Is New Hampshire an NRC Agreement State?
Yes
Yes. New Hampshire is an NRC Agreement State, with its agreement dating from May 16, 1966.
New Hampshire: radiation safety rules for fluoroscopy teams
What New Hampshire'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 It is not comprehensive and not always accurate: rules change, and answers may be incomplete, out of date or wrong.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
In brief
ORSIF's research identified the NH Department of Health and Human Services, Division of Public Health Services, Radiological Health Section (DHHS/RHS), Radiation Machines Program as the agency that regulates X-ray and fluoroscopy equipment in New Hampshire. New Hampshire is a U.S. Nuclear Regulatory Commission (NRC) Agreement State: it has signed an agreement with the NRC to regulate certain radioactive materials itself.
New Hampshire's ALARA requirement is in He-P 4020.04(b), a unified part covering both materials licensees and X-ray registrants. He-P 4045.03(p) applies He-P 4020-4022 to all X-ray workers. Occupational dose limits match the federal ones: 50 mSv whole body, 150 mSv lens, 500 mSv skin/extremities, and 5 mSv to the embryo/fetus. Scatter protection may come from either aprons or whole-body barriers of at least 0.5 mm lead equivalent; engineered systems are not named. Limited operators are barred from fluoroscopy. The main X-ray parts (He-P 4045 except 4045.03, and He-P 4046) showed a 7-21-25 expiration with no readoption found, so their current status needs confirmation.
The rules, question by question
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.
Where the rules live
Which rules apply, and whether ALARA is among them.
Which rules cover X-ray and fluoroscopy equipment in New Hampshire?
Yes
Yes. Chapter He-P 4000 contains the general standards (He-P 4019-4022) and the machine rules (He-P 4040, 4041, 4045, 4046). Fluoroscopy is covered at He-P 4046.02-4046.05. He-P 4020 was readopted effective 7-23-24. The current status of He-P 4045/4046 is uncertain.
Rule text and source
- Rule
- He-P 4020.01(a); He-P 4046.01
- Source
- gc.nh.gov
law.cornell.edu - What it says
He-P 4020 through He-P 4023 establish standards for protection against ionizing radiation resulting from activities conducted pursuant to licenses or registrations issued by the department of health and human services radiological health section (DHHS/RHS).
This quote was matched word for word to the source page.
Does New Hampshire require X-ray users to keep doses as low as reasonably achievable (ALARA)?
Yes
Yes. Licensees and registrants must use procedures and engineering controls to keep occupational and public doses ALARA, run a radiation protection program, and review it at least every 12 months.
Where ALARA lives in New Hampshire: Only in a rule shared with radioactive materials. ALARA is in He-P 4020.04(b), a unified part applying to both materials licensees and machine registrants. He-P 4045.03(p) applies He-P 4020-4022 to everyone associated with X-ray operation. No separate X-ray occupational-ALARA language was found, though He-P 4046.03-.05 were not read. (He-P 4020.02; He-P 4045.03(p))
Rule text and source
- Rule
- He-P 4020.04(b)
- Source
- gc.nh.gov
- What it says
The licensee or registrant shall use procedures and engineering controls based upon sound radiation protection principles to achieve occupational doses and public doses that are as low as is reasonably achievable (ALARA).
This quote was matched word for word to the source page.
Dose limits
The annual limits for workers, written in millisieverts (mSv). Ten mSv equal one rem.
What is the annual whole-body dose limit in New Hampshire?
Yes
0.05 Sv (5 rem) = 50 mSv per year total effective dose equivalent. Any single organ or tissue other than the lens is limited to 500 mSv.
What is the annual eye-lens dose limit in New Hampshire?
Yes
0.15 Sv (15 rem) = 150 mSv per year. No lower International Commission on Radiological Protection (ICRP)-style limit has been adopted.
Rule text and source
- Rule
- He-P 4020.05(a)
- Source
- gc.nh.gov
- What it says
A lens-dose equivalent of 0.15 Sv (15 rem); and b. A shallow-dose equivalent of 0.5 Sv (50 rem) 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.
What is the annual limit for the skin, hands and feet in New Hampshire?
Yes
0.5 Sv (50 rem) = 500 mSv shallow-dose equivalent to the skin or any extremity.
Rule text and source
- Rule
- He-P 4020.05(a)
- Source
- gc.nh.gov
- What it says
A lens-dose equivalent of 0.15 Sv (15 rem); and b. A shallow-dose equivalent of 0.5 Sv (50 rem) 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.
What limit applies to a declared pregnant worker in New Hampshire?
Yes
5 mSv (0.5 rem) to the embryo/fetus of a declared pregnant woman for the whole pregnancy.
Dosimeters
When a worker must wear a dosimeter, and where.
When must a worker in New Hampshire wear a dosimeter?
Not foundCheck the source
not found
Rule text and source
- Rule
- He-P 4022.02 (not read); referenced in He-P 4020.06(a)
- Source
- gc.nh.gov
- What it says
If the licensee or registrant shall monitor pursuant to He-P 4022.02(a), (b), and (c), the licensee or registrant shall demonstrate compliance with the dose limits by summing external and internal doses.
This quote was matched word for word to the source page.
Where must the dosimeter be worn in New Hampshire when a protective apron is worn?
In partLess certain
With a single dosimeter at the neck outside the apron, the deep-dose reading is reported as the effective dose equivalent. Otherwise deep-dose equivalent is used unless the effective dose is determined by a dosimetry method acceptable to DHHS/RHS. No named two-badge method was found, and He-P 4022.03 was not read.
Rule text and source
- Rule
- He-P 4020.05(c) and (g)
- Source
- gc.nh.gov
- What it says
when one individual monitoring device is used and it is located at the neck outside the protective apron, the reported deep-dose equivalent shall be the effective dose equivalent for external radiation
This quote was matched word for word to the source page.
Aprons and alternatives
Protective apparel, how it is checked, and whether other systems are addressed.
Must staff in New Hampshire fluoroscopy rooms wear protective aprons or other apparel?
Yes
Yes. Everyone in the room except the patient must be protected from scatter by aprons or whole-body barriers of at least 0.5 mm lead equivalent. Enough garments or barriers must be provided, and each must be labeled with its lead equivalence. No thyroid shield or eyewear requirement was found.
Rule text and source
- Rule
- He-P 4045.03(i), (n)(6), (n)(7)
- Source
- law.cornell.edu
- What it says
shall be protected from scatter radiation by either protective aprons or whole body protective barriers, of not less than 0.5 millimeter lead equivalent material.
This quote was matched word for word to the source page.
Does New Hampshire require protective aprons to be inspected?
Not foundCheck the source
not found
Rule text and source
- Rule
- He-P 4045.03(n)(7) (closest provision)
- Source
- law.cornell.edu
- What it says
All protective apparel or barriers shall be clearly labeled with its lead equivalence.
This quote was matched word for word to the source page.
Do the rules in New Hampshire address engineered protection systems used in place of aprons?
In partLess certain
Addressed indirectly. Whole-body protective barriers of at least 0.5 mm lead equivalent are accepted as an alternative to aprons. Engineered radiation protection systems are not mentioned by name.
Rule text and source
- Rule
- He-P 4045.03(i)
- Source
- law.cornell.edu
- What it says
shall be protected from scatter radiation by either protective aprons or whole body protective barriers, of not less than 0.5 millimeter lead equivalent material.
This quote was matched word for word to the source page.
Who operates the equipment
Who may use fluoroscopy equipment and what training the rules ask for.
Who may operate fluoroscopy equipment in New Hampshire?
In partCheck the source
Partly found. RSA 328-J requires a license to perform medical imaging, and limited X-ray machine operators may not perform fluoroscopy. Students and residents may perform imaging under supervision. Physician, PA and NP exemptions were not verified.
What training or credentials does New Hampshire require to operate fluoroscopy equipment?
In partLess certain
Partly found. Operators must be instructed in the manufacturer's safe operating procedures and be competent. Diagnostic operators must show competence in listed areas, including personnel protection and dosimetry. American Registry of Radiologic Technologists (ARRT), fluoroscopy permit, training-hour and continuing-education requirements were not verified.
Rule text and source
- Rule
- He-P 4045.03(b), (d)
- Source
- law.cornell.edu
- What it says
Persons who operate radiation or MRI machines shall be instructed in the manufacturer's safe operating procedures and be competent in the safe use of the equipment.
This quote was matched word for word to the source page.
Changes on the way, and recent ones
Rules, bills and guidance the research found from 2025 and 2026, with the ones that touch fluoroscopy teams first.
- Adopted ruleHe-P 4020 readoption
Effective 7-23-24 (#14028)
Standards for Protection Against Radiation readopted. This contains the ALARA text (He-P 4020.04(b)) that would be relevant if NH matches the NRC proposed ALARA change.
- OtherHe-P 4045 (except 4045.03), 4046 and 4047 possible lapse
Last readopted effective 7-21-15 with listed expiration 7-21-25; no later readoption shown in filing history; status unsettled
Main X-ray parts may have expired or may remain in force while a readoption is pending.
5 other items the research logged (radiation therapy, industrial machines, fees and other subjects)
- Adopted ruleHe-P 4040 interim rule (registration)
Interim rule effective 4-24-26, expiring 10-21-26 (#14566); unclear whether replaced by a final rule
Interim registration rule.
- Adopted ruleHe-P 4070 interim rule (fees)
Interim rule effective 4-22-26, expiring 10-19-26 (#14562); unclear whether replaced by a final rule
Interim fees rule.
- Adopted ruleHe-P 4022 readoption with amendments
Effective 7-1-25 (#14303)
Surveys and monitoring part readopted with amendments.
- Adopted ruleHe-P 4019 and He-P 4041 readoptions
Effective 7-1-25 (#14301, #14300)
Notices/instructions to workers and definitions readopted.
- Adopted ruleHe-P 4043 readoption
Effective 8-8-25 (#14336)
He-P 4043 readopted.
Also worth knowing
- Workers likely to receive more than 1 mSv a year must be instructed on health risks, ways to reduce exposure, and the purpose of protective devices (He-P 4019.04).
- Fluoroscopic exposure must be on a continuous-pressure (dead-man) control (He-P 4046.02(d)).
- Fluoroscopes must be image-intensified or digital (He-P 4046.02(a)).
- Hand-held fluoroscopic screens are banned unless listed by Conference of Radiation Control Program Directors (CRCPD) or accepted by FDA (He-P 4001.06).
- Only staff and others who must be present may be in the room during exposure (He-P 4045.03(h)), and people may not be used routinely to hold patients (He-P 4045.03(n)(4)).
- Hospital licensing rules include He-P 802.39 Cardiac Catheterization Services (table of contents only; not read).
- Operator licensing is handled by OPLC and its Advisory Board of Medical Imaging and Radiation Therapy, not by RHS.
What ORSIF could not confirm
Questions the research could not settle. If you know the answer, tell us.
- Are He-P 4045 and 4046 still in force given the 7-21-25 expiration? Has the He-P 4040 interim rule been replaced by a final rule?
- What do He-P 4022.02 (monitoring threshold) and He-P 4022.03 (badge location) say?
- Do He-P 4046.03-4046.05 contain requirements on drapes, thyroid shields, eyewear or apron inspection, and does He-P 4041.02 define 'whole body protective barrier'?
- Under full RSA 328-J and Plc 1300, may physicians, PAs and NPs operate fluoroscopy, and what supervision, credentials and continuing education apply?
- Are there 2025-2026 bills on medical imaging or radiation protection?
- Does He-P 802.39 set any staff radiation-safety requirements?
Who regulates, and where to read the rules
Double-check before you rely on this page
ORSIF compiled this page from the sources linked on it and did its best. It is not comprehensive and it is not always accurate. Rules change, a rule may have been missed or misread, and the sources themselves can be out of date. Treat this page as a starting point.
Where to check
- The rule itself. Open "Rule text and source" under any answer, or read the sources listed below.
- The state. NH Department of Health and Human Services. Program contacts in the CRCPD directory.
- Your radiation safety officer. They know the federal, accreditation and facility requirements that apply at your site, which the state rules do not cover.
What may be missing here
- 2 of 14 answers on this page are "Not found" or "Unclear". That means ORSIF did not find the answer in the rules it reviewed, not that no rule exists.
- 6 answers carry a flag or a lower confidence ("Check the source" or "Less certain").
- Researched November 3, 2026. Rules may have changed since.
- Only the state's rules for X-ray and fluoroscopy equipment were reviewed.
Found something wrong or missing? Tell ORSIF.
Sources and terms
Terms used on this page
- ALARA
- As low as reasonably achievable: keep radiation doses as low as is reasonable, below the legal limits.
- Agreement State
- A state that has signed an agreement with the U.S. Nuclear Regulatory Commission to regulate certain radioactive materials itself.
- mSv
- Millisievert, a unit of radiation dose. Ten mSv equal one rem, the older unit some rules still use.
- Dosimeter
- A badge or device worn to measure a worker's radiation dose.
- Lead equivalent
- The thickness of lead (mm Pb) that would give the same protection as the material described.
- NRC
- U.S. Nuclear Regulatory Commission
- ICRP
- International Commission on Radiological Protection
- ARRT
- American Registry of Radiologic Technologists
- CRCPD
- Conference of Radiation Control Program Directors
All 19 sources the research read
- NH General Court, He-P 4001-4022
- NH General Court, filing history for He-P rules
- NH General Court, He-P table of contents
- Cornell LII, He-P 4000 chapter index
- Cornell LII, He-P 4020 part index
- Cornell LII, § 4020.12
- Cornell LII, He-P 4022 part index
- Cornell LII, He-P 4045 part index
- Cornell LII, § 4045.02
- Cornell LII, § 4045.03
- Cornell LII, He-P 4046 part index
- Cornell LII, § 4046.01
- Cornell LII, § 4046.02
- NH DHHS Radiation Machines Program
- NH DHHS Radiological Health
- RSA 328-J
- Plc 1300
- OPLC laws and rules page
- ASRT radiologist assistant statute summary
Found something out of date or wrong? Tell ORSIF. Corrections are checked against the rule text and the page is updated.