TITLE 32: ENERGY CHAPTER II: DEPARTMENT OF NUCLEAR SAFETY SUBCHAPTER b: RADIATION PROTECTION PART 360 USE OF X-RAYS IN THE HEALING ARTS INCLUDING MEDICAL, DENTAL, PODIATRY, AND VETERINARY MEDICINE Section 360.10 Scope 360.20 Definitions 360.30 General Requirements and Administrative Controls 360.40 General Equipment and Operation Requirements for Diagnostic X-Ray Systems 360.50 Fluoroscopic Systems 360.60 Stationary Radiographic Systems Other Than Fluoroscopic, Dental Intraoral, Veterinary, or Systems Used Solely for Mammography 360.70 Mobile/Portable Radiographic Systems Other Than Systems Used Solely for Mammography 360.71 Requirements for Facilities Performing Mammography 360.80 Photofluorographic Systems 360.90 Intraoral Dental Radiographic Systems 360.100 Veterinary Radiographic Systems 360.110 Therapeutic X-Ray Installations 360.120 Special Requirements for X-Ray Therapy Equipment Operated at Potential of Fifty (50) kVp and Below 360.APPENDIX A Medical Radiographic Exposure Limits 360.APPENDIX B Mammography Dose Limit 360.ILLUSTRATION A Thimble and Pancake Chamber - Radiation Measuring Devices 360.ILLUSTRATION B Mammography Dose Evaluation Graph 360.TABLE A Filtration Required as a Function of Operating kVp (Repealed) 360.TABLE B Half-Value Layer as a Function of Tube Potential 360.TABLE C Entrance Exposure Limits Per Intraoral Bitewing Film AUTHORITY: Implementing and authorized by the Radiation Protection Act of 1990 (P.A. 86-1341, effective September 7, 1990) SOURCE: Filed April 20, 1974 by the Department of Public Health; old rules repealed, new rules adopted at 4 Ill. Reg. 25, p. 157, effective July 1, 1980; transferred to the Department of Nuclear Safety by P.A. 81-1516, effective December 3, 1980; codified at 7 Ill. Reg. 16406; amended at 10 Ill. Reg. 13271, effective July 28, 1986; amended at 13 Ill. Reg. 803, effective April 1, 1989; amended at 15 Ill. Reg. 6180, effective April 16, 1991. Section 360.10 Scope a) This Part establishes requirements for use of x-ray producing devices in the healing arts by a practitioner licensed to practice a treatment of human ailments by virtue of the Medical Practice Act of 1987 (Ill. Rev. Stat. 1987, ch. 111, pars. 4400-1 et seq.), the Illinois Dental Practice Act (Ill. Rev. Stat. 1987, ch. 111, pars. 2301 et seq.), or the Podiatric Medical Practice Act of 1987 (Ill. Rev. Stat. 1987, ch. 111, pars. 4801 et seq.), or by a medical radiographer or radiation therapy technologist accredited in accordance with the provision of 32 Ill. Adm. Code 401.100 or an individual exempt from the provisions of 32 Ill. Adm. Code 401, by Section 401.30 of that Part, acting under the supervision, prescription or direction of such licensed person or the non-human use of x-ray by veterinarians by virtue of the Veterinary Medicine and Surgery Practice Act of 1983 (Ill. Rev. Stat. 1987, ch. 111, pars. 7001 et seq.). The provisions of this Part are in addition to, and not in substitution for, other applicable provisions of 32 Ill. Adm. Code 310, 320, 340, 400, and 410. b) It is recognized that some installations and equipment designed before the adoption of this Part, coupled with conditions of use, may be adequate to achieve minimum exposures. Request for exemption from some provisions of this Part will be considered in accordance with 32 Ill. Adm. Code 310.30(a). (Source: Amended at 13 Ill. Reg. 803, effective April 1, 1989) Section 360.20 Definitions As used in this Part, the following definitions apply: "Accelerator" means any therapeutic machine capable of producing a useful beam of x-rays or charged particles with energies greater than 500 keV. "Added filtration" means the effect of the material (filter) added to the inherent filtration. "Aluminum equivalent" means the thickness of type 1100 aluminum alloy affording the same attenuation, under specified conditions, as the material in question. The nominal chemical composition of type 1100 aluminum alloy is 99.00 percent minimum aluminum, 0.12 percent copper. "Automatic exposure control" means a device which automatically controls 1 or more technique factors in order to obtain at a preselected location(s) a required quantity of radiation (see "Phototimer"). "Barrier" (see "Protective barrier"). "Beam axis" means a line from the source through the center of the x-ray field. "Beam-limiting device" means a device which provides a means to restrict the dimensions of the x-ray field (see "Collimator", "Diaphragm", and "Shutter"). "Certified system" means an x-ray system which is subject to regulations promulgated under Public Law 90-602, the Radiation Control for Health and Safety Act of 1968 (42 U.S.C.A. 263(b) et seq.), 21 CFR 1000.3 et seq., in effect as of April 1, 1988, exclusive of subsequent amendments or editions. A copy of this document is available for public inspection at the Illinois Department of Nuclear Safety (Department), 1035 Outer Park Drive, Springfield, Illinois. "Collimator" means a device or mechanism by which the x-ray beam is restricted in size (see "Beam-limiting device"). "Contact therapy system" means an x-ray system used for therapy with the x-ray tube port placed in contact with or within 5 centimeters of the surface being treated. "Control panel" means that part or parts of the x-ray system upon which are mounted the switches, knobs, pushbuttons, and other hardware necessary for setting the technique factors prior to initiating an x-ray exposure. "Dead-man switch" means a switch so constructed that a circuit- closing contact can be maintained only by continuous pressure on the switch by the operator. "Diagnostic source assembly" means an x-ray tube housing assembly, designed for use in diagnostic x-ray applications, with a beam limiting device attached. "Diagnostic-type protective tube housing" means an x-ray tube housing constructed so that when a beam limiting device is attached, the leakage radiation measured at a distance of 1 meter from the source cannot exceed 100 mR in 1 hour when the tube is operated at its maximum continuous rated current for the maximum rated tube potential. "Diaphragm" means a device or mechanism by which the x-ray beam is restricted in size (see "Beam-limiting device"). "Filter" means material placed in the useful beam to absorb, preferentially, radiations based on energy level (see "Filtration" and "Inherent filtration"). "Filtration" means the act of preferentially absorbing radiation with filters or inherent filtration (see "Filter" and "Inherent filtration"). "General purpose radiographic x-ray system" means any radiographic x-ray system which, by design, is not limited to radiographic examination of specific anatomical regions. "Gonad shield" means a protective device for the testes or ovaries which provides a minimum of 0.50 mm lead equivalent protection. "Half-value layer (HVL)" means the thickness of a specified material that attenuates the beam of radiation to an extent such that the exposure rate is reduced to one-half of its original value. AGENCY NOTE: The contribution of all scattered radiation, other than any that might be present initially in the beam concerned, is minimized. "Healing arts screening" means the examination of human beings using x-ray machines for the detection or evaluation of potential diseases when such examinations are not specifically ordered by a licensed practitioner of the healing arts legally authorized to prescribe such x-ray examinations for the purpose of diagnosis or treatment. However, healing arts screening does not include mammography on self-referred patients. "Image intensifier" means a device, installed in a housing, which converts an x-ray pattern into a corresponding light image. "Image receptor" means any device, such as a fluorescent screen or radiographic film, which transforms incident x-ray photons either into a visible image or into another form which can be made into a visible image by further transformations. "Inherent filtration" means the filtration permanently in the useful beam; it includes the effect of the x-ray tube window and any permanent tube or source enclosure (see "Filter" and Filtration"). "Interlock" means a device arranged or connected such that the occurrence of an event or condition is required before a second event or condition can occur or continue to occur. "Kilovolts peak (kVp)" means the crest value, in kilovolts, of the electric potential applied to the x-ray tube between the cathode and anode of a pulsating electric potential generator. "Lead equivalent" means the thickness of lead affording the same attenuation, under specified conditions, as the material in question. "Leakage radiation" means all radiation emanating from the diagnostic source assembly except for: The useful beam; and The radiation produced when the exposure switch or timer is not activated. "Leakage technique factors" means the technique factors used to measure leakage radiation from the diagnostic source assembly. They are defined as follows: For capacitor energy storage equipment, the maximum-rated peak tube potential and the maximum-rated number of exposures in an hour for operation at the maximum-rated peak tube potential with the quantity of charge per exposure being 10 millicoulombs, i.e. 10 milliampere seconds, or the minimum obtainable from the unit, whichever is larger. For field emission equipment rated for pulsed operation, the maximum-rated peak tube potential and the maximum-rated number of x-ray pulses in an hour for operation at the maximum-rated peak tube potential. For all other equipment, the maximum-rated peak tube potential and the maximum-rated continuous tube current for the maximum-rated peak tube potential. "Light field" means that area of the intersection of the light beam from the beam-limiting device and any one of the sets of planes parallel to and including the plane of the image receptor. The edge of the light field is defined as the locus of points at which the illumination is 25 percent of that at the center of the light field. "Mammography" means radiography of the breast for the purpose of enabling a physician to determine the presence, size, location and extent of cancerous or potentially cancerous tissue in the breast. "Mammography dosimetry test phantom" means a phantom for determining the mean glandular breast dose. For automatic exposure control mammography systems it shall be any phantom material that is equivalent to a nominal 4.5 centimeter compressed breast of average density (i.e., 50 percent adipose and 50 percent glandular tissue). "Mammography System" means an x-ray system that is used to perform mammography. "Medical radiographer" means a person other than a licensed practitioner, accredited in accordance with the provisions of 32 Ill. Adm. Code 401, or an individual exempt from the provisions of 32 Ill. Adm. Code 401, who performs medical radiation procedures and applies x-radiation, to any part of the human body, for diagnostic purposes while under the supervision of a licensed practitioner. "Mobile equipment" (see "X-ray equipment"). "Non-certified system" means an x-ray system which is not subject to regulations promulgated under Public Law 90-602, the Radiation Control for Health and Safety Act of 1968 (see "Certified system"). "Personnel monitoring" means the determination of radiation exposure to a person. Devices used for this purpose may include, but are not limited to, film badges, pocket dosimeters, and thermoluminescent dosimeters worn by the individual. "Phototimer" means a method for controlling radiation exposures to image receptors by the amount of radiation which reaches a radia- ion monitoring device(s). The radiation monitoring device(s) is part of an electronic circuit which controls the duration of time the tube is activated (see "Automatic exposure control"). Portable equipment" (see "X-ray equipment"). "Position indicating device" means a device on intraoral dental x-ray equipment used to indicate the beam position and to establish a definite source-skin distance. "Positive beam limitation" means a beam-limiting device which will, at the source-image receptor distance for which the device is designed, either cause automatic adjustment of the x-ray field in the plane of the image receptor to the image receptor size within 5 seconds after insertion of the image receptor or, if adjustment is accomplished automatically in a time interval greater than 5 seconds or is manual, prevent production of x-rays until such adjustment is completed. For SIDs at which the device is not intended to operate, the device prevents the production of x-rays. "Primary protective barrier" (see "Protective barrier"). "Protective apron" means an apron of radiation absorbing materials, at least 0.25 mm lead equivalent, used to reduce exposure from stray radiation (see "Stray radiation"). "Protective barrier" means a barrier of radiation absorbing material(s) used to reduce radiation exposure. The types of protective barriers are as follows: "Primary protective barrier" means the material, excluding filters, placed in the useful beam to reduce the radiation exposure. "Secondary protective barrier" means a barrier sufficient to attenuate the stray radiation to the required degree (see "Stray radiation"). "Protective glove" means a glove made of radiation absorbing materials, at least 0.25 mm lead equivalent, used to reduce exposure from stray radiation (se