Maine: radiation safety rules for fluoroscopy teams

Yes. Maine is not among the non-Agreement States on the NRC list, and the NRC's July 10, 2025 periodic meeting summary on the Maine Agreement State Program is consistent with this.

All rules are in 10-144 CMR ch. 220 (Radiation Protection Rule). Part D (Standards for Protection Against Radiation, October 23, 2022) covers licensees and registrants. Part F (X-Rays in the Healing Arts, October 23, 2022) covers medical X-ray, with §F.6 specific to fluoroscopy. Part A holds the definitions. The chapter was last amended October 23, 2022 (filing 2022-210).

Yes. Part D requires every licensee or registrant (which includes X-ray machine users) to use procedures and engineering controls to keep occupational doses ALARA. Part F §F.3.A(1)(j) also makes X-ray personnel subject to D.1201, D.2104 and D.1502.

Where ALARA lives in Maine: Only in a rule shared with radioactive materials. The binding occupational ALARA duty is in Part D §1101.B, the Standards for Protection Against Radiation part shared by radioactive-materials licensees and X-ray registrants. Part F mentions ALARA only in Appendix G, as the stated basis for the QA program, and has a general duty to minimize personnel exposure (§F.3.A(1)(i)); neither is a separate occupational-dose ALARA requirement. This research's own reading, not stated in the rules, is that an NRC-driven change to Part D would affect the X-ray ALARA duty unless the State carves it out. (Part D §1101.B; Part F §F.3.A(1)(i) and Appendix G §I.C; 22 M.R.S. §674(4)(B)-(C))

TEDE of 0.05 Sv (5 rem) = 50 mSv/yr, or 0.5 Sv to any organ other than the lens, whichever is more limiting. Minors are limited to 10% of the adult limits.

0.15 Sv (15 rem) = 150 mSv/yr. Maine has not adopted a lower lens limit such as the ICRP's 20 mSv.

0.5 Sv (50 rem) = 500 mSv/yr shallow dose equivalent to the skin or any extremity.

5 mSv (0.5 rem) to the embryo/fetus of a declared pregnant woman over the whole pregnancy. D.1208.D states the allowance remaining after declaration as "5mSv (0.05 rem)"; the units do not match, which looks like a typo in the Maine text.

Individual dosimeters must be supplied and used for: adults likely to exceed 10% of the D.1201.A limits in a year; minors likely to exceed 1 mSv deep dose, 1.5 mSv lens dose, or 5 mSv skin/extremity dose; declared pregnant women likely to exceed 1 mSv (0.1 rem) during the pregnancy; and anyone entering a high or very high radiation area. Part F §F.3.A(1)(j) applies this to X-ray personnel.

When an apron is worn, at least one dosimeter must be worn at the collar, outside the apron. If more than one device is used, each dose must be identified with where it was worn, and the whole-body dose is based on the maximum dose attributed to the most critical organ. No formal two-badge method and no named effective-dose method (NCRP 122, Webster) is specified. Part D §1201.C allows effective dose equivalent only by a dosimetry method approved by the NRC.

Staff must be protected from scatter by protective aprons or whole-body protective barriers of at least 0.25 mm lead equivalent, and anyone who could be struck by the useful beam needs at least 0.5 mm. Facilities must keep enough leaded aprons and gloves. For fluoroscopy, under-table scatter must be attenuated by at least 0.25 mm Pb. For above-table scatter, staff must stand at least 120 cm from the beam center, or the scatter must pass through at least 0.25 mm Pb (drapes, Bucky-slot cover, curtains) in addition to the apron. Thyroid shields and protective eyewear are not addressed.

Yes, semi-annually. Under the Appendix G QA program, aprons, gloves and drapes are tested semi-annually. The method is not specified, and facilities may change tests or frequencies if they show image quality will still be assured.

Not specifically addressed; engineered apron-replacement systems are not mentioned. §F.3.A(1)(e)(ii) allows whole-body protective barriers as an alternative to aprons. §F.6.I(3) allows Agency exceptions where a sterile field prevents normal barriers. §F.3.D(4) allows exemptions with a qualified expert's written justification. No Maine bill or rule on this topic was found.

Physicians and other licensed practitioners may operate fluoroscopy, as may licensed radiographers under a licensed practitioner's supervision. Credentialed cardiovascular technologists may do certain table-side fluoroscopy tasks under a physician's direct supervision in cath and EP labs. Residents and students are exempt while supervised. Limited radiographers and limited-license trainees may not perform fluoroscopy. Whether PAs and NPs may operate is unclear.

There is no separate fluoroscopy permit and no fluoroscopy-specific training hours were found. Radiographers need a board-approved course and exam, or American Registry of Radiologic Technologists (ARRT) certification and current registration, plus continuing education at each two-year renewal (current ARRT registration in continuing education (CE) compliance or 24 CE hours, among other options). Cardiovascular technologists must hold the credentials named in the statute. For physicians, Part F requires only that operators be adequately instructed and competent.