What Rhode Island'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 It is not comprehensive and not always accurate: rules change, and answers may be incomplete, out of date or wrong.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 Rhode Island Department of Health (RIDOH), Center for Health Facilities Regulation, Radiation Control Program ("Rhode Island Radiation Control Agency (RCA)") as the agency that regulates X-ray and fluoroscopy equipment in Rhode Island. Rhode Island is a U.S. Nuclear Regulatory Commission (NRC) Agreement State: it has signed an agreement with the NRC to regulate certain radioactive materials itself.
Rhode Island (an Agreement State) has no ALARA wording of its own for X-ray users. ALARA applies through 216-RICR-40-20-1, which adopts the fixed 2021 edition of 10 CFR Part 20 and deems "licensee" to include "registrant," so the requirement sits in a rule shared with radioactive-materials licensees. Dose limits are the federal ones: 50 mSv whole body, 150 mSv lens of the eye, 500 mSv skin and extremities, and 5 mSv embryo/fetus. Everyone in the fluoroscopy room except the patient must wear 0.25 mm lead-equivalent garments where sterile fields prevent the use of drapes or barriers. Aprons must be checked for integrity annually. The general X-ray rule accepts "whole-body protective barriers," but engineered apron replacements are never mentioned. Fluoroscopy is operated by licensed radiographers or by exempt practitioners. All fluoroscopy operators and supervisors need 4 hours of training (8 for interventional work) plus refreshers every 2 years.
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. Rhode Island is not on the NRC list of non-Agreement States (updated 2026-10-29), so it is one of the 41 Agreement States.
Yes. The X-ray/fluoroscopy rule is 216-RICR-40-20-4, Medical Diagnostic and Interventional X-Ray and Imaging Systems. Fluoroscopy is in §4.5 and training in §4.3.3. Per Cornell LII, §4.5 was amended effective 11/28/2023. Part 4 adopts the ACR-AAPM fluoroscopy standard (2021) and National Council on Radiation Protection and Measurements (NCRP) 168 by reference. The general standards rule is 216-RICR-40-20-1, which applies to licensees and registrants and adopts 10 CFR Part 20 (2021) by reference; its effective date is unconfirmed, possibly 5/25/2022. Facility registration is in 216-RICR-40-20-3.
Yes, but only indirectly. Part 1 adopts 10 CFR Part 20 (2021), including 20.1101(b) (ALARA), and deems "licensee" to include "registrant."
Where ALARA lives in Rhode Island: Only in a rule shared with radioactive materials. ALARA reaches X-ray registrants only through Part 1's adoption of the fixed 2021 edition of 10 CFR Part 20, which is shared with radioactive-materials licensees. NRC changes do not flow in automatically; RIDOH would have to amend Part 1. Part 4 has no ALARA wording; §4.3.10(B), which requires minimizing exposure, is the closest language, and the research does not treat it as an ALARA requirement. (216-RICR-40-20-1 §1.2; 216-RICR-40-20-4 §4.3.10(B))
Any reference to licensee shall be deemed to include registrant.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.
5 rem (50 mSv) total effective dose equivalent per year, via 10 CFR 20.1201 adopted by reference.
For the purpose of this Part, the occupational dose limits for adults are defined by 10 C.F.R. § 20.1201.This quote was matched word for word to the source page.
15 rem (150 mSv) per year. No lower lens limit has been adopted.
A lens dose equivalent of 15 rems (0.15 Sv), andThis quote was matched word for word to the source page.
50 rem (500 mSv) shallow-dose equivalent to the skin and extremities per year.
0.5 rem (5 mSv) to the embryo/fetus of a declared pregnant worker for the whole pregnancy.
When a worker must wear a dosimeter, and where.
Monitoring is required for adults likely to exceed 10% of the adult limits in a year, declared pregnant women likely to exceed 1 mSv (0.1 rem) deep dose during the pregnancy, minors above lower thresholds, and anyone entering a high or very high radiation area.
Adults likely to receive, in 1 year from sources external to the body, a dose in excess of 10 percent of the limits in § 20.1201(a),This quote was matched word for word to the source page.
Yes, state-specific rules apply. A single badge is worn at the neck outside the apron; if the reported dose is above 25% of the limit, effective dose equivalent = deep dose × 0.3. With two badges (waist under the apron, neck outside it), effective dose equivalent = 1.5 × waist + 0.04 × neck. A declared pregnant woman needs a waist badge under the apron; if it reads more than 0.5 mSv in a month, a medical physicist should be consulted. The eye-dose badge goes at the neck or an unshielded spot closer to the eye. The extremity badge goes on the extremity likely to receive the highest dose.
When only one individual monitoring device is used to determine the effective dose equivalent for external radiation pursuant to § 1.7.1(B) of this Part, it shall be located at the neck outside the protective apron.This quote was matched word for word to the source page.
Protective apparel, how it is checked, and whether other systems are addressed.
Yes. Stationary fluoroscopy systems need drapes, curtains or shields, used for everyone except the patient. Where sterile fields prevent their use, everyone except the patient must wear garments of at least 0.25 mm lead equivalent. Anyone in the direct beam needs 0.5 mm. Scatter protection requires 0.25 mm garments or whole-body barriers. Facilities must keep enough aprons, gloves and collars available. No thyroid shield or eyewear requirement was found.
All persons, except the patient, in the room where fluoroscopy is performed shall wear protective garments that provide a lead equivalent shielding of at least twenty-five one hundredths of one millimeter (0.25 mm);This quote was matched word for word to the source page.
Yes. All protective apparel and auxiliary shields must be evaluated annually for integrity and labeled with their lead equivalence. The method is not specified.
All protective apparel and auxiliary shields shall be evaluated annually for integrity and clearly labeled with their lead equivalence.This quote was matched word for word to the source page.
Not addressed by name. Engineered systems that replace aprons are never mentioned. §4.3.6(A)(2) accepts "whole-body protective barriers" as an alternative to garments for scatter protection, and §1.5.2(A) allows Agency exemptions. The incorporated ACR-AAPM and NCRP documents were not read.
All individuals shall be protected from the secondary radiation by protective garments or whole-body protective barriers of not less than twenty-five one hundredths of one quarter millimeter (0.25 mm) lead equivalent material.This quote was matched word for word to the source page.
Who may use fluoroscopy equipment and what training the rules ask for.
Licensed (ARRT-certified) radiographers under the general supervision of a licensed practitioner. Exempt from the technologist license: licensed practitioners within their field (physicians, chiropractors, podiatrists, nurse practitioners, physician assistants), American Registry of Radiologic Technologists (ARRT) radiologist assistants, supervised medical students, medical physicists and supervised radiologic technology students. For interventional (FGI) procedures, the Radiation Protocol Committee identifies authorized users. No fluoroscopy-specific supervision rule was found.
A licensed practitioner when practicing within his or her field of expertise.This quote was matched word for word to the source page.
Everyone who operates or supervises fluoroscopy, physicians included, needs at least 4 hours of training before performing fluoroscopy. Interventional (FGI) work needs 8 hours of Agency-approved training, including 1 hour hands-on. Training is given by a Qualified Medical Physicist or an Agency-approved individual. Refreshers are required every 24 months (2 hours in-service or continuing medical education (CME)), and records are kept for 3 years. Radiographers need ARRT certification. There is no separate fluoroscopy permit, and no continuing-education requirement for license renewal was found.
All individuals operating, or supervising the operation of, fluoroscopic X-ray systems shall have completed a minimum of four (4) hours training, prior to performing fluoroscopy proceduresThis quote was matched word for word to the source page.
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