Attachment RFI 150 Physics Report.pdf

The Medical Physics Experts

W E S TW E S T P H Y S I C S

3 0 3 3 9S u i t e 2 5 0 A t l a n t a , G A3 8 2 5 P a c e s W a l k S E 866-275-WEST (9378) www.westphysics.com

August 23, 2022

Maia Carter Sacramento VA Medical Center 10535 Hospital Way Mather, CA 95655

RE: Fluoroscopic Suite Shielding Design Evaluation – Sacramento VA Medical Center 10535 Hospital Way, Mather, CA 95655

Dear Ms. Carter, Please find enclosed the radiation shielding design evaluation for your Fluoroscopic suite. The first page of the shielding plan summarizes the total minimum required shielding for each applicable room barrier.

Additional information supporting the shielding recommendations constitutes the remaining sheets. You should retain a copy of this shielding design evaluation at your facility in the event that a regulatory agency wishes to verify the room’s shielding. We expect that a regulatory audit of the installation will take place, and an inspector will likely request this document at that time.

Thank you for the opportunity to take care of your radiation protection needs. Should you have any questions or comments about this shielding design, we would be happy to speak with you at your convenience. Please feel free to contact us at (866) 275-9378 or at shielding@westphysics.com.

Thank you, Matthew Fitzmaurice, Ph.D., DABR, DABSNM, CHP Chief Medical Physicist

Lancer Smith, B.S.

Associate Medical Physicist

Enclosure: Radiation Shielding Design Evaluation

Radiation Shielding Design Evaluation

Performed by

Site: Sacramento VA Medical Center

10535 Hospital Way Mather, CA 95655

Room: Hybrid OR #1

Unit: Philips Azurion 7 M20

Shielding Design Results:

Barrier Function of Space Behind Barrier

Controlled or Uncontrolled

Occupancy Factor (T)

Distance (ft,in)

Total Minimum Shielding Required

A-B Control Room Controlled 1.000 14' 10-1/2" 1/64" lead or equivalent

B-C Control Room Controlled 1.000 14' 11-3/4" 1/64" lead or equivalent

C-D Control Room Controlled 1.000 15' 11" 1/64" lead or equivalent

D-E Corridor Door Uncontrolled 0.125 24' 9-3/8" 1-3/4" solid core wood door (PC- 5), 1/64" lead, or equivalent*

E-F Corridor Uncontrolled 0.200 25' 8-3/4" 1/2" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

F-G Work Area Uncontrolled 1.000 17' 2-7/8" 1/32" lead or equivalent

G-H Storage Room Uncontrolled 0.050 13' 10-3/4" 1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

H-I Storage Room Uncontrolled 0.050 14' 11-1/8" 1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

I-J Corridor Door Uncontrolled 0.125 22' 1/4" 1/64" lead or equivalent

J-K Corridor Uncontrolled 0.200 20' 2-1/4" 1" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

K-A Corridor Uncontrolled 0.200 14' 9-5/8" 1/64" lead or equivalent

Floor X-Ray Room Uncontrolled 1.000 17' 0" 1/32" lead, or 1-3/4" standard density concrete; or equivalent*

Ceiling Nurse's Station Uncontrolled 1.000 17' 0" 1/32" lead, or 1-3/4" standard density concrete; or equivalent*

*Appropriate concrete thickness may already be installed in the floor and ceiling. Please double check.

Facility Diagram:

Note: Cardinal directions are approximate only. Shielding should be installed carefully and with respect to the function of the surrounding areas to ensure proper barrier thicknesses.

Room: OR #2

Unit: GE OEC Elite or Siemens Cios Mobile C-Arms

Shielding Design Results:

Barrier Function of Space Behind Barrier

Controlled or Uncontrolled

Occupancy Factor (T)

Distance (ft,in)

Total Minimum Shielding Required

A-B Work Area Uncontrolled 1.000 18' 5-1/8" 1" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

B-C Corridor Door Uncontrolled 0.125 15' 6-3/8" No additional shielding required

(Standard door construction sufficient)

C-D Corridor Uncontrolled 0.200 14' 9" 1/8" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

D-E X-Ray Room Controlled 1.000 11' 5-1/8" 1/2" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

E-F Corridor Uncontrolled 0.200 13' 9-1/8" 1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

F-G Corridor Door Uncontrolled 0.125 15' 2-7/8" No additional shielding required

(Standard door construction sufficient)

G-H Corridor Uncontrolled 0.200 17' 4-3/4" No additional shielding required (Standard 2 × 5/8" drywall panel construction sufficient)

H-I Storage Room Uncontrolled 0.050 13' 3-1/8" No additional shielding required (Standard 2 × 5/8" drywall panel construction sufficient)

I-J Storage Room Uncontrolled 0.050 13' 2-7/8" No additional shielding required (Standard 2 × 5/8" drywall panel construction sufficient)

J-A Work Area Uncontrolled 1.000 17' 7-1/8" 1-1/8" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

Floor Office Uncontrolled 1.000 17' 0" 1/64" lead, or 5/8" standard density concrete; or equivalent*

Ceiling Corridor Uncontrolled 0.200 17' 0" 1/64" lead, or 5/8" standard

*Appropriate concrete thickness may already be installed in the floor and ceiling. Please double check.

Note: Cardinal directions are approximate only. Shielding should be installed carefully and with respect to the

Room: OR #3

Behind Barrier

Controlled or Uncontrolled

Occupancy Factor (T)

Distance

(m) Total Minimum Shielding Required

D-K Corridor Uncontrolled 0.200 17' 7-3/4" No additional shielding required (Standard 2 × 5/8" drywall panel construction sufficient)

K-L Corridor Door Uncontrolled 0.125 15' 1/2" No additional shielding required

(Standard door construction sufficient)

L-M Corridor Uncontrolled 0.200 14' 6-3/8" 1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

M-N Corridor Uncontrolled 0.200 12' 1-3/8" 3/8" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

N-O Corridor Uncontrolled 0.200 14' 0" 1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

O-P Corridor Door Uncontrolled 0.125 15' 1-1/8" No additional shielding required

(Standard door construction sufficient)

P-E Corridor Uncontrolled 0.200 16' 11-7/8" No additional shielding required (Standard 2 × 5/8" drywall panel construction sufficient)

E-D OR #2 Controlled 1.000 12' 5-1/4" 3/8" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

Floor Office Uncontrolled 1.000 17' 0" 1/64" lead, or 5/8" standard density concrete; or equivalent*

Ceiling Office Uncontrolled 1.000 17' 0" 1/64" lead, or 5/8" standard density concrete; or equivalent*

*Appropriate concrete thickness may already be installed in the floor and ceiling. Please double check.

Note: Cardinal directions are approximate only. Shielding should be installed carefully and with respect to the

Room: Cysto/OR #4

Controlled or Uncontrolled

Occupancy Factor (T) Distance (m) Total Minimum Shielding

Required

A-B Corridor Uncontrolled 0.200 14' 6-3/4" 1/8" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

B-C Corridor Door Uncontrolled 0.125 14' 11-7/8" No additional shielding required

(Standard door construction sufficient)

C-D Corridor Uncontrolled 0.200 16' 5" 1/8" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

D-E Clean Core Uncontrolled 0.200 10' 3-7/8" 5/8" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

E-F Anesthesia Team Room Uncontrolled 1.000 12' 4-1/2" 1/64" lead or 1-7/8” drywall or equivalent

F-G Corridor Door Uncontrolled 0.125 17' 4-1/8" No additional shielding required

(Standard door construction sufficient)

G-H Corridor Uncontrolled 0.200 13' 9-1/2" 1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

H-I Corridor Uncontrolled 0.200 13' 7-1/2" 1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

I-J Corridor Uncontrolled 0.200 15' 8-3/8" 1/8" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

J-K Office Uncontrolled 1.000 10' 11-3/8" 1/64" lead or 2-1/4” drywall or equivalent

K-A Work Area Uncontrolled 1.000 11' 0" 1/64" lead or 2-1/4” drywall or equivalent

Floor Office Uncontrolled 1.000 17' 0" 1/64" lead, or 5/8" standard density concrete; or equivalent*

Ceiling Office Uncontrolled 1.000 17' 0" 1/64" lead, or 5/8" standard

*Appropriate concrete thickness may already be installed in the floor and ceiling. Please double check.

HP

Pen

Note: Cardinal directions are approximate only. Shielding should be installed carefully and with respect to the

Room: Ortho OR #5

Controlled or Uncontrolled

Occupancy Factor (T)

Distance

(m) Total Minimum Shielding Required

A-B Corridor Uncontrolled 0.200 18' 9-3/4" No additional shielding required (Standard 2 × 5/8" drywall panel construction sufficient)

B-C Corridor Door Uncontrolled 0.125 16' 4-3/8" No additional shielding required

(Standard door construction sufficient)

C-D Corridor Uncontrolled 1.000 13' 10-1/2" 1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

D-E Workstation Uncontrolled 1.000 16' 9-3/8" 1-1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

E-F Corridor Uncontrolled 0.200 13' 1-3/4" 1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

F-G Corridor Uncontrolled 0.200 13' 8-1/8" 1/4" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

G-H Corridor Uncontrolled 0.200 15' 7" 1/8" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

H-I Corridor Door Uncontrolled 0.125 18' 8-1/2" No additional shielding required

(Standard door construction sufficient)

I-J Anesthesia Team Room Uncontrolled 1.000 16' 11-1/4"

1-1/4" drywall (Standard 2 × 5/8" drywall panel construction sufficient)

J-A Corridor Uncontrolled 0.200 15' 5-5/8" 1/8" drywall

(Standard 2 × 5/8" drywall panel construction sufficient)

Floor Receptionist Area Uncontrolled 1.000 17' 0" 1/64" lead, or 5/8" standard density concrete; or equivalent*

Ceiling Office Uncontrolled 1.000 17' 0" 1/64" lead, or 5/8" standard density concrete; or equivalent*

*Appropriate concrete thickness may already be installed in the floor and ceiling. Please double check.

Note: Cardinal directions are approximate only. Shielding should be installed carefully and with respect to the

Other Recommendations and Requirements

• The registrant must ensure that each radiation machine is labeled in a conspicuous manner, which cautions individuals that radiation is produced when it is energized.

• Leaded glass of equivalent lead thickness may be used where appropriate.

• All barrier wall shielding shall extend from floor-to-ceiling unless the required amount of ceiling shielding has already been satisfied (refer to the “Shielding Design Results” table for the minimum ceiling shielding requirement).

• If the ceiling shielding requirements are already satisfied, all barrier wall shielding shall extend from the finished floor to a height of at least 84 inches.

• All shielded barriers, including view windows and frames, doors and door frames, should be of the specified shielding equivalencies or greater and should have no voids. Joints between lead sheets should be constructed so that their surfaces are in contact and with an overlap of at least 1 cm.

• Any penetrations in a given barrier should be designed to afford the same shielding equivalency as that specified for the barrier. For example, pipes, electrical outlets, or other barrier penetrations must be wrapped, covered, or backed up with appropriate shielding-equivalent material.

• If any of the above barriers already meets the “total minimum required shielding” amount, stated above, no additional shielding is needed.

• If any of the above barriers’ existing shielding falls short of the “total minimum required shielding” amount, then enough shielding must be added to meet the total requirement.

• Doors, windows, frames, conduits and wall openings must have the same lead equivalency as the walls supporting them.

• The operator shall be allotted no less than 7.5 ft2 of unobstructed floor space in the booth, exclusive of any encumbrance by the X-Ray control panel such as overhangs, cables, etc.

• Viewing system(s) shall be provided to permit continuous observation of the patient during irradiation and shall be located so that the operator can observe the patient from the control panel.

• The X-Ray control shall be permanently mounted in a protected area so that the operator must remain in that protected area during the entire exposure. This control shall be at least 40 inches from any point subject to direct scatter, leakage or primary beam radiation.

• This shielding design is for the equipment layout and occupancy of adjacent areas as indicated on the attached drawing. If any of these parameters are changed, the shielding design will require re-evaluation by a qualified physicist.

• The shielding requirements specified in this plan review were based on the stated conservative workload(s). If the patient volume increases significantly, the shielding will require re-evaluation by a qualified physicist.

• A qualified contractor with experience in shielded construction should be utilized and a follow-up inspection performed to verify the adequacy of the installation after completion.

Additional Shielding Design Calculation Information Sacramento VA Medical Center

All calculations were performed in accordance with industry-standard guidance as detailed in NCRP Report No. 147, “Structural Shielding Design and Evaluation for Medical X-Ray Imaging Facilities.”

Wherever possible, vendor and model-specific information for the x-ray units and/or radioactive sources in question were used. Where appropriate, calculations account for attenuation by primary beam pre-shielding using the equivalent thickness values listed in Table 4.6 of NCRP Report No. 147. Patient throughput estimates as well as workload kVp distributions were used in the following calculations, based on average values contained in NCRP Report No. 147. The recommended shielding amounts are specified in a highly conservative fashion, which will allow for a broad range of patient workloads, technique factors, etc. without creating a radiation exposure issue. However, if any major changes occur (i.e., replacement of the x-ray unit, facility/x-ray room structural layout and/or changes in the usage of the x-ray room surrounding areas), the facility administration is advised to seek the services of a qualified medical physicist to determine whether shielding additions would be needed in those cases.

All shielding design goals, occupancy factors and workloads are as specified in NCRP Report No. 147 unless stated otherwise.

Equipment Specifications and Workload (W):

Hybrid OR #1

Equipment Type Patients per Week mA-min per patient Workload (W)

Philips Azurion 7 M20 3 160 480 mA-min/week

OR Room #2, #3, #4, and #5

Equipment Type Patients per Week mA-min per patient Workload (W)

GE OEC Elite or Siemens Cios Mobile C-Arms 3 64 192 mA-min/week

*Workload represents each room individually.

Shielding Design Goals (P):

Area Type Shielding Design Goal (P) (mGy/week)

Controlled 0.10 Uncontrolled 0.02

Methodology:

For this shielding design evaluation, the fitting parameter method for shielding calculation was employed, based on manufacturer data and information provided by the user. The room will be primarily used for the purpose of general fluoroscopy, and all barriers have been treated as secondary barriers. This shielding evaluation assumed a conservative number of exposures per week, based on facility estimates of its typical weekly workload. Equation 4.10 of NCRP Report No. 147 was used to compute required barrier thicknesses, and fitting parameters for this equation for lead, concrete, glass, and gypsum wallboard thicknesses were found in Table C.1. Patient exam technique was based upon the typical workload distributions defined in Table 4.3 of NCRP Report No. 147 along with facility estimates.

All barrier thickness calculations were performed in Excel. These are available from West Physics and may be furnished upon request of the detailed calculations.

Summary:

The above referenced calculations and recommendations are made by West Physics based on data provided by the facility planners and unit manufacturer. As such, the recommendations made herein are subject to that information’s accuracy. This shielding design is hereby certified and executed:

Chief Medical Physicist

08/23/2022 Date