North Dakota: radiation safety rules for fluoroscopy teams

Yes. North Dakota is not on the NRC list of non-Agreement States. State rules substitute the state department for "NRC".

NDAC ch. 33.1-10-06, "X-Rays in the Healing Arts" (fluoroscopy at 33.1-10-06-05; effective January 1, 2019, with no later amendments), plus NDAC ch. 33.1-10-04.2, "Standards for Protection Against Radiation." Chapter 33.1-10-04.2 adopts 10 CFR Part 20 "as they exist on May 9, 2022" (amended effective January 1, 2023) and adds fluoroscopy-specific sections 04.2-02 to 04.2-04.

Yes. 10 CFR 20.1101(b) is adopted by reference, and the chapter applies to registrants as well as licensees.

Where ALARA lives in North Dakota: In a shared rule and in X-ray-specific language. The binding ALARA duty is in the shared chapter 33.1-10-04.2 (covering both radioactive-materials licensees and X-ray registrants) through adoption of 10 CFR 20.1101 as of May 9, 2022, so an NRC change would not alter North Dakota's text automatically and NDDEQ would have to amend 33.1-10-04.2-01. Chapter 33.1-10-06 defines ALARA but has no operative sentence using the term. It separately requires exposure-minimizing procedures for personnel, which would remain even if Part 20 changed. (NDAC 33.1-10-04.2-01; 33.1-10-06-02(9); 33.1-10-06-03(1)(a)(10))

TEDE of 5 rem (50 mSv) per year, or 50 rem (500 mSv) to any organ other than the lens, whichever is more limiting (federal limits adopted by reference).

15 rem (150 mSv) per year. No lower limit (such as International Commission on Radiological Protection (ICRP)'s 20 mSv) has been adopted.

Shallow-dose equivalent of 50 rem (500 mSv) to the skin or any extremity.

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

Under adopted 10 CFR 20.1502, a dosimeter is required for adults likely to exceed 10% of the limits, for declared pregnant women likely to exceed 1 mSv, and for minors above set levels. Separately, 33.1-10-04.2-02 requires dose monitoring for people working with medical fluoroscopy and states no threshold; NDDEQ's reading of that section is unconfirmed.

With an apron, the whole-body badge is worn at the collar outside the apron and the fetal badge at the waist under the apron. Approved effective-dose methods are: a single collar badge (multiplied by 0.3 if the reading exceeds 25% of the limit), or two badges (1.5 × waist + 0.04 × collar). The 0.3 and two-badge methods require leaded glasses, a thyroid shield, a wraparound apron, scatter barriers, minimized beam-on time, formal training, a quality assurance (QA) program and dose monitoring. The rule does not name National Council on Radiation Protection and Measurements (NCRP) 122 or Webster, though the two-badge coefficients match the Webster (1989) equation.

Operators and required staff must be protected from scatter by aprons or whole-body barriers of at least 0.25 mm lead equivalent (0.5 mm if the body could be struck by the useful beam). Facilities must keep enough leaded aprons and gloves for personnel not otherwise shielded. Fluoroscopy rooms need drapes or curtains of at least 0.25 mm lead equivalent in addition to the apron, unless the person is at least 120 cm from the beam center. Thyroid shields and eyewear are not generally required.

not found

Engineered systems are not addressed by name. The scatter-protection rule allows "protective aprons or whole body protective barriers," and protective barrier is defined broadly. Drapes and curtains count as scatter barriers in fluoroscopy, and sterile-field exceptions are available. No rule, bill or guidance like Arizona SB 1121 or Illinois' 32 Ill. Adm. Code 360 was found, and there is no NDDEQ interpretation.

Performing fluoroscopy requires a license under NDCC ch. 43-62 unless the person is a licensed practitioner (physician, APRN, chiropractor, dentist or podiatrist). Radiographers work under general supervision and radiologist assistants under a radiologist. RCIS/RCES may assist only under personal supervision. Legacy fluoroscopy technologists are limited to GI fluoroscopy, and limited operators may not perform fluoroscopy. Physician assistants' scope excludes medical imaging. "Panning" and activating fluoroscopy count as performing imaging.

All operators except physicians (MD/DO), chiropractors and podiatrists must be instructed in the Appendix F safety topics; general diagnostic operators need American Registry of Radiologic Technologists (ARRT) eligibility or certification, or department approval, plus 24 CEUs per two years (12 for limited operators). Radiographers need ARRT or the state exam. RCIS/RCES need the CCI registry plus 12 hours of fluoroscopy safety education every two years; fluoroscopy technologists need 6 hours per renewal. APRN guidance (not binding) calls for 40 classroom hours, 40 logged cases and a national exam. No state fluoroscopy training requirement was found for physicians.