Louisiana: radiation safety rules for fluoroscopy teams

Yes. Louisiana is not on the NRC's list of non-Agreement States. LDEQ sent the NRC its final compatibility rule RP071, published in the Louisiana Register on December 20, 2024.

LAC Title 33, Part XV (Radiation Protection). Chapter 6, "X-Rays in the Healing Arts" (§§601-699), covers X-ray and fluoroscopy, with fluoroscopy at §605. Chapter 4, "Standards for Protection Against Radiation", is the general rule. Chapter 6 adds to the rest of Part XV rather than replacing it. The text used is LDEQ's April 2026 compilation, not the official OSR LAC. The older 2017 PDF is out of date.

Yes. §406.B requires each licensee or registrant to use procedures and engineering controls to keep occupational and public doses ALARA. §406.C requires the radiation protection program to be reviewed at least every 12 months.

Where ALARA lives in Louisiana: Only in a rule shared with radioactive materials. The ALARA duty for X-ray users appears only in Chapter 4 (§406), which applies to both materials licensees and machine registrants. Chapter 6 has no ALARA wording, only related dose-minimization duties (§603.A.14, §603.A.18). Chapter 7's ALARA program (§705) does not apply to X-ray registrants. (LAC 33:XV.402.A, 406.B, 603.A.14, 603.A.18)

0.05 Sv (5 rem), or 50 mSv, TEDE per year. The limit applies to X-ray workers via §603.A.21.

0.15 Sv (15 rem), or 150 mSv, per year. Louisiana has not adopted the International Commission on Radiological Protection (ICRP) 20 mSv lens limit. The limit was last amended at LR 40:1341 (July 2014).

0.5 Sv (50 rem), or 500 mSv, per year shallow dose to the skin of the whole body or to any extremity.

5 mSv (0.5 rem) to the embryo/fetus of a declared pregnant woman over the whole pregnancy. Employers should avoid substantial variation above a uniform monthly exposure rate; a footnote cites National Council on Radiation Protection and Measurements (NCRP) 91's recommendation of no more than 0.5 mSv per month.

Adults likely to receive more than 10% of a §410 limit in a year from external sources must wear a dosimeter, and the same 10% test applies to minors and declared pregnant women against their own limits. Separately, individuals working with medical fluoroscopic equipment are listed as a group that must be given and use dosimeters, apparently without the 10% test. LDEQ's interpretation of that category is unconfirmed.

When an apron is worn, at least one badge goes at the collar outside the apron. A second badge, if used, goes at the waist under the apron, and it is required for declared pregnant women. Effective dose is calculated as follows: with one neck badge, the deep dose counts in full; with one neck badge and a reported dose above 25% of the limit, the deep dose is multiplied by 0.3; with two badges, effective dose is 1.5 × waist + 0.04 × neck. Other department-approved methods are allowed. NCRP 122 and Webster are not named.

Everyone in the fluoroscopy room except the patient must wear aprons of at least 0.25 mm lead equivalent where sterile fields or special procedures prevent using barriers or drapes. Stationary systems must have drapes, curtains or viewing shields. Staff may instead be protected by whole-body protective barriers of at least 0.25 mm lead equivalent (§603.A.7.b). Facilities must have enough aprons and gloves for all X-ray personnel not otherwise shielded. Thyroid shields and protective eyewear are not mentioned.

Yes. All protective apparel and auxiliary shields must be evaluated for integrity every 12-14 months and labeled with their lead equivalence. The inspection method is not specified.

Engineered radiation protection systems are not addressed by name. "Whole body protective barriers" of at least 0.25 mm lead equivalent are allowed as an alternative to aprons, but the term is undefined.

Under the DEQ rule: licensed practitioners (including NPs and PAs) or medical residents within their scope of practice; ARRT fluoroscopy-certified individuals under general supervision; and other RTs or RT students only under personal supervision. The statute's definition of licensed practitioner (2018 compilation) does not list PAs, so PA status is unresolved.

Everyone who operates or supervises fluoroscopy needs at least 2 hours of training on 10 listed topics, with records kept 3 years. Operators who are not practitioners or residents need ARRT fluoroscopy certification. There is no state fluoroscopy permit or fluoroscopy-specific continuing education, and the LXMO limited permit excludes fluoroscopy.