The National Council of Radiation Protection and Measurements Report No. 49, originally issued on September 15, 1976, has been the primary design guide for diagnostic x-ray structural shielding in the United States. To further protect the public from various areas of medical radiation exposure, NCRP issued Report 116 in 1987 to decrease the public exposure limits. These new limits used in conjunction with NCRP 49 to determine shielding requirements for diagnostic radiological rooms can be shown to over-shield based on current technologies and protocols. This paper explores the NCRP conservative assumptions that physicists specifying barrier requirements for diagnostic x-ray facilities normally utilize. These evaluated assumptions, which are incorporated in the methodology and attenuation data presented in NCRP Report 49 formulas, include relatively high single kVp's, a "one size fits all" workload default, and the lack of attenuation factors by the patient, the wall, and the film. In essence, an analysis of the conservative nature of NCRP 49 is demonstrated. An example of Primary and Secondary Shielding Methodology utilizing NCRP 49 and NCRP 116 dose limits is provided as well as the cost factors associated with the results. These examples are further evaluated using a Monte Carlo software program. In addition, an analysis of actual current radiographic conditions in an imaging room is performed. This is done to determine first, the actual mA utilized for specific exams; secondly, the actual mA-min weekly workload; and thirdly, the tangible exams performed per week in small and large medical facilities. Based on the information and analysis presented, this paper concludes that the formulas for NCRP 49 and NCRP 116 need to be reexamined. Furthermore, this paper also demonstrates once again that NCRP 49, utilizing NCRP 116 dose limits is extremely conservative. / Graduation date: 2004

This study discusses reject film analyses (RFAs) before and after the implementation of a quality improvement intervention. RFAs were undertaken to investigate the effect of the introduction and use of exposure charts (ECs) on department and student reject rates of extremity radiographs. Methods: A quantitative comparative pre and post-treatment research design was used. Data was collected from the x-ray departments of two training hospitals in Windhoek, Namibia over a five month period. A retrospective RFA was conducted to determine the department and student reject rates for both departments before intervention. Emphasis was placed on exposure related reject films. ECs were compiled and introduced at Katutura State Hospital (venue B) by the researcher. The students were instructed to use these charts. At Windhoek Central Hospital (venue A) no ECs were used. A prospective RFA was conducted to establish department and student reject rates at both hospitals after the intervention at venue B. Results: During the retrospective phase the department reject rate for venue A was 21 percent while the student reject rate was 23 percent. At venue B 24 percent and 26 percent were scored respectively. Students at venue A produced rejected radiographs due to overexposure (49 percent) and underexposure (23 percent), whilst 37 percent was recorded for both causes at venue B. At venue A, 35 percent of films were rejected due to incorrect mAs selection, at venue B the figure was 42 percent. Undiagnostic radiographs due to inaccurate kV selection comprised 62 percent for venue A and 59 percent for venue B. During the prospective phase the department reject rate for venue A was 20 percent and that of the students was 19 percent. For venue B 12 percent and 11 percent were scored respectively. At venue A radiographs rejected due to over and underexposure were 43 percent and 33 percent respectively while those at venue B were 33 percent and 34 percent. Incorrect mAs selection caused 33 percent of discarded films at venue A and 38 percent at venue B. The figures for inaccurate kV selection were 68 percent and 62 percent for venues A and B. Conclusions: The introduction and use of ECs lowered the student reject rate at venue B in the prospective phase.

Radiation from Computed Tomography (CT) is now the major contributor to population radiation dose. Despite controversy around the dose-effect relationship of radiation from CT, the linear non-threshold (LNT) theory is endorsed by many authorities, and constitutes the basis of cancer risk estimates. The purpose of this study was (1) a literature review of radiobiological theories, and methods of dose saving stategies in CT; (2) to highlight the importance of dose saving in CT, and to demonstrate how dose can be saved in a radiology department: Following a 40% reduction in reference X-ray tube current for a CT of the urinary tract, the effecitve dose and estimated lifetime attributable risk of incident cancer due to this CT in a group (n=103) were reduced by 37% and 38% in an age and sex-matched group respectively. The literature review showed that the public health implications of CT radiation exposure remain uncertain. / Health Studies / M.A. (Public Health)

Radiation from Computed Tomography (CT) is now the major contributor to population radiation dose. Despite controversy around the dose-effect relationship of radiation from CT, the linear non-threshold (LNT) theory is endorsed by many authorities, and constitutes the basis of cancer risk estimates. The purpose of this study was (1) a literature review of radiobiological theories, and methods of dose saving stategies in CT; (2) to highlight the importance of dose saving in CT, and to demonstrate how dose can be saved in a radiology department: Following a 40% reduction in reference X-ray tube current for a CT of the urinary tract, the effecitve dose and estimated lifetime attributable risk of incident cancer due to this CT in a group (n=103) were reduced by 37% and 38% in an age and sex-matched group respectively. The literature review showed that the public health implications of CT radiation exposure remain uncertain. / Health Studies / M.A. (Public Health)