Changes to Safety Code 30
Highlights of the changes and how they impact your practice.
Health Canada updated Radiation Protection in Dentistry – Recommended Safety Procedures for the Use of Dental X-Ray Equipment – Safety Code 30 to address changes in radiography over the last 20 years. Safety Code 30 provides guidance about radiation safety procedures, equipment performance, and radiation protection for the use of dental X-ray equipment.
So, have you read Safety Code 30? Do you know about the updates? Do you know how they impact your practice or the place you work?
Dental practices and staff need to ensure they are aware of and comply with the current requirements. Here’s what you need to know:
Radiation Dosimetry Monitoring
Safety Code 30 indicates personnel only need to use dosimeters in certain circumstances, however Alberta’s Occupational Health and Safety Code (OHS Code) requires all workers who use or are exposed to radiation to use them. In Alberta we follow the OHS Code as it takes precedence. S. 291.5 requires that “a worker who uses or may be exposed to radiation through the use of any ionizing radiation equipment” must use a monitoring device.
Questions to ask yourself:
- Do we use radiation monitoring devices where I work?
- Do I wear them on a regular basis?
- Do I know where to store them, or where not to store them?
- What monitoring service do we use?
Radiation Safety Officers
They are now referred to as Coordinators of the Radiation Protection Program. A qualified staff member must be assigned to this role and the responsibilities of the coordinator are outlined in Safety Code 30 s. A.1.2.2.
- Who is the Coordinator of Radiation where I work?
& Lead Aprons
The patient must be provided with a thyroid shield when it will not interfere with the required diagnostic information. When taking x-rays on children, it is even more important to use the thyroid shield, as the thyroid gland is very sensitive to radiation.
Safety Code 30 s. A.3.2.1, 7 states “With the exception of CBCT procedures, the use of a lead apron is not required for the patient during routine dental X-ray procedures, if all other recommendations for limiting patient radiation exposure are respected, as the dose to the patient will not be significantly affected by abdominal shielding.” Although lead aprons are no longer required for routine X-rays, it is important to think about the comfort level of your patient. They may be used to and expect to be given a lead apron to wear whenever X-rays are taken.
- How will the patient feel if they are no longer given a lead apron?
- What is the difference between a thyroid shield and a lead apron?
- What are the general practices where I work?
Collimators must now be rectangular instead of circular. Safety Code 30 s. A.3.2.2, 2 states “Rectangular collimation of the X-ray beam must be used, except in occlusal protocols, as it significantly reduces the dose to the patient compared to circular collimation.” Dental practices will need to contact their suppliers about installing aftermarket adaptors as needed.
Keeping in mind the concept of ALARA (As Low As Reasonably Achievable), these are some questions to ask yourself:
- How will the change from circular to rectangular collimation affect the X-rays I take?
- Do I need to refresh my skills for taking radiographs?
Quality Assurance Program
All dental practices must have a quality assurance program (QAP) in place. A QAP ensures that all X-ray equipment is working properly and helps to address issues before exposing patients to radiation. Safety Code 30 s. C.1.2.1 outlines four steps that must be included in quality control procedures. Dental practices may be able to purchase quality assurance kits from X-ray equipment supply companies along with record keeping forms.
Questions to ask:
- Do we have a quality assurance program in place where I work?
- How is quality assurance being tracked and documented?
- Who is performing the quality assurance and when?
- Are we completing the QAP only to comply with requirements, or to provide maximum possible benefit to the patient?
- What is the consequence to the patient if radiography equipment is not producing images of the highest quality or is functioning but damaged?
Now that you are aware of just some of the changes that were made to Safety Code 30, we encourage you to start discussions with your employers, coworkers, and other dental practitioners about how they are applying the updates. Some dental practices may not even be aware of them. The entire dental team has a joint responsibility to put the patient’s well-being first. By taking necessary measures to ensure radiation procedures and equipment are being monitored, and that staff and operators are informed, your practice is patient-centered.