What Iowa's rules say about ALARA (as low as reasonably achievable), dose limits in millisieverts (mSv), dosimeters, aprons and training for the people who work in fluoroscopy labs.
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 It is not comprehensive and not always accurate: rules change, and answers may be incomplete, out of date or wrong.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
ORSIF's research identified the Bureau of Radiological Health, Iowa Department of Health and Human Services (Iowa HHS) as the agency that regulates X-ray and fluoroscopy equipment in Iowa. Iowa is a U.S. Nuclear Regulatory Commission (NRC) Agreement State: it has signed an agreement with the NRC to regulate certain radioactive materials itself.
Iowa replaced its radiation rules under Executive Order 10, effective 7/1/26, with Chapter 37 effective 7/29/26. The binding ALARA duty for X-ray registrants is in shared Chapter 37.11, which is consistent with 10 CFR Part 20. Dose limits follow the federal model, including a 150 mSv lens limit. All fluoroscopy workers must be badged. Aprons of at least 0.25 mm lead equivalent are required in interventional rooms and must be inspected annually. Apron alternatives are not addressed. Technologists need an American Registry of Radiologic Technologists (ARRT)-based permit and direct supervision for fluoroscopy; ARNPs may supervise after a course.
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.
Which rules apply, and whether ALARA is among them.
Yes. Iowa has been an NRC Agreement State since January 1, 1986.
The state of Iowa is an agreement state as of January 1, 1986.This quote was matched word for word to the source page.
641-Chapter 40 (ARC 0180D, effective 7/1/26) covers X-ray and fluoroscopy, with fluoroscopy in rule 40.6. General protection standards are in 641-37.11 (ARC 0387D, effective 7/29/26). Related chapters are 38 (operator permits), 39 (radioactive materials) and 42 (therapy and analytical machines). Pre-July 2026 numbering (Chapters 40/41) is out of date.
Yes, binding on registrants under 37.11(2)"b". 37.1(7) uses weaker 'should be made' wording, and ALARA is defined in 37.2.
Where ALARA lives in Iowa: In a shared rule and in X-ray-specific language. The binding occupational ALARA duty is in shared Chapter 37 (37.11(2)"b"), which applies to registrants and licensees and is consistent with 10 CFR Parts 19/20. Materials licensees also follow Part 20 by reference as amended to August 1, 2025. Chapter 40 mentions ALARA only for patient shielding (40.4(9)"b") and for staff not wearing aprons (40.6(14)"d"). (641-37.11 (introduction); 641-39.5(1); 641-40.6(14)"d")
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 public doses that are ALARA.This quote was matched word for word to the source page.
The annual limits for workers, written in millisieverts (mSv). Ten mSv equal one rem.
TEDE of 5 rem (50 mSv) per year. Deep dose plus committed dose to any single organ other than the lens is limited to 50 rem (500 mSv). Minors are limited to 10% of adult limits.
The total effective dose equivalent being equal to 5 rem (0.05 Sv)This quote was matched word for word to the source page.
15 rem (150 mSv) per year. Iowa has not adopted a lower lens limit.
A lens dose equivalent of 15 rem (0.15 Sv), andThis quote was matched word for word to the source page.
Shallow dose equivalent of 50 rem (500 mSv) per year to the skin or any extremity.
A shallow dose equivalent of 50 rem (0.5 Sv) to the skin of the whole body or to the skin of any extremity.This quote was matched word for word to the source page.
0.5 rem (5 mSv) to the embryo/fetus of a declared pregnant worker over the whole pregnancy.
does not exceed 0.5 rem (5 mSv).This quote was matched word for word to the source page.
When a worker must wear a dosimeter, and where.
Adults likely to exceed 10% of a limit in a year must be monitored. All individuals working with medical fluoroscopic equipment must be monitored regardless of expected dose. Declared pregnant workers likely to exceed 0.1 rem (1 mSv) must be monitored. Dosimeters must be processed by a National Voluntary Laboratory Accreditation Program (NVLAP)-accredited processor.
Eye-dose badge goes at the collar outside the apron, or at an unshielded spot closer to the eye. Fetal badge goes at the waist under the apron. Extremity badge goes on the highest-dose extremity. Badges under protective clothing follow National Council on Radiation Protection and Measurements (NCRP) Report No. 57, Chapter 4. Deep dose must be used for effective dose equivalent (EDE) unless a department-approved method is used, but no named approved method was found.
An individual monitoring device used for monitoring the eye dose equivalent, to demonstrate compliance with subrule 37.11(3) shall be located at the neck (collar), outside any protective apron being worn by the monitored individual or at an unshielded location closer to the eye;This quote was matched word for word to the source page.
Protective apparel, how it is checked, and whether other systems are addressed.
Aprons of at least 0.25 mm lead equivalent must be worn by all except the patient in interventional/special-procedure rooms (brief occupants may skip them if badge reports confirm low exposure) and in sterile-field cases. Barriers with viewing panels of at least 0.5 mm must be available. Ancillary shielding must be used on stationary systems, and sufficient apparel must be kept on hand. No rule requires wearing thyroid shields or eyewear.
Protective aprons of not less than 0.25 mm of lead equivalent shall be worn in the fluoroscopy room by all individuals (except the patient).This quote was matched word for word to the source page.
Yes. All protective apparel and auxiliary shields must be evaluated annually for integrity and labeled with their lead equivalent. The method is not specified.
All protective apparel and auxiliary shields shall be evaluated annually for integrity and clearly labeled with lead equivalent.This quote was matched word for word to the source page.
Not addressed. No rule covers engineered systems replacing aprons. Ancillary shielding is supplemental and aprons are still required. 40.4(8)"b"(3) allows whole body barriers but is framed around radiographic exposure. Waivers and exemptions exist but are not specific to this technology.
For stationary fluoroscopic systems, ancillary shielding, such as drapes, self-supporting curtains, or viewing shields, shall be available and used as supplemental protection for all individuals other than the patient in the room during a fluoroscopy procedure.This quote was matched word for word to the source page.
Who may use fluoroscopy equipment and what training the rules ask for.
An Iowa permit is required, except for physicians, PAs, chiropractors, dentists, hygienists, podiatrists, certified dental radiographers and students. Limited permit holders may not perform fluoroscopy. Technologists and students need direct supervision by a licensed practitioner, radiologist assistant or ARNP. ARNPs may supervise after a course, but it is unclear whether they may operate. A licensed practitioner must interpret all images.
The use of fluoroscopy by radiologic technologists and radiologic students shall be performed under the direct supervision of a licensed practitioner, a radiologist assistant or an ARNP, pursuant to 481-subrule 621.4(5)This quote was matched word for word to the source page.
Technologist permit requires passing the ARRT radiography exam and 24 continuing education (CE) hours every two years. Radiologist assistants need formal education, one year as a technologist, the ARRT RA exam and 50 CE hours. All fluoroscopy operators need qualified-expert training in eight topics and competence in dose-saving features. Supervising ARNPs need a course. There is no separate fluoroscopy permit, set hour count or physician-specific requirement.
Submit proof of a passing score on the ARRT general radiography examination, the NMTCB nuclear medicine examination, or the ARRT radiation therapist examination.This quote was matched word for word to the source page.
Rules, bills and guidance the research found from 2025 and 2026, with the ones that touch fluoroscopy teams first.
Adopted; effective July 29, 2026
Proposed as ARC 9772C (11/26/25), amended as ARC 0223D (4/29/26), adopted in IAB 6/24/26 with no comments and no changes.
Adopted; effective July 1, 2026
Full Red Tape Review replacement of Chapters 38-42; the new chapters carry a rescission date of 7/1/31.
Questions the research could not settle. If you know the answer, tell us.
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