MEDICAL UNIVERSITY OF SOUTH CAROLINA RADIATION MONITOR AND ITS USE

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MEDICAL UNIVERSITY OF SOUTH CAROLINA RADIATION MONITOR AND ITS USE Radiation dosimetry badges are furnished in accordance with existing State and Federal regulations regarding monitoring of personnel exposed to ionizing radiation. The Radiation Safety Office will determine eligibility for participation in the Dosimetry Badge Program. The monthly or quarterly Radiation Dosimetry Reports regarding your exposure become a part of your permanent records and are available for your review. If you leave MUSC for other employment, please request a copy of your exposure record to be sent to your new employer. A. In order to utilize the badge most effectively, and to have the most accurate record possible, the following requirements must be observed: 1. You may not enter a controlled area without a radiation monitoring badge. This includes any room in which a fluoroscopic unit is used. Always wear your badge when working in radiation areas. 2. Badges shall be worn on your collar or at collar level. Rings shall be worn on the index finger, underneath gloves, facing toward inside of hand. 3. When wearing a lead apron, wear the collar badge on the outside of the lead apron. 4. Be sure that the badge is firmly attached. Loss of a badge requires that your permanent record be posted with a calculated dose for that wear period for both lost body badge and lost ring badges. 5. Be sure that you are wearing a current badge; the month or quarter appears on the face of the badge with your name and assigned number. If you are required to wear a badge and do not receive it, notify Radiation Safety immediately. All badges must be returned to the Radiation Safety Office no later than the 10th of each month or month following quarter wear period. Return the badge to the Radiation Safety Office at 301 HOT so that it can be processed promptly. 6. Protect your badge from moisture, i.e., rain, washing machines, accidental splashing, etc. Moisture damage cannot be read properly and your record will be posted with an estimated dose for that month. Immediately contact Radiation Safety for another badge to wear for the remainder of that month. 7. Accidental exposure (splashing with radioactive material, leaving in room, etc.) should be reported immediately to Radiation Safety. Keep the badge separate from others. 8. Your department is charged for all damaged, lost, and/or late badges and holders. Additional charges are incurred for misuse and/or abuse of service. 9. Notify the Radiation Safety Office of any change in status; termination of employment, leave of absence, pregnancy, name change due to marriage/divorce, change of departments, etc.

B. Lost or damaged personnel monitoring device: RADIATION BADGE INFORMATION - PAGE 2 1. If a personnel monitoring device is lost or damaged, the worker shall cease to work immediately until a replacement badge is provided and the exposure is calculated for the time period from issuance to loss or damage of the badge. 2. In the event a replacement badge is not available, the Radiation Safety Officer shall be contacted immediately to evaluate the probable radiation exposure to the worker until a replacement device is received. 3. Replacement badges are to be picked up in person at Harborview Tower (HOT) 301. If more than one badge is lost in a year, it will be reported to upper management for disciplinary actions. IMPORTANT - SEE NEXT PAGE

RADIATION BADGE INFORMATION - PAGE 3 NEVER ALLOW ANYONE ELSE TO WEAR YOUR BADGE! NEVER WEAR A BADGE WHICH IS NOT ASSIGNED TO YOU!! DO NOT WEAR THE BADGE MARKED "CONTROL", CALL RADIATION SAFETY FOR A BADGE! NEVER INTENTIONALLY EXPOSE YOUR BADGE TO RADIATION. TO DO SO MAY RESULT IN SUSPENSION FROM YOUR DUTIES. NEVER WEAR YOUR BADGE WHEN YOU ARE UNDERGOING MEDICAL IMAGING PROCEDURES (X-RAY, DENTAL X-RAY OR FLUOROSCOPY) OR NUCLEAR MEDICINE PROCEDURES. THE BADGE MONITORS OCCUPATIONAL EXPOSURE, NOT MEDICAL EXPOSURE. NEVER TAKE YOUR BADGE HOME WITH YOU. LEAVE IT IN A SAFE PLACE, AWAY FROM ANY SOURCE OF RADIATION AT YOUR PLACE OF WORK. LEAVE THE MONITOR IN THE HOLDER EXCEPT TO CHANGE IT FOR THE NEXT MONTH'S BADGE. KEEP THE MONITOR AND RINGS INTACT - DO NOT REMOVE ANY LABELS!! IF ACCIDENTALLY WASHED/DRIED ASK FOR IMMEDIATE REPLACEMENT. Any questions regarding badge service, radiation safety, etc. should be directed to the Radiation Safety Office(r), ext. 4255.

REQUEST FOR BADGE SERVICE Spare # Part # Series Code FOR RADIATION SAFETY OFFICE USE ONLY Name ( M) ( F) LAST FIRST MIDDLE MAIDEN Date of Birth: Department: Division/Lab/Floor: Supervisor: Bldg: Room #: Ext: Have you completed a radiation safety online training? Yes No Type of employee: New Hire Current Employee Occupation: Researcher Rad Tech Nurse Physician Interventional Radiologist Cardiologist Other (please specify) Will you operate radiation producing devices as part of your job responsibilities? Yes No New Hire: If yes, then a Radiation Producing Machine Compliance Certificate and any associated documentation (i.e. SCRQSA certification) must be submitted to Radiation Safety within 14 days of start date. Current Employee: If yes, then a Radiation Producing Machine Compliance Certificate and any associated documentation (i.e. SCRQSA certification) must be submitted with this request. Type of Badge: FOR RADIATION SAFETY OFFICE USE ONLY COLLAR Badge (worn outside lead apron) RING Badge ( Lg/ Med/ Sm) Fetal Badge (new employee only): Conception Date Due Date

You must list all previous and current employment including employment at MUSC only if you wore a badge or were monitored in any way for Occupational Radiation Exposure. If you were a student and were monitored complete this information. Please give your full name at the time of previous employment. Please make sure addresses are legible and complete. I have never been monitored for occupational radiation exposure PREVIOUS EXPOSURE EMPLOYER DEPARTMENT COMPLETE ADDRESS ZIP CODE DATES Phone# Are you currently monitored for radiation exposure at another location or another employer? Yes No If yes list other facilities below CURRENT EXPOSURE EMPLOYER DEPARTMENT COMPLETE ADDRESS ZIP CODE DATES Phone# I hereby authorize the release of my current and past occupational radiation exposure records to the Medical University of South Carolina. I recognize that providing false or incomplete information on this application may lead to the loss of my radiation use privileges. I recognize that misuse of the radiation badge or failure to wear the badge as required may lead to the loss of my radiation use privileges. Have you ever had your radiation use privileges suspended? Yes No Signature: Date: Printed Name Please return this completed form to the Radiation Safety Office. Allow 7-10 days for delivery. You may not enter a controlled area without a badge. You may email this request to radiationsafety@musc.edu or FAX to extension 2-5099; Call ext. 2-4255 if you have any questions.

MUSC Film Badge Agreement Department: Badge Coordinator: Name (please print): Please check appropriate designations below: MUSC Employee MUHA Employee Other (UMA, Carolina Family Care, etc) M.D. Yes No By signing below, I affirm that I have read and fully understand the requirements involved in the wearing and returning of my MUSC film badge. Furthermore, I agree to abide by the requirements of the MUSC Radiation Safety Film Badge Policy. Signature: Date: