California: radiation safety rules for fluoroscopy teams

Yes. Based on the NRC Agreement State list (updated 2026-10-29).

General radiation protection: 17 CCR § 30253 (Group 3, Subchapter 4; scope § 30252). Medical X-ray: Group 3, Article 4, starting at § 30305, plus § 30305.5 and § 30307. Operator rules: Subchapter 4.5, starting at § 30400. Text was read on Cornell LII (secondary); Cornell's heading for § 30305 appears mislabeled. § 30253 was last amended operative 7-1-2022.

Yes, by adoption. § 30253 adopts 10 CFR 20.1001-20.2402; 20.1101 (ALARA) falls in that range and is not excepted. "Licensee" is replaced by "User," which includes X-ray registrants. The text of 20.1101 itself was not read. The X-ray rules' "as low as is practicable" wording (§ 30307(a)(7)(A)) concerns the beam exposure rate at the patient, not staff doses.

Where ALARA lives in California: Only in a rule shared with radioactive materials. The staff ALARA duty comes from the general § 30253 adoption of 10 CFR 20, which applies to "Users" (both radioactive-materials licensees and X-ray registrants). No X-ray-specific staff ALARA language was found. Because the adoption is fixed at January 1, 2021, an NRC change would not apply automatically; CDPH would have to amend § 30253. (17 CCR §§ 30100(z), 30253(a)(5), 30305(a)(1))

Federal 10 CFR 20.1201 is adopted as of 2021 and applies to any source of ionizing radiation. The standard federal figure is 5 rem (50 mSv) per year total effective dose equivalent (TEDE), but this number was not verified by this research.

California adopts the federal occupational dose limits, which set the annual limit for the lens of the eye at 15 rem (150 mSv). No lower California lens limit, such as the International Commission on Radiological Protection (ICRP)'s 20 mSv, appears in the adopted rules.

California adopts the federal occupational dose limits, which set the annual limit for the skin and the extremities (shallow-dose equivalent) at 50 rem (500 mSv).

Under the adopted federal rule, the dose to the embryo/fetus of a declared pregnant worker may not exceed 0.5 rem (5 mSv) over the entire pregnancy. Employers must also try to avoid large month-to-month variation in that worker's exposure.

Under the adopted federal rule, an individual dosimeter is required for workers likely to receive more than 10 percent of an applicable annual dose limit in a year. California does not set a separate X-ray badging threshold.

California adopts the federal rule that a badge reading must be counted as the dose to the part of the body that gets the highest exposure. A lower effective dose estimate (for example a two-badge method) may be used only if the method is approved by the state health department, which stands in for the federal regulator. The rules name no badge location, two-badge method or formula, and no state-approved method is published.

Aprons of at least 0.25 mm lead equivalent are required for everyone in the fluoroscopy room except the patient who is likely to be exposed to 5 mR/hr or more (in place since 10-1-2020). Drapes and panels of at least 0.25 mm lead equivalent are required whenever practicable. Thyroid shields and eyewear are not addressed.

California's fluoroscopy rules require protective aprons for people likely to be exposed to 5 mR per hour or more, but set no requirement to inspect aprons on any schedule.

The rules do not mention engineered shielding systems. Aprons of at least 0.25 mm lead equivalent must be worn by each person, except the patient, whose body is likely to be exposed to 5 mR/hr (0.05 mSv per hour) or more, so by the rule's own terms the apron duty depends on the exposure rate. Drapes and hinged or sliding panels on their own may not replace the apron.

Only permit holders may operate. Physicians, osteopaths, podiatrists and chiropractors need a fluoroscopy S&O permit (§ 30463); radiologists may instead hold a radiology S&O certificate (§ 30466). Certified technologists need an RTF permit and work under a licentiate's supervision (§§ 30450, 30461). PAs need a PA fluoroscopy permit and work under an S&O-permitted physician (§ 30456.1). Unpermitted people may move the patient or equipment but may not energize the beam or select technique (§ 30305.5). No NP pathway was found.

Licentiates must pass a CDPH-approved fluoroscopy exam (ACBR-certified chiropractors exempt); a secondary source says renewal needs 10 CE credits every 2 years, at least 4 in fluoroscopy radiation safety (§ 30403(b), not read directly). A temporary permit has been available since December 15, 2022. Technologists must be certified, complete permit school or have American Registry of Radiologic Technologists (ARRT) credentials, and pass CDPH exams. PAs need at least 40 hours of coursework plus supervised clinical training, and 10 CE hours every 2 years.