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NHS Trust fined after radiologist exposed to radiation

7 October 2013

United Lincolnshire Hospitals NHS Trust has been fined after an interventional radiologist was exposed to significant amounts of ionizing radiation.

Boston Magistrates’ Court today (7 October) heard that an interventional radiologist working with a CT scanner at Pilgrim Hospital, Boston, received more than double the annual dose limit for skin exposure in just over three months.

As an interventional radiologist his work involved the insertion of biopsy needles into patients, which he carried out using the CT scanner operating in continuous “fluoroscopy” mode, giving “real time” x-ray images which he observed whilst standing next to the scanner.

The scanner, which the trust had bought in 2009, was used by a number of other consultants for the same purpose but they used the conventional “step and shoot” method which required them to leave the room when the CT scanner was generating x-rays.

However, when the interventional radiologist arrived at the hospital in August 2011 he favoured the fluoroscopy mode, operating the x-rays for periods of up to 30 seconds at a time. Moreover, whilst inserting the biopsy needles he placed his hands directly in the main x-ray beam, resulting in an overexposure of radiation to his hands.

An investigation by the Health and Safety Executive (HSE) found that the Trust had never carried out a risk assessment for the CT scanner operating in the fluoroscopy mode so a safe system of work was not developed. In addition, managers were aware that this technique was being carried out but did not ensure proper procedures were followed.

United Lincolnshire Hospitals NHS Trust, of Greetwell Road, Lincoln, pleaded guilty to breaching Regulations 7(1) and 11 of the Ionising Radiations Regulations 1999 and was fined a total of £30,000 and ordered to pay costs of £15,128.

Speaking after the hearing HSE inspector Judith McNulty-Green said:

“The regulations require exposures to ionising radiation to be kept as low as is reasonably practicable. In addition there are dose limits which should never be exceeded. In this case the dose to the radiologist’s hands was twice the relevant legal dose limit.

“As United Lincolnshire Hospitals NHS trust failed to assess the risk of this machine operating in continuous mode it led to the interventional radiologist being exposed to radiation for far longer and to a much greater extent than should have been allowed.”

Notes to editors

  1. The Health and Safety Executive is Britain’s national regulator for workplace health and safety. It aims to reduce death, injury and ill health. It does so through research, information and advice, promoting training, new or revised regulations and codes of practice, and working with local authority partners by inspection, investigation and enforcement.
  2. Regulation 7(1) of the Ionising Radiations Regulations 1999 states: Before a radiation employer commences a new activity involving work with ionising radiation in respect of which no risk assessment has been made by him, he shall make a suitable and sufficient assessment of the risk to any employee and other person for the purpose of identifying the measures he needs to take to restrict the exposure of that employee or other person to ionising radiation.
  3. Regulation 11 of the Ionising Radiations Regulations 1999 states: Subject to paragraph (2) and to paragraph 5 of Schedule 4, every employer shall ensure that his employees and other persons within a class specified in Schedule 4 are not exposed to ionising radiation to an extent that any dose limit specified in Part I of that Schedule for such class of person is exceeded in any calendar year. Where an employer is able to demonstrate in respect of any employee that the dose limit specified in paragraph 1 of Part I of Schedule 4 is impracticable having regard to the nature of the work undertaken by that employee, the employer may in respect of that employee apply the dose limits set out in paragraphs 9 to 11 of that Schedule and in such case the provisions of Part II of the Schedule shall have effect.

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