Instructions on labor protection for personnel of radiodiagnostic units of medical institutions

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OCCUPATIONAL SAFETY AND HEALTH
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Instructions on labor protection for personnel of radiodiagnostic units of medical institutions

Occupational Safety and Health

Occupational Safety and Health / Standard instructions for labor protection

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Safe Operation

1. General requirements for labor protection

1.1. Persons at least 18 years of age who have undergone special training in radioisotope diagnostics and are assigned by order of the institution to the personnel of the unit (category "A") are allowed to work in radiodiagnostic units.

1.2. The personnel of the unit 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 (according to order No. 700 of the USSR Ministry of Health of June 19, 1984 "On conducting mandatory preliminary upon admission to work and periodic medical examinations of workers exposed to harmful and unfavorable working conditions").

1.3. All newcomers to work in the unit, as well as persons sent to perform work at certain periods of time, must undergo an introductory safety briefing by the person responsible for safety in the institution.

The results are recorded in the registration log of the introductory briefing on labor protection (OST 42-21-14-82, Appendix No. 2). After that, the personnel department or the person responsible for working with personnel makes the final registration of the newly arriving employee and sends him to the place of work.

1.4. Each newly hired to the unit must undergo an initial safety briefing at the workplace, repeated at least twice a year and unscheduled (in case of changes in working conditions, safety violations and accidents). The briefing is carried out by the head of the unit or a person authorized by him. The results of the briefing are recorded in the journal (OST 42-21-14-82, Appendix No. 3).

1.5. Before starting work and periodically at least once a year, an examination of the knowledge of personnel safety should be carried out according to a program approved by the administration of the institution and agreed with the trade union committee.

1.6. Office staff must:

be guided by job descriptions;
avoid deviations from the technological process of working with radionuclides;
know and comply with the requirements of OST 42-21-14-82 "SSBT. Radiodiagnostic units. Safety requirements", "Basic sanitary rules for working with radioactive substances and other sources of ionizing radiation, OSP-72/80", "Radiation safety standards NRB-76 ", technical specifications and descriptions of the rules for working with devices and devices, this manual and other safety regulations issued by higher organizations and the USSR Ministry of Health;
know how to provide first aid;
know the coordinates of organizations and persons who are informed about the occurrence of the accident;
Maintain order and cleanliness of the premises.

1.7. Prohibited in the unit:

the presence of persons not related to work;
store radiopharmaceuticals (RP) with an activity exceeding that stipulated by the sanitary passport;
use sources of ionizing radiation and radiodiagnostic equipment for other purposes;
work with faulty appliances, fixtures, tools and alarms;
use damaged or expired personal protective equipment;
work without the established overalls and safety devices;
carry out technological operations with radiopharmaceuticals outside the workplace;
carry out technological operations with radiopharmaceuticals without special trays and pallets;
store and use drugs without labels, in a damaged vial;
taste and smell the drugs used;
leave unattended electric heaters on;
store cotton wool, alcohol and other flammable substances near electric heaters;
store radioactive waste at workplaces after work with radionuclides is completed;
work when the water supply, sewerage and ventilation systems are turned off;
place unused equipment and furniture in the unit;
store food products, home clothes and other items not related to work, except for specially designated places;
eat and smoke in work areas.

1.8. In emergency situations, personnel must act in accordance with the detailed instructions for the elimination of accidents.

1.9. In the event of a radiation accident, the personnel must notify the head of the unit and act, depending on the situation:

if it is suspected that the exposure of personnel is higher than the values established by the NRS, the head of the unit is obliged to organize an urgent check of the reasons that caused the overexposure, evaluate the dose received and, depending on the amount of absorbed dose, decide on the medical examination of the victim and his further work in the field of ionizing radiation;
in case of radioactive contamination of personnel, it is necessary to determine the site and level of contamination, remove clothing and send it to the holding chamber, carry out the necessary decontamination of contaminated areas of the body, followed by dosimetric control. Permissible surface contamination should not exceed the values established by the NRB;
in case of radioactive contamination of production premises and equipment above the values established by the NRB, it is necessary to organize cleaning, clearly marking the place of accidental contamination, in some cases it is possible to organize exposure of equipment to values less than the permissible level of surface contamination;
in case of loss of radiopharmaceuticals, their presence in the subdivision in an amount that does not correspond to the documentation, if they are used for other purposes, the personnel must notify the head of the subdivision.

1.10. In case of a non-radiological accident, the personnel must notify the head of the unit and act, depending on the situation:

in case of a short circuit, break in the power supply systems, turn off the main power switch in the room and call the person responsible for the operation of the equipment in the unit;
in case of electric shock and other injuries to a person, act in accordance with the "Instructions for first aid for victims of electric current and other accidents";
in the event of a fire, call the fire brigade and the police, before the arrival and meeting of the fire brigade, the fire is extinguished by primary fire extinguishing means;
in the event of a breakdown in the communication systems of water supply, sewerage, heating and ventilation that impede the performance of technological operations, stop work until the accident is eliminated, inform the head of the unit and take measures to prevent possible radiation accidents.

1.11. In the event of a power outage or a burning smell, the personnel must turn off the equipment and electrical appliances and call an electrician.

1.12. Electric heaters must be installed on heat-insulating material.

1.13. In rooms where electric heaters are located, a sign should be posted indicating the nearest location of fire extinguishing equipment.

2. Special requirements for labor protection

2.1. The head of the division is responsible for compliance with the safety regulations by the personnel of the division.

2.2. The head of the department must:

study and implement in daily work the orders, standards, methodological recommendations and other normative documents on labor protection and safety issued by higher organizations related to the unit;
develop an optimal technology for working with radiopharmaceuticals from the moment it enters the unit to the moment the radioactive waste is removed after it has been stored;
organize systematic training of personnel in methods of safe work with radiopharmaceuticals and testing knowledge of safety precautions;
carry out constant monitoring of the passage of periodic medical examinations by personnel;
organize effective measures to eliminate radiation and other emergencies;
identify persons responsible for the preparation and administration of radiopharmaceuticals in the unit;
identify persons responsible for safety, including radiation safety;
exercise control over the storage and consumption of radiopharmaceuticals, timely conduct of dosimetric monitoring and the fire-fighting condition of the unit, the delivery of containers and waste disposal;
maintain a safety briefing log at the workplace;
carry out daily control over the maintenance of reporting and accounting documentation.

2.3. The head of the subdivision develops a detailed instruction on safety and industrial sanitation and instructions for the elimination of accidents. Approves instructions from the administration of the institution, in the trade union committee and coordinates them with the local bodies of the sanitary and epidemiological service and the State Fire Supervision.

2.4. The radiologist must:

exercise control over the observance of safety rules by middle and junior personnel;
determine the research methodology, calculate the activity of the radiopharmaceutical required for the study;
to control the preparation and administration of the drug.

2.5. The head nurse of the unit, being at the same time the responsible keeper of the radiopharmaceutical, is obliged to:

to receive, issue, store and account for radionuclides entering and used in the unit and to keep an income and expenditure log of radiopharmaceuticals, the form of which is given in the "Rules and norms for the use of radiopharmaceuticals for diagnostic purposes" No. 2813-83 dated 25.05.83 of the USSR Ministry of Health;
organize decontamination works related to emergencies;
organize the control of the cleanliness of containers from under the radiopharmaceutical and their timely return;
exercise control over the storage of radioactive waste and organize their timely disposal;
exercise control over the implementation of safety rules by middle and junior medical personnel when working with radiopharmaceuticals.

2.6. The Unit Nurse is responsible for:

carry out the correct and timely removal of radioactive waste from workplaces;
maintain accounting and reporting documentation on the use of radiopharmaceuticals within their job description.

2.7. The person responsible for safety in the unit is obliged to:

study and implement in daily work the regulatory documents on labor protection and safety, issued by higher organizations;
keep records and registration in the card of individual exposure doses of personnel;
systematically control the contamination of workplaces;
periodically monitor the availability of protective equipment and their quality.

2.8. Before starting work:

unit personnel must put on medical gowns and caps, change shoes;
persons working with radioactive substances must wear overalls: an apron and oversleeves or a half-gown made of plastic and gloves;
the person responsible for the storage of radiopharmaceuticals must check the integrity of the seal on the storage door, open the storage and issue the required drug to the workplace in the packing room; during the working day, the vault must be locked;
the radiologist must check the readiness for operation of radiodiagnostic devices, inform the head of the unit about the observed malfunctions and not start work without eliminating them, making the appropriate marks in the device form;
the head nurse should check the health of the ventilation, water supply, sewerage and electric lighting systems, inform the head of the unit about the observed malfunctions and take measures to carry out repair work.

2.9. During the study, personnel must comply with the technological process of working with sources of ionizing radiation.

2.10. The nurse is obliged to carry out wet cleaning of all premises daily. Periodically, at least once a month, a complete cleaning should be carried out with washing of walls, floors, doors, window sills, and the inside of windows.

2.11. Upon completion of work:

2.11.1. The staff of the department is obliged to:

put the workplace in order, send radioactive waste to the holding chamber;
conduct dosimetric self-control of overalls, body and hands; upon detection of contamination, take measures in accordance with clause 1.9 of this Instruction.

2.11.2. The person responsible for safety precautions must conduct a dosimetric control of the levels of radiation contamination of the workplace - if contamination is detected, organize the decontamination of work surfaces.

2.11.3. Persons operating radiodiagnostic devices must turn off the devices or switch them to the mode specified in the operating instructions, and write down comments on their operation in the device log.

2.11.4. The radiopharmaceutical custodian must send all unused radiopharmaceuticals to storage and seal it.

2.11.5. The head of the department must check the correctness of maintaining all accounting and reporting documentation.

2.11.6. The head nurse should turn off the special ventilation in all rooms, except for the storage room, and check the communication systems.

2.11.7. The person responsible for safety precautions must carry out a final check of the radiation state of all workplaces, as well as the hands and clothing of the personnel - if necessary, carry out measures according to clause 1.9.

2.11.8. The nurse must carry out a wet cleaning of all rooms.

Control over the implementation of this Instruction is assigned to the person responsible for safety (radiation safety) in the radiodiagnostic unit.

For violation of the requirements of this Instruction, the perpetrators are liable in administrative or criminal proceedings, depending on the nature of the violations and their consequences.

Notes:

clause 1.2. the Order of the Ministry of Health of the Russian Federation of March 14.03.96, 90 No. XNUMX "On the procedure for conducting preliminary and periodic medical examinations of workers and medical regulations for admission to the profession" is in force.
clause 1.6. the Radiation Safety Standards (NRB-96) are in force. Hygienic standards. GN 2.2.054-96 of the State Committee for Sanitary and Epidemiological Supervision of the Russian Federation dated April 19.04.96, 14, No. 72 and OSP-87/XNUMX.

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