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Pregnant MRTs notify their employers of their pregnancy and take steps to minimize their exposure to radiation |
+ Radiation during pregnancy
- Avoiding unnecessary exposure to the developing fetus or embryo is essential due to the radiosensitivity of rapidly dividing cells.1
- Exposure of the unborn fetus to ionizing radiation increases the risk of somatic effects as well as genetic effects that could be passed to subsequent generations.1
- Federal and provincial regulations exist to address occupational exposure to radiation, and include considerations for pregnant workers.
- MRTs should be familiar with the regulations that apply to their jurisdictions and facility
+ Ionizing radiation dose limits
- An MRT can continue working during pregnancy, but must take measures to keep effective fetal dose below prescribed limits.2
- The whole body effective dose limit for pregnant MRTs (both radiation and nuclear energy workers) in Canada is 4 mSv, from the time that pregnancy is declared until the end of term.1,3
- After an MRT has declared her pregnancy, the effective dose to the surface of the abdomen should not exceed 2 mSv for the remainder of the pregnancy.4
- There are relevant provincial regulations in some jurisdictions, as well.5-10
- Additional radiation monitoring equipment may be provided, depending on the facility.4
- Health Canada recommends dosimeters are monitored closely and checked for radiation doses every 2 weeks.11
- The recommended dose limit applies to the fetal dose and it is not directly comparable to the dose measured on a personal dosimeter.2
- A personal dosimeter may overestimate fetal dose by a factor of 10 or more2
- If the dosimeter has been worn outside a lead apron, the measured dose is likely to be about 100 times higher than the fetal dose2
- In radiation therapy, doses are not likely to exceed 25% of the personal dosimeter measurement2
+ Considerations for radiologic technology
- An MRT who becomes aware that she is pregnant must notify her employer.1
- Personal protective equipment is used.1
- There are no limitations to the performance of diagnostic x-ray procedures, including the use of mobile units.1
- There are no limitations to the performance of interventional procedures including the use of fluoroscopy.1
+ Considerations for nuclear medicine
- An MRT who becomes aware that she is pregnant must notify her employer in writing, as well as the Radiation Safety Officer.3
- Personal protective equipment is used.1
- Performance of procedures that result in high exposure to radiation (e.g., therapeutic procedures, preparation of radiopharmaceuticals) is considered in the context of total fetal dose limit for the pregnancy.
+ Considerations for radiation therapy
- An MRT who becomes aware that she is pregnant must notify her employer.3
- Personal protective equipment is used.1
- Radiation therapists are restricted from handling brachytherapy sources and may be restricted in treating patients on a Cobalt unit.
- Radiation therapists may perform simulations, linear accelerator administered external beam radiation therapy and image guidance.
+ Considerations for magnetic resonance
- An MRT who becomes aware that she is pregnant must notify her employer.
- Pregnant MRI technologists are permitted to work in and around the MRI environment throughout all stages of their pregnancy.12,13
- MRI technologists are advised not to remain in the scanner room during actual data acquisition or scanning.12
+ References
- Health Canada. Safety Code 35: Safety Procedures for the Installation, Use and Control of X-ray Equipment in Large Medical Radiological Facilities. Available at: http://www.hc-sc.gc.ca/ewh-semt/pubs/radiation/safety-code_35-securite/section-a3-eng.php#a3. Accessed March 27, 2013.
- International Atomic Energy Agency. Radiation Protection of Patients. Pregnancy and Radiation Protection in Diagnostic Radiology. Available at: https://rpop.iaea.org/RPOP/RPoP/Content/SpecialGroups/1_PregnantWomen/Pregnancyandradiology.htm. Accessed March 27, 2013.
- Government of Canada. Justice Laws Website. Radiation Protection Regulations (SOR/2000-203). Available at: http://laws.justice.gc.ca/PDF/SOR-2000-203.pdf. Accessed November 25, 2015.
- Health Canada. Safety Code 20A: X-Ray Equipment in Medical Diagnosis Part A: Recommended Safety Procedures for Installation and Use. Available at: http://www.hc-sc.gc.ca/ewh-semt/pubs/radiation/safety-code_20-securite/index-eng.php. Accessed March 27, 2013.
- Health Canada. Environmental and Workplace Health. Dose Limits. Available at: http://www.hc-sc.gc.ca/ewh-semt/occup-travail/radiation/dosim/res-centre/limits-limites-eng.php. Accessed October 4, 2013.
- Government of British Columbia. Workers Compensation Act. Occupational Health and Safety Regulation. Available at: http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/296_97_05. Accessed October 4, 2013.
- Government of Alberta. Radiation Protection Act. Radiation Protection Regulation. Available at: http://www.qp.alberta.ca/1266.cfm?page=2003_182.cfm&leg_type=Regs&isbncln=0779731042. Accessed October 4, 2013.
- Government of Saskatchewan. The Radiation Health and Safety Regulations, 2005. Available at: http://www.qp.gov.sk.ca/documents/English/Regulations/Regulations/R1-1r2.pdf. Accessed October 4, 2013.
- Government of Manitoba. The Workplace Safety and Health Act. Workplace Safety and Health Regulation. Available at: http://web2.gov.mb.ca/laws/regs/pdf/w210-217.06.pdf. Accessed October 4, 2013.
- Government of Ontario. Occupational Health and Safety Act (R.R.O. 1990, Regulation 861) X-ray Safety. Available at: http://www.e-laws.gov.on.ca/html/regs/english/elaws_regs_900861_e.htm. Accessed March 21, 2013.
- Health Canada. Healthy Living: It's Your Health. Occupational Exposure to Radiation. Available at: http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/environ/expos-eng.php. Accessed March 21, 2013.
- Kanal E, Bark al. ovich J, Bell C, et al. ACR Guidance Document on MR Safe Practices: 2013. J Magn Reson Imaging 2013;37:501-530.
- Shellock FG. Reference Manual for Magnetic Resonance Safety, Implants, and Devices. 2012 Ed. Los Angeles, CA: Biomedical Research Publishing Group; 2012.
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Related guidelines
>Personal protective equipment
Validation
October 16, 2013
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