Part VIII:Medical Exposures in Radiotherapy

Lecture 2 : Scope and Responsibilities – Training of staff

IAEA Post Graduate Educational Course on Radiation Protection and Safe Use of Radiation Sources

Module 1 Scope and Responsibilities

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Objective

• Appreciate the need for training of the Appreciate the need for training of the staffstaff

• Understand the method of organising a Understand the method of organising a training program for stafftraining program for staff

• Appreciate and understand the need for Appreciate and understand the need for updating the training programsupdating the training programs

• Able organise refresher trainingAble organise refresher training

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Professional to be trained

• Radiation Oncologists• Medical Physicists• Radiotherapy Technologists• Nurses• Equipment maintenance Engineers

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Education and Training

• Are essential for a StaffAre essential for a Staff• As part of a the implementation of a Radiation As part of a the implementation of a Radiation

Protection Programme (IAEA TecDoc 1040, Protection Programme (IAEA TecDoc 1040, 2.2.1): “Early in the process a decision should 2.2.1): “Early in the process a decision should be made about additional training required for be made about additional training required for the hospital staff…”the hospital staff…”

• The relevant plan should include who, where The relevant plan should include who, where and when shall be trained. and when shall be trained.

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Responsibility of the licensee

• BSS 2.30.: “Provision shall be made for BSS 2.30.: “Provision shall be made for reducing as far as practicable the contribution reducing as far as practicable the contribution of human error to accidents and other events of human error to accidents and other events that could give rise to exposures, by ensuring that could give rise to exposures, by ensuring that: that: (a)(a) all personnel on whom protection and all personnel on whom protection and

safety depend be appropriately trained and safety depend be appropriately trained and qualified so that they understand their qualified so that they understand their responsibilities and perform their duties with responsibilities and perform their duties with appropriate judgement and according to defined appropriate judgement and according to defined procedures;” procedures;”

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In practice training is required for both:

• Staff on whom radiation protection depends - Staff on whom radiation protection depends - typically radiotherapy professionals and typically radiotherapy professionals and service staffservice staff

• Persons who could be subject to irradiation: Persons who could be subject to irradiation: staff (module VIII), patients (module IX) and staff (module VIII), patients (module IX) and public (module XVII) - in the latter case the public (module XVII) - in the latter case the education may be limited to information education may be limited to information sheets and/or warning signssheets and/or warning signs

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Education

• All staff in radiotherapy must have All staff in radiotherapy must have appropriate education to perform their appropriate education to perform their duties…duties…

• For radiation protection purposes this affects For radiation protection purposes this affects particularly:particularly:– Radiation Protection OfficerRadiation Protection Officer– PhysicianPhysician– Qualified Expert (Medical Physicist)Qualified Expert (Medical Physicist)– Radiotherapy TechnicianRadiotherapy Technician– Maintenance staffMaintenance staff

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IAEA TecDoc 1040...

• ……provides specific provides specific information on the role of the information on the role of the physician (3.2.2.1) and physician (3.2.2.1) and medical physicist (3.2.2.2) - medical physicist (3.2.2.2) - the skills and competencies the skills and competencies identified there determine the identified there determine the education and training education and training requirements.requirements.

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Qualifications and Training of others

• There should also be a process in place There should also be a process in place which ensures that outside contractors which ensures that outside contractors on whom radiation protection may on whom radiation protection may depend (eg service engineers) are depend (eg service engineers) are appropriately trained and qualified. This appropriately trained and qualified. This is typically reflected in a license of the is typically reflected in a license of the contractor of which a copy should be contractor of which a copy should be available in the radiotherapy facility.available in the radiotherapy facility.

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BSS: Education is part of Management Requirements

In radiotherapy, these requirements will be fulfilled by theIn radiotherapy, these requirements will be fulfilled by therequirement for a qualified expert in radiotherapy physicsrequirement for a qualified expert in radiotherapy physics. .

• Qualified radiation safety expertsQualified radiation safety experts– Licencee shall arrange for qualified radiation Licencee shall arrange for qualified radiation

safety experts to provide observance to the safety experts to provide observance to the RegulationsRegulations

– The qualifications of the radiation safety experts The qualifications of the radiation safety experts shall include appropriate academic knowledge and shall include appropriate academic knowledge and professional experienceprofessional experience

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Regulations – Management requirements

Continuous Continuous education and training in education and training in radiation protection shall be provided to radiation protection shall be provided to meet with changes in equipment, meet with changes in equipment, instrumentation, practice, monitoring instrumentation, practice, monitoring methods, recommendations and methods, recommendations and regulationsregulations

A transition periodA transition period should be provided for should be provided for those already involved in the delivery of those already involved in the delivery of radiation exposure in order to meet the radiation exposure in order to meet the requirements of trainingrequirements of training

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Continuing Education

• Technology in radiation therapy is Technology in radiation therapy is fast developingfast developing

• It is essential for all staff to have It is essential for all staff to have regular updates on radiation regular updates on radiation protection aspects (eg. consider protection aspects (eg. consider the introduction of HDR the introduction of HDR brachytherapy)brachytherapy)

• Continuing education must be Continuing education must be documenteddocumented

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BSS: There is also a role for the regulatory authority

The Regulatory Authority should encourage medical The Regulatory Authority should encourage medical authorities, universities and professional authorities, universities and professional organizations to design and implement training organizations to design and implement training programmes in radiation protection for:programmes in radiation protection for:– radiation oncologistsradiation oncologists– qualified experts in radiotherapy physicsqualified experts in radiotherapy physics– radiotherapy technologistsradiotherapy technologists– dosimetrists dosimetrists – maintenance personnelmaintenance personnel

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Education & Training

• The Regulatory Authority should The Regulatory Authority should establish training curricula for (for establish training curricula for (for example) :example) :– RPOsRPOs– members of the RSCmembers of the RSC– relevant physiciansrelevant physicians– medical physicistsmedical physicists– laboratory stafflaboratory staff

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Education and Training (cont)

– Nurses working with radioactive patientsNurses working with radioactive patients– maintenance staffmaintenance staff– radiation technologistsradiation technologists– other relevant staff eg. cardiologists who other relevant staff eg. cardiologists who

need to use x-raysneed to use x-rays

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Content of the Training Programme

Training in radiation protection for Training in radiation protection for radiotherapy should cover:radiotherapy should cover:– radiation modalitiesradiation modalities– facility designfacility design– characteristics of safety features of sources and source characteristics of safety features of sources and source

realeted equipmentrealeted equipment– dosimetry and instrument calibrationdosimetry and instrument calibration– treatment planningtreatment planning– radiactive waste disposalradiactive waste disposal– accident prevention and emergency procedures (+ lessons accident prevention and emergency procedures (+ lessons

learned from past accidents)learned from past accidents)

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How to achieve Education and Training for staff?

• As well as ensuring that specialist radiation As well as ensuring that specialist radiation workers (eg. radiographers) have the workers (eg. radiographers) have the necessary training, the employer should also necessary training, the employer should also provide local trainingprovide local training

• This could be basic safety training for new This could be basic safety training for new employees such as nurses and lab. staffemployees such as nurses and lab. staff

• Training should include the local rulesTraining should include the local rules

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• The Regulatory Authority should also The Regulatory Authority should also have an audit system to ensure that have an audit system to ensure that training is of an appropriate standardtraining is of an appropriate standard

• The use of licenses to use radiation is The use of licenses to use radiation is one method of ensuring complianceone method of ensuring compliance

How to achieve Education and Training for staff?

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Education and Training

• If the number of professionals is too If the number of professionals is too small to justify setting up a training small to justify setting up a training course, then international co-operation course, then international co-operation programs may be usedprograms may be used

• Distance learning programs may be Distance learning programs may be usefuluseful

• A course such as the present may play A course such as the present may play an important role...an important role...

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Summary

• A radiation protection program is an essential A radiation protection program is an essential requirement for every radiotherapy facilityrequirement for every radiotherapy facility

• The radiation protection officer and the The radiation protection officer and the radiation safety committee plays an important radiation safety committee plays an important role in the implementation of the programrole in the implementation of the program

• Education and training of staff and all other Education and training of staff and all other persons who may be in ocntact with radiation persons who may be in ocntact with radiation is essentialis essential

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Typical elements of a RPP• Assignment of responsibilitiesAssignment of responsibilities• The Radiation Protection OfficerThe Radiation Protection Officer• Designation of radiation areasDesignation of radiation areas• Local rulesLocal rules• Education and trainingEducation and training• Planning for accidents and emergenciesPlanning for accidents and emergencies• Health surveillance and monitoringHealth surveillance and monitoring• Review and audit Review and audit • System of recording and reportingSystem of recording and reporting

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References

• Basic Safety Standards Basic Safety Standards – Safety series No 115 IAEA publicationSafety series No 115 IAEA publication

• Lecture Material of Lee Collins prepared for Lecture Material of Lee Collins prepared for IAEAIAEA

• Design and implementation of a radiotherapy programme: clinical, medical physics, radiation protection and safety aspects - IAEA Tec Doc 1040