West Virginia: radiation safety rules for fluoroscopy teams

No. West Virginia is not an NRC Agreement State. The Governor sent a letter of intent on 9 January 2023, and HB 208 (2024) created the Radiation Control Act to support an agreement. The NRC showed no draft application submitted yet.

Yes. 64CSR23, the Radiological Health Rule, effective 1 July 2001. Section 6 sets general radiation protection standards and Section 7 covers the healing arts, with fluoroscopy at §7.7. A 2020 revision was withdrawn on 6 November 2020.

Yes. §6.4.b requires ALARA for occupational and public doses for all registrants. §7.3.a.9 adds a duty to minimize personnel exposure.

Where ALARA lives in West Virginia: In a shared rule and in X-ray-specific language. The formal ALARA duty (§6.4.b) is in Section 6, which is shared by all registrants, including radioactive-materials registrants (§11.1.b). Section 7 adds X-ray-specific minimization language (§7.3.a.9). §7.3.a.10 does not list §6.4, so ALARA reaches X-ray users through §6.1.a. (64CSR23 §§6.1.a, 6.4.b, 7.3.a.9, 7.3.a.10, 11.1.b, 2.1; W. Va. Code §16-27B-5(d))

50 mSv (5 rem) TEDE per year for adults. Minors are limited to 10% of adult limits.

150 mSv (0.15 Sv) per year. No lower International Commission on Radiological Protection (ICRP)-style limit has been adopted.

500 mSv (50 rem) shallow dose per year to the skin or any extremity.

5 mSv (0.5 rem) to the embryo/fetus of a declared pregnant woman over the whole pregnancy. If the fetus has already received more than 4.5 mSv when pregnancy is declared, a further 0.5 mSv is allowed.

Adults likely to exceed 10% of a limit in a year must be monitored, as must minors and declared pregnant women likely to exceed 10% of their limits and anyone entering high or very high radiation areas. Everyone working with medical fluoroscopic equipment must be monitored, with no dose threshold.

The badge is worn at the collar outside the apron. A fetal badge goes at the waist under the apron and is required for a declared pregnant woman. With a single collar badge, the collar deep dose counts as effective dose, or collar × 0.3 if the reading exceeds 25% of the limit. The two-badge method uses 1.5 × waist (under apron) + 0.04 × collar (outside apron).

Staff must be protected from scatter by aprons or whole-body barriers of at least 0.25 mm lead equivalent, and anyone who could be struck by the useful beam needs 0.5 mm. Facilities must keep enough aprons and gloves for all X-ray personnel. Fluoroscopy requires 0.25 mm above-table drapes or curtains in addition to the apron, with exemptions such as Table 64-23 S. Thyroid shields and eyewear are not required.

not found

Not specifically addressed. §7.3.a.5.B accepts 'protective aprons or whole body protective barriers', but 'whole body protective barrier' is not defined. Drapes and curtains under §7.7.h.2.B are required in addition to the apron, not instead of it.

Licensed radiologic technologists, whose scope includes noninterpretive fluoroscopy. Licensed practitioners (medicine, osteopathy, podiatry, chiropractic, dentistry), radiologists and residents are exempt from the license. PAs and NPs are not exempt. Radiologist assistant status is uncertain after HB 5458 (2026).

Technologists need an accredited program and the Board exam. From 1 July 2026, active national certification (ARRT, NMTCB, ARMRIT or ASPMA) is required to renew. All operators must be adequately instructed (Table 64-23 P). There is no fluoroscopy-specific permit or physician fluoroscopy training rule.