NZ Vet Nurse Journal 99 September 2021

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RADIATION SAFETY LEGISLATIONrelationship between irradiation of the foetus andleukaemia in the first 10 years of a child’s life”. In light ofthese facts, it is vital that the risk of exposure in practiceis effectively managed.As Low As Reasonably Achievable (ALARA)The ‘as low as reasonably achievable’ (ALARA) principleis the mainstay of international radiation protectionlaw, and of safe practice. The aim is to keep the dose topersonnel ‘as low as reasonably achievable’. It is basedon the premise that any exposure to ionising radiation,no matter how small, can increase the chance of negativebiological effects such as cancer. Under the new Code ofPractice for Veterinary Radiation the managing entitymust set up radiography equipment and protocolsaccording to the ALARA principle (ORS, 2020). To protectfrom radiation exposure and meet the requirements of theRadiation Safety Act 2016 three basic elements of practicemust be controlled: distance, time, and shielding.Exposure to radiation occurs in three ways: by directexposure to the primary beam, from exposure to scatteredradiation caused by the interaction of the primary beamwith objects in its path, and by leakage of radiationfrom the x-ray tube housing (Brown & Brown, 2017). Theintensity of radiation falls away rapidly with distancefrom the source, therefore the further away radiographersposition themselves from the source of the radiation, thesafer they are. Under no circumstances should any partof a human body be directly in the path of the primarybeam. This includes hands inside lead gloves. Studiesshow that standing two to three metres away providesadequate protection from scattered radiation (Cartwright,1992). Historically, maintaining safe distance has beenidentified as an issue by veterinary nurse radiographersin New Zealand.Radiation protection and the veterinary nurseIn a 2013 survey of New Zealand veterinary nurses 30% ofparticipants expressed concern about the safety of theirradiography work practices. The most significant matteridentified by survey respondents was the expectationthat they would perform routine manual restraint ofveterinary patients undergoing radiographic procedures.Fifty-eight percent of the veterinary nurses reportedholding animal patients for radiographic procedures moreoften than industry recommendations. A lack of sedationof small animal patients was identified as a significantbarrier to safe practice (Rice, 2013). Consequently,the wording in the updated code regarding the use ofsedatives to avoid the manual restraint of animals duringradiographic procedures is of specific interest.Manual restraint regulationsThe new Code of Practice for Veterinary Radiation directlyprohibits holding patients for procedures unless sedationor general anaesthesia is contraindicated. The ManagingEntity must under section 4 (e)(ii) “prevent the manualrestraint of animals unless it is medically unacceptable toimmobilise the animal by sedation or general anaesthesiaand/or mechanical restraint” (ORS, 2020). This wordingis more robust than the preceding legislation which didnot directly address the practice of manual restraint ofanimals for radiographic procedures. Veterinary users ofx-radiation were simply advised to keep doses of ionisingradiation “as low as reasonably achievable, social andeconomic considerations being taken into account” (ORS,2006).The new code provides clarity on the requirement for theuse of sedatives or general anaesthesia to immobiliseanimals for x-ray procedures. This offers protection forthose veterinary nurses who have been expected toperform routine manual restraint of veterinary patients.Radiation protection and the Rural Animal TechnicianThe new Code’s direction on the use of mobile stands anddevices to hold the image receptor (long handled cassetteor spade holders) is of interest to equine veterinarynurses and rural animal technicians. The former Codewhich guided large animal practitioners in the applicationof the previous legislation recommended that veterinaryradiographers simply keep exposure to ionising radiation‘as low as reasonably achievable’ (ORS, 2006). Aninformation pamphlet issued by the National RadiationLaboratory (the agency that preceded the ORS) offeredmore specific advice for large animal radiographersincluding, “do not hold the x-ray machine unless it isstrictly necessary” and “use a spade holder or stand forthe cassette” (Cartwright, 1992). However, no specificdirective on the use of equipment designed to enable theoperator to maintain a safe distance from the primarybeam was written into the Code of Safe Practice for theUse of X-Rays for Veterinary Diagnosis (ORS, 2006).16 September 2021
RADIATION SAFETY LEGISLATIONWhile it was mandatory for the management (principallicensee) to make “cassette holders or other mechanicalmeans available for use” (ORS, 2006) for persons involvedin field radiography, the document stopped short ofmaking management responsible to ensure the use of theprotective equipment.The revised code now requires that clinic managementnot only ‘provides’ but also ‘ensures the use’ of equipmentthat enables veterinary radiographers to maintain therecommended (two-metres) distance from the primarybeam wherever possible. In section 4, the code states that“the managing entity must prevent the: (e)(i) holding ofx-ray equipment unless it is specifically designed for thatpurpose and it is impracticable or medically unacceptableto use fixed x-ray equipment” (ORS, 2020, p. 9).The Managing Entity must not only “provide restraintsand positioning aids to enable mechanical restraint” suchas “foot blocks, vice grips and long-handled x-ray plateholders” and “mobile stands to position the x-ray machinefor radiography”, but significantly, the code also statesthat the Managing Entity must “ensure the use of” this“protective equipment for the operator and all peopleproviding assistance during the radiation procedure” (ORS,2020, p. 10).In radiation protection, maintaining two-metres distancefrom the primary beam is safe practice. Clarity on therequirement to use mobile stands, and devices to holdthe image receptor is provided in the new Code enablingveterinary radiographers to maintain a safe distance fromthe primary beam.Protection for veterinary radiographersThe Code of Practice for Veterinary Radiation (2020)provides legal protection for veterinary nurses and ruralanimal technicians in managing the risk of exposureto ionising radiation in their work. Whilst veterinaryradiographers have always been advised to keeptheir dose of ionizing radiation ‘as low as reasonablyachievable’. The wording of the new code is more specificthan its predecessor. Whilst the previous legislationguided practice using the ALARA principle, in some areas itleft what is ‘reasonable’ open for interpretation.The new Code applies the Radiation Safety Act 2016in the veterinary context. It specifically addresses themanual restraint of small animal patients and the holdingof x-ray tube heads and image receptors during largeanimal radiographic procedures. These practices whichput the veterinary radiographer closer to the primarybeam than radiation protection guidelines recommendare now directly prohibited. This removes contention andprotects veterinary nurses, rural animal technicians andveterinarians from exposure to ionising radiation at work.For further information and to update your clinic on thenew requirements you can download the Code of Practicefor Veterinary Radiation from the Ministry of Health’sOffice of Radiation Safety webpage.ReferencesAyres, M. H. (2012). Small Animal Radiographic Techniquesand Positioning. Wiley.Brown, M., & Brown, L. (2017). Lavin’s Radiography forVeterinary Technicians (6th ed.). ElsevierCartwright, P. H. (1992). Radiation Protection in VeterinaryRadiography. Vetscript, 5(8), 6-7. http://www.sciquest.org.nz/node/43011Easton, S. (2012). Practical Veterinary Diagnostic Imaging.Wiley.Ministry of Health. (2021). Codes of Practice. https://www.health.govt.nz/ourwork/ionising-radiationsafety/codes-practiceMinistry of Health. (2021). Ionising radiationsafety. https://www.health.govt.nz/our-work/ionising-radiation-safetyMorris, S. (2000). Health and safety in the veterinaryclinic. Proceedings of the Annual Conference of the NewZealand Veterinary Nursing Association. http://www.sciquest.org.nz/node/42730New Zealand Government. (2015) Health & Safety atWork Act 2015. https://www.legislation.govt.nz/act/public/2015/0070/latest/DLM5976660.htmlNew Zealand Government. (1982) Radiation ProtectionRegulations 1982. https://www.legislation.govt.nz/regulation/public/1982/0072/latest/DLM81126.htmlNew Zealand Government. (2016) Radiation SafetyRegulations 2016. https://www.legislation.govt.nz/regulation/public/2016/0303/4.0/DLM7049020.htmlNew Zealand Government. (1965) Radiation SafetyAct 1965. https://www.legislation.govt.nz/act/public/1965/0023/latest/DLM372539.html?search=qs_17 September 2021
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Page 3 and 4: CONTENTSVOLUME 27 No. 99 September
Page 5 and 6: NZVNALetter from the EditorFirstly,
Page 7 and 8: REFLECTIVE PRACTICEReflective pract
Page 9 and 10: REFLECTIVE PRACTICEThe Fook and Gar
Page 11 and 12: ENDOMETRITISEndometritis in the Dai
Page 13 and 14: ENDOMETRITIS• Increase in service
Page 15: RADIATION SAFETY LEGISLATIONUnder t
Page 19 and 20: NZVNAInstructions for authors submi
Page 21 and 22: RESCUE CATS AND CARERSWorld-first s
Page 23 and 24: RESCUE CATS AND CARERSHPNZ is a cha
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NZ Vet Nurse Journal 99 September 2021

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