Virginia: radiation safety rules for fluoroscopy teams

Yes. Virginia is an NRC Agreement State.

All rules are in one chapter, 12VAC5-481 (Virginia Radiation Protection Regulations). The X-ray rules are in Part VI, "Use of Diagnostic X-Rays in the Healing Arts" (12VAC5-481-1581 through -1657, effective Aug. 27, 2015), which includes -1591 (general and administrative requirements) and -1611 (fluoroscopic equipment). The general standards are in Part IV, "Standards for Protection Against Radiation" (12VAC5-481-600 et seq.), which applies to both licensees and registrants. Part VI is in addition to the rest of the chapter.

Yes in effect, but the wording is not explicit for registrants. The ALARA rule in 12VAC5-481-630 B is in Part IV, which by its scope covers registrants, but the sentence is addressed to the "licensee." The Part VI cross-reference (1591 A 10) applies only the dose-limit sections, not 630. Part VI has only a general duty to "minimize" patient and personnel exposure (1591 A 9).

Where ALARA lives in Virginia: Only in a rule shared with radioactive materials. The only explicit ALARA requirement is 12VAC5-481-630 B, in the unified Part IV that also governs radioactive-materials licensees and is revised for compatibility with NRC changes to 10 CFR. The X-ray-specific Part VI never uses the term ALARA; it has only a general duty to minimize personnel exposure (1591 A 9) and scatter-control design rules (1611 M). (12VAC5-481-630 B; 12VAC5-481-1591 A 9; Town Hall Action 5931)

5 rem (50 mSv) per year total effective dose equivalent, or 50 rem (500 mSv) to any organ or tissue, whichever is more restrictive. This applies to X-ray workers via 12VAC5-481-1591 A 10. Minors are limited to 10% of the adult limits.

15 rem (150 mSv) per year. Virginia has not adopted a lower lens limit such as 20 mSv.

50 rem (500 mSv) per year shallow-dose equivalent to the skin of the whole body or to any extremity.

500 mrem (5 mSv) to the embryo/fetus of a declared pregnant woman over the whole pregnancy. Employers must also try to avoid substantial variation above a uniform monthly exposure rate.

Individual dosimeters are required for adults likely to receive more than 10% of the 640 A limits in a year from external sources (by this research's arithmetic, about 5 mSv whole body, 15 mSv lens, 50 mSv skin/extremity). They are also required for minors above set thresholds, for declared pregnant women likely to exceed 100 mrem (1 mSv) over the pregnancy, and for anyone entering a high or very high radiation area. The section is addressed to the "licensee" but covers unlicensed sources under the licensee's control.

12VAC5-481-770 covers the "licensee or registrant" and sets badge locations. The whole-body badge goes at the unshielded spot likely to get the highest exposure, typically the collar when an apron is worn. The lens badge goes at the collar outside the apron or closer to the eye. The embryo/fetus badge goes at the waist under the apron. The extremity badge goes on the extremity likely to get the highest dose. Effective dose equivalent may be used only with an agency-approved method; no named method (such as National Council on Radiation Protection and Measurements (NCRP) 122 or Webster) or two-badge formula was found.

Staff needed for the procedure must be protected from direct scatter by aprons or whole-body protective barriers of at least 0.25 mm lead equivalent, unless distance gives enough protection or the device has a low dose rate. Facilities must keep enough leaded aprons and gloves for personnel who are not otherwise shielded. Fluoroscopy design rules (1611 M) require scatter shielding under and above the table. Thyroid shields and protective eyewear were not found in the rules.

not found

Engineered radiation protection systems are not addressed by name. The rules allow "whole body protective barriers" (0.25 mm lead equivalent) instead of aprons, and accept drapes, Bucky-slot cover panels or self-supporting curtains in addition to aprons. The agency may grant exemptions where a sterile field prevents normal barriers. Bill searches for 2025-2026 could not be run.

Fluoroscopy may be operated only by a licensed practitioner of the healing arts, or by a radiologic technologist "or equivalent" under a practitioner's direct supervision. Students must be directly supervised. Operators must be licensed by the Department of Health Professions, ARRT-certified, or supervised students. Physician assistants may use fluoroscopy only under a practice agreement with a radiology or orthopedics physician and if it is in their protocol. Radiologic technologists-limited may not perform fluoroscopy. Nurse practitioners and others were not found.

Physician assistants need at least 40 hours of didactic instruction and 40 hours of supervised clinical experience under the AAPA/ASRT Fluoroscopy Educational Framework, plus a pass on the ARRT Fluoroscopy Examination. Radiologic technologists need a Board of Medicine licence and graduation from an ARRT-acceptable program (seen only in a search snippet). No physician-specific fluoroscopy training requirement was found, and technologist continuing education was not found.