Part A Dose magnitudes Radiation Safety JUAS 2014

Part A. Dose magnitudes Radiation Safety - JUAS 2014, X. Queralt 1. Definitions 2. Effects of the ionization radiation 3. Natural background 4. Medical application 5. Rules for workers & zones / 36

1. Definitions Radiation Safety - JUAS 2014, X. Queralt Ionizing radiation directly ionizing: charged particles (electrons, protons, …) indirectly ionizing: photons, neutrons of the order of 10 e. V required to ionise an atom Ionization potential (e. V) electromagnetic radiation: (hard ultraviolet) carbon 11. 260 oxygen 13. 618 potassium 4. 341 iron 7. 870 lead 7. 416 / 36

1. Definitions Radiation Safety - JUAS 2014, X. Queralt Quantities and units used to quantify stochastic effects: Exposure Absorbed Dose Energy absorbed per mass unity (Joule/kg; Gray - Gy). Equivalent Dose (Joule/kg; Sievert - Sv). Effective Dose (Joule/kg; Sievert - Sv). Radiation type weighting factor Tissue type weighting factor 1 Sv = 100 rem. 1 m. Sv = 0. 1 rem. / 36

1. Definitions Radiation Safety - JUAS 2014, X. Queralt Activity Fluence F particles per cm 2 1/distance 2 Becquerel (Bq): 1 Bq = 1 s-1 (Curie (Ci): 1 Ci = 3. 7 1010 Bq) Absorbed dose D Biological effects: Effective dose E (Sv) - Ambient dose equivalent H*(d) gray (Gy): 1 Gy = 1 J. kg-1 (rad: 1 rad = 0. 01 Gy) / 36

1. Definitions Radiation Safety - JUAS 2014, X. Queralt Ionising Radiation Dose (Equivalent Dose): is a measure of the radiation dose absorbed by a tissue depending on the different types of ionizing radiation. 1 m. Sv = 0, 001 Sv (Sievert) Energy absorbed per kilogram: 1 Sv = 1 Joule / 1 kg (1 Joule = 0, 25 calories) Assuming that the hours per year for a worker is 2000 hours: 0, 001 Sv / 2000 h = 0, 0000005 Sv/h = 0, 5 µSv/h 5 / 36

1. Definitions Radiation Safety - JUAS 2014, X. Queralt ICRP Publication 60 (1991): Organ dose DT Individual organ, e. g. stomach Tissue or organ equivalent dose HT, R Unit of equivalent dose: J. kg-1 Special name: Sievert (Sv) Old unit: rem (1 Sv = 100 rem) / 36

1. Definitions Radiation Safety - JUAS 2014, X. Queralt ICRP Publication 60 (1991): Effective dose E Σ different organs Unit of effective dose: Sv Dose limits on: • Effective dose E • Tissue or organ equivalent dose HT / 36

Radiation Safety - JUAS 2014, X. Queralt ICRP Publication 103 (2007) Tissue weighting factor w. T ICRP 60 ICRP 103 Gonads 0. 20 0. 08 Bone marrow (red) 0. 12 Colon 0. 12 Lung 0. 12 Stomach 0. 12 Bladder 0. 05 0. 04 Breast 0. 05 0. 12 Liver 0. 05 0. 04 Oesophagus 0. 05 0. 04 Thyroid 0. 05 0. 04 Skin 0. 01 Bone surface 0. 01 Brain - 0. 01 Salivary gland - 0. 01 0. 05 0. 12 1 1 Remainder Total Radiation weighting factor w. R neutrons protons: 2 / 36

1. Definitions Radiation Safety - JUAS 2014, X. Queralt ICRP Publication 60 (1991): Irradiation geometries Antero-posterior (AP) Postero-anterior (PA) Isotropic (ISO) Lateral (LAT) Rotational (ROT) / 36

1. Definitions Radiation Safety - JUAS 2014, X. Queralt ICRU Report 51 (1993): Protection quantities (ICRP) operational quantities Dose equivalent Ambient dose equivalent H*(d) H*(10) (d = 10 mm) Unit of dose equivalent: Sv ICRU sphere 30 cm diameter tissue-equivalent sphere: density 1 g. cm-3 composition by mass: 76. 2 % O, 11. 1 % C, 10. 1 % H and 2. 6 % N / 36 /95

2. Effects of the ionization radiation Radiation Safety - JUAS 2014, X. Queralt DETRIMENTAL EFFECTS OF IR Dose Response Curve for a Stochastic Effect with no Threshold Dose Below which the Effect Dose not Occur. 11 / 36

2. Effects of the ionization radiation Radiation Safety - JUAS 2014, X. Queralt DETRIMENTAL EFFECTS OF IR Dose Response Curve for a Deterministic Effect Exhibiting a Threshold Dose Below which the Effect Dose not Occur. 12 / 36

2. Effects of the ionization radiation Radiation Safety - JUAS 2014, X. Queralt DNA AS A TARGET 13 / 36

2. Effects of the ionization radiation Radiation Safety - JUAS 2014, X. Queralt 14 / 36

2. Effects of the ionization radiation Radiation Safety - JUAS 2014, X. Queralt RADIATION INTERACTION WITH MATTER The radiation-induced DNA damage can occur through a direct action or an indirect action. OH· H H O Indirect Action Direct Action 2 nm 4 nm For X- and Gamma-rays: 35% of the damage is direct and 65% indirect. / 36

2. Effects of the ionization radiation Radiation Safety - JUAS 2014, X. Queralt OXIGEN EFFECT A H* + O 2 HO 2* Less oxidant but with a largest half life. HO 2* + H* H 2 O 2 HO 2* + HO 2* H 2 O 2 + O 2 e-aq + O 2 O 2 - + H 2 O HO 2* + OHRadiotherapy generates radicals in cellular DNA and adjacent molecules that lead to cell death. Oxygen is important because it intercepts the short-lived free radicals and enhances DNA damage. / 36

2. Effects of the ionization radiation Radiation Safety - JUAS 2014, X. Queralt WHOLE BODY RESPONSE: ADULT Dose (Gy) Prodromic Latency Desease manifestation 1 -5 Few hours Some days - 3 weeks Infections, haemorrhage, anaemia 30 -60 days (>3 Gy) Gastrointestinal 5 -15 syndrome Few hours 2 -5 days Dehydration, Malsnutrition, Infections 10 -20 days Central Nervous > 15 system syndrome Minutes Few hours Convulsions, Ataxia, Coma 1 -5 days Bone marrow syndrome Death Lethal dose - LD 50/30: Dose which would cause death to 50% of the population in 30 days. For humans after whole body irradiation LD 50/30 is about 2. 5 – 4. 5 Gy. / 36

2. Effects of the ionization radiation Radiation Safety - JUAS 2014, X. Queralt Effect Population Exposure period Hereditary effects Whole population Lifetime 1% (all generations) Fatal cancer Whole population Lifetime 5% Working population Age 18 -65 4% Whole population Lifetime 7. 3 % Working population Age 18 -65 5. 6 % Health detriment Probability/Sv / 36

3. Natural background Radiation Safety - JUAS 2014, X. Queralt 0, 4 Cosmic Radiation TOTAL ~2. 4 m. Sv external = 0, 8 m. Sv (32%) internal = 1, 6 m. Sv (68%) 0, 4 In our body and food 1, 2 Gases in air and materials 0, 4 Direct Radiation from the soil 19 / 36

3. Natural background Radiation Safety - JUAS 2014, X. Queralt WORLDWIDE AVERAGE DOSES Source Effective dose (m. Sv per year) Typical range (m. Sv per year) External exposure • • Cosmic rays Terrestrial gamma rays 0. 4 0. 5 0. 3 -1. 0 0. 3 -0. 6 1. 2 0. 3 0. 2 -10 0. 2 -0. 8 2. 4 1– 10 Internal exposure • • Inhalation Ingestion Total 20 / 36

Radiation Safety - JUAS 2014, X. Queralt Natural background radiation exposure in Europe NATURAL BACKGROUN D RADIATION 21 / 36

3. Natural background Radiation Safety - JUAS 2014, X. Queralt 10 Natural Medical 0. 1 (m. Sv) EFECTIVE DOSE PER YEAR 1 0. 01 Nuclear experiments Chernobyl accident 0. 001 Producción de Energía Nuclear 0. 0001 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 YEARS 22 / 36

Radiation Safety - JUAS 2014, X. Queralt 3. Natural background Cosmic Radiation 23 / 36

3. Natural background Radiation Safety - JUAS 2014, X. Queralt Santiago Chile - Madrid 6. 0 Total dose High LET 14 Low LET Altitude 12 5. 0 10 4. 0 8 3. 0 6 2. 0 4 1. 0 2 0. 0 0 Altitude, km Dose rate , µSv/h 7. 0 16/03/01 17/03/01 15: 00 18: 00 21: 00 00: 00 03: 00 06: 00 09: 00 Flight duration: Time at high altitude: Average dose - rate (µSv h-1) Experimental: 2. 03 CARI 6: 2. 25 EPCARD: 1. 94 12. 52 h 11. 33 h 10. 3 km Annual dose (600 hours) (m. Sv a-1) 1. 22 1. 35 1. 17 24 / 36

3. Natural background Radiation Safety - JUAS 2014, X. Queralt AVERAGE DOSES TO WORKERS Radiation source Number of workers Average dose (m. Sv per year) Enhanced natural sources • Mining (excluding coal) • Coal mining • Air travel (crew) • Mineral processing • Above ground workplaces (radon) Total 760, 000 3, 900, 000 250, 000 300, 000 1, 250, 000 2. 7 0. 7 3 1. 0 4. 8 6. 500, 000 1. 7 25 / 36

4. Medical application Radiation Safety - JUAS 2014, X. Queralt Radiation exposure to US population from all sources. NCRP 160 published 2009 Medical dose per capita (m. Sv) . 54 3. 0 has increased 560% / 36

4. Medical application Radiation Safety - JUAS 2014, X. Queralt RADIATION RISKS IN X-RAY EXAMINATIONS Examination Skin dose Effective dose Risk (m. Gy) (%) Urography Lumbar spine Abdomen Chest Extremities 30 40 10 2 3 8 5 2. 5 0. 25 0. 04 0. 025 0. 013 0. 00013 RADIATION RISKS IN NUCLEAR MEDICINE Examination Radiopharmaceutical Myocardium Tl-201 chloride Bone Tc-99 m MDP Thyroid Tc-99 m pertechnetate Lungs Tc-99 m MAA Kidney clearance Cr-51 EDTA Effective dose (m. Sv) 23 3. 6 1. 1 0. 9 0. 01 Risk (%) 0. 12 0. 018 0. 006 0. 005 0. 00005 / 36

4. Medical application Radiation Safety - JUAS 2014, X. Queralt Radiation doses to patients from various types of medical imaging procedures • With X-rays Approx. Equiv. Period of natural background radiation Average adult effective dose (m. Sv) Estimated dose equivalent (n. of chest Xrays) Dental X-ray 0. 005 – 0. 01 0. 25 -0. 5 Chest X-ray 0. 02 1 3 days Mammography 0. 4 20 60 days CT 2 - 16 100 - 800 300 days – 7. 4 years Interventional fluoroscopy 5 - 70 250 - 3500 2. 3 years – 32. 2 years Type of procedure < 1. 5 day Initiative to reduce unnecessary radiation exposure from medical imaging, FDA. 2010 / 36

5. Rules for workers & zones Radiation Safety - JUAS 2014, X. Queralt DOSE LIMITS - PERSONAL Ø WORKERS : 1. For Exposed Workers - A: maximum dose 50 m. Sv per official year (100 m. Sv for 5 years) 2. For Exposed Workers - B: maximum dose 6 m. Sv per official year 3. For None Exposed Workers: 1 m. Sv per official year 4. For women during pregnancy (*): 1 m. Sv 5. For general public: 1 m. Sv per official year 29 / 36

5. Rules for workers & zones Radiation Safety - JUAS 2014, X. Queralt Dose Limit Aplication Effective Dose Equivalent Dose (/year): Cristaline Workers 20 m. Sv/year averaged for 5 years periods 1 Public 1 m. Sv/year 2 150 m. Sv 15 m. Sv Skin 3 500 m. Sv 50 m. Sv Hands and foot 500 m. Sv ------ 1 The effective dose will be below 50 m. Sv any year. 2 Under exceptional situations a higher effective dose could be accepted, if the average in 5 years Is not above 1 m. Sv/year. 3 These dose limits (equivalent dose) prevent deterministic effects after local exposures. / 36

Radiation Safety - JUAS 2014, X. Queralt 1 m. Sv/year is the annual limit for public due to artificial radiations Exposed Worker Annual dose (2000 h/year): < 1 m. Sv/year Dose per day: < 12 µSv Dose rate @ public areas: < 0. 5 µSv/h The smoker case Annual dose (1. 5 pack/day): 13 m. Sv/year Dose per cigarrette: ~ 1. 2 µSv/cigarette Dose rate (5 min/cigarette): ~ 14. 4 µSv/h / 36

5. Rules for workers & zones Radiation Safety - JUAS 2014, X. Queralt AREA DOSE LIMITS Ø ZONE CLASIFICATION: 1. Controlled Zone: dose higher than 6 m. Sv (per official year) i. Limit Access Zone: dose higher than 100 m. Sv (for 5 years) ii. Ruled Access Zone: high dose rate (short period) iii. Prohibited Access Zone: high dose (single exposition) 2. Watched Zone: dose lower than 6 m. Sv (per official year) Always ANNUAL DOSE is ABOVE the background LEVEL 32 / 36

5. Rules for workers & zones Radiation Safety - JUAS 2014, X. Queralt DOSE LIMITS - SIGNALS WATCHED ZONE > 0, 5 m. Sv/h up to 3 m. Sv/h CONTROLLED ZONE > 3 m. Sv/h up to 25 m. Sv/h LIMIT ACCESS ZONE > 25 m. Sv/h up to 1 m. Sv/h RULED ACCESS ZONE > 1 m. Sv/h up to 100 m. Sv/h PROHIBITED ACCESS ZONE > 100 m. Sv/h 33 / 36

5. Rules for workers & zones Radiation Safety - JUAS 2014, X. Queralt Passive personnel dosimeters § Thermoluminiscense § Based on detectors TLD-100 (Li. F: Mg, Ti): § Equivalent dose § Range of usage: 10μGy-10 Gy. § The filter system allow to distinguish the energy radiation Whole body dosimeter / 36

5. Rules for workers & zones Radiation Safety - JUAS 2014, X. Queralt Different passive dosimeters configurations Wrist Body dosimeter Belly O-ring / 36