Transcript IAEA Training Material on Radiation Protection in Radiotherapy

IAEA Training Material on Radiation Protection in Radiotherapy
Radiation Protection in
Radiotherapy
Part 14
Transport Safety
Transport of sources
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A problem in external beam therapy only for
dosimetric check sources and in the context
of source replacement for a tele-therapy unit
A day-to-day problem in brachytherapy
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Objective
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To understand the process of
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ordering
storage
accounting for
and transport
of radiation sources within the hospital
and externally
 To appreciate the protection and safety
issues associated with this process
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Contents
1 Notes on ordering of sources
2 Transport
IAEA transport regulations
 external of the hospital
 internal

3 Storage and accounting
Disposal discussed in part 15
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1. Ordering of sources
Need authorization
 Require all relevant licenses
 Order from approved supplier
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More in part 18 of the course
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The BSS on ordering and transport:
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General obligations:
“2.7. No practice shall be adopted, introduced, conducted,
discontinued or ceased and no source within a practice shall,
as applicable, be mined, milled, processed, designed,
manufactured, constructed, assembled, acquired, imported,
exported, distributed, sold, loaned, hired, received, sited,
located, commissioned, possessed, used, operated,
maintained, repaired, transferred, decommissioned,
disassembled, transported, stored or disposed of, except in
accordance with the appropriate requirements of the
Standards, unless the exposure from such practice or source
is excluded from the Standards or the practice or source is
exempted from the requirements of the Standards, including
the requirements of notification and authorization.”
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Receiving of sources
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Consignments are often sent ‘by default’ to
the hospital store
Care must be taken that:
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either sources are directly sent to and received by the
person who holds the appropriate license and has the
appropriate expertise
or that the hospital receiving officer is trained appropriately,
records all details of the shipping and informs the
responsible person in radiotherapy immediately
Radioactive sources MUST not be allowed to
be stored with other goods without being
under immediate control of an appropriately
trained person
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2. Transport of radioactive
sources for radiotherapy

Between the radiotherapy center and
outside facilities
delivery of sources
 disposal of sources
 transport between hospitals
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Within the radiotherapy center
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BSS and transport
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General obligations:
“2.9.
The transport of radioactive sources
shall be subject to the requirements of the
IAEA Regulations for the Safe Transport of
Radioactive Material and any applicable
international convention.”
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Transport of Radioactive
Material

IAEA Safety
Standards No.
ST-1: Regulations
for the Safe
Transport of
Radioactive
Material, 1996
Edition
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Objective of the IAEA
Transport Regulations

To protect persons, property and the
environment from the effects of radiation
during the transport of radioactive material.
This protection is achieved by requiring:
 containment of the radioactive contents
 control of external radiation levels
 prevention of criticality (not a concern for
radiotherapy sources)
 prevention of damage caused by heat.
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Scope of the IAEA
Transport Regulations

The Regulations apply to the transport of
radioactive material by all modes on land,
water or in the air.
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The Regulations cover the design and
manufacture of packaging, the preparation,
consigning, loading, carriage, unloading and
receipt of the packages.
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Types of Packages as defined by the
IAEA Transport Regulations
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Excepted package
Industrial package Type 1, 2 and 3
Type A package
Type B(U) package
Type B(M) package
Type C package
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Type B container
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Used for transport of
60-Co sources for
external beam
therapy
Used for 192-Ir
sources for high
dose rate
brachytherapy
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Please note
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Usually the
head of a 60Co unit is
NOT a
suitable
container for
transport of
the source!
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In practice
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The ‘transport’
container and the
treatment unit may
be identical (as
seen here for the
Nucletron HDR
brachytherapy
afterloading unit)
Courtesy of Nucletron
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Gammamed mobile unit
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Must be labelled
once source is
present
Easy to transport
Must be
accompanied by
appropriately
trained person
Courtesy of MDS Nordion
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The Transport Index
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The Transport Index is the maximum radiation level,
in mSv/h, at a distance of 1 m from the external
surface of the package, multiplied by 100.
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The categories of packages, are determined by the
Transport Index and the maximum radiation level at
any point on the surface of the package.
1.0 m
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Categories of Packages
T ra n s p o rt In d e x
M a x d o s e ra te o n
th e s u rfa c e
C a te g o r y
0 (ie < 0 .0 5 )
to 5 µ S v/h
I-W H IT E
> 0 to 1
> 5 µ S v/h
to 0 .5 m S v/h
II-Y E L L O W
> 1 to 1 0
> 0 .5 m S v/h
to 2 m S v/h
III-Y E L L O W
> 10
> 2 m S v/h
to 1 0 m S v/h
III-Y E L L O W
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White-I Label
 < 5.0 Sv/h @ surface
 < 0.05 Sv/h @ 1.0 m
 TI close to 0
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Yellow-II Label
 < 500 Sv/h, > 5 Sv/h
@ surface
 < 10 Sv/h @ 1.0 m
 0 < TI < 1.0
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Yellow-III Label
 > 500, < 2000Sv/h
@ surface
 > 10, < 100Sv/h
@ 1.0m
 1.0 < TI < 10
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Vehicle Placards
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Required every
time activity is
transported
Need at least
three
Other
documentation
also required
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Consignor’s Responsibilities
 all
labelling and placarding
 provision of transport documents
 provision of local rules and any other
relevant information
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Package Labels
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Package type
Isotope, activity, calibration date
Transport index (surface dose)
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Potential problems in
Brachytherapy
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Source order, delivery, calibration
and acceptance
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Different units were used by the hospital (mCi)
and the manufacturer (mg-Ra-equivalent); this
led to an overdosage of 74% of one patient
In three cases there was an underdosage due
to the use of the sources without checking the
source activity.
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Brachytherapy problems
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Source order, delivery, calibration
and acceptance. Contributing
factors:
Different units were used by the
hospital and manufacturer
 Insufficient check of documents (order
and delivery
 No source calibration by the users
(source strength determination)
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Transport of sources between
hospitals
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Brachytherapy sources prepared on a
different site to where they are used
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often the case for highly specialized
medical areas such as eye surgery
Radioactive applicators stored at a
different site to where they are used
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ophthalmic applicators
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Transport of sources between
hospitals
May be the case for entire HDR
brachytherapy unit and control
 Infrastructure (cables, beds, theatre) in
place at multiple
locations
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Courtesy of Nucletron
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Transport within a hospital
Aim to minimize all transport needs by
initial layout of the facility or choice of
brachytherapy areas.
Transport within a hospital
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Often required for brachytherapy
Need mobile safe to suit the isotope in use
Transport must be
accompanied by an
appropriately trained
person at all times
Labels required
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Transport containers
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Maximum dose rate at the
surface should be
<100mSv/hr
Should have large wheels to
negotiate uneven surfaces
Could double up as
emergency storage
container
Courtesy of Nucletron
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Transport within a hospital
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Some practical suggestions:
Transport routes must be chosen prior to
transport and adhered to
 Avoid lifts
 Avoid public areas (not only to protect
patients but also to minimize anxiety of
patients and others)
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Transport of patients with
radioactive implants
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Should be avoided for brachytherapy
patients
shielding is difficult
 the implant may
move during transport
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Label and signs
required
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Transport of patients with implants
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If possible, the
activity should be
removed prior to
transport of the
patient
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Disposal of sources
Only to person licensed to do this
 Documentation required
 This is a potential for accidents
 Compare part 15 of the course
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BIN
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3. Source storage
See part 15: “Safety of sources”
 Before ordering sources it must be
assured that they can be safely stored
 Information required for storage is
similar to information required for
transport
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Features of
source storage
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Secure (lock and
key)
Labels
Different
compartments
Shielding
Easy access
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BSS on Security of sources
2.34. “Sources shall be kept secure so as to prevent
theft or damage and to prevent any unauthorized
legal person from carrying out any of the actions
specified in the General Obligations for practices of
the Standards (see paras 2.7-2.9), by ensuring that:
...
(b) a source not be transferred unless the receiver possesses
a valid authorization; and
(c) a periodic inventory of movable sources be conducted at
appropriate intervals to confirm that they are in their
assigned locations and are secure.”
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In radiotherapy practice
Source storage area should be close to
areas where the sources are to be used
(theatres, brachytherapy ward)
 Storage and transport containers are
usually of different design - a storage
container is NOT necessarily suitable
for transport
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Emergency storage
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In brachytherapy an emergency storage
container should be available in case a
source must be removed form the
patient.
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Emergency storage
Next to temporary LDR implants in case
sources must be removed for medical
emergency
 Next to HDR applications in case the
source gets stuck and the whole
applicator has to be removed
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Summary
Transport of sources is always a
potential for exposure
 Source transport is mainly an issue in
the context of brachytherapy
 Appropriate containers and labeling is
required
 Transport issues can occur outside and
inside of a radiotherapy facility
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Any questions?
Question
Please design a source inventory suitable
for your institution.
Some suggestions
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Should include:
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Type of source
Activity (and date of
specification)
Ordered by:
(authorization?)
Received by
Received when
Storage where?
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Part 14: Transport safety
Patient name and
identification number
(for brachytherapy
patients)
Used for?
Can be disposed of
when (if applicable)
Disposed by
Disposed when
Disposed to
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Acknowledgment

Lee Collins, Westmead Hospital,
Sydney
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