afman48-148.pdf

BY ORDER OF THE

SECRETARY OF THE AIR FORCE

AIR FORCE MANUAL 48-148

20 JULY 2020

Aerospace Medicine

IONIZING RADIATION PROTECTION

COMPLIANCE WITH THIS PUBLICATION IS MANDATORY

ACCESSIBILITY: Publications and forms are available on the e-Publishing website at www.e-Publishing.af.mil for downloading or ordering.

RELEASABILITY: There are no releasability restrictions on this publication.

OPR: AFMRA/SG3PB

Supersedes: AFI48-148, 20 November 2014

Certified by: AF/SG3/4

(Maj Gen Robert I. Miller)

Pages: 65

This manual implements Air Force Policy Directive (AFPD) 48-1, Aerospace & Operational

Medicine Enterprise. This manual applies to all civilian employees and uniformed members of the Regular Air Force, Air Force Reserve and Air National Guard. It also applies to all tenants of Air Force controlled property, including Department of Energy personnel, in accordance with host-tenant support agreements, and Air Force contractors where specified herein and when required by the terms of their contracts. See paragraph 1.2 for additional applicability. This manual specifies the requirements for the protection of Air Force (AF) personnel and the public from exposure to ionizing radiation resulting from AF activities. It defines responsibilities for the protection, monitoring and medical follow-up of military personnel for the full spectrum of military operations. This manual requires the collection and/or maintenance of information protected by the Title 5 United States Code (U.S.C.) Section 552a, Privacy Act of 1974, authorized by Title 10 Code of Federal Regulations (CFR), Section 20.2106, Records of

Individual Monitoring Results and Title 29 CFR Section 1910.1096(b), Exposure of Individuals to Radiation in Restricted Areas, Title 29 CFR Section 1910.1096(n), Records, and Title 29 CFR

Section 1910.1096(o), Disclosure to Former Employee of Individual Employee's Record. The applicable system of records notice (SORN) F044 AF SG O, United States Air Force Master

Radiation Exposure Registry is available at: http://dpclo.defense.gov/Privacy/SORNs.aspx.

Ensure that all records created as a result of processes prescribed in this publication are maintained in accordance with Air Force Instruction (AFI) 33-322, Management of Records and

Information Governance Program, and disposed of in accordance with the Air Force Records

Disposition Schedule in the Air Force Records Information Management System. Refer recommended changes and questions about this publication to the Office of Primary

Responsibility using the AF Form 847, Recommendation for Change of Publication; route AF http://www.e-publishing.af.mil/ http://dpclo.defense.gov/Privacy/SORNs.aspx

2 AFMAN 48-148 20 JULY 2020

Forms 847 from the field through the appropriate functional chain of command to the Air Force

Medical Readiness Agency (AFMRA)/Bioenvironmental Engineering Division, 7700 Arlington

Blvd., Falls Church, VA 22041. This publication may be supplemented at any level, but all supplements must be routed to the OPR of this publication for coordination prior to certification and approval. The authorities to waive wing and unit level requirements in this publication are identified with a Tier (“T-0, T-1, T-2, T-3”) number following the compliance statement. See

AFI 33-360, Publications and Forms Management, for a description of the authorities associated with the Tier numbers. Submit requests for waivers through the chain of command to the appropriate Tier waiver approval authority, or alternately, to the requestor’s commander for non-tiered compliance items. Compliance with the attachment in this publication is mandatory

SUMMARY OF CHANGES

This document has converted from an AFI to a manual; it has been substantially revised and must be completely reviewed. The document has been streamlined, revised, and updated. Major changes include radon policy revision, updated training requirements, revised clearance criteria, and updated local policy requirements.

Chapter 1—PROGRAM OVERVIEW 6

1.1. Overview

1.2. Applicability

1.3. Requirements Outlined

1.4. Objectives of the AF Radiation Protection Program

1.5. Planned, Emergency, and Existing Exposures

Chapter 2—ROLES AND RESPONSIBILITIES 9

2.1. The Assistant Secretary of the Air Force for Installations, Environment and

Energy (SAF/IE). The Assistant Secretary of the Air Force for Installations, Environment and Energy (SAF/IE)

2.2. The Assistant Secretary of the Air Force for Acquisition (SAF/AQ) shall:

2.3. The Deputy Chief of Staff for Logistics, Engineering, and Force Protection

(AF/A4) shall:

2.4. The Surgeon General of the Air Force (AF/SG) shall:

2.5. The Commander, Air Force Inspection Agency shall:

2.6. The Chief, Weapons Safety Division, AF Safety Center (AFSEC) shall:

2.7. The Commander, Air Force Legal Operations Agency (AFLOA) shall:

2.8. Major Commands (MAJCOM) shall:

AFMAN 48-148 20 JULY 2020 3

2.9. The Air Force Radiation Safety Committee (AF-RSC) shall:

2.10. The Wing or Installation Commander, as appropriate, shall:

2.11. Organization or Unit Commander, as appropriate, shall:

2.12. Medical Treatment Facility (MTF) Commander or equivalent, as appropriate, shall:

2.13. The Commander (or Director, or Chief), Installation Contracting, shall:

2.14. The Commander (or Director, or Chief), Installation Civil Engineering, shall:

2.15. Referring medical practitioners shall:

2.16. Radiological medical practitioners

2.17. Medical physicists shall: s

2.18. Workplace supervisors shall:

2.19. Radiation worker shall:

Chapter 3—TRAINING AND QUALIFICATIONS 20

3.1. General

3.2. IRSO Qualifications

3.3. URSO Qualifications

3.4. Permit RSOs Qualifications

3.5. Radiation Workers

Table 3.1. Training guidance for radiation safety officers and radiation workers

Chapter 4—RADIATION PROTECTION FOR OCCUPATIONAL PRACTICES 23

4.1. Organization and Administration

4.2. Facility Design, Layout, and Area Classification

4.3. Training

4.4. Radiation Exposure Control

4.5. Radiation Dosimetry

4.6. Monitoring and Surveillance Programs and Instrumentation

4.7. Radioactive Waste Management

4.8. Occupational Medical Surveillance and Follow-Up

4 AFMAN 48-148 20 JULY 2020

Chapter 5—RADIATION PROTECTION OF THE PUBLIC 31

5.1. General

5.2. Control of Public Exposures from AF Practices

5.3. Protection of the Public During Emergencies

Chapter 6—RADIATION PROTECTION OF AF PERSONNEL DURING

EMERGENCIES 33

6.1. General

6.2. Radiation Protection Principles and Guidance for Emergencies

6.3. Allowable Contamination Levels

6.4. Training and Risk Communication

6.5. Monitoring During Emergency Operations

6.6. Medical Diagnosis and Treatment

6.7. Medical Surveillance

Chapter 7—INDOOR RADON EXPOSURE SURVEILLANCE AND MITIGATION 36

7.1. Radon Exposure Guidance. Note:

Figure 7.1. Convert Radon Gas Concentrations to WLM/yr

Figure 7.2. Residential Housing Example

Figure 7.3. Occupied Workplace Example

Table 7.1. Mitigation Timelines. (T-3)

7.2. Housing, Child Development Centers, and DoD Education Activity Schools

7.3. Occupied Workplace Buildings (Structures not included in paragraph 7.2)

7.4. Additional Radon Requirements

Chapter 8—MEDICAL TREATMENT FACILITY SPECIFIC GUIDANCE AND

REQUIREMENTS 40

8.1. Introduction

8.2. Not Used

8.3. Medical Credentialing, Authorizations and Qualifications

8.4. Equipment Requirements

8.5. Facility Requirements

AFMAN 48-148 20 JULY 2020 5

8.6. Clinical Requirements

8.7. Staff and Public Safety Requirements

8.8. Adverse Medical Incident Reporting and Notification

Figure 8.1. REGIONAL CONSULTING MEDICAL PHYSICS OFFICES

Table 8.1. REGIONAL CONSULTING MEDICAL PHYSICS OFFICES

Chapter 9—AIR FORCE RADIATION SAFETY COMMITTEE (AF-RSC) 52

9.1. Purpose

9.2. AF-RSC Members Organizations and Responsibilities

Table 9.1. AF-RSC Membership

9.3. Business Practices

9.4. Disagreement Resolution

9.5. Record Keeping

Attachment 1—GLOSSARY OF REFERENCES AND SUPPORTING INFORMATION 55

6 AFMAN 48-148 20 JULY 2020

Chapter 1

PROGRAM OVERVIEW

1.1. Overview. This manual addresses the hazards associated with exposure to ionizing radiation, regardless of source, and specifies requirements to keep exposures as low as reasonably achievable (ALARA). It outlines ionizing radiation protection roles and responsibilities for all ionizing radiation threats including those encountered by nuclear capable units and weapons storage areas unless stated otherwise in Department of Defense (DoD) publications or AF 91-series publications. This manual should be read in conjunction with Air

Force Manual (AFMAN) 40-201, Radioactive Materials (RAM) Management, AFMAN 48-125, Personnel Ionizing Radiation Dosimetry and AFI 91-108, Air Force Nuclear Weapons Intrinsic

Radiation and 91(b) Radioactive Material Safety Program. Specific AF requirements for nuclear weapons and the AF Radioisotope Committee regulated RAM, are found in AFI 91-108 and AFMAN 40-201, respectively.

1.2. Applicability. The requirements outlined in this manual apply to all AF, or AF-led, installations with operations that involve:

1.2.1. Possession or use of RAM as specified in AFMAN 40-201 and AFI 91-108.

1.2.2. Possession or use of radiation producing devices including situations where emissions are incidental to use.

1.2.3. Use of RAM or radiation producing devices by contractors, as specified by contract.

Note: Contractors are solely responsible for the health and safety of their employees in accordance with Occupational and Safety Health Administration and/or Nuclear Regulatory

Commission requirements, to include ionizing radiation, unless otherwise specified by the contract. This manual does not prohibit providing workplace sampling and survey information to contractors, based on local arrangements or in order to determine AF personnel and public exposures from contractor activities.

1.2.4. Doses resulting from planned, emergency, or existing exposures.

1.3. Requirements Outlined. The requirements outlined in this manual apply at Air Force installations overseas, including deployed locations, so long as the requirements do not conflict with applicable provisions from any of the following: international agreements, the Overseas

Environmental Baseline Guidance Document, country-specific final governing standards, geographic combatant command policy, and environmental annexes to operational orders, operational plans or other operational directive.

1.4. Objectives of the AF Radiation Protection Program.

1.4.1. Prevent radiation exposures that would result in deterministic effects (i.e., cataracts, skin erythema).

1.4.2. Limit the risk of stochastic effects (e.g., cancer and leukemia) for which the probability of occurrence is proportional to dose.

1.4.3. Ensure radiation workers are properly trained on the risks of radiation and methods to minimize exposure.

AFMAN 48-148 20 JULY 2020 7

1.4.4. Assess health risks, recommend and implement controls, and document exposures to ionizing radiation.

1.5. Planned, Emergency, and Existing Exposures. For the purposes of radiation protection, there are three broad categories of exposure: planned, emergency, and existing.

1.5.1. Radiation Protection Policy for Planned Exposure. This manual considers all AF activities involving the routine use of radiation producing devices or RAM in medicine, research, industry and training to be planned exposures. In addition to occupational exposures, medical exposures of patients also fall within the “planned” category for radiation protection purposes.

1.5.1.1. Examples of planned exposures. Common practices resulting in potential occupational exposures include, but are not limited to: industrial radiography, depleted uranium munitions handling, research involving nuclear materials or radiation producing devices, soil density testing, diagnostic radiology, nuclear medicine, radiation therapy and activities involving maintenance of nuclear weapon systems.

1.5.1.2. Justification: Any proposed activity causing exposure to persons should yield a sufficient benefit to society, the individual (for medical exposures), or the military to justify the risks incurred by the radiation exposure.

1.5.1.3. Optimization: The magnitude of individual doses and the number of people exposed shall be kept ALARA.

1.5.1.4. Dose limits: The dose to an individual resulting from a combination of all relevant planned exposures shall not exceed the occupational or public limits, as applicable, specified in this manual, see paragraph 4.4.1 for occupational limits and paragraph 5.2.4 for public limits. Note: These limits do not apply to a patient who is prescribed radiation as part of a diagnostic or therapeutic medical procedure.

1.5.2. Radiation Protection Policy for Emergency Exposures. These are unexpected situations that may require urgent protective actions to be implemented to avoid or reduce exposures. Examples include, but not limited to, incident or contingency response activities required to save life or property, humanitarian assistance operations, and military operations conducted where national interests may force personnel to incur radiation doses beyond occupational limits.

1.5.2.1. Justification: A proposed emergency response should do more good than harm by balancing the goals of military objectives and/or humanitarian assistance with the increased risk of deterministic and/or stochastic effects.

1.5.2.2. Optimization: The form, scale, and duration of the emergency response should be optimized so the net benefit is maximized and the net detriment is minimized. Again, individual doses shall be maintained ALARA.

1.5.2.3. Dose guidance: Occupational or “planned” dose limits do not apply for emergency exposures. Instead, operational dose guidance is utilized which considers the factors of acceptable risk and mission importance.

1.5.3. Existing Exposures. These are exposure situations that already exist, such as natural background radiation.

8 AFMAN 48-148 20 JULY 2020

1.5.4. Exposures to the Public. Public exposures may occur as a result of planned, emergency, or existing exposures. Public exposures of concern, for the purposes of this manual, include those resulting indirectly from AF occupational and medical practices, radon, and from radiological incidents and accidents.

AFMAN 48-148 20 JULY 2020 9

Chapter 2

ROLES AND RESPONSIBILITIES

2.1. The Assistant Secretary of the Air Force for Installations, Environment and Energy

(SAF/IE). The Assistant Secretary of the Air Force for Installations, Environment and

Energy (SAF/IE) shall appoint a voting representative and alternate to the Air Force Radiation

Safety Committee (AF-RSC).

2.2. The Assistant Secretary of the Air Force for Acquisition (SAF/AQ) shall:

2.2.1. Appoint a voting representative and alternate to the AF-RSC.

2.2.2. Ensure adequate acquisition procedures exist governing the life-cycle management of sources of radiation not covered by AFMAN 40-201 or AFI 91-108.

2.2.3. Ensure the AF-RSC is informed regarding the acquisition of new systems and upgrades that utilize sources of radiation not covered by AFMAN 40-201 or AFI 91-108 prior to fielding.

2.3. The Deputy Chief of Staff for Logistics, Engineering, and Force Protection (AF/A4) shall:

2.3.1. Appoint one voting representative and one alternate from among the staff of both

AF/A4L and AF/A4C to the AF-RSC, who can represent their respective offices and will coordinate with AF/A4 functional areas as required.

2.3.2. Ensure adequate radiation safety guidance exist as they pertain to logistics, maintenance, civil engineering, and security.

2.3.3. Provide logistics, maintenance, civil engineering, and security consultation associated with accidents, incidents, or attacks involving RAM, radiation producing devices, or weapons of mass destruction.

2.4. The Surgeon General of the Air Force (AF/SG) shall:

2.4.1. Establish AF policy for controlling radiation hazards. Ensures AF policy compliance with relevant federal policies and accepted scientific practice.

2.4.2. Appoint an AF/SG Health Physics Consultant and an AF/SG Medical Physics

Consultant, who can be one individual if qualified for both positions.

2.4.3. The Assistant Surgeon General, Medical Operations (AF/SG3/4), shall:

2.4.3.1. Oversee the use of sources of radiation not covered by AFMAN 40-201 or AFI

91-108 to ensure compliance with all Federal, DoD, and AF regulations and requirements.

2.4.3.2. Establish the AF-RSC to serve as the focal point for all ionizing radiation issues and medical non-ionizing radiation issues, e.g. magnetic resonance imaging and medical lasers.

2.4.3.3. Chair, or delegate a primary and alternate to chair the AF-RSC.

10 AFMAN 48-148 20 JULY 2020

2.4.3.4. Appoint a voting representative and alternate from the Radioisotope Committee

Secretariat to the AF-RSC. They will be the Executive Secretary of the AF-RSC (AF-

RSCES). The AF-RSCES is authorized to conduct business on behalf of the AF-RSC such as setting the AF-RSC agenda, preparing for and conducting AF-RSC meetings, etc.

2.4.3.5. Appoint a voting representative and alternate from Bioenvironmental

Engineering (AFMRA/SG3PB) to the AF-RSC.

2.4.3.6. Appoint the AF/SG Consultant on Medical Physics and an alternate medical physicist as voting representatives to the AF-RSC. The Consultant on Medical Physics serves as the liaison for the Air Force Medical Physics Working Group (AFMPWG) to the AF-RSC.

2.4.3.7. Appoint a voting representative and alternate from Medical Readiness

(AFMRA/SG3X) to the AF-RSC.

2.4.3.8. Appoint a voting representative and alternate to the DoD Ionizing Radiation

Working Group.

2.4.4. AF/SG Consultant(s) for Health Physics and Medical Physics shall:

2.4.4.1. Adjudicate conflicts in prioritization between competing health and medical physics requirements.

2.4.4.2. Provide a recommendation on the qualification status, to the Bioenvironmental

Engineering Associate Corps Chief, for Air Force active duty medical physicists.

2.4.4.3. Manage the Air Force-Medical Physics Working Group to address medical physics policy, requirements, and standards.

2.5. The Commander, Air Force Inspection Agency shall:

2.5.1. Appoint a voting representative to the AF-RSC.

2.5.2. Conduct special emphasis inspections as requested by the AF-RSC.

2.6. The Chief, Weapons Safety Division, AF Safety Center (AFSEC) shall:

2.6.1. Appoint a voting representative to the AF-RSC to provide consultation on radiation programs related to nuclear weapon systems.

2.6.2. Consult with AF/SG3/4 on ionizing radiation exposures to personnel from nuclear weapon systems and nuclear weapons testing.

2.7. The Commander, Air Force Legal Operations Agency (AFLOA) shall:

2.7.1. Appoint one non-voting legal advisor and one alternate from AFLOA/JAC to the AF-

RSC to attend all scheduled meetings of the AF-RSC.

2.7.2. Serve as chief counsel to both the AF-RSC and to the AF- RSCES on an as needed basis and collaborate with AF-RSCES to obtain and provide accurate interpretations of all statutes, regulations, instructions, and guidance documents affecting implementation of the

AF radiation protection program for all AF components covered by this manual.

AFMAN 48-148 20 JULY 2020 11

2.8. Major Commands (MAJCOM) shall:

2.8.1. MAJCOM Surgeon Generals shall appoint a voting representative and an alternate to the AF-RSC for consultation which may include: research and development, training, health risk surveillance, and medical readiness issues.

2.8.2. The Commander, 711th Human Performance Wing, on behalf of the

Commander, Air Force Materiel Command (AFMC/CC), shall :

2.8.2.1. Appoint a voting representative and an alternate to the AF-RSC to provide consultation on research and development, training, and technical matters. (T-1).

2.8.2.2. Maintain a consultative service capable of addressing the radiation issues facing the AF. (T-1).

2.8.2.3. Provide operational health physics support during nuclear or radiological contingencies. (T-1).

2.8.2.4. Manage the Air Force Personnel Dosimetry Program and implement AFMAN

48-125 requirements. (T-1).

2.8.2.5. Maintain the AF Master Radiation Exposure Registry (MRER). (T-1).

2.8.2.5.1. Utilize the MRER to archive comprehensive dosimetry records for the lifetime of the AF Master Materials License, for all military personnel and for other personnel who use AF dosimetry services. (T-0).

2.8.2.5.2. Data from classified operations will be included to the fullest extent possible. (T-0). An individual’s assessed dose, in most circumstances, is not classified. Where classification is deemed necessary, see paragraph 6.5.4.2 for further guidance.

2.8.2.6. Update discrepancies (e.g., dates of birth, social security numbers, name spelling, MRER dose vs. historical hard copy records) in MRER based on credible evidence provided to the AF Dosimetry Center. (T-1). For significant MRER changes, as determined by the AF Dosimetry Center, present discrepancy in question to AF-RSC for adjudication. (T-1).

2.8.2.7. Provide operational reach back support to installations for radiation dosimetry to include consultation and supply of emergency dosimeters when available. (T-2).

2.8.2.8. Maintain a capability suitable for the collection of environmental and bioassay samples, conducts in-vivo monitoring, and performs radiochemical analysis of samples.

(T-2). The capability shall support both operational requirements and medical-legal documentation of individual internal exposures during peacetime, combat and non-combat military operations, and war. (T-2).

2.8.2.9. Process, analyze and interpret bioassay and environmental samples in accordance with the most current, industry-accepted methods of sample analysis and assessments methodology to meet regulatory requirements. (T-3).

2.8.2.10. Maintain complete records of all bioassay samples, sample analysis results, and estimation of internal dose for the lifetime of the AF Master Materials License, including estimates below detection limits of the analytical method. (T-2).

12 AFMAN 48-148 20 JULY 2020

2.8.2.11. Provide a dose estimate, resulting from bioassay analysis, to the supported commander’s medical staff. (T-2).

2.8.2.12. Provide technical advisory services on radiation protection issues, examples include health risk assessments, exposure reconstructions, radiation safety program reviews, radiation safety quality assurance program development, radiation safety training, and decommissioning survey reviews. (T-2).

2.9. The Air Force Radiation Safety Committee (AF-RSC) shall:

2.9.1. Provide direction on uses of radiation, not otherwise covered in AFMAN 40-201 (e.g.

machine generated radiation) and AFI 91-108, and grants authority to the AF-RSC Executive

Secretariat to conduct all business on its behalf (reference Chapter 9). Note: Issues related to the AF Master Materials License, or directed energy, to include non-medical lasers, are addressed by other groups.

2.9.2. Serve as the primary AF point of contact for communications with federal, state, and host nation regulatory authorities regarding radiation issues, not otherwise covered in

AFMAN 40-201 and AFI 91-108. Note: HQ AFSEC is the single point of contact for material controlled under Section 91 of the Atomic Energy Act of 1954 codified in Title 42

U.S.C. Section 2121, Authority of Commission.

2.9.3. Recommend policies to AF/SG for keeping radiation exposure ALARA.

2.9.4. Identify new or special inspection needs and reports them to the Air Force Inspection

Agency.

2.9.5. Establish the AFMPWG via the Associate Corps Chief for Bioenvironmental

Engineering and the AF/SG Consultant for Medical Physics. Note: The AFMPWG reports on medical physics issues to the AF-RSC and to the Associate Corps Chief for

Bioenvironmental Engineering for planning purposes of the Bioenvironmental Engineering

Corporate Board.

2.9.6. Meet as often as necessary, but not less than semi-annually, and delegate action items to voting representatives or other technical representatives. A quorum of at least 50% of the appointed representatives is required for each meeting.

2.9.7. Publish and makes available minutes to all members.

2.9.8. Provide final resolution for allegations concerning the safe use of radiation in compliance with all regulations, not otherwise covered in AFMAN 40-201 and AFI 91-108.

2.9.9. Be comprised of the members identified in Table 9.1, but may add non-voting members as deemed necessary.

2.9.10. The AF-RSC Executive Secretariat (AF-RSCES) shall:

2.9.10.1. Manage the affairs and executes the decisions of the AF-RSC and maintains AF policy pertinent to ionizing and medical non-ionizing radiation safety.

2.9.10.2. In collaboration with relevant AF/SG consultant(s), determine whether individuals are qualified by training, education, and experience to use radiation covered by this AFMAN.

AFMAN 48-148 20 JULY 2020 13

2.9.10.3. Prior to making a recommendation to procure and field new sources of ionizing radiation covered by this AFMAN, ensure safe operating procedures exist, ionizing radiation hazards are fully characterized, and exposures to operators, maintainers, and personnel are kept ALARA using engineering controls, administrative controls, or personal protective equipment. Note: Equipment procured through the Air Force

Diagnostic Imaging and Radiotherapy Board is outside the scope of the AF-RSC.

2.9.10.4. Prior to making a recommendation to procure and field new ionizing radiation detectors or dosimeters, ensure the devices are appropriate for the desired use, proper calibration requirements exist, and adequate training requirements are identified.

2.9.10.5. Consult with AFLOA/JAC or SAF/GCN, as designated in Headquarters Air

Force Mission Directive 1-14, General Counsel and The Judge Advocate General, on questions regarding federal regulations, Department of Defense instructions (DoDIs) and

AF publications; AFLOA/JAC and SAF/GCN will coordinate with each other on consultation requests, consistent with HAFMD 1-14, when significant or non-routine matters are at issue.

2.9.10.6. As necessary, conduct visits, respond to incidents and mishaps within the scope of this manual, and accompany the Air Force Inspection Agency during inspections where special emphasis investigations are being addressed.

2.10. The Wing or Installation Commander, as appropriate, shall:

2.10.1. Ensure the wing or installation radiation safety program is comprehensive, compliant with current requirements, and fully integrates the radiation safety programs of units, tenant units, and geographically separated units. Specific tasks include:

2.10.2. Appoint, in writing and by name, a qualified individual to be the installation radiation safety officer (IRSO) and an alternate if possible. Qualifications for IRSOs are listed in Chapter 3. (T-1).

2.10.3. Ensure tenant organization and unit radiation safety programs are fully integrated into the wing or installation radiation safety program. (T-2).

2.10.4. The IRSO shall:

2.10.4.1. Ensure the overall coordination of installation radiation safety activities and provide direct support and information to the installation commander on radiation health and safety issues and effectiveness of measures to control radiation hazards to comply with Federal, DoD and AF requirements (reference: AFMAN 40-201, AFI 91-108, and

AFMAN 48-125). (T-1).

2.10.4.2. Joint Basing. If an Air Force wing is not lead agent on a joint base, lead service will appoint IRSO; if AF member is not appointed IRSO, the AF wing commander must designate a wing radiation safety officer (RSO) to execute IRSO responsibilities for wing-owned personnel and operations. (T-2). The wing RSO is equivalent to IRSO and must meet same requirements. (T-2).

2.10.4.3. Develop and maintain specific written guidance for the execution of all applicable AFIs, AFMANs, and federal regulations concerning radiation protection on the installation (e.g. installation-level guidance memos, instructions, or AFMAN supplements, etc.). (T-3).

14 AFMAN 48-148 20 JULY 2020

2.10.4.3.1. Annually review the installation guidance. (T-3).

2.10.4.3.2. For an AF-led joint base or joint operation, the guidance must be signed by each co-located service component commander in addition to the installation commander. (T-2).

2.10.4.4. Establish and manage the overall installation radiation safety program in accordance with Chapter 4. (T-1). The program must include at least: annual reviews of current procedures and practices; status or outcome of any new facility designs and work orders; current and new restricted areas; radiation training status; exposure control

(including dosimetry trends and results); and monitoring/surveillance (e.g. compliance and shipping surveys) activities. (T-1). Reports deviations from this manual and local policy, as applicable, to the installation commander, AFMRA/SG3PB or AFSEC/SEW, and through the MAJCOM/SGPB, as applicable. (T-1). This review is separate from intrinsic radiation and radioactive material permit reviews that may also need to be done at the installation in accordance with AFI 91-108 and AFMAN 40-201, but they may all be done within one document.

2.10.4.4.1. Brief the installation commander at least annually regarding the results of this review. (T-1). Note: Providing this briefing to the Environmental, Safety, and

Occupational Health Council satisfies this requirement; may be done in conjunction with similar AFI 91-108 and AFMAN 40-201 requirements if applicable to the installation.

2.10.4.5. Assist commanders with the development of installation radiation safety policies, operating instructions or radiation safety manuals, as appropriate and requested.

(T-3).

2.10.4.6. Ensure radiation workers receive training on the risks of radiation, methods to minimize exposure, and the ALARA principle. (T-0).

2.10.4.7. Conduct public dose assessments and radon monitoring and assessment described in Chapters 5 and 7. (T-1).

2.10.4.8. Assist Civil Engineering as requested to ensure adequate design of facilities containing radiation sources and/or devices or requiring radon mitigation. (T-3).

2.10.4.9. Manage installation’s personnel dosimetry and bioassay program in accordance with AFMAN 48-125 requirements.

2.10.4.10. Ensure discrepancies in radiation dosimetry reports due to lost or damaged radiation monitoring devices are corrected in the MRER in coordination with the AF

Dosimetry Center within 30 days of identification. (T-1).

2.10.4.11. Forward unit personnel’s off-duty or moonlighting radiation dose records to

United States Air Force School of Aerospace Medicine (USAFSAM) for inclusion into the MRER. (T-0).

2.10.4.12. Document radiation source incidents (T-2) and coordinate with

Bioenvironmental Engineering to ensure installation personnel's potential workplace radiation hazards are referenced in the appropriate Defense Occupational and

Environmental Health Readiness System similar exposure group. (T-1).

AFMAN 48-148 20 JULY 2020 15

2.11. Organization or Unit Commander, as appropriate, shall:

2.11.1. Designate, in writing, a unit RSO (URSO) when in possession of RAM (not requiring a permit RSO in accordance with AFMAN 40-201, such as generally licensed devices) or radiation producing devices. (T-2). Note: This URSO is separate from, and in addition to, requirements of URSO and permit RSO appointments in AFI 91-108 and

AFMAN 40-201. However, the same member may be appointed if qualified to fulfill this manual’s, AFMAN 40-201, and/or AFI 91-108 requirements. Units possessing only exempt radioactive material (e.g. magnesium-thorium components, thoriated optics, or check sources not covered by permits) do not require URSOs. Commanders may appoint URSO for their units possessing only exempt radioactive material, for purposes of appropriate control of the material and program.

2.11.2. Provide facilities, equipment, and resources for radiation protection and safety. The nature and extent must be commensurate with the ALARA concept and the radiation hazards of the workplace. (T-0).

2.11.3. Implement policies, procedures, and a radiation protection program to ensure the requirements of this manual are met. (T-1).

2.11.4. Ensure implementation of AF radiation dosimetry and/or bioassay program, as necessary. (T-2).

2.11.5. Ensure radiation workers receive education and training in accordance with this manual. (T-3). Ensure radiation workers are properly trained on the risks of radiation, methods to minimize exposure, and the ALARA principle. (T-0).

2.11.6. Ensure reports are made and records are maintained in accordance with this manual.

(T-1).

2.11.7. Ensure workers incidentally exposed to ionizing radiation in their workplace (not otherwise directly related to or required by their work) receive the same level of protection as if they were members of the public. (T-1).

2.11.8. Integrate risk management into operations, activities, and planning during establishment, review, and approval of procedures involving ionizing radiation exposure in accordance with established policy (DoDI 6055.01, DoD Safety and Occupational Health

(SOH) Program and AFI 90-802, Risk Management). (T-3).

2.11.9. Notify the IRSO before procurement or making changes regarding RAM, radiation or radiation producing devices (RPD) (i.e., the amount or types of RAM or RPDs; new or altered radiation producing devices; special operations; solicitation of goods or services using

RAM or RPDs; or construction of new facilities). (T-1). The IRSO shall also be notified prior to any change in facilities affecting source or device security requirements, increased potential for personnel exposures, the location of RAM or radiation producing devices, or the potential for release of RAM. (T-1).

2.11.10. Unit Radiation Safety Officer (URSO) shall:

2.11.10.1. Meet the qualifications for URSOs listed in Chapter 3. (T-1).

16 AFMAN 48-148 20 JULY 2020

2.11.10.2. Provide technical support to organization or unit commanders on radiation protection issues; inform organization/unit commanders and the IRSO about radiation health and safety issues and effectiveness of measures to control radiation hazards. (T-1).

2.11.10.3. Establish and manage the organization or unit radiation safety program in accordance with Chapter 4, as applicable. (T-2). The program must include review of procedures and practices, facility design review and classification, training, exposure control activities, and routine monitoring and surveillance activities. (T-2).

2.11.10.4. Provide commanders assistance in developing organization specific radiation safety operating instructions and radiation safety manuals. (T-3).

2.11.10.5. Maintain and manage records as required by this manual. (T-2).

2.11.10.6. Ensure radiation workers are properly trained on the risks of radiation, methods to minimize exposure, and the ALARA principle. (T-0).

2.11.10.7. Forward unit personnel’s off-duty or moonlighting radiation dose records to

IRSO for inclusion into the MRER. (T-0).

2.12. Medical Treatment Facility (MTF) Commander or equivalent, as appropriate, shall:

2.12.1. Ensure either measured or estimated radiation dose received by personnel during occupational practices and/or contingency operations is available to the monitored individual.

(T-1).

2.12.1.1. Ensure dose determination records are forwarded to USAFSAM for incorporation into the MRER (to include locally performed bioassays). (T-1).

2.12.1.2. Maintain and ensure accessibility to all radiation exposure data for organizations or units including classified operations. (T-1).

2.12.2. Ensure collection of bioassay and laboratory specimens as necessary to assess internal exposures from ingested or inhaled RAM or contaminated wounds. (T-1). Samples shall be forwarded to USAFSAM for analysis and interpretation. (T-1).

2.12.3. Ensure medical follow-up of personnel receiving significant exposures in accordance with paragraph 6.7 (T-1).

2.12.4. If the MTF maintains qualified medical physicists:

2.12.4.1. Support medical physics regional mission as identified by Chapter 8. (T-1).

2.12.4.2. Shall ensure the resourcing of assigned medical physicists consistent with

AFMPWG recommendations to the Bioenvironmental Engineering Associate Corps

Chief, The Joint Commission requirements and Air Force Diagnostic Imaging Review

Board equipment outfitting recommendations. (T-1).

2.12.5. If the MTF does not maintain qualified medical physicists:

2.12.5.1. Shall request support from their regional medical physics office at least 90 days in advance of a requirement; if the regional consulting physics office does not deem direct support as feasible and advantageous, the MTF shall seek support through alternative means under advisement of the regional office. (T-1). Note: MTFs receive baseline funding for one routine medical physics visit per year, and shall be responsible

AFMAN 48-148 20 JULY 2020 17

for the funding and logistical support of their organization’s medical physics requirements. (T-3).

2.12.5.2. Final reports of testing performed by non AF medical physicists must be forwarded to the designated regional consulting medical physics office for review within

30 days of receipt and, for initial testing, prior to equipment acceptance. (T-1). Note:

See Chapter 8, Medical Treatment Facility Specific Guidance and Requirements, for additional and more detailed guidance.

2.13. The Commander (or Director, or Chief), Installation Contracting, shall:

2.13.1. Ensure that all contracts involving RAM or use of RPDs contain required contract clauses and incorporate a detailed performance work statement or statement of work. (T-1).

2.13.2. Ensure requirements likely to contain RAM or use RPDs contain IRSO approval documented in the requirement package prior to procuring goods or services. (T-1). Note:

Common equipment that contains RAM or RPDs include: x-ray machines, medical diagnostic imaging equipment, chemical detectors, laboratory analysis equipment (e.g. gas chromatographs and lead paint analyzers), and moisture density gauges. Common contracted services that may utilize RAM or RPDs include: medical shielding surveys, soil moisture density testing, and lead based paint surveys.

2.14. The Commander (or Director, or Chief), Installation Civil Engineering, shall:

2.14.1. Design facilities in accordance with paragraph 4.2 (T-3).

2.14.2. Incorporate radon reduction measures in the construction of new facilities as required in current DoD and AF policy (T-1); mitigate structures with radon exposures in accordance with Chapter 7. (T-3).

2.14.3. Manage radioactive waste generated during remedial actions or emergency operations, and ensure wastes are disposed of via the Air Force Radioactive Recycling and

Disposal Office in accordance with AFMAN 40-201, AFI 91-108 and AFMAN 32-7002, Environmental Compliance and Pollution Prevention. (T-1).

2.15. Referring medical practitioners shall:

2.15.1. Consult with an expert in radiation bio-effects (e.g. radiologist, nuclear medicine authorized user, radiation oncologist, and/or medical physicist) regarding abnormally high potential/actual radiation doses or demonstrable radiation injuries prior to advisement of a patient to pursue an irreversible action based on radiation concerns (e.g. termination of a pregnancy based on radiation exposure). (T-3).

2.15.2. Request a dose estimate consult from a qualified medical physicist following an exposure of a conceptus to a primary radiation field (i.e. direct beam of radiation) or internalization of radioactive material. (T-3).

2.16. Radiological medical practitioners. Radiologists, radiation oncologists, nuclear medicine physicians, other qualified physicians, and qualified radiological technologists that use radiation devices and/or RAM shall:

2.16.1. Control all aspects of the conduct and extent of the examinations. (T-3).

18 AFMAN 48-148 20 JULY 2020

2.16.2. Ensure radiographic examinations, radiation therapies or nuclear medicine procedures are only performed by properly trained personnel with adequate knowledge of the physical properties and harmful effects of radiation. (T-3).

2.16.3. Ensure the procedures used are appropriate and the minimum necessary radiation used for the clinical problem presented. (T-3).

2.17. Medical physicists shall: s upport diagnostic imaging, nuclear medicine, radiation oncology, and/or related medical radiation protection functions within their MTF or medical physics region as applicable, within the scope of their practice. (T-1).

2.18. Workplace supervisors shall:

2.18.1. Ensure workplace adherence to the requirements of this manual. (T-2).

2.18.2. Ensure protection of Airmen and AF civilians from occupational exposures.

Contractors shall comply with this manual regarding the use and control of radiation devices and are solely responsible for the health and safety of their personnel as specified in their contract. (T-1).

2.18.3. Ensure protection of the public from workplace practices. (T-1).

2.18.4. Ensure personnel are trained on radiation hazards in the workplace and appropriate protection requirements. (T-2).

2.18.5. Ensure radiation safety procedures are current and adhered to by radiation workers.

(T-2).

2.18.6. Notify the IRSO and URSO, as soon as practicable after identification, of changes in practices or procedures involving radiation, potential violations of this manual, unsafe work practices involving radiation, or accidents or incidents involving radiation. (T-1).

2.18.7. Ensure radiation workers are properly trained on the risks of radiation, methods to minimize exposure, and the ALARA principle. (T-0).

2.18.8. For MTF supervisors where ionizing radiation and/or RAM are used: designate personnel to execute the patient dose monitoring, occupational dosimetry, personal protective equipment (PPE) inventory and testing, radiation safety training, and equipment quality control programs in their area. (T-2).

2.19. Radiation worker shall:

2.19.1. Follow applicable rules or procedures, and receive information, instruction, and training for radiation protection and safety specified by organizational management and this manual. (T-1).

2.19.2. Use issued dosimeters and personal protective equipment correctly. (T-1).

2.19.3. Provide the URSO and/or IRSO information on past and current work relevant to ensure comprehensive effective protection and safety for themselves and others, to include any moonlighting dosimetry data to the URSO and IRSO. (T-1).

2.19.4. Perform operations in a manner that maintains doses ALARA. (T-1).

AFMAN 48-148 20 JULY 2020 19

2.19.5. Notify workplace supervisors of changes to procedures or operations that could affect exposure, potential violations of this manual, unsafe work practices involving radiation, or accidents or incidents involving radiation. (T-1).

2.19.6. An active duty pregnant female shall, on becoming aware she is pregnant, notify her workplace supervisor or primary care manager. (T-1). Note: A non-military or civilian member is encouraged to notify her workplace supervisor or Public Health office of her pregnancy. It is important to remember that it is the decision of a civilian woman whether or not she declares her pregnancy. This applies to female radiation workers and not all females.

20 AFMAN 48-148 20 JULY 2020

Chapter 3

TRAINING AND QUALIFICATIONS

3.1. General. This chapter provides the training requirements and qualifications required for all

AF radiation workers and radiation safety officers (RSOs). In general, the AF has three types of

RSOs: installation radiation safety officer (IRSO), URSO, and permit RSO.

3.2. IRSO Qualifications.

3.2.1. A Primary IRSO shall:

3.2.1.1. Be a fully qualified Bioenvironmental Engineer (43E3X) or 1306 Series General

Scale (GS) employee who meets at least one of the following: (T-1)

3.2.1.1.1. Attended the Bioenvironmental Engineer Officer Course prior to 1999 or after 2007; or

3.2.1.1.2. Be a fully qualified Bioenvironmental Engineer Health Physics Specialty

(43E3G); or

3.2.1.1.3. Is a certified health physicist; or

3.2.1.1.4. Has received 40 hours of RSO training (reference Table 3.1) via a formal course.

3.2.1.2. Knows the radiation hazards on the installation in order to fulfill the IRSO requirements of this manual, AFMAN 40-201, and AFI 91-108 IRSO requirements as applicable to the installation. (T-3). Note: Bioenvironmental Engineering Radiation

Skills Course completion is preferred but not required for IRSO appointment.

3.2.1.3. In the absence of a 43E3X or 1306 Series GS employee, or if a unit is geographically separate from one, the IRSO may be a 43E2X or a 7-level

Bioenvironmental Engineering Craftsman (4B071) provided they meet at least one of the criteria in paragraphs 3.2.1.1.1, 3.2.1.1.2, 3.2.1.1.3, or 3.2.1.1.4

3.2.2. Alternate IRSO. A 43E3X, 1306 Series GS employee, 43E2X, or a 7-level

Bioenvironmental Engineering Craftsman (4B071) may be appointed as an alternate IRSO provided they meet at least one of the criteria in paragraphs 3.2.1.1.1, 3.2.1.1.2, 3.2.1.1.3, or 3.2.1.1.4

3.2.3. Contractors cannot be the IRSO or alternate. (T-1).

3.2.4. Permittees listed on a permit issued by the AF Radioisotope Committee Secretariat cannot be an IRSO or alternate. (T-1).

3.3. URSO Qualifications.

3.3.1. URSO qualifications are based upon radioactive material and/or radiation producing devices used by the unit. URSOs shall have the required training listed on Table 3.1 (T-1).

3.3.2. URSOs responsible for general licensed devices will be trained on: locations of use and storage of RAM, material control and accountability, transfer and disposal, and AFMAN

40-201. (T-0).

AFMAN 48-148 20 JULY 2020 21

3.3.3. URSOs for nuclear capable units (intrinsic radiation programs) will be appointed and trained in accordance with AFI 91-108 requirements. (T-1).

3.4. Permit RSOs Qualifications. See AFMAN 40-201.

3.5. Radiation Workers. All radiation workers will have the training listed on Table 3.1 (T-

3). Initial and annual training is provided by the IRSO, URSO, or permit RSOs depending on scope and use as determined by the IRSO. (T-3).

Table 3.1. Training guidance for radiation safety officers and radiation workers.

Topic IRSO1 URSO2

Radiation

Worker3

Radioactivity, radioactive decay, and radiation production devices (x-rays, neutrons)

X As Applicable As Applicable

Radiation vs. contamination X X X

Internal vs. external exposure and dose X X X

Biological effects of radiation X X X

Types and hazards associated with RAM or devices possessed

X

X

X

X

X

ALARA concept X X X

Training in the principles of time, distance, and shielding to minimize exposure

X

X

X X

Radiation detection and measurement X As Applicable As Applicable

Personnel dosimetry X X X

Applicable regulations and reporting requirements X X X

License/Permit conditions, amendments, renewals X - -

Locations of use and storage of RAM X

X

As Applicable4 As Applicable

Material control and accountability X As Applicable4 As Applicable

Annual audit of radiation safety program X As Applicable As Applicable

Transfer and disposal X As Applicable4 As Applicable

Record keeping X X X

Prior events involving permitted material X - -

Managing incidents and mishaps X X X

Recognition and assurance of radiation warning signs;

visibility and legibility

X

Inspection by regulatory agencies X X -

Requirement for complete and accurate information X X -

Employee protection X X X

Deliberate misconduct X X X

Emergency response procedures X X X

Protective action guides X - -

Air monitoring procedures X - -

Bioassay techniques X As Applicable As Applicable

22 AFMAN 48-148 20 JULY 2020

1 These are the minimum topics for a 40 hr course to train IRSOs.

2 Specific training requirements for permit RSOs are contained in AFMAN 40-201 and intrinsic radiation URSOs are contained in AFI 91-108.

3 Specific training requirements for intrinsic radiation workers are contained in AFI 91-108.

4 Required for general licensed device URSOs in accordance with DoDI 6055.08, Occupational

Ionizing Radiation Protection Program. (T-0).

Note: Medical unit RSOs should ensure radiological medical practitioners are additionally trained on national initiatives for patient dose reduction or optimization (e.g. “Image Wisely”, “Image Gently”) for compliance with accrediting bodies.

AFMAN 48-148 20 JULY 2020 23

Chapter 4

RADIATION PROTECTION FOR OCCUPATIONAL PRACTICES

4.1. Organization and Administration. Every organization or installation that uses non-exempt quantities of RAM, RPDs, or has the potential for exposures to residual RAM associated with AF operations shall implement a radiation safety program commensurate with the scope of the program and its potential health hazards and have a URSO. (T-1). Critical program elements are found in this chapter and are generic to all AF practices involving potential exposure to ionizing radiation.

4.1.1. Installation Radiation Safety.

4.1.1.1. IRSO. The IRSO has overall responsibility and authority over the installation or

Air Force owned operations requiring a radiation safety program, as described in paragraph 2.10, to include suspension of radiological operations, see AFMAN 40-201 para 2.9.2. (T-1).

4.1.1.2. URSO. This individual shall be directly responsible to senior management of the organization, properly resourced to execute the requirements of the radiation safety program, and have ready access to all levels of the organization that may use radiation.

(T-3).

4.1.1.3. Radiation Safety Committee (RSC) shall be established when directed by federal standard (e.g. Title 10 CFR Section 33.13, Requirements for the Issuance of a Type A

Specific License of Broad Scope, or Title 10 CFR Section 35.24, Authority and

Responsibilities for the Radiation Protection Program) or when specified as a permit condition issued by the AF Radioisotope Committee Secretariat. (T-0). Note: Optional

RSCs may be established by commanders of facilities, organizations, or installations with extensive radiation protection program requirements after advisement from their respective IRSO or URSO(s). Examples include installations with many diverse operations involving radioactive material permits or activities with large radiation sources

(e.g. irradiators, radioactive waste facilities). Optional RSCs should be composed of senior management, the IRSO, URSO(s), and other individuals knowledgeable and responsible for RAM and radiation producing devices. The RSC should meet at a frequency appropriate to evaluate the purpose, safety, and compliance of the radiation safety program and regulatory requirements.

4.1.2. Radiation Safety Program Policy,…