SOAL – SOAL TERKAIT PENGAWASAN PEMANFAATAN RADIOTERAPI

Beberapa waktu yang lampau sudah disajikan “Soal-soal X-ray Beam Properties”, pada kesempatan berikut ini “Soal-soal Terkait Pengawasan Pemanfaatan Radioterapi” yang secara khusus ditujukan bagi kawan-kawan Inspektur Keselamatan Nuklir Bapeten, khususnya Inspektur Kesehatan dan Industri. Namun Pihak lain yang terkait pemanfaatan layanan radioterapi, misalnya Praktisi Medik (Radiografer Terapi/Radioterapis dan Fisikawan Medik), PPR Medik Tingkat I dan adik-adik mahasiswa (Fisika Medik FMIPA UI dan D4 Radioterapi Poltekkes Kemkes) juga dapat melatih kemampuan akademisnya.

Untuk dapat menjawab soal-soal ini, sebaiknya dibaca terlebih dahulu beberapa referensi diantaranya, (1) IAEA, International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources”, Safety Series No. 115, Vienna (1996); (2) IAEA-TECDOC-1067, Organisation and implementation of a national regulatory infrastructure governing protection against ionising radiation and the safety of radiation sources, Vienna (1999); (3) IAEA-TECDOC No. XXX, Radiation Safety in Radiotherapy, Vienna (2000); (4) IAEA-TECDOC No. 1040, Design and Implementation of a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects, Vienna (1988); (5) IAEA, Safety Report Series, Radiation Protection in the Design of Radiotherapy Facilities, Vienna (2006); dan (6) Togap Marpaung “Memahami Basic Safety Standard-BSS No.15 Tahun 1996”, Bapeten, Jakarta (2003), materi tulisan BSS ada dalam blog ini.

Soal-soal ini diperoleh ketika mengikuti IAEA Regional Training Course on Authorization and Inspection of Radiation Sources in Radiotherapy di Manila, Philippines 14 – 25 November 2005. Selamat Mengasah Otak dan Semoga Bermanfaat!

IAEA REGIONAL TRAINING COURSE ON AUTHORIZATION AND INSPECTION OF RADIATION SOURCES IN RADIOTHERAPY

Manila, Philippines 14 – 25 November 2005

EVALUATION TEST

PART 1: Course on Organization and implementation of a Natioal Regulatory Programme for the Control of Radiation Sources

NAME: ----------------------------------------------------------------------------------

COUNTRY:  ----------------------------------------------------------------------------

Instructions: This is a multiple choice type of evaluation test

                      Encircle the best answer among the choices given after each question or

                      as specifically directed.

1.  Mark the statement which is not a disavantage of a prescriptive regulation

a.   its routine use can lead to a “compliance culture” instead of a “safety culture”.

b.   its preparition can be difficult and requires considerable practice, specific knowledge and experience.

c.   it is easily applicable to a specific practice.

d.   its reviewing and amending is necessasry to keep pace with changes in technology.

2.  Guidance levels for medical exposure shall be established for use by medical practitioners. The guidance levels are not intended:

a.  to be a reasonable indication of doses for average sized patients.

b.  to provide guidance on what is achievable with current good practice rather than on what should be considered optimum performance.

c.  to limit or to constrain higher exposures if these are indicated by sound clinical judgement.

d.  to be revised as technology and techniques inmprove.

3.  Exemption should not be granted to permit practices that would otherwise not be:

a.  optimized.

b.  justified.

c.  notified.

d.  ALARA.

4.   Read very carefully the following criteria. Two from the criteria laid down can not be considered as criteria for exemption of practices and sources within practices without further consideration from the requirements of the BSS.

a.   the expected effective dose incurred to any user due to the practice or source is in the order of 10 µSv per year and the collective dose committed by one year of performance of the practice is no more than about 1 person Sv.

b.   the expected effective dose incurred to any member of the public due to the practice or source is in the order of 10 µSv per year and the collective effective dose committed by one year of performance of the practice is no more than about 1 person Sv.

c.   the expected effective dose incurred to any member of the public due to the practice or source is in the order of 10 µSv per year and an assessment for the optimisation of protection shows that exemption is the optimum option.

d.   the expected effective dose occured to any member of the public due to the practice or source may exceed 10 µSv per year but the collective dose committed by one year of performance of the practice is no more than about 1 person Sv. 

5.  Read carefully following statements related to clearance levels. Only one of them  is with the BSS.

a.   clearance levels shall  not be approved by the Regulatory Authority.

b.   clearance levels ≥   exemption levels.

c.   clearance levels  ≤  exemption levels.

d.   for bulk amounts of materials, clearance > > exemption levels.

6.  Mark the unreasonable criteria:

The Regulatory Authority is reviewing an application for a temporary change in dose limitation. Such change shall be  approved only exceptionally and for a limited period of time, if the Regulatory Authority determines that:

a.   special circumtances exist which require such temporary change.

b.   visitors be accompanied in the specific working area by a person  knowledgeable about the protection and safety measures.

c.   the practice is still justified and radition safety is optised.

d.   workers involved have been consulted and their agreement was obtained.   

7.  Which one of following devices should be subject to licensing?

a.   Mammography X-ray equipment.

b.   Linear accelerator.

c.   a set of calibration sources for educational use.

d.   LDR brachyterapy equipment.

8.  The basic purpose of a regulatory system for practices with radiation sources is

a.   to balance benefits and detriments of the use of radiation sources for individuals and society.

b.   to eliminate possible harmful effects of radiation to exposed workers, patients’ public and enverinment.

c.   to prevent the occurrence of deterministic effects and to minimize the stochastic effects.

d.   to tensure full safety in the use of radiation sources in medical, industrial, agriculture, research and other practices.

9.  Primary responsibility for radiation safety is held by

a.   designated Radiation Protection Officer as an individual competent in radiation protection matters relevant for the practice.

b.  any exposed worker as part his duty to follow applicable rules and procedures for protection and safety.

c.  Regulatory Authority established by national legislation.

d.  licensees and/or employers.

10. For medical exposure, dose limits are not applied

a.  at all.

b.  for patients only.

c.  for patients in radiotherapy.

d.  for patients and persons voluntary helping in the support and comport of patients.

11. Pregnancy is not a reason to exclude a female worker from work, but

a.  working conditions of pregnant female worker should be appropriately adopted.

b.  pregnant female worker is not allowed to work in cotrolled areas.

c.  pregnant female worker is not allowed to work with unsealed sources.

d.  pregnant female worker should be temporarily moved to other type of work without radiation risk.

12. Worker occupationally exposed to effective dose higher than 50 milisievert (mSv) shall not with radiation souces

a.  at least until the end of the year.

b.  for ever.

c.  until his fitness for such work is recognized as a result of health surveillance.

d.  until report of the event is accepted by the Regulatory Body.

13. Exposures grater than a dose limit shall be communicated to the regulatory  Authority

a.  as soon as possible .

b.  monthly or in the case of  accidents immediately.

c.  after investigation of the event an a written report on its cause and with recommendations for preventing the recurrence.

d.  as a part of the regular annual radiation safety report only.

14. Qualified experts are

a.  the most experienced and competent workers capable to advise others to perform their work safely.

b.  individuals recognized as having expertise in a relevant field of specialization.

c.  Radiation Protection Officers.

d.  designated by the registration or licensee and approved by the regulatory authority.

15. Clearance levels are activity concentration and/or total values used

a.  for evaluation of proper decontamination of the workplace.

b.  in releasing radioactive material from regulatory control.

c.  as maximum activity for patients in therapy on discharge from hospitals.

d.  as un upper value in the dose optimization process.

16. Which of the following applications using radioactive sources would notification be sufficient for purposes of regulatory control?

a.  Industrial radiography using Ir-192.

b.  nuclear medicine using I-131.

c.  commercial sale of references check sources.

d.  teletherapy facility using Co-60.

17. Graded enforcement means

a.  action taken by the regulatory authority for non compliance of the licensees to regulatory requirements.

b.  enforcement action is based on the nature of non compliance and implications to safety.

c.  imposition of maximum penalty for repeated non compliances.

d.  issuance of suspension order until corrective actions are implemented by the licences.

18. The regulatory authority must have the following powers and responsibilities clearly defined in the law, EXCEPT.

a.  standard setting and rule making powers.

b.  inspections of licensee’s facility and enforcement of the regulatory requirements, including the conduct of unannounced inspection.

c.  grant of exemptions from regulatory requirements based on a set of criteria and establishment of clearence levels for radioactive waste.

d.  setting up guidance levels for medical diagnosis using radiation source.

19. To implement the role and functions of the regulatory authority in the national emergency plan, which of the following is required

a.  appropriate trained manpower.

b.  equipment and facilities.

c.  logistic support and funding.

d.  all of the above.

20. Emergency exercises are necessary for the following purposes, EXCEPT:

a.  to assess the effectiveness and adequacy of the emergency plan and procedures.

b.  to ensure that emergency response capabilities remain effective.

c.  to generate more resources for the intervening organization for the maintenance of the emergency plan.

d.  to provide information which can be used as a basis for the modification and/or revision of the emergency plan.

Instruction: In questions 21-25, encircle the letter of the incorrect anwer

21. The following essential technical services should be available to the regulatory authority

a.  dosimetry services

b.  calibration services.

c.  analitycal services.

d.  accreditation for services.

e.  academic program in regulation.

22. Staffing levels will depend on:

a.   the size, scope and complexity of practices.

b.   the nature of the regulation (prescriptive/performance).

c.   the country geographical condition.

d.   the extend to which practice specific guidance documents and standard assesments plans used.

e.   the status of the regulatory program i.e. organization, implementatiaon, or operational phase.

23. The purpose of monitoring external and internal doses is to:

a.   provide security and confidence in safety procedures.

b.   provide legal evidence.

c.   identify poor working practise.

d.   identify personnel changes in working conditions.

e.   exercise control over individual dose.

24. Hiring of consultans by regulatory authority is governed by the following politics:

a.   consultans should be effectively independent of the operator.

b.   the use consultants shall not relieve the regulatory authority of any of its responsibilities.

c.   the regulatory authority’s responsibility for making dicisions and recomendations may be delegated to the consultant, subject to the country’s regulations.

25. The regulatory authority should be empowered to:

a.   develop safety pricinciples and criteria.

b.   establish regulations and issue guidance documents and advice.

c.   require operators to conduct safety assesments on behalf of the regulator.

d.   issue, amend, suspend and revoke authorizations.