Louisiana Administrative Code
Title 33 - ENVIRONMENTAL QUALITY
Part XV - Radiation Protection
Chapter 6 - X-Rays in the Healing Arts
Section XV-699 - Appendices A, B, C, and D

Universal Citation: LA Admin Code XV-699

Current through Register Vol. 50, No. 3, March 20, 2024

Appendix A

Information on Radiation Shielding Required for Plan Reviews

In order for the department to provide an evaluation, technical advice, and official approval of shielding requirements for a radiation installation, the following information shall be submitted.

A. The plans should show, as a minimum, the following.

1. The normal location of the X-ray system's radiation producing equipment's radiation port, the port's travel and traverse limits, general direction(s) of the useful beam, locations of any windows and doors, the location of the operator's booth, and the location of the X-ray control panel.

2. The structural composition and thickness or lead equivalent of all walls, doors, partitions, floor, and ceiling of the room(s) concerned.

3. The dimensions of the room(s) concerned.

4. The type of occupancy of all adjacent areas inclusive of space above and below the room(s) concerned. If there is an exterior wall, show distance to the closest area(s) where it is likely that individuals may be present.

5. The make and model of the X-ray equipment and the maximum technique factors.

6. The type of examination(s) or treatment(s) that will be performed with the equipment.

B. Information on the anticipated workload of the X-ray system(s) shall be submitted with the plans.

C. If the services of a qualified expert have been utilized to determine the shielding requirements, a report, including all basic assumptions used, shall be submitted with the plans.

Appendix B

Design Requirements for an Operator's Booth

A. Space Requirements. The operator shall be allotted not less than 7.5 square feet (0.697 m2) of unobstructed floor space in the booth.

1. The operator's booth may be any geometric configuration with no dimension of less than 2 feet (0.61 m).

2. The space shall be allotted excluding any encumbrance by the X-ray control panel, such as overhang, cables, or other similar encroachments.

3. The booth shall be located or constructed such that unattenuated direct scatter radiation originating on the examination table or at the wall cassette does not reach the operator's station in the booth.

B. Structural Requirements. The booth walls shall be permanently fixed barriers of at least 7 feet (2.13 m) high.

1. When a door or movable panel is used as an integral part of the booth structure, it shall have an interlock that will prevent an exposure when the door or panel is not closed.

2. Shielding shall be provided to meet the requirements of LAC 33:XV.Chapter 4.

C. X-Ray Control Placement. The X-ray control for the system shall be fixed within the booth and:

1. shall be at least 40 inches (1.02 m) from any open edge of the booth wall that is nearest to the examining table; and

2. shall allow the operator to use the majority of the available viewing windows.

D. Viewing System Requirements

1. Each booth shall have at least one viewing device that will be so placed that:
a. the operator can view the patient during any exposure; and

b. the operator can have full view of any occupant of the room, and the operator can view any entry into the room. If any door that allows access to the room cannot be seen from the booth, then that door shall have an interlock controlling the exposure that will prevent the exposure if the door is not closed.

2. When the viewing system is a window, the following requirements also apply:
a. the viewing area shall be at least 1 square foot (0.0929 m2);

b. the design of the booth shall be such that the operator's expected position when viewing the patient and operating the X-ray system is at least 18 inches (0.457 meter) from the edge of the booth; and

c. the material constituting the window shall have the same lead equivalence as that required in the booth's wall in which it is mounted.

3. When the viewing system is by mirrors, the mirror(s) shall be so located as to accomplish the general requirements in Paragraph C.1 of this Appendix.

4. When the viewing system is by electronic means:
a. the camera shall be so located as to accomplish the general requirements of Paragraph C.1 of this Appendix; and

b. there shall be an alternate viewing system as a backup for the primary system.

Appendix C

Information to be Submitted by Persons Proposing to Conduct Healing Arts Screening

Persons requesting that the department approve a healing arts screening program shall submit the following information for evaluation and approval.

A. Name and address of the applicant and, where applicable, the names and addresses of agents within Louisiana.

B. Diseases or conditions for which the X-ray examinations are to be used in diagnoses.

C. A detailed description of the X-ray examinations proposed in the screening program, i.e., type and number of views.

D. Description of the population to be examined in the screening program, i.e., age range, sex, physical condition, and other appropriate information.

E. An evaluation of any known alternate methods not involving ionizing radiation that could achieve the goals of the screening program and why these methods are not used instead of the X-ray examinations.

F. An evaluation by a qualified expert of the X-ray system(s) to be used in the screening program. The evaluation by the qualified expert shall show that such system(s) do satisfy all requirements of LAC 33:XV.

G. A description of the X-ray quality control program.

H. A copy of the protocol information for the X-ray examination procedures to be used.

I. The qualifications of each individual who will be operating the X-ray system(s).

J. The qualifications of each individual who will be supervising the operator(s) of the X-ray system(s). The extent of supervision and the method of work performance evaluation shall be specified.

K. The name and address of the practitioner licensed in Louisiana who will interpret the radiograph(s).

L. Procedures to be used in advising the individuals screened and their practitioner of the healing arts or health care provider of the results of the screening procedure and any further medical needs indicated.

M. Procedures for the retention or disposition of the radiograph(s) and other records pertaining to the X-ray examination(s).

N. The name and address of the responsible party and service agent in the event legal charges or allegations arise as a result of the X-ray screening.

O. In the event the applicant is a foreign corporation, documents shall be submitted to demonstrate that the applicant has complied with Louisiana laws regarding domestication of that corporation.

P. Any other information requested by the department that may be necessary to evaluate the justification or possible effects of an X-ray screening proposal.

Q. Frequency of screening of individuals.

R. The duration of the screening program.

Appendix D

A. Each installation using a radiographic X-ray system and using analog image receptors (radiographic film) shall have available suitable equipment for handling and processing radiographic film in accordance with the following provisions:

1. manually developed film:
a. processing tanks for manually developed film shall be constructed of mechanically rigid, corrosion resistant material;

b. the temperature of solutions in the tanks for manually developed film shall be maintained within the range of 60°-80°F (16°-27°C). Film shall be developed in accordance with the time-temperature relationships recommended by the film manufacturer or, in the absence of such recommendations, with the following time-temperature chart.

Time-Temperature Chart

Thermometer Reading (Degrees)

Minimum Developing Time (Minutes)

°C

°F

26.7

80

2

26.1

79

2

25.6

78

2 1/2

25.0

77

2 1/2

24.4

76

3

23.9

75

3

23.3

74

3 1/2

22.8

73

3 1/2

22.2

72

4

21.7

71

4

21.1

70

4 1/2

20.6

69

4 1/2

20.0

68

5

19.4

67

5 1/2

18.9

66

5 1/2

18.3

65

6

17.8

64

6 1/2

17.2

63

7

16.7

62

8

16.1

61

8 1/2

15.6

60

9 1/2

c. devices shall be utilized for manually developed film that will:
i. indicate the actual temperature of the developer; and

ii. signal the passage of a preset time appropriate to the developing time required;

2. automatic processors and other closed processing systems:
a. films shall be developed by automatic processors and other closed processing systems in accordance with the time-temperature relationships recommended by the film manufacturer; in the absence of such recommendations, the film shall be developed using the following chart.

Developer Temperature

Minimum Immersion Time*

°C

°F

Seconds

35.5

96

19

35

95

20

34.5

94

21

34

93

22

33.5

92

23

33

91

24

32

90

25

31.5

89

26

31

88

27

30.5

87

28

30

86

29

29.5

85

30

*Immersion time only, no crossover time included.

b. the specified developer temperature and immersion time shall be posted in the darkroom or on the automatic processor in a manner that provides sufficient and legible notice to persons present in these areas;

3. other requirements:
a. pass boxes, if provided, shall be so constructed as to exclude light from the darkroom when cassettes are placed in or removed from the boxes, and shall incorporate adequate shielding from stray radiation to prevent exposure of undeveloped film;

b. the darkroom shall be light tight and use proper safe lighting such that any film type in use exposed in a cassette to X-radiation sufficient to produce an optical density from one to two when processed shall not suffer an increase in density greater than 0.1 (0.05 for mammography) when exposed in the darkroom for two minutes with all safelights on. If used, daylight film handling boxes shall preclude fogging of the film;

c. darkrooms typically used by more than one individual shall be provided a positive method to prevent accidental entry while undeveloped films are being handled or processed;

d. film shall be stored in a cool, dry place and shall be protected from exposure to stray radiation. Film in open packages shall be stored in a light tight container;

e. film cassettes and intensifying screens shall be inspected periodically and shall be cleaned and replaced as necessary to best assure radiographs of acceptable diagnostic quality;

f. outdated X-ray film shall not be used for human diagnostic radiographs, unless the film has been stored in accordance with the manufacturer's recommendations and a sample of the film passes a sensitometric test for normal ranges of base plus fog and speed; and

g. film developing solutions shall be prepared in accordance with the directions given by the manufacturer of the chemicals, and shall be maintained in strength by replenishment or renewal so that full development of film is accomplished within the time specified by the manufacturer.

AUTHORITY NOTE: Promulgated in accordance with R.S. 30:2001 et seq. and 2104.B.

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