Occupational Health Management Plan

This article discusses the risks of ionizing radiation in the radiography department and the need for an occupational health management plan to reduce harm. It covers the sources of radiation, exposure to ionizing radiation, the risks associated with it, and the management plan to reduce harm. The article also includes ethical and legal considerations, as well as the desired outcomes of the management plan.

RUNNING HEAD: OCCUPATIONAL HEALTH MANAGEMENT PLAN 1
Occupational Health Management Plan
Name:
Institution:
Tutor:
Date:

OCCUPATIONAL HEALTH MANAGEMENT PLAN 2
OCCUPATIONAL HEALTH MANAGEMENT PLAN
INTRODUCTION
In the clinical set up especially the radiography department, there are risks associated
with ionization radiations. The risks of these radiations are severe since they are associated with
different types of malignancies .Ionizing radiation can basically be defined as a form of energy
whose source is different atom sand it moves from one place to another as electromagnetic
waves which take the form of either gamma or x-rays or particles otherwise the neutrons, beta
and alpha. Radioactivity is the process whereby different atoms disintegrate spontaneously and
the excess energy from this process is released as ionizing radiation. Radionuclides are the
unstable elements that break down to release the ionizing radiation. Radionuclides are basically
identified through three criteria which include the type of radiation they emit, the energy of the
radiation and finally their half-life.
Activity is the term used to express the quantity of a radionuclide present and it is
expressed as Becquerel (Mothersill et al., 2018). Half-life on the other hand is the time needed
for the radionuclide to disintegrate half to its original value. Half-life can range from either a
fraction up to million years.
Ionizing radiation are used in hospitals on a daily basis to perform x-rays on the human
body. Despite having medical benefits, they are harmful or can be defined as occupational
hazards (Kraft & Howells, 2017). This therefore calls for a management plan to reduce its harm
to the human body. Some of the management plans include shielding, dosimeter, signage as well
labelling.

OCCUPATIONAL HEALTH MANAGEMENT PLAN 3
PHYSICAL DESCRIPTION OF THE WORKPLACE
The workplace in this case is a hospital in the department of radiography. Hospitals have
different departments, one of them is the department of radiography. The core function or rather
role of this department is to carry out x-rays and fluoroscopy on patients to diagnose deformities
inside the human body .This is achieved by the use of different medical appliances. This
workplace is prone to the ionization radiation hazard. There are usually around eight workers at
the radiography department with five men and three women.
SOURCES OF THE RADIATION HAZARD AT THE WORKPLACE
There are two types of ionization sources. The human and the natural sources. The
natural sources include exposure to different radioactive materials that can be found in the soil,
water as well as air .It basically happens as a result of exposure to more than 60 naturally
occurring radioactive substances. The most common radioactive substance is Radon whose
source is the rocks and soil and individuals ingest this elements from air and food or even water.
Besides inhalation and ingestion, the other natural way is through exposure from the
cosmic rays especially those people who are located at high altitude localities (Corbett, 2013).
According to studies, approximately 80% of the dose an individual receives is as a result of the
cosmic sources.
Human sources or exposure on the other hand is as a result of human made appliances
such as the nuclear power plants to those diagnostic appliances that are used in the hospitals.
This is now the center of interest in this case since the workplace in question is the Hospital
environment. According to recent studies, the leading source of human made sources of the
ionizing radiations are the medical appliances such as the X-ray machines.

OCCUPATIONAL HEALTH MANAGEMENT PLAN 4
EXPOSURE TO IONIZING RADIATIONS
At the hospital, exposure to ionization radiations can either be internal or external.
Internal exposure takes place when the radionuclide goes into the bloodstream and this can be
either be through injection or through wounds (Hricak & Dauer, 2017). Internal exposure
however cease when the radionuclide is expelled from the body either by excreta or through
treatment as well.
External exposure on the other hand takes place when radionuclides are either deposited
on the skin or clothes. The radionuclides in this case however can be eliminated through washing
(Dauer et al., 2015). In this case at the hospital, exposure to the ionization radiations is due to
irradiation from different external sources like the medical radiation exposure from the X-rays
(Burns, Taragin, & Markowitz, 2017). External irradiation however cease through shielding the
source of the radiation or when someone moves out of the focus of the radiation field.
People get exposed to ionization radiation under different conditions such as home,
public places or workplace like in this case the medical setting where patients, caregivers and
volunteers are exposed. Currently, there are three exposure situations to ionizing radiations:
planned exposure situations, existing exposures and finally the emergency exposure situations
(Akahane et al., 2015). Emergency exposure occurs due to unexpected situation that need quick
response like nuclear accidents as well as malicious acts (Paolicchi et al., 2016).Planned
exposure is the deliberate introduction of the ionization radiations to achieve particular
objectives (Bärenfänger, Rohde, & Block, 2017). One such exposure is treatment and this holds

OCCUPATIONAL HEALTH MANAGEMENT PLAN 5
for this case. Existing exposure on the other hand refers to already existing exposure but now
there is need for control.
Of all the artificial sources of radiations, medical use accounts for a junk of the
population dose currently at 80% and this further represents 20% of the whole population
exposure ("NCRP 52nd Annual Meeting, Meeting The Needs of the Nation for Radiation
Protection," 2017). According to studies, it is estimated that in excess of 3600 million diagnostic
radiology examinations are carried out.
THE RISKS OF IONIZING RADIATIONS
The effects of radiation are numerous. Radiation results to damage of tissues and this
depends on the dose rate. The amount of radiation absorbed is expressed as gray (Gy).The extent
of damage however depends on the nature of radiation and the sensitivity nature of tissues and
organs (Kroger, 2015). Effective dose is the qualitative estimation of the ionizing radiations and
the potential to cause damage. This is measured by a unit known as the Sievert.
Exposure to radiations beyond certain thresholds results impairment in the functioning of
tissues and organs and the end results might be acute effects like reddening of the skin, loss of
hair, burns and finally the acute radiation syndrome (Xu, 2014). A t higher doses however, the

OCCUPATIONAL HEALTH MANAGEMENT PLAN 6
effects become more severe. If the dose rate is low and delivered for a long time over an
extended period of time, the risks are reduced since there is greater chance of repairing the
damage over time. However, the risk of long term effects like cancer can happen years or
decades later. However, the chance of this effects occurring is minimal and their occurrences is
directly proportional to the dose rate. The risks are however high in children and adolescents
since their cells are actively dividing and due to the fact that their bodies are highly sensitive to
radiations as opposed to adults.
According to epidemiological research like the atomic bomb survivors, it was found out
that doses above 100mSv are likely to cause cancer. However, the same study did find out that
exposure during infancy or childhood is likely to cause cancer with exposures to dose rate
between 50-100mSv (M’Garrech & Ncib, 2009).Incase a pregnant woman is exposed to
radiations, brain damage is likely to develop in the fetus as long as the dose is above
100mSv.This is likely to happen between the 8-15 weeks of pregnancy as well as a dose rate of
200mSv between weeks 16-25.Prior to week 8 of pregnancy however, studies have shown no
significant risks associated with radiations.
NEED FOR CHANGE
Since time immemorial, many people including the patients and workers at the
department have been exposed to ionizing radiation with the risk of developing cancer. This
therefore necessitates change which should reduce the harm of the ionizing radiations.

OCCUPATIONAL HEALTH MANAGEMENT PLAN 7
MANAGEMENT PLAN
The management plan to reduce the effects of radiations in the X-rays departments
include setting up clear guidelines on the disposal of radioactive substances, signage, labelling,
shielding and security concerning radioactive substances and dosimetry.
IMPLEMENTATION
Personal dosimetry is one of the management plan that should be implemented at the
radiography department in the hospital. This is through ensuring that all users of the radiation
wear a dosimeter.
An example of a simple dosimeter
A dosimeter is simply a badge that is used to indicate the dose rate of the radiation. This
is a good management plan since it will indicate the dose rate when it exceeds the threshold and
will enable the concerned individual to take the necessary step to avoid harm. Another
management is shielding. Shielding is simply protecting or barring radiations from going into the

OCCUPATIONAL HEALTH MANAGEMENT PLAN 8
body. This can be implemented by the use of lead wears since lead does not allow radiations to
go through it. Another effective management plan is the security of the room with radiation
appliances. The place should have total security. This is implemented by restricting unauthorized
access to the room and only allow designated staff who have protected themselves go in the
room. This will reduce on the emergency exposure of radiations to different people. The use of
signage is another good management plan to reduce the potential harm of radiations. This can be
implemented through including the word HAZARD to the entrance of the radiation room so that
anyone entering the room is adequately prepared before they go inside.
MONITORING AND EVALUATION
The management plan will be monitored and evaluated by estimating the extent of the
harm caused by the radiations such as cancer. With time, the incidences of cancer and damage to
the brains of the fetus inpatients and workers exposed to radiations should reduce considerably.
This might however take time since the effects of radiation are not instant. They take some time
to be felt. This management plan therefore needs a long timeframe to be effectively evaluated.
LEGAL REQUIREMENTS
According to the law, each one has a right to be protected from any form of harm. Based
on this case of radiation, each worker should therefore be protected from potential damage of the
radiations. The objectives of this management therefore are in line with the requirements of the
law.
DESIRED OUTCOMES
The objective of the management plan is to reduce the harm or effects associated with
radiations. The desired outcomes in this management is to minimize the dose rate that is

OCCUPATIONAL HEALTH MANAGEMENT PLAN 9
subjected to the radiography workers so as to reduce the risks of cancer and brain damage to the
fetus. It is my desire that this outcome is attained within the shortest time possible.
ETHICAL CONSIDERATION
Since this a medical management plan, ethical dilemmas are likely to occur. One such
ethical dilemma is whether to avoid exposing radiations to pregnant women or not. Apparently,
the protocol of radiation bar pregnant women from being exposed to radiations as this may affect
the brain of the fetus.It is the sole decision of the patient however to choose whatever they deem
suitable to them and this is called the principle of autonomy. This management plan will
therefore take into account this principle by ensuring there is balance between autonomy and
non-maleficence.
NECESSITY FOR CHANGE
In the past years, the management of radiations basically did focus only on the reduction
in the time of exposure. This therefore necessitates the need for change to focus on other
management options such as shielding, signage, the use of dosimeter and finally security.
CONCLUSION
Since workers are likely to be exposed to hazards while at their workplaces, there is need
to have a management plan to reduce on the likelihood of such harm. Such risky environment
include the X-ray department in the hospital whereby exposure to radiations can lead of risks
such as development of cancer or brain damage in the fetus. Management plan is simply a
strategy that can be put in place to reduce potential harm to the workers. Example of
management plan in X-rays department include the implementation of the dosimeter, signage,
dietary management, shielding, labelling and disposal of radioactive substances. The

OCCUPATIONAL HEALTH MANAGEMENT PLAN 10
management plan needs ethical and legal considerations before they are implemented. The
ethical consideration includes the chances of the plan going against the patients wish while the
legal requirements dictates that the plan should be implemented within the jurisdiction of the
constitution or the law. Every workplace where there is potential harm should therefore consider
setting up management plans to bar the workers from the harmful effects of different hazards.

OCCUPATIONAL HEALTH MANAGEMENT PLAN 11
References
Akahane, K., iimoto, T., Ichiji, T.,iwai, S.,ohguchi, H.,ohno, K., … Yokohama, S. (2015).
Interim Report of the JHPS Expert Committee on Radiation Protection of the Lens of
the Eye (VI). Japanese Journal of Health Physics, 50(2), 128-137.
doi:10.5453/jhps.50.128
Burns, K., Taragin, B., & Markowitz, M. (2017). Presence of lead on the external surface of
lenses in radiation protection eyewear. Journal of Vascular and Interventional
Radiology, 28(2), S22-S23. doi:10.1016/j.jvir.2016.12.634
Bärenfänger, F., Rohde, S., & Block, A. (2017). Poster session 28: Dosimetry, radiation
protection and radiation biology IV. Biomedical Engineering / Biomedizinische
Technik, 62(s1). doi:10.1515/bmt-2017-5073
Corbett, R. H. (2013). International Conference on Radiation Protection in Medicine: Setting
the scene for the next decade. Journal of Radiological Protection, 33(1), 251-255.
doi:10.1088/0952-4746/33/1/m02
Dauer, L. T., Miller, D. L., Schueler, B., Silberzweig, J., Balter, S., Bartal, G., … Nikolic, B.
(2015). Occupational Radiation Protection of Pregnant or Potentially Pregnant
Workers in IR: A Joint Guideline of the Society of Interventional Radiology and the
Cardiovascular and Interventional Radiological Society of Europe. Journal of
Vascular and Interventional Radiology, 26(2), 171-181.
doi:10.1016/j.jvir.2014.11.026
Hricak, H., & Dauer, L. T. (2017). Radiation Brain Drain? The Impact of Demographic
Change on U.S. Radiation Protection. Health Physics, 112(2), 126-130.
doi:10.1097/hp.0000000000000602

OCCUPATIONAL HEALTH MANAGEMENT PLAN 12
Kraft, J. K., & Howells, P. (2017). Ionizing radiation and radiation protection. Oxford
Medicine Online. doi:10.1093/med/9780199659579.003.0131
Kroger, L. (2015). MO-AB-201-00: Radiation Safety Officer Update. Medical Physics,
42(6Part27), 3550-3550. doi:10.1118/1.4925286
Mothersill, C., Abend, M., Bréchignac, F., Iliakis, G., Impens, N., Kadhim, M., …
Schofield, P. N. (2018). When a duck is not a duck; a new interdisciplinary synthesis
for environmental radiation protection. Environmental Research, 162, 318-324.
doi:10.1016/j.envres.2018.01.022
M’Garrech, S., & Ncib, F. (2009). Colorimetric study of effect of gamma-radiation on the
color of cotton fabric colored by “henna” dye. Applied Radiation and Isotopes,
67(11), 2003-2006. doi:10.1016/j.apradiso.2009.07.017
NCRP 52nd Annual Meeting, Meeting The Needs of the Nation for Radiation Protection.
(2017). Health Physics, 112(2), 182-190. doi:10.1097/hp.0000000000000625
Paolicchi, F., Miniati, F., Bastiani, L., Faggioni, L., Ciaramella, A., Creonti, I., …
Caramella, D. (2016). Erratum to: Assessment of radiation protection awareness and
knowledge about radiological examination doses among Italian radiographers.
Insights into Imaging, 7(2), 243-244. doi:10.1007/s13244-015-0458-1
Xu, X. G. (2014). An exponential growth of computational phantom research in radiation
protection, imaging, and radiotherapy: a review of the fifty-year history. Physics in
Medicine and Biology, 59(18), R233-R302. doi:10.1088/0031-9155/59/18/r233

OCCUPATIONAL HEALTH MANAGEMENT PLAN 13