Pregnancy & Radiation Exposure

Many women have concerns about radiation exposure and its effects during pregnancy. For women to make informed decisions regarding their work around radiation, a clear understanding of the risk of radiation exposure during pregnancy, including risk to the fetus, is required. Understanding the magnitude of the risk and mechanisms to limit exposure are necessary in order to feel comfortable in the work environment. This webpage was designed to provide you with the information needed to make informed decisions regarding your work around radiation sources.

If a woman wishes to become pregnant while working around sources of radiation, there are precautions that can be taken. The individual’s work environment and potential exposure should be evaluated and a plan for protective actions can be established. As an example, a pregnant radiation worker in interventional cardiology can be issued an additional fetal dosimeter to be worn under the lead apron to assess dose to the fetus. Fetal dose can be significantly reduced by appropriate fit and thickness of lead aprons, radiation shielding, and maximizing distance from the radiation source. Based on the available evidence, heritable or developmental risks to the fetus of pregnant interventional cardiology physicians and staff are extremely low provided that good radiation safety practices are used and dose limits are respected.

Questions often arise regarding a pregnant employee providing care of patients who have received diagnostic doses of radioactive material for nuclear medicine and nuclear cardiology imaging studies. With all such studies, the radionuclide administered will be eliminated over time due to physical decay and biological elimination. Most radionuclides administered for diagnostic studies have a relatively short half-life. When a patient is administered a radiopharmaceutical, the source is spread out inside a patient after administration. In addition, the patient’s body absorbs much of the radiation, reducing the amount of radiation emitted from the body. The shielding effect from even a thin person’s body will minimally reduce the intensity of the radiation by at least one half in the case of Tc-99m. For someone standing at the bedside, these amounts would be further reduced as the distance from the patient increases. Given the caveats mentioned above, pregnant staff can periodically care for these patients without exceeding permitted dose limits. If care for radioactive patients is routine, please contact the Radiation Safety Office for evaluation of potential dose.

In general, radiation doses to the public and caregivers from diagnostic radiopharmaceuticals are typically quite low. While the radiation emitted from the patient can be detected with radiation instruments, detectability does not mean hazardous. If one wishes to further minimize any dose that might be received, you can minimize the time spent close to the patient and use distance to reduce dose.

Radiation doses and dose rates form patients who have undergone diagnostic nuclear medicine procedures have been measured. Based on such measurements, physicians, scientists and regulators have unanimously concluded that such radiation doses from patients are extremely small and do not warrant an undue concern or any radiation precautions. Pregnant caregivers should not feel at risk and no protective lead is necessary. No special precautions are needed in caring for them and no restrictions on patient activities or contact with other people is required. If you find that you still have concerns, you should contact the Radiation Safety Officer at 434.982.4911.

University of Virginia Policy ID:SEC-010 - Radiation Protection during Pregnancy

Pregnancy and Radiation Exposure Information Sheet is an information sheet published by the Health Physics Society. It provides information pertaining to reproductive risks of radiation exposures to women who are pregnant and have questions about the risk of birth defects and miscarriage. It is also for men and women who are concerned about radiation exposures they have had that might impact the development of their sperm or their eggs (ova) and their risk of genetic diseases because of the radiation exposure.

Commonly asked Questions and Answers regarding Pregnancy and Radiation Exposure from the HPS Ask the Experts site.

Radiation Workers Concerned with Pregnancy

This policy contains guidelines that have been established for the protection of a declared pregnant employee from ionizing radiation.

Radiation Protection During Pregnancy - Guidance for Nuclear Medicine and Nuclear Cardiology Staff.

NRC Regulatory Guide 8.13 - Instructions Concerning Prenatal Radiation Exposure - This regulatory guide is intended to provide information to pregnant women, and other personnel, to help them make decisions regarding radiation exposure during pregnancy.

In order for a pregnant worker to take advantage of the lower exposure limit and dose monitoring provisions specified in the regulations, the woman must declare her pregnancy in writing to the Radiation Safety Office. The following form must be used for declaration: Declaration of Pregnancy Form.

This form provides the University (licensee) with information that will be used to "ensure that the dose equivalent to the embryo/fetus during the entire pregnancy, due to the occupational exposure of a declared pregnant woman, does not exceed 0.5 rem (5 mSv)".

In order to withdrawal your pregnancy declaration, you need to complete this form and submit to the Dosimetry Program Coordinator: Withdrawal of Pregnancy Declaration.

Radiation Safety Manual for Nursing Staff

Sources of radiation are used at UVA for diagnosis, therapy and research. The Radiation Safety Manual for Nursing Staff was created to provide health care workers with information on how to work safely in these different environments. There is in general, minimal external radiation hazard to nursing staff from procedures involving radiation. During use of certain nuclides considered therapeutic in nature (not diagnostic levels) there exists the potential for higher dose to caregivers. In these cases, additional training, dosimeter use, shielding, etc. may be required. This manual discusses radiation protection guidelines for the different uses here at UVA. Adherence to guidelines contained in this manual will help health system staff members reduce radiation exposure to levels allowable for individual members of the general public, or in some cases, to levels indistinguishable from natural background.

Policy for Imaging Pregnant Patients

This policy applies to all imaging procedures of pregnant or potentially pregnant patients involving ionizing radiation at the University of Virginia. The pregnancy status of a female patient of reproductive age is to be determined prior to radiation exposure. The primary goal is to protect the well-being of the mother because her well-being also preserves the life of the fetus.

Other Radiation-Related Information for Health Care Personnel

Radiation Exposure From Medical Diagnostic Imaging Procedures

This fact sheet provided by the Health Physics Society includes dose estimates for typical diagnostic x-ray and nuclear medicine exams.

Radiation and Your Patient: A Guide for Medical Practitioners - "In the practice of medicine, there must be a judgement made concerning the benefit/risk ratio. This requires not only knowledge of medicine but also of the radiation risks. This document is designed to provide basic information on radiation mechanisms, the dose from various medical radiation sources, the magnitude and type of risk, as well as answers to commonly asked questions (e.g. radiation and pregnancy)."

Radiation-related information designed for physicians - whose patients might have questions, or who may have questions themselves. Information provided by the Health Physics Society for Health Care Personnel.

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