TITLE 32: ENERGY
CHAPTER II: ILLINOIS EMERGENCY MANAGEMENT AGENCY
SUBCHAPTER b: RADIATION PROTECTION
PART 360 USE OF X-RAYS IN THE HEALING ARTS INCLUDING MEDICAL, DENTAL, PODIATRY, AND VETERINARY MEDICINE
SECTION 360.30 GENERAL REQUIREMENTS AND ADMINISTRATIVE CONTROLS
Section 360.30 General Requirements and Administrative Controls
The requirements in this Section apply to all uses of x-rays in veterinary medicine and to all uses of x-rays in the healing arts including the use of x-rays for both diagnostic and therapeutic purposes. Additional requirements for all diagnostic x-ray systems are in Section 360.40 and specific equipment application classes are contained in Sections 360.41 through 360.100. For therapeutic x-ray systems also see Sections 360.110 and 360.120.
a) Registrant. The registrant shall:
1) Direct the operation of the x-ray systems;
2) Register with the Agency, in accordance with the provisions of 32 Ill. Adm. Code 320, all x-ray equipment which is used at the facility and all portable or mobile x-ray equipment used by the registrant;
3) Verify that each individual required to be accredited by 32 Ill. Adm. Code 401 to apply x-rays for either diagnostic or therapeutic purposes is properly accredited with the Agency prior to allowing the individual to apply medical radiation procedures on human beings;
4) Permit operation of the x-ray systems only by individuals who are licensed in accordance with State law (see Section 360.10(a)), or who are accredited by the Agency pursuant to 32 Ill. Adm. Code 401 or who are exempt from such requirements in accordance with the provisions of 32 Ill. Adm. Code 401.
b) Shielding. Each installation shall be provided with such primary barriers and/or secondary barriers as are necessary to assure compliance with the provisions of 32 Ill. Adm. Code 340.210, 340.270, 340.280 and 340.310.
c) An x-ray system which does not meet the provisions of this Part shall not be operated for diagnostic or therapeutic purposes.
d) If an x-ray system is identified as not being in compliance with the provisions of this Part and if that system is accessible for use, it shall be rendered inoperable (i.e., dismantle the x-ray source from the source support assembly) if so ordered by the Director.
1) Unauthorized Exposure. Individuals shall not be exposed to the useful beam except for healing arts purposes and only when the exposure has been authorized by a licensed practitioner of the healing arts. A physician assistant or an advanced practice nurse may give authorization as long as he or she is acting under the supervision or direction of a licensed physician. This provision specifically prohibits deliberate exposure for the following purposes:
A) Exposure of individuals for training, demonstration or other non-healing arts purposes.
B) Exposure of individuals for the purpose of "healing arts screening" (see Section 360.20).
2) Fluoroscopy shall not be used as a substitute for radiography or in lieu of proper anatomical positioning/centering procedures prior to radiographic studies.
3) Fluoroscopic equipment using phosphorescent screens shall not be used. Image intensification shall be utilized on all fluoroscopic equipment.
4) The use of direct exposure x-ray film (without intensifying screens) for routine diagnostic radiological imaging procedures, other than intraoral dental radiography and therapeutic portal imaging, is prohibited.
AGENCY NOTE: Therapeutic portal imaging is a technique used in radiation therapy to verify correct alignment of therapy beams with the patient's anatomy.
5) The use of photofluorographic systems is prohibited.
6) The use of an individual accredited as a limited diagnostic radiographer by the Agency pursuant to 32 Ill. Adm. Code 401 by a portable x-ray service provider is prohibited.
AGENCY NOTE: Photofluorography is frequently called mass miniature radiography. In this technique the image of a fluorescent screen is recorded on film by means of a camera.
f) Individual Monitoring and Reporting Requirements. All persons who are associated with the operation of an x-ray system are subject to the radiation dose standards, requirements for the determination of the doses, requirements for individual monitoring and requirements for reporting of radiation doses that are contained in 32 Ill. Adm. Code 340.
g) The registrant shall comply with the requirements of the Agency's rules entitled Notices, Instructions and Reports to Workers; Inspections (32 Ill. Adm. Code 400).
h) Records and Associated Information. The registrant shall maintain at the facility, for a period of at least one inspection cycle (see 32 Ill. Adm. Code 320.10(c)), records showing the receipt, transfer, storage and disposal of all sources of radiation in accordance with the provisions of 32 Ill. Adm. Code 310 and 320.
i) Staff Qualifications. The registrant shall maintain at the facility, for review by the Agency, current certificates of accreditation (clear, legible copies are acceptable), issued by the Agency in accordance with the provisions of 32 Ill. Adm. Code 401, for all individuals who are required to be so accredited.
j) Radiation Safety Procedures. The registrant shall provide to each individual who operates x-ray equipment at the facility written operating and safety procedures. These procedures shall include restrictions required for the safe operation of each radiation machine and shall include the topics listed in the radiation safety program of subsection (k).
k) Radiation Safety Program. The registrant shall provide for initial and annual in-service training in radiation safety for individuals (excluding licensed practitioners) that apply ionizing radiation at the facility, to ensure their awareness of the registrant's radiation safety practices and policies. The in-service training shall include the following topics:
1) Operating and emergency procedures for the radiation machines;
2) Use of personnel and patient protective devices;
3) Procedures to minimize patient and occupational doses, including procedures for selecting personnel to support patients or film, as required by Section 360.40;
4) Use of individual monitoring devices (if such devices are used at the facility);
5) Film processing procedures; and
6) Prohibited uses of x-ray machines, as described in subsection (e).
l) Operator Training. Individuals who operate radiation machines shall be instructed in and able to demonstrate competence with the registrant's operating and safety procedures.
(Source: Amended at 38 Ill. Reg. 12031, effective May 29, 2014)