Indiana: radiation safety rules for fluoroscopy teams

Yes. Indiana became an Agreement State on 2026-09-30 (the IDHS page says the agreement was signed on Sept. 24). The IDHS Radioactive Materials Control Program runs the materials program, so materials rules may still be in transition.

410 IAC 5, Radiological Health (IDOH). General standards are in 410 IAC 5-4, Protection and Exposure Standards, which applies to all licensees or registrants. Medical X-ray and fluoroscopy rules are in 410 IAC 5-6.1, X-rays in the Healing Arts, especially 5-6.1-118 (general operating requirements) and 5-6.1-120 (fluoroscopic systems). Operator licensing is in 410 IAC 5.2. The text was read from IDOH's posted PDF, with history notes through a readoption filed Nov 13, 2019. A 2025 notice and memo say 410 IAC 5 was readopted without changes. The official site could not be loaded. IDHS's 290 IAC 3 covers radioactive-materials licensees.

Only partly. 410 IAC 5-4-1(b) says every reasonable effort 'should' be made to keep exposures ALARA, which is advisory. 410 IAC 5-6.1-118(x) mandates procedures and auxiliary equipment that minimize patient and personnel exposure, which is similar to ALARA but does not use the term.

Where ALARA lives in Indiana: In a shared rule and in X-ray-specific language. The advisory ALARA sentence is in the shared general standards rule, 410 IAC 5-4-1(b), but the X-ray rule (5-6.1-118(a)) cross-references only 5-4-2, 5-4-3 and 5-4-10, not 5-4-1. A separate X-ray-specific minimization duty is in 5-6.1-118(x). Materials licensees now fall under IDHS's 290 IAC 3, which incorporates 10 CFR Part 20. It is unconfirmed whether that incorporation is as of a fixed date. (410 IAC 5-4-1(b); 410 IAC 5-6.1-118(a), (x); 290 IAC 3-2-2)

Pre-1994 quarterly limit of 1¼ rem (12.5 mSv) per calendar quarter, which works out to 5 rem (50 mSv) a year. Up to 3 rem (30 mSv) per quarter is allowed if the dose history is recorded on Form Y and lifetime dose stays within 5(N-18) rem. There is no total effective dose equivalent (TEDE) concept and no annual limit. Minors are limited to 10% of these limits.

The lens of the eye falls under the whole-body limit of 1¼ rem (12.5 mSv) per quarter, or up to 3 rem (30 mSv) per quarter under the exception. There is no separate annual lens limit. This is a leftover of the old framework, not an adoption of the International Commission on Radiological Protection (ICRP)'s 20 mSv.

Hands, forearms, feet and ankles: 18¾ rem (187.5 mSv) per quarter. Skin of the whole body: 7½ rem (75 mSv) per quarter.

not found

A personal dosimeter is required for anyone in a restricted area who receives, or is likely to receive, more than 25% of a quarterly limit. For the whole body that is 0.3125 rem (3.125 mSv) per quarter. The threshold is 5% for workers under 18. Anyone entering a high radiation area must also be monitored. The dosimetry processor must be National Voluntary Laboratory Accreditation Program (NVLAP)-accredited. X-ray users are bound by 5-4-10 through 5-6.1-118(a).

not found. No rule covers collar or outside-apron placement, a two-badge method, or an approved effective dose formula. A footnote to 5-4-2 lets X-ray dose be taken as the exposure measured near the body surface where the dose rate is highest. 5-6.1-118(y) prohibits exposing a badge to give a false reading.

Only staff needed for the procedure or for training may be in the room. They must be protected from scatter by aprons or whole-body barriers of at least 0.25 mm lead equivalent. Any body part in the useful beam needs 0.5 mm lead equivalent. In fluoroscopy, there must be at least 0.25 mm lead equivalent below the table, and an additional 0.25 mm above the table beyond the apron unless the person is at least 120 cm from the beam center. No rule text was found on thyroid shields or protective eyewear.

not found

Engineered radiation protection systems are not named. 5-6.1-118(t)(2) accepts 'whole body protective barriers' of at least 0.25 mm lead equivalent as an alternative to aprons. 5-6.1-120(r)(2) lists drapes, Bucky-slot covers and self-supporting curtains for attenuating scatter above the table. The commissioner may exempt a facility where a sterile field prevents normal barriers, but not where prefitted sterilized covers are practical. Whether IDOH reads 'whole body protective barriers' to cover modern systems is unknown.

Only holders of an IDOH license, certificate or permit may operate a radiation machine. Physicians, dentists, chiropractors, podiatrists and dental hygienists are exempt, and IDOH may grant other exemptions. Radiologic technologists must be licensed to perform radiographic and fluoroscopic procedures. A limited cardiac catheterization radiography license exists, but its scope was not read. Physician assistants and nurse practitioners are not on the exemption list, and no provision authorizing them was found. A practitioner of the healing arts must authorize exposure to the useful beam.

A radiologic technologist license requires current American Registry of Radiologic Technologists (ARRT) certification and registration and lasts 24 months. A limited general radiography license excludes fluoroscopy, C-arm, contrast, mammography and portable surgery procedures. No physician fluoroscopy training rule and no state continuing education hours were found.