Delaware Radiation Safety Rules for Fluoroscopy Teams

Please double-check this information. This is an ORSIF research summary, researched November 3, 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 It is not comprehensive and not always accurate: rules change, and answers may be incomplete, out of date or wrong.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. Not yet reviewed by a regulatory expert. Confirm each requirement at the source linked beside the answer, with the state program and with your facility's radiation safety officer. How this was made

In brief

ORSIF's research identified the Delaware Department of Health and Social Services, Division of Public Health, Health Systems Protection, Office of Radiation Control (ORC) as the agency that regulates X-ray and fluoroscopy equipment in Delaware. Delaware is not a U.S. Nuclear Regulatory Commission (NRC) Agreement State, so the NRC regulates radioactive materials there directly. The state still regulates X-ray machines.

Delaware's Division of Public Health, Office of Radiation Control, regulates fluoroscopy under 16 Del. Admin. Code 4465. Part D requires every licensee or registrant to keep worker doses ALARA. Delaware is not an NRC Agreement State, so an NRC compatibility change would not automatically reach its rule. Dose limits follow the federal model: 50 mSv whole body, 150 mSv lens of the eye, 500 mSv skin and extremities, and 5 mSv embryo/fetus. All fluoroscopy workers must wear a dosimeter. Where sterile fields or special procedures prevent normal barriers or drapes, everyone in the room except the patient must wear an apron of at least 0.25 mm lead equivalent, and aprons must be checked annually. The rules do not mention engineered systems, though a general rule accepts whole-body protective barriers for scatter protection. Physicians, PAs and APRNs within their scope of practice and certified radiologic technologists may operate fluoroscopy; radiologist assistants, residents and students may do so under supervision. Every operator and supervisor must complete set training topics, but no number of hours is specified.

ALARA for X-ray usersYesBoth Whole-body limitTotal effective dose equivalent of 0.05 Sv (5 rem) = 50 mSv per year. Eye-lens limit150 mSva year Apron inspectionRequired Alternatives to apronsNot found

The rules, question by question

Every answer names the rule it comes from. Open "Rule text and source" to read the citation, the source page and, where it could be matched, the exact wording.

Where the rules live

Which rules apply, and whether ALARA is among them.

Is Delaware an NRC Agreement State?

No. Delaware is not an NRC Agreement State; the NRC licenses radioactive materials and the state only registers those facilities.

Rule text and source

Rule: NRC list of Agreement States, updated October 29, 2026; 4465 Part C §1.0
Source: nrc.gov
archive.regulations.delaware.gov
What it says: Primary radioactive material licensing and enforcement authority was transferred to the NRC in 2007, pursuant to the Federal Energy Policy Act of 2005. However, radioactive material facilities must be registered with the State of Delaware
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Which rules cover X-ray and fluoroscopy equipment in Delaware?

Yes

16 Del. Admin. Code 4465 Part F (fluoroscopy at §5.0), with the general protection standard in Part D. Related parts are Part B (registration and radiation safety officer (RSO)) and Part J (notices and instructions to workers). Technologist certification is in a separate rule, 4466.

Rule text and source

Rule: 4465 Part F §1.0; Part D §2.0
Source: archive.regulations.delaware.gov
What it says: This Part establishes requirements, for which a registrant is responsible, for use of diagnostic and interventional X-ray equipment and imaging systems
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Does Delaware require X-ray users to keep doses as low as reasonably achievable (ALARA)?

Yes

Yes. Part D §5.2 requires each licensee or registrant to keep occupational doses ALARA, with an annual program review (§5.3). Part F §3.1.10 adds an X-ray-specific duty to use dose reduction strategies.

Where ALARA lives in Delaware: In a shared rule and in X-ray-specific language. The binding ALARA duty is in Part D §5.2, written for licensee or registrant (the format shared with materials licensees). In practice it applies mainly to X-ray registrants because Delaware is not an Agreement State. X-ray-specific language appears in Part B Appendix C (RSO duties), Part F §3.1.10 and Part F §3.1.1.2. (4465 Part A §1.0; Part D §5.2; Part B §6.2.2 and Appendix C; Part F §§3.1.1.2, 3.1.10)

Rule text and source

Rule: 4465 Part D §5.2; Part F §§3.1.10, 3.1.21
Source: archive.regulations.delaware.gov
What it says: The licensee or registrant shall use, to the extent practical, procedures and engineering controls based upon sound radiation protection principles to achieve occupational doses and doses to members of the public that are as low as is reasonably achievable (ALARA).
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Dose limits

The annual limits for workers, written in millisieverts (mSv). Ten mSv equal one rem.

What is the annual whole-body dose limit in Delaware?

Yes

Total effective dose equivalent of 0.05 Sv (5 rem) = 50 mSv per year.

Rule text and source

Rule: 4465 Part D §6.1.1.1
Source: archive.regulations.delaware.gov
What it says: The total effective dose equivalent being equal to 0.05 Sievert (5 rem, or 5000 millirem)
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

What is the annual eye-lens dose limit in Delaware?

Yes

0.15 Sv (15 rem) = 150 mSv per year. No lower International Commission on Radiological Protection (ICRP)-style limit has been adopted.

Rule text and source

Rule: 4465 Part D §6.1.2.1
Source: archive.regulations.delaware.gov
What it says: A lens dose equivalent of 0.15 Sievert (15 rem, or 15,000 millirem)
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

What is the annual limit for the skin, hands and feet in Delaware?

Yes

Shallow dose equivalent of 0.5 Sv (50 rem) = 500 mSv per year to the skin or any extremity.

Rule text and source

Rule: 4465 Part D §6.1.2.2
Source: archive.regulations.delaware.gov

Why this matters, in ORSIF's FAQs

What limit applies to a declared pregnant worker in Delaware?

Yes

5 mSv (0.5 rem) to the embryo/fetus of a declared pregnant woman over the whole pregnancy. Registrants must also try to avoid substantial month-to-month variation.

Rule text and source

Rule: 4465 Part D §§12.1, 12.2
Source: archive.regulations.delaware.gov
What it says: does not exceed 5 millisievert (0.5 rem, or 500 millirem)
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Dosimeters

When a worker must wear a dosimeter, and where.

When must a worker in Delaware wear a dosimeter?

Yes

Adults likely to exceed 10% of a limit must be monitored, and declared pregnant women must be monitored if likely to exceed 1 mSv. Everyone working with medical fluoroscopic equipment must be monitored, with no threshold.

Rule text and source

Rule: 4465 Part D §§17.1.1.1, 17.1.1.3, 17.1.1.5
Source: archive.regulations.delaware.gov
What it says: shall supply and require the use of individual monitoring devices by: 17.1.1.1 Adults likely to receive, in 1 year from sources external to the body, a dose in excess of 10% of the limits in subsection 6.1; … 17.1.1.5 Individuals working with medical fluoroscopic equipment.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Where must the dosimeter be worn in Delaware when a protective apron is worn?

Yes

The whole-body badge goes at the unshielded location with the highest exposure, typically the collar when an apron is worn. A second badge at the waist under the apron is optional but required for a declared pregnant woman. With one collar badge, the reported deep dose equivalent counts as the effective dose equivalent, multiplied by 0.30 if the reported dose is above 25% of the limit. With two badges, effective dose equivalent (EDE) = 1.5 × waist + 0.04 × collar. The rule does not name National Council on Radiation Protection and Measurements (NCRP) Report 122 or Webster, and parts of the wording are garbled.

Rule text and source

Rule: 4465 Part D §§6.3.2.1-6.3.2.3, 17.1.1.5.1-17.1.1.5.2, 18.1.1-18.1.4
Source: archive.regulations.delaware.gov
What it says: the effective dose equivalent for external radiation shall be assigned the value of the sum of the deep dose equivalent reported for the individual monitoring device located at the waist under the protective apron multiplied by 1.5 and the deep dose equivalent reported for the individual monitoring device located at the neck outside the protective apron multiplied by 0.04.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Aprons and alternatives

Protective apparel, how it is checked, and whether other systems are addressed.

Must staff in Delaware fluoroscopy rooms wear protective aprons or other apparel?

Yes

Where sterile fields or special procedures prevent normal barriers or drapes, everyone in the room except the patient must wear an apron of at least 0.25 mm lead equivalent. Generally, scatter protection must be at least 0.25 mm (garments or whole-body barriers), and 0.5 mm is required where the direct beam could strike the body. Ancillary shielding is required on stationary fluoroscopy systems. Thyroid shields and eyewear are not required.

Rule text and source

Rule: 4465 Part F §§3.1.6, 3.1.18.1-3.1.18.2, 5.12.1-5.12.3
Source: archive.regulations.delaware.gov
What it says: Where sterile fields or special procedures prohibit the use of normal protective barriers or drapes, all of the following conditions shall be met: … All persons, except the patient, in the room where fluoroscopy is performed shall wear protective aprons that provide a lead equivalent shielding of at least 0.25 millimeters.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Does Delaware require protective aprons to be inspected?

Yes

Yes. All protective apparel and auxiliary shields must be evaluated annually for integrity and labeled with their lead equivalence. No inspection method is specified.

Rule text and source

Rule: 4465 Part F §§3.1.7, 5.15.1.7
Source: archive.regulations.delaware.gov
What it says: All protective apparel and auxiliary shields shall be evaluated annually for integrity and clearly labeled with their lead equivalence.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Do the rules in Delaware address engineered protection systems used in place of aprons?

UnclearLess certain

Not addressed directly. The rule does not mention engineered systems. §3.1.18.2 accepts whole-body protective barriers as an alternative to garments for scatter protection, but §5.12 makes aprons mandatory where sterile fields or special procedures prevent normal barriers. How the two interact is unsettled.

Rule text and source

Rule: 4465 Part F §§3.1.18.2, 5.12.1-5.12.2; Part D §5.2
Source: archive.regulations.delaware.gov
What it says: All persons shall be protected from the secondary radiation by protective garments or whole body protective barriers of not less than 0.25 millimeter lead equivalent material;
This quote was matched word for word to the source page.

About ALARA+

Who operates the equipment

Who may use fluoroscopy equipment and what training the rules ask for.

Who may operate fluoroscopy equipment in Delaware?

Yes

Physicians, PAs and APRNs within scope of practice, and certified radiologic technologists. Radiologist assistants may operate under direct radiologist supervision; licensed PAs who passed the American Registry of Radiologic Technologists (ARRT) Fluoroscopy Exam under direct physician supervision; and residents and students under personal physician supervision. Registered nurses are not listed.

Rule text and source

Rule: 4465 Part F §§2.0, 5.13.1.1-5.13.1.4, 5.14.1; Reg. 4466 §§4.0, 5.1-5.2
Source: regulations.delaware.gov
What it says: A licensed practitioner who is also a physician, or an advanced practitioner (PA or APRN) working within their professional scope of practice per Title 24 Delaware Code, or a certified radiologic technologist working within their scope of practice per these radiation control regulations.
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

What training or credentials does Delaware require to operate fluoroscopy equipment?

In part

All operators and supervisors must complete training in listed topics, with additional topics for fluoroscopically guided interventional (FGI) procedures and documentation kept for 3 years. No hours, physician permit or physician exam are required. Technologists need a state certificate based on a national credential, valid for 3 years.

Rule text and source

Rule: 4465 Part F §§5.13.2-5.13.3; Reg. 4466 §§6.2.3, 6.3.5, 7.1, 7.3, 8.1, 8.3
Source: archive.regulations.delaware.gov
What it says: All persons operating, or supervising the operation of, fluoroscopy systems shall have completed training that includes but is not limited to the following:
This quote was matched word for word to the source page.

Why this matters, in ORSIF's FAQs

Changes on the way, and recent ones

Rules, bills and guidance the research found from 2025 and 2026, with the ones that touch fluoroscopy teams first.

Adopted rule28 DE Reg. 667 (4465) and 28 DE Reg. 668 (4466) final amendments
final; 4465 amendments effective March 11, 2025 (Mar 1, 2025)
Restored the PA/APRN authority that the October 2024 amendments had accidentally removed.
Source: archive.regulations.delaware.gov
Adopted ruleAmendments to 4465 and 4466 (28 DE Reg. 312 and 313)
adopted (Oct 1, 2024)
October 2024 amendments to 4465 and 4466. These inadvertently removed PA/APRN authority.

Also worth knowing

FGI facilities must have a Radiation Protocol Committee that meets at least every 12 months (Part F §5.16).
Facilities need a written patient dose-management policy following ACR-AAPM, NCRP Report 168 or an equivalent (§5.14.7).
Only those needed for the procedure, those in training, or a parent or guardian may be in the immediate area while the tube is energized (§3.1.18).
No one may be used routinely to hold the patient or image receptor (§3.1.20.3).
Workers likely to exceed 1 mSv a year must be instructed in radiation risks and the purpose of protective devices (Part J §3.1).
ORC posts a sample declaration-of-pregnancy letter and the 'Form X' employee notice.
All fluoroscopy workers must be monitored regardless of expected dose (Part D §17.1.1.5).

What ORSIF could not confirm

Questions the research could not settle. If you know the answer, tell us.

Is the text current? The archive PDF runs through the March 2025 amendments, and the current official viewer at regulations.delaware.gov/AdminCode/title16/4465 could not be loaded.
2026 rulemaking: the May, June, September, October and November 2026 Register issues, and bills in the 153rd General Assembly, were not checked.
Would ORC accept an engineered system instead of aprons, given §3.1.18.2 and §5.12.2.2, or would it require an exemption under Part A §3.0?
Does 'certified radiologic technologist' cover CCI-credentialed cardiovascular technologists? How are the two PA provisions (§§5.13.1.1 and 5.13.1.3) applied? Can registered nurses ever activate fluoroscopy?
How do the single-collar-badge provisions §6.3.2.1 and §6.3.2.2 fit together, and what does the wording of §17.1.1.5.2 mean?
Apron inspection method is not specified in §3.1.7; ORC inspection guidance or the Users Guide to Machine Registration may address it.
The text of 16 Del.C. Chapter 74 (Radiation Control Act) was not read directly.

Who regulates, and where to read the rules

Double-check before you rely on this page

ORSIF compiled this page from the sources linked on it and did its best. It is not comprehensive and it is not always accurate. Rules change, a rule may have been missed or misread, and the sources themselves can be out of date. Treat this page as a starting point.

Where to check

The rule itself. Open "Rule text and source" under any answer, or read the sources listed below.
The state. Delaware Department of Health and Social Services. Program contacts in the CRCPD directory.
Your radiation safety officer. They know the federal, accreditation and facility requirements that apply at your site, which the state rules do not cover.

What may be missing here

1 of 14 answers on this page are "Not found" or "Unclear". That means ORSIF did not find the answer in the rules it reviewed, not that no rule exists.
1 answers carry a flag or a lower confidence ("Check the source" or "Less certain").
Researched November 3, 2026. Rules may have changed since.
Only the state's rules for X-ray and fluoroscopy equipment were reviewed.

Found something wrong or missing? Tell ORSIF.

Sources and terms

Terms used on this page

ALARA: As low as reasonably achievable: keep radiation doses as low as is reasonable, below the legal limits.
Agreement State: A state that has signed an agreement with the U.S. Nuclear Regulatory Commission to regulate certain radioactive materials itself.
mSv: Millisievert, a unit of radiation dose. Ten mSv equal one rem, the older unit some rules still use.
Dosimeter: A badge or device worn to measure a worker's radiation dose.
Lead equivalent: The thickness of lead (mm Pb) that would give the same protection as the material described.
NRC: U.S. Nuclear Regulatory Commission
ICRP: International Commission on Radiological Protection
NCRP: National Council on Radiation Protection and Measurements
EDE: Effective dose equivalent
ARRT: American Registry of Radiologic Technologists
FGI: Fluoroscopically guided interventional
RSO: Radiation safety officer

All 11 sources the research read

Found something out of date or wrong? Tell ORSIF. Corrections are checked against the rule text and the page is updated.