What each state's rules say about the people who work in fluoroscopy labs: keeping doses as low as reasonably achievable (ALARA), dose limits, dosimeters, aprons and who may operate the equipment. All 50 states and the District of Columbia, with the rule and the source behind every answer.
What the map colors mean
Where in its rules each state addresses keeping doses as low as reasonably achievable (ALARA) for X-ray users:
Please double-check this information. This map is an ORSIF research summary, researched November 3, 2026, with its weakest answers rechecked November 5, 2026. It is not comprehensive and not always accurate: rules change, and answers may be incomplete, out of date or wrong. It is education, not legal advice. A regulatory expert has not yet reviewed these summaries. Confirm any requirement at the source linked on each state's page, with your state's radiation control program and with your facility's radiation safety officer. How this was made
Five findings from reading every state's rules, as of November 5, 2026. On this page the NRC is the U.S. Nuclear Regulatory Commission, the federal agency that regulates radioactive materials, and an Agreement State is a state that has signed an agreement with it to regulate certain radioactive materials itself.
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ALARA means keeping doses as low as reasonably achievable. In these states the requirement for X-ray users sits in the same rule that covers radioactive-materials licensees: Alabama, Arkansas, California, Colorado, Florida, Kansas, Louisiana, Maine, Mississippi, Nebraska, Nevada, New Hampshire, New Mexico, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee and Virginia.
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Connecticut, Georgia and Wyoming, which are Agreement States, and Michigan, Missouri and South Dakota, which are not. Not found means ORSIF did not find a requirement in the rules it reviewed.
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The International Commission on Radiological Protection (ICRP) recommends 20 millisieverts (mSv) a year for the lens of the eye, averaged over five years. 44 states follow the NRC's 150 mSv. Connecticut, Georgia, Idaho, Indiana, Missouri, Montana and Wyoming apply about 50 mSv because older-style state or federal rules count the eye with the whole body.
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Arizona and New York. 37 more address them in part, mostly by accepting whole-body barriers or distance. Illinois has a proposed rule. See the developments below.
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In the other states the research found no such requirement in the rules it reviewed. Facilities and accreditors may still require it. Read ORSIF's FAQ on inspection.
All 50 states and the District of Columbia. Choose what to color by, then select a state to open its page. The smallest states and DC also have labeled boxes, so they are easy to find.
ALARA means keeping doses as low as reasonably achievable. States regulate X-ray machines themselves, often in a rule they share with radioactive-materials licensees, which the NRC proposal would reach.
Sort by any column, or filter. For the full answers, rule citations and sources, open a state.
Showing 51 of 51
| Alabama | Yes | Yes | Shared rule | 150 mSv | Not found | Not found |
|---|---|---|---|---|---|---|
| Alaska | No | Yes | Both | 150 mSv | In part | In part |
| Arizona | Yes | Yes | Both | 150 mSv | Required | Addressed |
| Arkansas | Yes | Yes | Shared rule | 150 mSv | Not found | In part |
| California | Yes | Yes | Shared rule | 150 mSv | Not found | In part |
| Colorado | Yes | Yes | Shared rule | 150 mSv | Required | In part |
| Connecticut | Yes | No | None found | ~50 mSv | Not found | Not found |
| Delaware | No | Yes | Both | 150 mSv | Required | In part |
| District of Columbia | No | Yes | Shared rule | 150 mSv | Not found | In part |
| Florida | Yes | Yes | Shared rule | 150 mSv | Not found | In part |
| Georgia | Yes | No | None found | ~50 mSv | Not found | In part |
| Hawaii | No | Yes | Both | 150 mSv | Not found | In part |
| Idaho | No | Yes | X-ray rule | ~50 mSv | Not found | Not found |
| Illinois | Yes | Yes | Both | 150 mSv | Not found | In part |
| Indiana | Yes | In part | Both | ~50 mSv | Not found | In part |
| Iowa | Yes | Yes | Both | 150 mSv | Required | In part |
| Kansas | Yes | Yes | Shared rule | 150 mSv | Not found | In part |
| Kentucky | Yes | Yes | Both | 150 mSv | Not found | Not found |
| Louisiana | Yes | Yes | Shared rule | 150 mSv | Required | In part |
| Maine | Yes | Yes | Shared rule | 150 mSv | Required | In part |
| Maryland | Yes | Yes | Both | 150 mSv | Not found | In part |
| Massachusetts | Yes | Yes | Both | 150 mSv | Required | In part |
| Michigan | No | No | None found | 150 mSv | Not found | Not found |
| Minnesota | Yes | Yes | X-ray rule | 150 mSv | Required | Not found |
| Mississippi | Yes | Yes | Shared rule | 150 mSv | Not found | In part |
| Missouri | No | No | None found | ~50 mSv | Not found | In part |
| Montana | No | In part | Shared rule | ~50 mSv | Not found | Not found |
| Nebraska | Yes | Yes | Shared rule | 150 mSv | Not found | In part |
| Nevada | Yes | Yes | Shared rule | 150 mSv | Not found | In part |
| New Hampshire | Yes | Yes | Shared rule | 150 mSv | Not found | In part |
| New Jersey | Yes | Yes | Both | 150 mSv | Required | Not found |
| New Mexico | Yes | Yes | Shared rule | 150 mSv | Not found | In part |
| New York | Yes | Yes | Shared rule | 150 mSv | In part | Addressed |
| North Carolina | Yes | Yes | Both | 150 mSv | Not found | In part |
| North Dakota | Yes | Yes | Both | 150 mSv | Not found | In part |
| Ohio | Yes | Yes | Shared rule | 150 mSv | Required | In part |
| Oklahoma | Yes | In part | X-ray rule | 150 mSv | Required | In part |
| Oregon | Yes | Yes | Shared rule | 150 mSv | Required | In part |
| Pennsylvania | Yes | Yes | Shared rule | 150 mSv | Not found | In part |
| Rhode Island | Yes | Yes | Shared rule | 150 mSv | Required | In part |
| South Carolina | Yes | Yes | X-ray rule | 150 mSv | Required | In part |
| South Dakota | No | No | None found | 150 mSv | Required | Not found |
| Tennessee | Yes | Yes | Shared rule | 150 mSv | Not found | Not found |
| Texas | Yes | Yes | X-ray rule | 150 mSv | Required | In part |
| Utah | Yes | Yes | Both | 150 mSv | Not found | Not found |
| Vermont | Yes | Yes | Both | 150 mSv | In part | In part |
| Virginia | Yes | In part | Shared rule | 150 mSv | Not found | In part |
| Washington | Yes | Unclear | Both | 150 mSv | Not found | In part |
| West Virginia | No | Yes | Both | 150 mSv | Not found | In part |
| Wisconsin | Yes | Yes | Both | 150 mSv | Required | In part |
| Wyoming | Yes | No | None found | ~50 mSv | Not found | Not found |
Eye-lens limits are in millisieverts (mSv) a year. "Not found" means ORSIF did not find the answer in the rules it reviewed. This table is not comprehensive or always accurate: double-check an entry at the sources on its state page before you rely on it. Download this table as a spreadsheet (CSV).
Checked against their sources on November 3, 2026. Each state page lists the other changes the research found.
On July 15, 2026, the U.S. Nuclear Regulatory Commission (NRC) proposed to drop the definition of ALARA (as low as reasonably achievable) from 10 CFR Part 20 and replace it with a graded approach to dose management. The proposal keeps the dose limits, including 150 mSv a year for the lens of the eye. Agreement States would generally need to adopt matching rules to stay compatible with the NRC. A final rule is expected around late November 2026.
Federal Register notice (91 FR 43456)Docket NRC-2025-1140ORSIF explainer: what ALARA means and what is changing
Senate Bill 1121 (Laws 2026, Chapter 142) added A.R.S. § 36-420.06. In cardiac catheterization rooms where a radiation protection system is in use, a hospital may not require staff to wear lead aprons. Staff who choose not to wear one must wear a real-time dosimeter, and a radiation safety officer may still require aprons in defined circumstances. The governor signed the bill on June 19, 2026.
Chaptered law (Laws 2026, Chapter 142)General effective date, 2026 sessionSee Arizona
The New York State Department of Health repealed and replaced Part 16 of Title 10 of the New York Codes, Rules and Regulations (NYCRR). Section 16.58(b)(2) accepts a method of dose reduction equivalent to protective garments, provided that measurements demonstrate its effectiveness.
Recently adopted regulations (New York Department of Health)10 NYCRR § 16.58, fluoroscopic installationsSee New York
The Illinois Emergency Management Agency and Office of Homeland Security (IEMA-OHS) proposed amendments to 32 Ill. Adm. Code 360 (First Notice March 13, 2026, 50 Ill. Reg. 3961) that would let facilities use enhanced radiation protection systems instead of lead aprons during fluoroscopy for cardiac catheterization. On October 22, 2026, the agency paused its Second Notice to review forthcoming guidance from the Conference of Radiation Control Program Directors (CRCPD), and says it still plans to file it.
Under the state's Regulatory Sunset Act, the Radiation Protection Act of 1990 is scheduled for repeal on January 1, 2027. Bills that would extend it to 2037 (SB 3645 and HB 5190) had not been confirmed as law when ORSIF last checked, on November 3, 2026.
Radiation Protection Act of 1990 (420 ILCS 40)SB 3645 bill statusSee Illinois
Indiana's agreement with the NRC took effect on September 30, 2026, and Connecticut became an Agreement State in 2025, bringing the NRC's list to 41. Rules in both states may still be changing as they take over from the NRC.
A 2025 study in the Journal of the Society for Cardiovascular Angiography and Interventions (JSCAI) found that no central repository collects state radiation rules. Read the FAQ. ORSIF's State Rules Map is a step toward one.
For each of the 50 states and the District of Columbia, an AI research assistant read the state's rules, statutes and regulator pages and answered the same 14 questions. Each answer records the rule section, a link to the source page and, where possible, a short quote. A program then checked every quote against the pages the research read for that state: 663 of 670 matched word for word. A quote that could not be matched is not shown, and its answer carries a "Check the source" flag.
On November 5, 2026, a second check went back over the weakest answers, this time reading the full source pages. An answer changed only when its new quote was found on the source page or, for a "No", when the rules it could read did not contain the requirement. Those "No" answers have no quote, and their citation says where it looked. ORSIF then fetched the linked pages again and found nearly all the printed quotes on a page linked beside them. Some official sites block automated reading, so those could not be rechecked this way.
The headline counts on this page are computed from those answers. Agreement State status comes from the NRC's own list, updated October 29, 2026. A regulatory expert has not yet reviewed these summaries. The research for Alaska, Connecticut, Montana, Pennsylvania, Virginia and Wyoming ended before every question was fully answered, and those pages say so.
Comparison table (CSV) · Full dataset with citations (JSON)
Cite as: ORSIF, State Rules Map, researched November 3, 2026, rechecked November 5, 2026. https://orsif.org/guidelines/us/states.html
See an error, or a rule we missed? Tell ORSIF.
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