Kansas: radiation safety rules for fluoroscopy teams

Yes. Kansas is not on the NRC list of non-Agreement States, so it is an Agreement State. KDHE describes its 2025 rule changes as keeping Kansas compatible with NRC rules.

Diagnostic X-ray rules are in Part 5, K.A.R. 28-35-241 to 28-35-256, including 28-35-243a for fluoroscopic systems and 28-35-256 for operator training. The Standards for Protection Against Radiation are in Part 4, K.A.R. 28-35-211a to 28-35-234a, written by Kansas itself. Rule text was taken from Cornell LII, a secondary source.

Yes. The Part 4 radiation protection program rule applies to each licensee or registrant. It requires procedures and engineering controls to keep doses ALARA and a program review at least every 12 months. The X-ray rules pull X-ray workers into Part 4.

Where ALARA lives in Kansas: Only in a rule shared with radioactive materials. The general ALARA duty is in K.A.R. 28-35-211d, the single Part 4 standard for both radioactive-materials licensees and X-ray registrants. The X-ray rules link to Part 4 through 28-35-242a(a)(9) rather than stating their own ALARA duty. ALARA is also mentioned in fluoroscopy weighting-factor approvals under 28-35-212a(c)(2), which is itself in Part 4. (K.A.R. 28-35-211d; 28-35-242a(a)(9) (effective Dec. 30, 2005); 28-35-212a(c)(2))

0.05 Sv (5 rem), which is 50 mSv per year TEDE. There is also a separate 500 mSv limit to any organ other than the lens.

0.15 Sv (15 rem), which is 150 mSv per year. Kansas has not adopted the International Commission on Radiological Protection (ICRP)'s 20 mSv.

0.50 Sv (50 rem), which is 500 mSv per year shallow dose to the skin or any extremity.

5 mSv (0.5 rem) to the embryo/fetus of a declared pregnant woman over the whole pregnancy.

Dosimeters are required for adults likely to exceed 10% of an adult limit in a year from external sources (5 mSv whole body, 15 mSv lens, 50 mSv skin or extremity). They are also required for minors and declared pregnant women likely to exceed 10% of the limit that applies to them, and for anyone entering a high or very high radiation area. Badges that need processing must be read by a National Voluntary Laboratory Accreditation Program (NVLAP)-accredited processor.

When an apron is worn, the badge goes at the collar outside the apron. A single badge reading is recorded as the whole-body dose. With written approval from the Secretary (the request must include ALARA procedures), apron-wearing fluoroscopists may use weighting factors. One neck badge: the deep dose is the effective dose. One neck badge reading above 25% of the limit: deep dose x 0.3. Two badges: 1.5 x waist reading + 0.04 x neck reading. The rule does not name National Council on Radiation Protection and Measurements (NCRP) 122 or Webster.

Everyone in the room other than the patient must be protected by aprons or whole-body protective barriers of at least 0.25 mm lead equivalent. Any body part in the useful beam needs at least 0.5 mm. Facilities must keep enough leaded aprons and gloves for X-ray personnel. Fluoroscopy rooms have under-table and over-table scatter shielding requirements. Thyroid shields and eyewear were not found in rule text; a KDHE dental guide mentions a thyroid shield, but that is not rule text.

not found

No rule specifically addresses engineered systems that replace aprons. Three provisions come close: 242a(a)(5)(B) accepts whole-body protective barriers of at least 0.25 mm lead equivalent; 243a(h)(2)(B) counts drapes and curtains as scatter shielding; and 28-35-242(a) allows the Secretary to waive requirements for an equivalent-protection alternative. Whether commercial systems qualify is not addressed.

Exposures must be authorized by a licensed practitioner, a physician-supervised PA or APRN, a dentist or a podiatrist. The fluoroscopy tube needs continuous manual activation by 'the fluoroscopist' (term not defined). Operators must be instructed and competent. KSBHA licenses radiologic technologists. Exempt from licensing are licensed practitioners, students, people helping in emergencies, and PAs, nurses and unlicensed persons who are supervised and trained on the equipment.

Licensed technologists: the Board may accept an American Registry of Radiologic Technologists (ARRT) (or equivalent) certificate, and 12 continuing education (CE) credits per year are required. Exempt operators need 12 CE credits per year including equipment training, per KSBHA. KDHE rule 28-35-256 lists general training topics without set hours. No state fluoroscopy permit, fluoroscopy-specific hours requirement or physician fluoroscopy training requirement was found.