NRC APPROVES EXPEDITED PROCEDURES FOR PERMITTING
HIGHER DOSE LIMITS FOR PATIENT CAREGIVERS
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The Nuclear Regulatory Commission has approved new procedures for permitting visitors to patients receiving nuclear medicine or brachytherapy to receive radiation doses above current regulatory limits if warranted by the patient’s needs.

Members of the public visiting patients who are undergoing nuclear medicine or brachytherapy procedures receive radiation doses from radiation emanating from the patient. The actual dose depends on many factors, including the medical procedure involved, the frequency and duration of the visits, proximity to the patient and the extent of the visitor’s involvement in the patient’s care.

Under NRC regulations, the permissible annual radiation dose to any member of the public, including hospital visitors, is 0.1 rem (100 millirem). Visitors to patients who cannot be discharged under NRC regulations are permitted to receive a dose of up to 0.5 rem (500 millirem) under certain circumstances. (For comparison, the average annual dose from natural sources to an individual in the United States is about 0.3 rem, or 300 millirem.)

Two recent cases involving exposures of visitors have shown that these limits are not sufficient to take certain patient needs into account. When a family member or friend becomes a caregiver and is actively involved in the patient’s care, a hospital licensee trying to enforce the regulatory dose limits may be forced to choose between risking potential NRC enforcement action by violating the regulatory limits or compromising the patient’s care to minimize the caregiver’s dose.

Currently, licensees may request emergency, case-specific exemptions from NRC regulations for these situations, asking the NRC staff to determine an allowable dose above the regulatory limit. This approach lacks standard procedures for granting exemptions and may not always ensure proper control of the caregiver’s exposures.

The new procedures approved by the Commission would allow the licensee to determine a dose limit based on the conditions of a particular case and establish standard procedures for requesting and granting an expedited license exemption. Caregivers would be given instruction in how to limit their exposure. NRC Regional offices will have authority to grant expedited exemptions for limits up to 5 rem, provided the licensee submits sufficient justification. Requests for limits above 5 rem will require special justification by the licensee and additional review by the agency’s Office of Nuclear Materials Safety and Safeguards.

The NRC staff expects to issue a Regulatory Issues Summary on the new procedures, including guidance on their implementation, by mid-2006. Until then, the current procedures for requesting an exemption from the regulatory requirement remain in effect.

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Thursday, February 22, 2007