Health And Safety Issues Around Ionising And Non Ionising Radiation In Medical Applications

Introduction

The application of radiation in medical operations is without doubt accompanied with health and safety risks, some of which could be so grave. Radiation in medicine entails transfer of energy from one body to another tin form of waves. Patients admitted to radiology often experience radiation procedures when managing their conditions. The application of radiation occurs in two main forms; ionising and non-ionising radiation (Barendson 1968). Ionising radiation is radiation that carries sufficient energy to disengage electrons from atoms or molecules, in so doing ionizing them. Ionizing radiation is composed of energetic subatomic particles, ions or atoms moving at great swiftness (usually greater than 1% of the speed of light), and electromagnetic waves on the high-energy end of the electromagnetic spectrum. Ionising radiation has the capacity of causing significant harm especially when cast on human body it can cause harm to the DNA and denaturation of proteins (Barendson 1968).

Non-ionising radiation on the other hand, provides a low energy ionisation with a longer wavelength when applied in medical operations (Barendson et al 1963). This therefore exposes patients to milder effects compared to ionisation radiation. It is therefore imperative that different technologies utilizing ionised and non-ionised radiation be examined. This paper provides a comprehensive insight on the health and safety issues involved in these types of radiation together with the relevant regulatory measures to enhance the safe application of the technologies in the medical operations; four technologies will be exclusively discussed in this paper.

Laser radiations

Laser radiations, known as light amplification by stimulated emission of radiation is a non-ionising type of technology applied in radiology medical operations. This type of non-ionising radiation involves devices that produce the laser beam, taken from the output aperture of the laser device back through the device to the point it connects to the services. Laser devices beam delivery utilized different mediums like air, fibre optic cable, through a beam tube or a combination of the three (Kleiman et al 2012). Mirrors and lenses are types of optic devices that are part and parcel of laser radiations.

The laser process combines the reflection, transmission and absorption of the beam and during operations, one of these steps often dominates. There are numerous health and safety issues with the application of laser radiations in medical operations. Medium and high power lasers can however cause significant health and safety effects on the health practitioner and the patients as well as the physician in charge of the repair and maintenance of the equipment due to failure to comply with the regulation 35 of the ionising radiation regulations 2017 (HSE 2018). Thermal effects are the predominant side effects of long exposure to high powered lasers. These devices have the potential to burn the eyes and the skin. Infrared lasers are even more hazardous since the body’s protective glare aversion response is only triggered by the visible light (Hendry et al 2012). Therefore, infrared light from the lasers can penetrate the eye without any detection by the eye exposing it to the effects of the light.

The other effect of laser radiation is the damage on the biological tissues. In medical operations for instance, cancer patients, the biological tissues are exposed to laser radiations and the high light from the devices may burn the tissues of the body as a result of non-compliance with section 4 of the CEMFAW regulation 2016. Photochemical damage is also possible with laser devices where the light from these devices may trigger chemical reactions of the body tissues (Kleiman et al 2012). This commonly occurs with short-wavelength lasers and can be accumulated over the course of hours.

Regulations aimed at enhancing the health and safety of laser devices in medical operations have been recommended and detailed in the control of electromagnetic field at work (CEMFAW) regulation 12, 2016 (HSE 2016). These regulatory measures serve as a guideline to the patients, medical practitioners and the engineers maintaining the devices to enhance their safety and minimize the side effects that may accompany the use of laser devices. A number of these regulations are disused herein.

The requirements of the facilities using laser devices (class 3 and class 4) to register with the quality commission is aimed at ensuring that the facility will comply with all the quality recommendations and standards of practice to ensure reduced harm to both the medical practitioners and the patients (Huda and Vance 2001). With this registration, medical practitioners will be obliged to wear appropriate protective equipment and expose the patients to the recommended duration and within the recommended range of light as supported by the CEMFAW regulation 12, 2016 (HSE 2016). This will in turn minimise the burns and damages to the skin of the patients.

The national minimum standards or regulations to medical facilities intending to use lasers in medical operations demands that such facilities develop local policy guidelines to guide all the users on the operation of equipment in a manner that enhances the safety and is not detrimental to their health and that of the patients involved in the procedures as emphasized in the CEMFAW regulations 2016 (HSE 2016). The local procedures capture the possible hazards of the devices, the recommendations on the use of Personal protective equipment and the personnel allowed in operating the equipment as well as the area where the laser devices will be used (Hendry 2012).

Radiofrequency and microwave frequencies

Radiofrequency radiation is applied in medical operations and is a non-ionising electromagnetic energy characterized by long wavelength, low frequency and low photon energy. The frequency of Radiofrequency radiation is expressed in Hertz (Wakano and Iwasa 2013). Microwave frequency is a subset of radiofrequency and is expressed in megahertz. The quantification of the frequency determines the level of radiofrequency applied to the patient. Just like other medical operations, there are potential health effects associated with radiofrequency operations and are discussed herein.

The degree of the health effects associated with the radiofrequencies relies on a number of reasons such as intensity of the fields, the duration of exposure and the distance from the source. In the course of using radiofrequency, the energy is absorbed within the body and might cause heating of the body tissues and thus prolonged exposure to the devices may cause increase in body temperature of the patients.

Localized heating or the hot- spots focused by the radiofrequency devices might result in the heating and burning of the body tissues focused by the light as a result of breach in the section 5 of the CEMFAW regulations 2016. Hot spots can emerge in different circumstances such as reflection and refraction of Radiofrequency fields in the body, and interaction between the radiofrequency fields with the metallic implants (Huda and Vance 2001).

Since the application of radiofrequency devices in the medical operations is indispensable, there are safety and healthy precautions that can be adhered to minimize the effects associated with the radiofrequency devices. Exposure controls are the main measures aimed at reducing the exposure of the radiofrequencies to the users in the medical settings. This is achieved through engineering controls and training on the use of the devices as detailed in the CEMFAW regulations 2016 (HSE 2016). Engineering controls provide recommendations on the actions that can be taken to ensure the devices are adjusted according to the required standards decreasing the harm that could accrue from the use of the devices (Kleiman et al 2012). In this case, careful configuration of the devices by ensuring that physical barriers are fitted limiting the eliminating and limiting the exposure of the body to high frequencies from these devices. This is achieved through measures such as shielding, grounding, interlocks and remote operation.

Other regulatory measures include appropriate training and ensuring that only trained personnel are allowed to operate the devices as well as wearing protective clothing when working on the radiofrequency machines as envisioned in the CEMFAW regulations 2016 (HSE 2016). Hazard signs should be fitted appropriately on the equipment and the users should effectively decode the signs when operating the devices in order to minimize the risk of exposure to the health hazards associated with radiofrequency devices (HSE 2018).

Electromagnetic waves

Electromagnetic radiation is a form of ionized radiation which refers to the waves of electromagnetic field travelling through space and carrying electromagnetic field. Electromagnetic radiation includes x-rays, gamma rays, and ultraviolet and the use of this medium for identification and diagnosis of different medical complications like cancer are popularly being used in the medical practice (Barendson et al 1963). This therefore means that the effects of electromagnetic radiation need to be understood. By application, electromagnetic radiation works by beaming lights on the atoms causing them to be charged and full of energy which is then transferred from one atom to the other.

The side effects associated with the electromagnetic field include headaches, and nausea on the patients as a result of the destabilization of the normal body functioning due to introduction of foreign charge inside the body. Continuous exposure to the electromagnetic fields may also cause damage to the body tissues since the rays from the devices have significant effect on the body tissues and parts like the eye due to breach in the regulation 9 of the ionising radiation regulation 2017 (HSE 2018). Therefore, medical practitioners who constantly operate the devices with electromagnetic waves may experience instances of diminished visibility due to the exposure to the eyes.

Regulatory measures to enhance the safety and guarantee the health of persons working with electromagnetic devices are quite similar within the radiation regulation field (HSE 2018). The devices should bear detailed precautionary information and hazard labels explaining the potential health and safety risk the devices pose on the operators in accordance with regulation 9 of ionising radiation regulations 2017 (HSE 2018). This helps to inform the users of the potential risks associated with the machines and remind them of taking necessary precautionary measures when operating the devices (Kleiman et al 2012).

Local procedures on the operation of the machines would be developed and clearly communicated to the staff in the medical facility as per regulation 9 (2) of ionising radiation regulation 2017 (HSE 2018). In fact, it would be quite prudent for the administration to ensure full adherence to the regulations and train the staff accordingly. This is aimed at reducing the cases of incidents and accidents that could have detrimental effects on the safety of the medical practitioners and the staff.

It is imperative that the personnel operating the devices to follow appropriate personal protective requirements as demanded for the operation of different devices as per regulation 9 (1) (98) and regulation 10 of ionising radiation regulations 2017 (HSE 2018). This is notwithstanding the observation of the exposure time accorded to patients and ensuring that it adheres to the recommended timeframe of exposure to the electromagnetic waves. This aims at ensuring better treatment is accorded to the patients at a limited exposure time

Radiation particles

Ionizing radiation is also achieved through use of radiation particles such as alpha, beta, and neutron particles. In this type of radiation, the respective particles are emitted from the nucleus of an atom and used to transfer energy from one atom to the other (Henry 2012). Like other radioactive methods, ionized radiation particles present significant health impacts such as damage of the skin and when exposed for a long period of time may cause complications like sterility, organ saturation and chelation occasioning from failure to adhere to article 98 under regulation 9 (1) of the ionising radiation regulation 2017 (HSE 2018).

Safety measures and regulations have been developed in order to minimize these side effects and should be pursuant to regulations 8, 9, and 10 of ionising radiation regulations 2017 (HSE 2018). Restrictions on the exposure time have been detailed to ensure that patients are exposed to these devices within the safety recommendations and shortest time possible to limit the exposure time and the infusion of the effects of the devices (Huda and Vance 2001). This is detailed in the instructions to safely operate the devices with recommendations on the appropriate safety measures taken when working or servicing the equipment

Conclusion

Radiation technology is a promising invention in healthcare due to the ability to diagnose some of the chronic medical complications like cancer. However, the devices for both ionised and non-ionised radiation technology present numerous side effects which can be harmful to the body and cause serious complications. In a bid to manage the condition and maximize the safe use of the machines, regulations have provided standard guidelines on the safe use of the machines and they have been extensively discussed in this essay.

Reference list:

• Barendson GW, Walter HM, Fowler JF, Bewly DK, 1963. Effects of different ionizing radiations on human cells in tissuecultures.Radiat. Res.; 18:106–119.
• Barendson GW. 1968. Responses of cultured cells, tumours, and normal tissues to radiations of different linear energy transfer. Radiat. Res; 4:293–356
• Hendry JH. 2012. Radiation biology and radiation protection.Am. IRCP. 41(3-4):64–71.
• HSE (2016): Electromagnetic fields at work; a guide to control of electromagnetic fields at work regulation 2016; HSG UK.
• HSE (2018): work with ionising radiation; ionising radiation regulations 2017, approved code of practice and guidance, HSE UK.
• Huda W, Vance A. 2001. Patient radiation doses from adult and paediatric CT. American Journal of Roentgenology; 176:303–306.
• Kleiman NJ, Macvittie TJ, Aleman BM, Edgar AB, Mabuchi K, Murihead CR, Shore RE, Wallace WH, 2012. ICRP publication 118: ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs: Thresholddoses for tissue reactions in a radiation protection context.Am. IRCP. 41(1-2):1–322.
• Wakano JY, Iwasa Y. 2013. Evolutionary branching in a finite population: Deterministic branching vs stochastic branching. Genetics.;193(1):229–241.