Illinois: radiation safety rules for fluoroscopy teams

Yes. Illinois is on the NRC's list of Agreement States, updated October 29, 2026.

The X-ray and fluoroscopy rule is 32 Ill. Adm. Code 360, "Use of X-Rays in the Healing Arts Including Medical, Dental, Podiatry, and Veterinary Medicine." Fluoroscopy is in Section 360.50. Part 360 was last amended effective May 29, 2014 (38 Ill. Reg. 12031), and Section 360.50 effective February 29, 2008 (32 Ill. Reg. 3693). Part 360 applies in addition to Parts 310, 320, 340, 400 and 410. General standards are in Part 340, and operator accreditation is in Part 401.

Yes. 340.110(b) applies to each licensee or registrant, and X-ray machine users are registrants. The annual program review in 340.110(c) applies only to licensees; registrants must review their program at least once per inspection cycle (340.110(e)).

Where ALARA lives in Illinois: In a shared rule and in X-ray-specific language. The explicit ALARA requirement is only in the shared rule, Part 340, which covers both licensees and registrants. The X-ray rule, Part 360 (Section 360.30), requires "procedures to minimize patient and occupational doses" but does not use ALARA wording. An NRC-driven change to Part 340 would apply to X-ray registrants unless Illinois limits it to licensees. (32 Ill. Adm. Code 340.110(b); 360.30)

0.05 Sv (5 rem), or 50 mSv per year, TEDE.

0.15 Sv (15 rem), or 150 mSv per year. No lower lens limit has been adopted.

0.5 Sv (50 rem), or 500 mSv per year, for the skin or any extremity.

not found. The only related figure found is the monitoring trigger for declared pregnant women: a deep dose above 1 mSv (0.1 rem) during the pregnancy.

Individual dosimeters must be provided and used for adults likely to receive more than 10% of the 340.210(a) limits in a year, minors likely to receive more than 10% of their limits, declared pregnant women likely to receive a deep dose above 1 mSv (0.1 rem) during the pregnancy, and anyone entering a high or very high radiation area. Section 360.30 applies these monitoring rules to everyone associated with X-ray operation.

not found. No badge location, two-badge method or effective-dose method was found. 340.210(d) allows doses to be estimated from surveys if the dosimeter was not in the region of highest exposure.

In general fluoroscopy, the operator, assistants and observers must be protected by aprons of at least 0.25 mm lead equivalent, by whole-body barriers, or by sufficient distance. A shield of at least 0.25 mm lead equivalent must be provided and used but does not replace the apron. In stationary cardiac cath rooms, aprons are mandatory for everyone except the patient, and any viewing panel must be at least 0.5 mm lead equivalent. No thyroid shield or eyewear requirement was found.

not found. Section 360.30 requires written procedures on the use of personnel and patient protective devices, but no inspection interval or method was found.

Current rules allow whole-body barriers or distance instead of aprons in general fluoroscopy, but shields do not replace aprons and aprons are required for everyone in stationary cardiac cath rooms. A proposed rule (50 Ill. Reg. 3961, published March 13, 2026) would authorize Enhanced Radiation Protection Systems as an alternative to lead aprons. It was paused on October 22, 2026.

Only those licensed under the Medical Practice Act, Dental Practice Act or Podiatric Medical Practice Act may operate fluoroscopy on people, with four exceptions: accredited medical radiographers for static functions needing no diagnostic interpretation, under supervision; accredited radiographers under the direct supervision of a licensed practitioner who is physically present and participating; accredited radiographers or radiation therapists for therapy simulation, under supervision; and accredited radiologist assistants under the supervision of an ABR- or AOBR-certified practitioner. Physician assistants and nurse practitioners are not listed.

Non-physician operators must hold IEMA-OHS accreditation under Part 401 as a medical radiographer, radiation therapist or radiologist assistant, which includes examination and renewal requirements. The hospital rule requires accredited staff to take continuing education. All operators must be instructed in, and show competence with, the registrant's operating and safety procedures. No fluoroscopy-specific training requirement for physicians was found.