The use of ionizing radiation has played a revolutionary role in the field of medicine. From disease diagnosis to treatment, it has opened new horizons and is proving highly effective in alleviating human suffering. At the same time, its use is steadily increasing in the industrial and agricultural sectors.
The most accessible and widely used source of ionizing radiation in our country is the X-ray machine, which is regarded as one of the most important diagnostic tools—from simple dental treatment to the management of many other diseases. Physicians use this test to examine the condition of teeth, bones, tissues, and various organs.
In addition, CT scans, BMD, and mammography are also carried out using ionizing radiation in the form of X-rays. In a nutshell, any equipment labeled as radiography or diagnostic X-ray is capable of producing ionizing radiation.
On the other hand, PET (Positron Emission Tomography), SPECT (Single Photon Emission Computed Tomography), and radiotherapy also use ionizing radiation. The first two techniques employ radioactive tracers to generate images of internal organs. PET-CT uses positron-emitting isotopes to produce clearer and higher-resolution images, while SPECT uses gamma-emitting isotopes to generate relatively lower-resolution images.
In radiotherapy, different types of radioactive isotopes are applied in controlled and specific doses, where the role of a medical physicist in dose determination is particularly crucial.
Medical physicists, radiologists, oncologists, and professionals from regulatory authorities work together to ensure the safe use of ionizing radiation through the ALARA (As Low As Reasonably Achievable) principle, proper shielding, dosimeters, and other protective measures. According to the ALARA principle, safety can be ensured by carefully controlling time, distance, and shielding during exposure. It must also be remembered that minimizing unnecessary radiation exposure is essential not only for radiation workers but also for patients receiving the exposure.
A natural question arises—why is so much caution needed when radiation is used as medicine? The simple answer is that exceeding the allowable dose limits (1 mSv/year for the general public and 20 mSv/year for radiation workers) is harmful to the human body. Ionizing radiation is a powerful force that can cause DNA mutations and various other complications. While its safe use is a blessing for humanity, uncontrolled use can bring devastating consequences.
Individual responsibility is integral to ensuring the safe, sustainable, and socially responsive use of nuclear energy and ionizing radiation, ultimately contributing to improved public health and the prevention of disease
To ensure the controlled use of scientific discoveries such as X-ray machines, CT scanners, angiograms, BMD, mammography, OPG, dental X-rays, and similar technologies, every individual can take the following steps:
1. Maintain distance from radiation sources: During X-rays, CT scans, or other radiological examinations, companions of patients should stay at a safe distance outside the room while the patient is inside. The instructions of the responsible technologist must be followed to ensure safety.
2. Ensure safety and radiation protection of the room: Radiation rooms should have at least 225 square meters of area with walls 10 inches thick. A separate control room with a lead glass viewing window (minimum 18×18 inches, embedded 1.5–2 inches within the wall) must be available for technologists to observe and guide patients. Rooms should have no windows or ventilators. Doors should be fully covered with 3–3.5 mm lead sheets without gaps, and double doors should overlap with lead-lined battens. Door frames and adjacent walls should be reinforced with 5–8 mm stainless steel sheets extending 3–4 inches. Warning signs and red lights must be installed outside to indicate the use of radiation. For CT scans and angiograms, a larger lead glass (minimum 36×20 inches) is preferable.
3. Use of TLD badges, lead aprons, and thyroid collars: Every individual (doctors, physicists, nurses, technicians, technologists, or others) present in the radiation room must wear a TLD badge for personal dose monitoring. Lead aprons and thyroid collars must be used where applicable. TLD badges must be reported every 90 days, and records must be preserved for the Bangladesh Atomic Energy Regulatory Authority (BAERA). Copies of these reports are required for license renewal of radiation-generating equipment.
4. Ensure proper positioning for single exposure: Patients should be positioned correctly to obtain quality images with minimal exposure.
5. Exercise caution with RVG, mobile, or portable X-ray machines: Since these do not provide full room shielding, users must apply ALARA principles themselves. Both patients and operators must wear lead collars and aprons (where applicable). Technologists must wear TLD badges and ensure that other patients or staff remain at a safe distance during exposure. For RVG, the doctor holds full responsibility for ensuring the safety of both patients and healthcare workers.
6. Ensure radiation safety in industrial use: Industrial radiation devices must be operated under strict radiation protection guidelines, with shielding, monitoring, and emergency plans in place. Remote-controlled operation is recommended. Operators must undergo training approved by BAERA and comply with its guidelines.
7. Obtain regulatory approval: Before import, a permit must be secured from BAERA. Before the operation, a practical user license must also be obtained, demonstrating that the user has fulfilled their primary civic duty toward safe radiation use.
Ensuring the safety and security of workers, patients, and the general public requires the controlled and regulated use of ionizing radiation. For this purpose, BAERA works continuously under the guidelines, standards, and regulations provided by the International Atomic Energy Agency (IAEA), in accordance with the Bangladesh Atomic Energy Regulatory Act 2012 and the Nuclear Safety and Radiation Control Rules 1997.
Finally, public awareness is indispensable. Ensuring the controlled and safe use of nuclear energy and ionizing radiation is not only an institutional responsibility but also a collective civic duty. Let us all remain aware and help others to become aware of this vital issue. Thus, individual responsibility is integral to ensuring the safe, sustainable, and socially responsive use of nuclear energy and ionizing radiation, ultimately contributing to improved public health and the prevention of disease with considerable confidence.
* Dr. Sheikh Mahatabuddin is former Associate Professor, Department of Nutrition and Food Engineering, Daffodil International University