What Ohio'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 It is not comprehensive and not always accurate: rules change, and answers may be incomplete, out of date or wrong.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
ORSIF's research identified the Ohio Department of Health, Bureau of Environmental Health and Radiation Protection (BEHRP), X-ray Program as the agency that regulates X-ray and fluoroscopy equipment in Ohio. Ohio is a U.S. Nuclear Regulatory Commission (NRC) Agreement State: it has signed an agreement with the NRC to regulate certain radioactive materials itself.
Ohio requires X-ray and fluoroscopy registrants to keep doses ALARA under its general radiation protection chapter (OAC 3701:1-38), which is shared with radioactive-materials licensees. The fluoroscopy rules only mention ALARA reviews by hospital quality assurance (QA) committees. Dose limits match NRC levels: 50 mSv whole body, 150 mSv lens, 500 mSv skin and extremities, and 5 mSv over a declared pregnancy. Everyone in the fluoroscopy room must use a whole-body barrier or an apron of at least 0.25 mm lead equivalent, and aprons must be checked annually. Engineered alternatives to aprons are not addressed. Physicians are exempt from radiologic licensing, and licensed radiographers' scope includes fluoroscopy. All fluoroscopy operators need 2 hours of fluoroscopy-specific training. ODH posted draft amendments on 2026-09-08, with comments due 2026-10-08; their contents were not reviewed.
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.
Which rules apply, and whether ALARA is among them.
Yes. Ohio is an NRC Agreement State, based on the NRC list (updated 2026-10-29), which does not name Ohio among non-Agreement States. OAC 3701:1-38-07(A) refers to equivalent NRC or agreement state regulations.
General standards are in OAC Chapter 3701:1-38, which covers both radioactive-materials licensees and X-ray registrants (key rules -07, -11, -12, -14). X-ray and fluoroscopy rules are in OAC Chapter 3701:1-66 (-01, -02, -04, -07). Operator licensing is in OAC Chapter 3701-72 and ORC Chapter 4773.
The rules in Chapter 3701:1-38 of the Administrative Code apply to facilities that receive, possess, use, transfer, or dispose of radioactive material, and to handlers of radiation-generating equipment.This quote was matched word for word to the source page.
Yes. Licensees and registrants must use procedures and engineering controls to keep occupational and public doses ALARA. They must also have a documented radiation protection program and review it at least every 12 months. The air-emissions dose constraint applies only to licensees.
Where ALARA lives in Ohio: Only in a rule shared with radioactive materials. The binding ALARA duty is in 3701:1-38-11(D)(2), in a chapter that applies to both radioactive-materials licensees and radiation-generating equipment handlers. Chapter 3701:1-66 only mentions ALARA reviews in hospital QA committee minutes (3701:1-66-04(C)(4)(c)) and does not restate the standard. (OAC 3701:1-38-07(A), 3701:1-38-11(D)(2), 3701:1-66-04(C)(4)(c).)
The licensee or registrant shall use, to the extent practicable, 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.This quote was matched word for word to the source page.
The annual limits for workers, written in millisieverts (mSv). Ten mSv equal one rem.
0.05 Sv (5 rem) = 50 mSv per year TEDE.
0.15 Sv (15 rem) = 150 mSv per year. Ohio has not adopted a lower limit such as 20 mSv.
(a) A lens dose equivalent of 0.15 sievert (fifteen rem), and (b) A shallow-dose equivalent of 0.5 sievert (fifty 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.
0.5 Sv (50 rem) = 500 mSv per year to the skin of the whole body or any extremity.
(a) A lens dose equivalent of 0.15 sievert (fifteen rem), and (b) A shallow-dose equivalent of 0.5 sievert (fifty 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.
5 mSv (0.5 rem) to the embryo/fetus of a declared pregnant woman over the whole pregnancy. If an apron is worn, the fetal dose is taken from the mother's lower torso region (3701:1-38-12(H)(4)).
When a worker must wear a dosimeter, and where.
A badge must be supplied and worn by: adults likely to receive more than 10% of an annual limit (5 mSv TEDE, 15 mSv lens, 50 mSv skin or extremity); minors above set levels; declared pregnant women likely to receive more than 1 mSv over the pregnancy; and anyone entering high or very high radiation areas. Anyone taking part in fluoroscopic procedures must wear a monitoring device unless the IRRP or a radiation expert determines those thresholds are unlikely to be exceeded.
Any radiation worker participating in fluoroscopic, veterinary, or mobile or portable x-ray procedures is obligated to wear an individual monitoring device unless the IRRP or radiation expert determines it is unlikely the radiation worker will receive in excess of the doses specified...This quote was matched word for word to the source page.
With an apron, the whole-body badge is typically worn at the neck. The lens badge goes at the neck outside the apron or near the eye. A fetal badge goes at the waist under the apron, and a second badge is required for a declared pregnant woman. Effective dose is calculated as follows: one neck badge outside the apron × 0.3; with two badges, (waist badge under the apron × 1.5) + (neck badge outside the apron × 0.04); or ANSI/National Council on Radiation Protection and Measurements (NCRP)/director-approved methods. Badges must be processed by a National Voluntary Laboratory Accreditation Program (NVLAP)-accredited processor.
When only one individual monitoring device is used and it is located at the neck outside the protective apron, the reported deep dose equivalent value multiplied by 0.3 shall be the effective dose equivalent for external radiationThis quote was matched word for word to the source page.
Protective apparel, how it is checked, and whether other systems are addressed.
Anyone in the room during fluoroscopy must stand behind a whole-body protective barrier or wear an apron of at least 0.25 mm lead equivalent. This may be skipped at a distance and for a time a radiation expert has documented in the QA program as unlikely to exceed 2 mrem in any hour or 100 mrem a year. Lead gloves are required for hands in the useful beam, and 0.5 mm lead equivalent for any body part in the useful beam. Enough aprons and gloves must be available. No thyroid shield or eyewear requirement was found. A 2025 PMC review lists Ohio as requiring 0.50 mm, which conflicts with the primary text.
Any individual who is in the room during the fluoroscopic procedure will be adequately protected by standing behind a whole body protective barrier or will wear a protective lead apron of not less than 0.25 millimeter lead equivalent.This quote was matched word for word to the source page.
Yes. An annual evaluation of the integrity of all necessary protective apparel is required. The method is not specified.
(11) Annual evaluation of the integrity of all necessary protective apparel.This quote was matched word for word to the source page.
Not addressed as such. A whole-body protective barrier is accepted as an alternative to an apron. Under-table drapes do not replace required apparel. The director may grant variances for good cause. Whether an engineered system counts as a whole-body protective barrier is not answered in the text.
Such devices will not substitute for wearing obligated protective apparelThis quote was matched word for word to the source page.
Who may use fluoroscopy equipment and what training the rules ask for.
Physicians are exempt from radiologic licensing. Licensed radiographers' scope includes fluoroscopy, under the general supervision of a licensed practitioner. General X-ray machine operators' scope excludes fluoroscopy. In cardiac catheterization, RNs, RCIS staff and certain pre-1995 conditionally licensed operators may only move the patient, move the unit and reset the timer, under in-room personal supervision. PA and NP authority was not settled.
The following radiologic procedure tasks will be performed only by an Ohio licensed practitioner, radiographer, nuclear medicine technologist, radiation therapist or general x-ray machine operator within his/her scope of practice:This quote was matched word for word to the source page.
All fluoroscopy operators, physicians included, and anyone likely to exceed 1 mSv a year from fluoroscopy need at least 2 hours of fluoroscopy-specific radiation protection training. The training must be approved by the facility's radiation expert, be equipment-specific and be documented. 1 hour of retraining is required whenever a person exceeds 30% of the allowable occupational dose in a calendar year. Radiographers need an ODH license (ARRT certification waives the Ohio exam) and 24 continuing education (CE) credits to renew. No separate state fluoroscopy permit was found for physicians.
All individuals operating fluoroscopic equipment, and individuals likely to receive an annual effective dose equivalent in excess of one millisievert (one hundred millirem) from participating in fluoroscopic procedures, will receive at least two hours of radiation protection training specific to fluoroscopyThis quote was matched word for word to the source page.
Rules, bills and guidance the research found from 2025 and 2026, with the ones that touch fluoroscopy teams first.
Effective (Aug 31, 2025)
Recently adopted operator licensing rules.
Effective (Dec 13, 2024)
Recently adopted general obligations, QA program and medical fluoroscopic equipment rules.
Bill number and status unconfirmed (Feb 27, 2026)
An LSC analysis (seen only as a search snippet) describes a bill letting general X-ray machine operators work under the direct supervision of certified nurse practitioners and physician assistants.
Draft posted for public comment, not yet formally proposed; comments closing October 8, 2026 (Sep 8, 2026)
ODH posted draft rules for radiation protection standards, radiation-generating equipment, operator licensing and health care facilities. Their contents were not reviewed.
Draft (Nov 24, 2025)
Draft amendments to the radiation therapy rules, not fluoroscopy.
Effective (Feb 16, 2026)
Recently adopted definitions rule. Changes were not compared with the prior version.
Questions the research could not settle. If you know the answer, tell us.
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.
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