and hang out a sign about the emergency condition.

4.3. To eliminate the accident, the head of the department must call a repair team.

4.4. In case of suspicion of personnel exposure above the norms given in clause 1.3 of this Instruction, the head of the department is obliged to organize an urgent check of the reasons that caused overexposure, evaluate the dose received, send the victims for a medical examination. Based on the results obtained, the head of the department should determine the possibility of further work of personnel in the field of ionizing radiation.

4.5. In case of contamination of personnel with open radionuclides, it is necessary to determine the area and level of contamination, send clothes to the holding chamber, carry out the necessary decontamination of contaminated body areas, followed by dosimetric control.

Surface contamination should not exceed the permissible values. Permissible contamination of the skin, overalls, the inner surface of the front parts of personal protective equipment should not exceed 2 parts / (cm2 x min) for alpha-active nuclides, 200 parts / (cm2 x min) for beta-active nuclides; surfaces of premises for permanent stay of personnel and the equipment located in them - respectively, for alpha-active nuclides 5-20 parts / (cm2 x min), for beta-active nuclides 2000 parts / (cm2 x min).

4.6. In case of radioactive contamination of production premises and equipment above the values ​​specified in clause 4.5 of this instruction, it is necessary to organize cleaning, clearly marking the place of accidental contamination, in some cases it is necessary to organize the exposure of equipment in order to reduce its level of contamination to acceptable values.

4.7. In case of loss of radioactive sources, their presence in the subdivision in a quantity that does not correspond to the documentation, or if they are used for other purposes, the personnel must notify the head of the department.

4.8. In case of a non-radiation accident, the personnel must turn off the main network switch and notify the head of the department about this.

4.9. If a person gets under the moving elements of apparatus or equipment, the victim should be released, evacuated from the office and provided with first aid.

5. Safety requirements at the end of work

5.1 At the end of work, the department staff must:

• tidy up the workplace;
• when working with open radionuclide sources, send radioactive waste to a storage facility;
• conduct dosimetric self-control of overalls, body and hands;
• bring the devices to their original state, turn off or switch to the mode specified in the operating instructions;
• turn off all electrical systems.

5.2. Persons responsible for the storage of open and sealed radionuclide sources must send all unused radiation sources to the storage and seal it.

5.3. Personnel must carry out wet cleaning of all premises.

5.4. The personnel must control the order of the workplaces and seal the cabinets in which the radiation sources are located.

5.5. The head of the department (office) must check the correctness of the accounting records.

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