What Vermont'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 It is not comprehensive and not always accurate: rules change, and answers may be incomplete, out of date or wrong.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 Vermont Department of Health, Radiological Health Program as the agency that regulates X-ray and fluoroscopy equipment in Vermont. Vermont is a U.S. Nuclear Regulatory Commission (NRC) Agreement State: it has signed an agreement with the NRC to regulate certain radioactive materials itself.
Vermont's Radiological Health Rule Part A (effective January 1, 2024) has its own X-ray ALARA requirement (§ 7.1.2), separate from Part B, which adopts 10 CFR Part 20 by reference. Worker dose limits match the NRC's: 50 mSv whole body, 150 mSv lens of the eye, 500 mSv skin and extremities, and 5 mSv to the fetus of a declared pregnant worker. Staff must be protected by aprons or whole-body barriers of at least 0.25 mm lead equivalent. Apron inspection appears only in non-binding guidance, and engineered protection systems are not directly addressed. Technologists need American Registry of Radiologic Technologists (ARRT) certification, including post-primary certification for cardiac or vascular interventional work. Non-radiologist practitioners need an OPR radiation-competency endorsement unless exempt.
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. Per the NRC list (updated 2026-10-29); Part B adopts NRC materials regulations, which fits.
Yes. Vermont's Radiological Health Rule (Code Vt. R. 13-140-030), effective 1/1/2024. Part A covers radiation-producing machines: § 7.0 has the protection standards, § 8.0 covers healing-arts X-ray and § 8.13 covers fluoroscopy. Part B covers radioactive materials and adopts 10 CFR Part 20. Part C covers Vermont Yankee.
Part A of this Rule establishes standards for the control of ionizing radiation-producing machines for the protection of occupational and public health and safety.This quote was matched word for word to the source page.
Yes. X-ray registrants must have a radiation protection program, use procedures and engineering controls to keep doses ALARA, and review the program at least annually.
Where ALARA lives in Vermont: In a shared rule and in X-ray-specific language. The X-ray ALARA requirement is Vermont's own text in Part A § 7.1.2. Separately, Part B adopts 10 CFR Part 20, including § 20.1101, by reference without an edition date. The NRC proposal would affect Part B directly but not Part A. (Part A §§ 2.3, 7.1.2; Part B §§ 1.2.5, 6.2.1-6.2.2)
The registrant shall use, to the extent practical, procedures and engineering controls based upon sound radiation protection principles to achieve occupational doses and doses to members of the public that are as low as is reasonably achievable (ALARA).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), or 50 mSv, per year total effective dose equivalent.
0.15 Sv (15 rem), or 150 mSv, per year. Vermont has not adopted the International Commission on Radiological Protection (ICRP)'s 20 mSv.
A lens dose equivalent of 0.15 Sv (15 rem); and … 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.
0.5 Sv (50 rem), or 500 mSv, shallow dose equivalent to the skin of the whole body or any extremity.
A lens dose equivalent of 0.15 Sv (15 rem); and … 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.
5 mSv (0.5 rem) to the embryo/fetus of a declared pregnant worker for the whole pregnancy. The registrant must try to avoid large swings above a steady monthly rate.
When a worker must wear a dosimeter, and where.
Dosimeters are required for adults likely to exceed 10% of any adult limit in a year (5 mSv whole body, 15 mSv lens, 50 mSv skin/extremity), for minors above lower thresholds, for declared pregnant workers likely to exceed 1 mSv during the pregnancy, and for anyone entering a high or very high radiation area. The Department may approve alternatives to continuous badging in writing. Dosimeters must be processed by a National Voluntary Laboratory Accreditation Program (NVLAP)-accredited processor.
Adults likely to receive, in 1 year from sources external to the body, a dose in excess of 10 percent of the limits in 7.2.1.This quote was matched word for word to the source page.
Yes, for machine sources. One badge at the neck outside the apron: if the reading exceeds 25% of the limit, effective dose equivalent = reading × 0.3. Two badges: (waist under apron × 1.5) + (neck × 0.04). The fetal badge goes under the apron at the waist. The non-binding March 2026 guidance conflicts with these placements.
When only one individual monitoring device is used and it is located at the neck outside the protective apron, and the reported dose exceeds 25% of the limit specified in 7.2.1, 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.
Aprons or whole-body barriers of at least 0.25 mm lead equivalent are required for staff in the room; the general rule also allows staying 2 m away instead. Fluoroscopy requires an additional 0.25 mm Pb above and below the table unless the person is at least 120 cm from the center of the X-ray field. A person who could be struck by the direct beam needs at least 0.5 mm Pb. Thyroid shields and eyewear are recommended only in guidance.
The x-ray operator, other staff, ancillary personnel and other persons required for the medical procedure shall be protected from the direct scatter radiation by protective aprons or whole body protective barriers of not less than 0.25 millimeter lead equivalent material.This quote was matched word for word to the source page.
Not found in the rule. Only the Department's non-binding Lead Aprons guidance (March 2026) calls for monthly visual inspection.
Lead or lead-equivalent aprons and thyroid collars shall be visually inspected for defects at least monthly, and replaced if they are damaged.This quote was matched word for word to the source page.
Not directly addressed. The rule accepts aprons or whole-body protective barriers but does not define such barriers. The fluoroscopy guidance implies that large mobile shields can substitute.
All personnel not protected by a large mobile shield should wear a well-fitted lead apron.This quote was matched word for word to the source page.
Who may use fluoroscopy equipment and what training the rules ask for.
Use must be by, or under the general supervision of, a Vermont-licensed practitioner. Licensed radiologic technologists may operate. Exempt licensed practitioners need an OPR competency endorsement unless they are ABR-certified radiologists or ABIM-certified interventional cardiologists or electrophysiologists. PA authority is unclear. Delegation to unauthorized staff is barred.
Use of a radiation machine in the healing arts shall be by or under the general supervision of a Vermont-licensed veterinarian, physician, chiropractor, dentist, podiatrist, or other Vermont-licensed health care practitioner authorized to do so within their scope of practice.This quote was matched word for word to the source page.
Technologists need an ARRT-approved program and ARRT radiography certification, plus post-primary certification for cardiac- or vascular-interventional work, and 24 hours of continuing education (CE) every two years. Endorsed practitioners need an approved radiation-safety course (for fluoroscopy, "Fluoroscopic Safety Explained for Physicians") and must keep fluoroscopy logs. No state fluoroscopy permit or set number of training hours was found.
The Director shall recognize and follow the ARRT and NMTCB postprimary certification process in the following postprimary practice categories: mammography, computed tomography (CT), cardiac-interventional radiography, vascular-interventional radiography, and positron emission tomography (PET).This 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.
Proposed (NRC) (Jul 15, 2026)
Would require Agreement States to revise their equivalent of 10 CFR 20.1101(b) to be essentially identical to the NRC's and remove ALARA; in Vermont this would affect Part B.
Signed June 8, 2026
No change to the radiology chapter found; it changes Board of Medical Practice background checks, including for radiologist assistants.
Reissued (Mar 2026)
The Department reissued its X-ray facility guidance; not a rule change.
Updated (Feb 2026)
OPR updated its endorsement instructions; not a rule change.
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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