home · Installation · Requirements for the placement of an X-ray room. Placement of X-ray equipment in a dental clinic Requirements and standards for X-ray rooms

Requirements for the placement of an X-ray room. Placement of X-ray equipment in a dental clinic Requirements and standards for X-ray rooms

The arrangement of a modern X-ray room includes several stages, starting with the preparation of the room itself. The planning of the room, calculation of parameters and technological arrangement are carried out by special services, preferably in tandem with an experienced radiologist.

The X-ray diagnostic room equipment includes:

  • arrangement of radiation protection,
  • treatment room equipment,
  • photo laboratory equipment,
  • equipment for the doctor's and laboratory assistant's workplace.

It is also advisable to have a separate room for storing film archives.

Arrangement of radiation protection

To provide protection from penetrating X-ray radiation, the treatment room is finished with special X-ray protective materials over the entire area: walls, ceilings and floors, doors and windows. Barite plaster is used for walls or special X-ray protective gypsum panels, leaded materials with a certain lead equivalent - glass and metal sheets for the protection of doors and windows.

Treatment room equipmentrooms

List of basic equipment for the X-ray room procedure room:

  • stationary X-ray machine for 2 or 3 workstations (radiography, fluoroscopy, linear tomography),
  • ward mobile device,
  • dental x-ray machine for intraoral images or orthopantomograph,
  • digital radiovisiograph (on request).

By sanitary standards to install one x-ray diagnostic complex for 2 or 3 workplaces, an area of ​​at least 6 square meters is required. m, including installation of a targeted dental apparatus. For additional installation of an orthopantomograph, more than 8 square meters are required. m area. For installation and operation of the second device, a room of 12 square meters is required. m.

In modern X-ray diagnostics, both film and digital X-ray systems with highly sensitive receivers are used, which improve the quality of research and reduce the radiation load. Remote-controlled complexes are used for remote fluoroscopy, which does not require light adaptation, and also reduces the radiation load on personnel.

A digital radiovisiograph is a wireless flat-panel detector in cassette format that allows you to obtain digital image using an analog X-ray machine.

Required additional equipment:

  • mobile (screens) and personal protective equipment made of leaded rubber, the set of which includes: aprons, collars, gloves, skirts and aprons, caps, a set of protective plates and safety glasses. All personal protective equipment must have factory markings and a lead equivalent of at least 0.3 mm,
  • individual wearable dosimeters-radiometers for individual monitoring of personnel, they are periodically changed and sent to a special laboratory (to determine the possible radiation dose received),
  • screw chair,
  • fixing chair for examining children (on request).

If there are two X-ray machines, a special blocker must be installed to prevent the simultaneous activation of all equipment.

X-ray complexes are placed in such a way that the main radiation beam is directed at the main wall.

In the absence of a specially designated room, the control panel is located behind a B-40 type protective screen.

The X-ray room must be equipped with independent supply and exhaust ventilation with an air exchange rate of at least 3 per hour.

The entrance door must be latchable from the inside and have a warning light for patients on the outside.

Equipping a photo laboratory and a doctor’s workplace

The X-ray laboratory must be equipped with the following equipment:

  • film processing plant manually(tank tanks) or developing machine for automatic processing of X-ray film,
  • non-actinic developing lights with red (for green-sensitive film) or green (for blue-sensitive film) light,
  • negatoscopes for viewing pictures,
  • darkroom clock with timer,
  • a set of several cassettes standard sizes for exposing film,
  • electrical cabinet for drying developed film,
  • cabinet for storing X-ray film supplies,
  • Consumables: X-ray film, photo reagents, barium for fluoroscopy.

The photo laboratory must have cold and hot water supply, supply and exhaust ventilation.

The radiologist's workplace is located in separate room or combined with a control room. Equipped with:

  • personal computer with a package of application programs,
  • fluoroscope (for viewing fluorograms),
  • negatoscope,
  • laser printer for printing digital images,
  • an intercom for transmitting commands to the patient, a video device for monitoring the patient, or a viewing window with X-ray protective glass.

TO additional equipment includes furniture: chairs and tables, cabinets for storing documentation.

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The equipping of the X-ray room and the placement of equipment in it is carried out according to a project developed by an organization that has a license that allows it to design radiation protection equipment and place generating sources of ionizing radiation.

An X-ray room is a complex of rooms, each of which has a specific purpose. All premises and equipment placed in them are subject to a number of regulatory and technical requirements, which will be discussed below.

Requirements for premises for placing X-ray machines

X-ray rooms (other than x-ray and dental rooms) are not allowed to be installed in residential buildings, as well as in the buildings of children's institutions. X-ray rooms are allowed to be located in clinics that operate in residential buildings, if the adjacent premises are non-residential. Also, the X-ray room can be located in an annex or in the basement of a residential building if it has a separate entrance.

Rooms with X-ray equipment are located, if possible:

  • centrally - in the form of x-ray units or departments at the junction of the clinic and the hospital (with the exception of x-ray rooms for tuberculosis, infectious diseases and obstetrics, and sometimes fluorography rooms);
  • in the end parts of the building;
  • isolated from rooms from which water can flow (showers, swimming pools, treatment rooms);
  • isolated from wards for children and pregnant women.

The X-ray room should not be walk-through. The entrance to it is equipped separately from the entrance to the clinic or hospital.

Requirements for the composition and area of ​​the X-ray room

The X-ray room includes at least 3 isolated rooms:

  • the procedural room, where the X-ray machine is located and work is performed with it;
  • X-ray equipment control room;
  • doctor's office.

The office may also include a darkroom, undressing and waiting rooms, a staff room, etc.

Area requirements individual species X-ray room premises are set out in Appendix 5 to SanPiN 2.6.1.1192-03.

This table presents the area requirements for treatment rooms depending on the type of X-ray machine used.

X-ray machine type

Minimum area, m2

Requires use of a gurney

No need to use a gurney

X-ray diagnostic complex (RDC) with a full set of stands (PSSh, image stand, image table, image stand)

RDK with PSSh, image stand, image tripod

RDK with PSSh and a universal stand - tripod, X-ray diagnostic apparatus with digital image processing

RDK with PSSh, having remote control

Apparatus for X-ray diagnostics using radiography (image table, image stand, image stand)

X-ray diagnostic apparatus with a universal tripod stand

Apparatus for close-range radiography

Long-distance fluoroscopy apparatus

Mammography machine

Apparatus for osteodensitometry

Here you can see the requirements for the composition and area of ​​the X-ray diagnostic room.

Room type

Minimum area, m2

Common areas of the office (department)

Office of the head of the department

Staff room

10 (+3 sq.m for each additional employee)

Room for viewing results (images)

Barium preparation cabin

Expected

Material

Spare parts storeroom

Pantry of cleaning supplies
Temporary storage room for X-ray film (no more than 100 kg)
Staff personal hygiene room
Restrooms for staff and patients

3 per cabin

Computer
Engineering

X-ray room

Fluorography room for mass examinations

Procedural

Changing room

Expected

Photo lab**

Staff room

Fluorography room for diagnostic images

Procedural

Control room (in the absence of a protective cabin)

Photo lab**

Changing cabin*

Doctor's office (for devices with digital image processing)

X-ray diagnostic room using fluoroscopy and radiography (1, 2 and 3 r.m.)

Procedural 1

Procedural 2

Control room

Changing cabin*

Photo lab**

Doctor's office

According to table 1

According to table 1

Room for X-ray diagnostics of gastrointestinal tract diseases (1 working day)

Procedural

Control room

Photo lab

Patient restroom

Doctor's office

According to table 1

X-ray diagnostic room using radiography and/or tomography (1, 2 and 3 r.m.)

Procedural

Control room

Changing cabin*

Photo lab**

Staff room

According to table 1

Room for X-ray diagnostics of breast diseases using mammography

Procedural

Procedural special methods (if necessary)

Changing cabin*

Photo lab**

Doctor's office

X-ray diagnostic room for diseases of the genitourinary system (urological)

Treatment room with drain

Control room

Photo lab**

Changing cabin with daybed*

Doctor's office

According to table 1

X-ray diagnostic room (box) of infectious diseases departments

Tambour at the entrance to the box (gateway at the entrance to the box)

Expected

Waiting room

Procedural

Control room

Photo lab**

Doctor's office

According to table 1

Topometry room (radiation therapy planning)

Procedural

Control room

Barium preparation cabin

Photo lab**

Doctor's office

According to table 1

X-ray operating unit

Diagnostic unit for heart and vascular diseases

X-ray operating room

Control room

Preoperative

Sterilization*

Temporary room for the patient after the study*

Photo lab**

Doctor's office

Unit for diagnosing diseases of the lungs and mediastinum

X-ray operating room

Control room

Preoperative

Sterilization *

Cytological diagnostics*

Photo lab**

Photo review room*

Doctor's office

Nurses' room*

Rooms, and personal hygiene of staff*

Dirty linen storage room*

Diagnostic unit for diseases of the urogenital system

X-ray operating room

Control room

Photo lab**

Doctor's office

Contrast preparation room*

Patient restroom

Diagnostic unit for diseases of the reproductive organs (breast)

X-ray operating room

Control room

Photo lab**

Doctor's office

X-ray computed tomography room

RCT room for head examination

Procedural

Control room

Generator/computer room

Photo lab**

Doctor's office

RCT room for routine examination

Procedural

Control room

Generator/computer room

Photo lab**

Doctor's office

RCT room for x-ray surgical studies

Procedural

Preoperative

Control room

Generator/computer room

Photo lab**

Contrast preparation room

Patient restroom

Nurse's room

Engineers' room

* Not necessary.

** Not required when using equipment for digital fluorography and radiography.

And this table presents data on the composition and area of ​​​​the premises of the X-ray therapy room.

Requirements for the X-ray room procedure

A procedure room is an X-ray room in which a source of ionizing radiation is located and X-ray procedures and studies are performed.

When designing a procedure room for an x-ray diagnostic or x-ray therapy room, the following requirements must be taken into account:

  • The distance between the walls of the room and the employee’s workplace behind a protective screen (small) should be 1.5 meters.
  • The distance between the walls of the room and the employee’s workplace behind the protective screen (large) should be from 0.6 meters.
  • There should be a distance of at least 1 meter between the turntable-tripod or imaging table and the walls of the room. There should be at least 10 centimeters from the photo stand to the nearest wall.
  • The minimum distance between the viewing window and the X-ray tube is 2 meters. For dental and mammography machines, this figure is reduced to 1 meter.
  • Between the elements of the stationary equipment of the office there must be a technical passage for personnel with a width of at least 0.8 meters. A space of at least 1.5x2 meters is allocated for placing gurneys for patients. For the import of a gurney and other technological needs, the treatment room must have at least 6 m2 of free space.

The treatment room must have a sink with a hot and cold water(the requirements do not apply to fluorography treatment rooms and X-ray operating rooms). For rooms where urological X-ray examinations are carried out, there is also a requirement for the mandatory placement of visual instruments.

Requirements for a photo lab

The X-ray laboratory must have a “dark room”. If it has a developing machine, it is also necessary to equip a “light room” where dry photographs will be cropped, sorted and labeled.

Requirements for the minimum area of ​​the “dark room” of the darkroom:

  • for small format photographs ---- 6 m2;
  • for large format photographs ---- 8 m2.

Between the equipment of the “dark room” there must be passages for personnel at least 1 meter wide. The doorway should have a width of 0.9-1 meter.

Light tiles are used to decorate the walls of the darkroom next to the sink and photo processing device. Height tiled apron- at least 2 meters from the floor. The remaining sections of the walls should be finished with materials that are subject to repeated wet cleaning.

The entrance door, window and transfer hatch in the darkroom should be protected with light-proof curtains (so that photographic materials are not exposed to light).

The use of digital equipment eliminates the need to set up a darkroom in the X-ray room.

Other requirements for premises and equipment of X-ray rooms

The floor of the darkroom premises should be made of artificial or natural materials with electrical insulating properties.

The floor in the preoperative, X-ray operating room, and darkroom must be waterproof, spark-free, and antistatic (when using linoleum, its base must be grounded).

The doors from the darkroom, as well as from the control room and the treatment room, open “towards the exit”; from the control room to the treatment room - towards the treatment room (to facilitate evacuation).

The ceiling and walls of the X-ray room must be smooth and resistant to frequent washing, not giving light glare.

All materials used in the decoration of the X-ray room must have sanitary and epidemiological certificates authorizing their use in public and residential buildings.

It is advisable to orient the windows in the X-ray room to the northwest. Darkening systems are installed on the window of the fluoroscopy room to protect from sunlight.

When the anode voltage is turned on at the entrance to the treatment room and the control room of the X-ray room, the “Do not enter!” sign should automatically light up. white-red color. It is located above the door or at a height of 1.6-1.8 meters from the floor.

The air flow into the X-ray room should be in the upper zone, and the exhaust should be 50% (+-10%) from below and from above.

When constructing new X-ray rooms, the design includes autonomous ventilation. In premises that are already in use (except for computed tomography departments and x-ray departments of infectious diseases hospitals), it is possible to use general exchange systems supply and exhaust ventilation. Air conditioning may be installed in rooms with X-ray equipment.

Detailed requirements for air exchange, temperature conditions, illumination of X-ray diagnostic and X-ray therapy rooms are set out in Appendix 6 to SanPiN 2.6.1.1192-03.

The placement of the X-ray room and equipment in it is carried out on the basis of a project completed by an organization that has a license to operate in the placement of ionizing radiation sources (generating) and the design of radiation protection equipment.

X-ray room, unlike other rooms medical institutions is not one room, but several rooms (rooms isolated from each other), each of which has its own purpose and corresponds in area to the established regulatory requirements, and also meets all other sanitary and hygienic requirements. We will dwell on the latter in detail.

The X-ray room includes at least 3 isolated rooms, one of which serves as a treatment room (the room in which work is directly carried out using sources of ionizing radiation), the second is a control room (the room in which the equipment that controls the radiation source is located) and the third is an office doctor Depending on the purpose x-ray equipment or the specifics of the activity of a medical institution, an X-ray room may include a darkroom, a waiting room, a undressing cabin, a staff room, etc. ( detailed information the types of x-ray rooms are described in the article "").

Appendix 5 to SanPiN 2.6.1.1192-03 establishes the composition and area of ​​X-ray rooms. Thus, based on the information in Appendix 5 to SanPiN 2.6.1.1192-03, we present below in Table 1 the area of ​​the treatment room with different X-ray machines, in Table 2 the composition and area of ​​the premises of the X-ray diagnostic room, in Table 3 - the composition and area of ​​the premises of the X-ray therapy room.

Table 1

Treatment room area with different x-ray machines

X-ray machine Area, sq. m (not less)
The use of a gurney is provided The use of a gurney is not provided
X-ray diagnostic complex (RDC) with a full set of stands (PSSh, image table, image rack, image stand) 45 40
RDK with PSSh, image stand, image tripod 34 26
RDK with PSSh and universal tripod stand, X-ray diagnostic apparatus with digital image processing 34 26
RDK with PSSh, having remote control 24 16
Apparatus for X-ray diagnostics using radiography (image table, image stand, image stand) 16 16
X-ray diagnostic apparatus with a universal tripod stand 24 14
Apparatus for near-distance radiotherapy 24 16
Device for long-distance radiotherapy 24 20
Mammography machine 6
Apparatus for osteodensitometry 8

table 2

Composition and area of ​​the premises of the X-ray diagnostic room

The name of a room Area, sq. m
(no less)
Common areas of the department (office)
Office of the head of the department 12
Staff room 10 (+3.5 sq. m for each additional employee)
Room for viewing results (images) 6
Barium preparation cabin 3
Expected 6
Material 8
Spare parts storeroom 6
Pantry of cleaning supplies 3
Temporary storage room for X-ray film (no more than 100 kg) 6
Staff personal hygiene room 3
Restrooms for staff and patients 3 per cabin
Computer 12
Engineering 12
X-ray room
Fluorography room for mass examinations

- procedural
- dressing room
- expected
— darkroom**
- staff room

14
6
6
6
9

Fluorography room for diagnostic images

- procedural
— control room (in the absence of a protective cabin)
— darkroom**
— changing cabin*
— doctor’s office (for devices with digital image processing)

14
6
6
3
9

X-ray diagnostic room using fluoroscopy and radiography (1, 2 and 3 r.m.)

- procedural 1
- procedural 2
— control room
— changing cabin*
— darkroom**
- doctor's office

According to the table 1
according to table 1
6
3
8
9

X-ray diagnostics room for gastrointestinal diseases (1 working day)

- procedural
— control room
— darkroom
- restroom for patients

- doctor's office

According to the table 1
6
8
3
4
9

X-ray diagnostic room using radiography and/or tomography (1, 2 and 3 r.m.)

- procedural 1
— control room
— changing cabin*
— darkroom**
- staff room

According to the table 1
6
3
8
9

Room for X-ray diagnostics of breast diseases using mammography

- procedural
- procedural special methods (if necessary)
— changing cabin*
— darkroom**
- doctor's office

6
8
3
8
9

X-ray diagnostic room for diseases of the genitourinary system (urological)

- treatment room with drain
— control room
— darkroom**
— changing cabin with a couch*
- doctor's office

According to the table 1
6
8
4
9

X-ray diagnostic room (box) of infectious diseases departments

— vestibule at the entrance to the box (gateway at the entrance to the box)
- expected
- waiting room restroom
- procedural
— control room
— darkroom**
- doctor's office

1,5
6
3
according to table 1
6
8
9

Topometry room (radiation therapy planning)

- procedural
— control room
- cabin for preparing barium
— darkroom**
- doctor's office
- restroom

According to the table 1
6
3
8
9
3

X-ray operating unit
1. Diagnostic unit for heart and vascular diseases

- X-ray operating room
— control room
- preoperative
— sterilization*
— temporary room for the patient after the study*
— darkroom**
- doctor's office

48
8
6
8
8
8
9

2. Block for diagnosing diseases of the lungs and mediastinum

- X-ray operating room
— control room
- preoperative
— sterilization*
— cytological diagnostics*
— darkroom**
— image viewing room*
- doctor's office
- nurses' room*
— staff personal hygiene room*
— dirty linen storage room*

32
8
6
6
6
8
6
9
13
4
4

3. Diagnostic unit for diseases of the urogenital system

- X-ray operating room
— control room
— darkroom**
- doctor's office
— room for preparing contrast agents*
- restroom for patients

26
6
8
9
5
3

4. Diagnostic unit for diseases of the reproductive organs (breast)

- X-ray operating room
— control room
— darkroom**
- doctor's office

8
4
6
9

X-ray computed tomography room
1. RCT room for head examination

- procedural
— control room
— generator/computer room
— darkroom**
- doctor's office

18
7
8
8
9

2. RCT room for routine examination

- procedural
— control room
— generator/computer room
— darkroom**
- doctor's office
- changing cabin
— viewing room

22
8
8
8
9
4
6

3. RCT room for x-ray surgical studies

- procedural
- preoperative
— control room
— generator/computer room
— darkroom**
- doctor's office
— viewing room
— room for preparing contrast agents
- restroom for patients
- medical staff room
- engineers room

36
7
10
8
8
9
10
5
3
12
12

* Not necessary.
** Not needed when using devices for digital radiography and fluorography.

Table 3

Composition and area of ​​premises of the X-ray therapy room

The name of a room Area, sq. m (not less)
1. Close-range radiotherapy room
— procedural with 2-3 emitters 16
— procedural with 1 emitter 12
— control room 9
— doctor’s office (examination room) 10
- expected 6
2. Long-distance radiotherapy room
- procedural 20
— control room 9
— doctor’s office (examination room) 10
- expected 6

The use of premises of a smaller area or a reduced set of premises is possible in cases where the equipment used, the organization of work, the number of personnel, etc. ensure compliance with general hygienic requirements (microclimate, bacterial contamination, sanitary and epidemiological regime, etc.).

According to the hygienic requirements of SanPiN 2.6.1.1192-03, it is advisable to place x-ray rooms centrally, as part of the x-ray department, at the junction of the hospital and the clinic. X-ray rooms of infectious diseases, tuberculosis and obstetric departments of hospitals and, if necessary, fluorography rooms of emergency departments and outpatient departments can be located separately.


By general rule The X-ray department (office) is not allowed to be located in residential buildings and children's institutions. The exception is X-ray dental rooms (devices), the possibility of placing which in residential buildings is regulated by a special chapter of rules SanPiN 2.6.1.1192-03, as well as the “Basic sanitary rules for ensuring radiation safety (OSPORB-99/2010” SP 2.6.1.2612-10 and Amendment 1 to SP 2.6.1.2612-10. It is not allowed to place dental X-ray machines with a film image receiver in residential buildings.

In dental and X-ray rooms adjacent to residential apartments, it is allowed to place X-ray diagnostic devices with digital image processing, the total rated workload of which does not exceed 40 mA-min/week. (detailed information on this issue is outlined in the article “Placement of X-ray equipment in dental clinic»).

It is allowed to operate X-ray rooms in clinics built into residential buildings if the vertically and horizontally adjacent rooms are not residential. It is also possible to place X-ray rooms in an extension to residential building, as well as on the ground floors, if the entrance to the X-ray department (office) is separate from the entrance to the residential building.

As stated in clause 3.3 of SanPiN 2.6.1.1192-03, an X-ray department serving only a hospital or only a clinic should be located in the end parts of the building. In this case, the department should not be a walk-through. Entrances to the X-ray department for inpatient and outpatient department patients are separate.

Important: by virtue of clause 3.4 of SanPiN 2.6.1.1192-03, it is not allowed:

  • Place X-ray rooms under rooms where water can leak through the ceiling (swimming pools, showers, restrooms, etc.);
  • Place the X-ray treatment room adjacent to the wards for pregnant women and children.

According to clause 2 of Appendix 7 to SanPiN 2.6.1.1192-03, the selection of premises included in the X-ray room (department) is carried out by the administration of the medical institution together with the X-ray and radiological department (RRO) (or another organization similar in function to the RRO) of the region and is consistent with institution of sanitary and epidemiological surveillance. At the same time, in relation to individual rooms of the X-ray room, the medical organization must comply with special requirements, established by SanPiN 2.6.1.1192-03. However, in practice, such coordination of the selected premises with Rospotrebnadzor no longer exists and applications for approval of the placement of the X-ray room are no longer submitted.


A treatment room is a specially equipped room in an X-ray room in which an X-ray emitter is located and X-ray examinations or radiotherapy are carried out.


According to clause 3.11 of SanPiN 2.6.1.1192-03, the height of the X-ray treatment room must ensure the functioning of technical equipment, for example, ceiling mounting of an X-ray emitter, tripod, television monitor, shadowless lamp, etc. X-ray equipment with ceiling suspension emitter, screen-imaging device or X-ray image intensifier requires a room height of at least 3 m (2.6 meters according to the newer SanPiN 2.1.3.2630-10). The height of the X-ray treatment room in the case of rotational irradiation must be at least 3 m. The width of the doorway in the X-ray diagnostic room, RCT room and cath lab must be at least 1.2 m with a height of 2.0 m, the size of the rest doorways- 0.9×1.8 m.

Requirements for the treatment room area, including depending on the X-ray machine, are given in Tables 1, 2 and 3 above. At the same time, as stated in clause 3.9, the area of ​​the procedural room can be adjusted in agreement with the body exercising federal sanitary and epidemiological supervision, taking into account the following requirements:

  • The distance from the personnel workplace behind a small protective screen to the walls of the room is at least 1.5 m;
  • The distance from the personnel workplace behind a large protective screen to the walls of the room is at least 0.6 m;
  • The distance from the rotating tripod table or from the imaging table to the walls of the room is at least 1.0 m;
  • The distance from the photo stand to the nearest wall is at least 0.1 m;
  • The distance from the X-ray tube to the viewing window is at least 2 m (for mammography and dental devices - at least 1 m);
  • The technological passage for personnel between elements of stationary equipment is at least 0.8 m;
  • The area where the gurney is placed for the patient is at least 1.5x2 m;
  • Additional space for the technological need to bring a gurney into the treatment room is 6 m2.

In accordance with clause 3.30 of SanPiN 2.6.1.1192-03, in the treatment room, in addition to the procedure room for fluorography and the X-ray operating room, it is provided for the installation of a sink with a supply of cold and hot water. In a procedural room designed for urological studies, a viduar should be installed.

In the treatment room for the study of children, the presence of toys (washed in a soap and soda solution and disinfected) and distracting design is allowed.

Important: Placement in procedural equipment, which is not included in the project, as well as carrying out work not related to x-ray examinations.

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The first private dental offices and clinics appeared in Russia in the early 1990s, and today most Russians turn to them. Patients are attracted by the quality of medical services and the use of the latest methods treatment and diagnosis. Even in a small dental office located indoors housing stock, you can come across a dental apparatus, which, by the way, is a source of X-ray radiation, which means that during its operation it is necessary to comply with radiation safety standards. Read the article about what requirements dental offices and clinics that conduct X-ray examinations must meet.

In accordance with clause 3.30 of SanPiN 2.6.1.1192-03 “ Hygienic requirements to the construction and operation of X-ray rooms, devices and the conduct of X-ray examinations" To install and operate X-ray dental equipment, the institution must collect the following documents:

Sanitary and epidemiological conclusion on the type of activity: operation, storage, testing, etc. of an X-ray machine (devices) in an X-ray room (rooms);

Sanitary and epidemiological certificate for the X-ray machine as a product that poses a potential danger to humans;

Sanitary and epidemiological report on the X-ray room project;

Technical passport for the X-ray room;

Instructions for labor protection, including requirements for radiation safety, for the prevention and elimination of radiation accidents;

Sanitary rules, other regulatory and instructional documents regulating radiation safety requirements.

X-ray machines are permitted for use in medical practice provided they are registered by the Russian Ministry of Health and have a sanitary-epidemiological report on their compliance with sanitary rules in the field of radiation safety. The data bank on registered X-ray devices is located in the Center for Standardization and Certification of the Russian Ministry of Health. Often, private clinics use exclusive copies of X-ray diagnostic equipment that are not included in the data bank of the Center for Standardization and Certification. Such equipment must undergo radiation-hygienic tests with the involvement of specialists from an organization accredited in in the prescribed manner.

Today, X-ray machines with image recording on film are being replaced by more modern systems, in which data is recorded digitally. For example, when using a radiophysiograph - one of the types of digital dental radiographic systems - studies are carried out by introducing solid-state X-ray sensitive detectors into the oral cavity, which makes it possible to reduce the patient’s radiation dose by 2-4 times.

Normative base

1. SanPiN 2.6.1.1192-03 “Hygienic requirements for the design and operation of X-ray rooms, devices and the conduct of X-ray examinations”, approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated February 18, 2003 No. 8.

2. SanPiN 2.6.1.2523-09 “Radiation Safety Standards (NRB-99/2009)” (hereinafter referred to as NRB-99/2009), approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated 07.07.2009 No. 47.

3. SP 2.6.1.2612-10 “Basic sanitary rules ensuring radiation safety (OSPORB-99/2010)" (hereinafter referred to as OSPORB-99/2010), approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated April 26, 2010 No. 40.

4. MU 2.6.1.2838-11 “Radiation monitoring and sanitary-epidemiological assessment of residential, public and industrial buildings and structures after completion of their construction, overhaul, reconstruction according to radiation safety indicators”, approved by the Chief State Sanitary Doctor of the Russian Federation on January 28, 2011.

5. MU 2.6.1.3015-12 “Organization and conduct of individual radiation monitoring. Personnel of medical organizations”, approved by the Chief State Sanitary Doctor of the Russian Federation on April 19, 2012.

6. MU 2.6.1.2944-11 “Control of effective radiation doses to patients during medical X-ray examinations”, approved by the Chief State Sanitary Doctor of the Russian Federation on July 19, 2011.

Requirements for the arrangement of the office and placement of the X-ray diagnostic apparatus

A dental apparatus that works with ordinary film without an intensifying screen is installed in a room of at least 8 m2 only in the X-ray department (room) of a general medical or dental treatment institution. To accommodate a device operating with a highly sensitive film and (or) digital image receiver, including a radiovisiograph, the area of ​​the room must be at least 6 m2. The radiovisiograph can also be installed in the premises of a dental institution located in a residential building, including in areas adjacent to residential premises. At the same time, radiation safety standards for the population within the premises in which X-ray dental examinations are carried out must be observed. Square dental office, equipped with a radiovisiograph, must be at least 14 m2. According to clause 7.3.1 of SanPiN 2.1.3.2630-10, panoramic devices (orthopantomographs) cannot be placed in the dental office, as well as in the premises of the dental clinic adjacent to residential premises.

If the x-ray diagnostic room is located on the first or ground floors, then the windows of the treatment room are screened with protective shutters to a height of at least 2 m from the level of the building’s blind area. If the X-ray room is located above the first floor at a distance from the treatment room to residential and office premises neighboring building is less than 30 m, the windows of the treatment room are screened with protective shutters to a height of at least 2 m from the finished floor level.

The X-ray machine is placed in such a way that the radiation beam falls in the direction of the wall behind which there is a less visited room. If a dental clinic has several rooms, and an X-ray machine is installed in only one of them, then it must be stationary in order to exclude the possibility of its transfer to other rooms that do not have appropriate stationary or mobile radiation protection equipment.

Assortment of modern building materials and the capabilities of private dental clinics make it possible to choose for the manufacture of stationary radiation protection equipment those materials that provide reliable protection. Lead equivalents of building materials used for protection against X-ray radiation are listed in Table. 3-6 appendices 9 SanPiN 2.6.1.1192-03. When using materials not listed in the tables, it is necessary to have information on their protective properties or determine protective characteristics in accredited organizations using control samples.

Stationary radiation protection facilities The x-ray room (walls, floor, ceiling, protective doors, observation windows, shutters, etc.) must ensure attenuation of x-ray radiation to a level at which the main dose limit (PD) for the relevant categories of exposed persons will not be exceeded. The calculation of radiation protection is based on determining the attenuation factor (K) of the absorbed dose rate ( D 0) X-ray radiation in the air at a given point in the absence of protection up to the value of the permissible absorbed dose rate (ADR) in the air:

K = D 0 / DMD = 10 3 × KR × W × N/ (30 × r 2 × DMD),

where 10 3 is the conversion factor from mGy to μGy;

KR- radiation output - the ratio of the power of the air kerma in the primary X-ray beam at a distance of 1 m from the focus of the tube, multiplied by the square of this distance, to the strength of the anode current, mGy × m 2 / (mA × min.);

W— workload of the X-ray machine (mA × min.)/week;

N— radiation directivity coefficient, relative unit;

30 - the value of the normal operating time of the X-ray machine per week during single-shift work of group A personnel (30-hour work week), h/week;

r— distance from the focus of the X-ray tube to the calculation point, m.

When equipping an X-ray diagnostic room in a room adjacent to residential, it is necessary to adhere to the requirements of radiation safety standards for the population within the X-ray dental office. Therefore, when calculating radiation protection in this case, the points located:

Close to internal surfaces the walls of the X-ray room located horizontally adjacent to the living quarters;

At the floor level of the X-ray room - when the living space is located under the room;

At the ceiling level of the X-ray room - when the living space is located above the room.

It should be noted that the materials used today for the manufacture of protective fences and interfloor ceilings, in most cases, provide the necessary attenuation factor for X-ray radiation, so residents of apartments located adjacent to the X-ray room are not exposed to doses exceeding the dose limit for the population. Moreover, the calculation of radiation protection is carried out in such a way that the requirements of radiation safety standards for the population living in rooms adjacent to the rooms in which X-ray examinations are carried out are met with a significant margin. Often, part of the residential premises adjacent to the X-ray room of a private dental clinic is occupied by its owners, which for the population serves as a strong argument in favor of the reliability of radiation safety.

When planning to equip an X-ray room in a dental clinic located in a residential building, you need to make sure that it interfloor ceilings are not made of wood, which is not a barrier to x-rays. Wooden floors preserved in many old houses. In this case, it becomes necessary to create a special protective ceiling in the X-ray room.

Radiation protection of personnel and patients

The office where X-ray dental examinations are carried out must have a set mobile And individual funds protection of staff and patients. If the control panel and the treatment room are located in the same room, it is necessary to install large protective screen with viewing window. It is possible to move the X-ray machine control panel (anode voltage switch button) to a separate room (control room). In any case, it must be possible to monitor the patient through the viewing window. The office can also be equipped with a television camera. If the power button is located outside the office, it is necessary to exclude the possibility of access to it by random persons.

To protect personnel, the X-ray room must be equipped with an apron protective one-sided lung and collar protective. The patient is provided with a protective dental apron or cape (cape) protective and apron to protect gonads.

According to NRB-99/2009, persons working with man-made radiation sources are defined as Group A personnel. In our case, these are employees who work directly with dental devices. Persons working at a radiation facility or on the territory of its sanitary protection zone and located in the sphere of influence of man-made sources are defined as Group B personnel. This includes employees who do not work with an x-ray diagnostic apparatus, but are exposed to x-ray radiation. The main dose limits and permissible exposure levels for group B personnel are equal to 1/4 of the values ​​for group A personnel.

The effective dose for personnel should not exceed over a period of labor activity(50 years) 1000 mSv, and for the population over a lifetime - 70 mSv. Planned increased exposure (above established dose limits) is allowed only for men over 30 years of age with their voluntary written consent after being informed of the possible radiation doses and health risks. The main radiation dose limits for personnel of groups A, B and the population, established by NRB-99/2009, are given in the table.

Basic Dose Limits

Standardized values

Dose limits

Group A personnel

Group B personnel

Population

Effective dose

20 mSv per year on average for any consecutive 5 years, but not more than 50 mSv per year

5 mSv per year on average over any consecutive 5 years, but not more than 12.5 mSv per year

1 mSv per year on average for any consecutive 5 years, but not more than 5 mSv per year

Equivalent dose

in the lens of the eye,

hands and feet

The International System of Units (SI) measures absorbed dose in grays (Gy). 1 Gy is equal to the absorbed energy of 1 J per 1 kg of mass of the substance. To take into account the biological effect of the absorbed dose, an equivalent absorbed dose of ionizing radiation was introduced, equal to the product of the absorbed dose and the biological effectiveness coefficient. In the SI system, the effective and equivalent absorbed dose is measured in sieverts (Sv).

In order to prevent unnecessary re-exposure of patients at all stages of medical care, the results of previously conducted x-ray studies and the doses received during the year are taken into account. When referring a patient for an x-ray examination, consultation or hospital treatment, when he is transferred from one hospital to another, the results of X-ray studies (description, pictures) are transferred along with an individual card. The established standard for annual preventive radiation exposure during preventive medical X-ray examinations and scientific research for practically healthy individuals is 1 mSv. Radiation dose limits for patients for diagnostic purposes are not established.

Requirements for personnel working with X-ray dental equipment

Persons at least 18 years of age who have a document confirming appropriate training, who have been instructed and tested their knowledge of safety rules, documents and instructions in force in the institution are allowed to operate an X-ray machine. Training of specialists involved in X-ray examinations is carried out according to programs that include the section “Radiation Safety” in institutions licensed to educational activities. X-ray examinations are carried out radiologist And x-ray technician. For dental clinic best option when X-ray diagnostics are carried out by a radiologist with a higher education professional education in the specialty "Dentistry" and postgraduate professional education (internship and (or) residency) in the specialty "Radiology", as well as a radiographer who has received secondary vocational education in the specialty "Dentistry", "Preventive Dentistry", "Orthopedic Dentistry" and a specialist certificate in specialty "Radiology".

Before starting an X-ray dental examination, personnel must check the serviceability of equipment and reagents with mandatory recording of the results in a control and technical journal. If malfunctions are detected, it is necessary to suspend work and call a representative of the organization carrying out Maintenance and equipment repair. After the end of the working day, the X-ray machine, electrical appliances, table lamps, electric lighting, ventilation are turned off, the walls are wet cleaned, the floors are washed, and the elements and accessories of the X-ray machine are thoroughly disinfected. Wet cleaning is carried out monthly using a 1-2% solution acetic acid. It is not allowed to carry out wet cleaning procedure room and control room of the X-ray dental room immediately before and during the examination.

The administration of the dental clinic is responsible for organizing preliminary (upon employment) and annual periodic medical examinations of group A personnel. Persons who do not have medical contraindications for working with sources of ionizing radiation are allowed to work. If deviations in the state of health are identified that prevent the continuation of work in the X-ray room, the question of temporary or permanent translation these persons to work outside of contact with radiation in the prescribed manner is decided by the administration of the institution in each individual case individually.

NOTE!

Women are exempt from direct work with X-ray equipment for the entire period of pregnancy and breastfeeding child.

Radiation control

The person responsible for conducting radiation monitoring is appointed by the administration of the dental institution. The implementation of radiation monitoring is part of production control, the program of which is determined taking into account the characteristics and conditions of work performed in the X-ray and dental room, and is agreed upon with the state sanitary and epidemiological inspection body.

In accordance with clause 8.5 of SanPiN 2.6.1.1192-03 radiation monitoring includes:

Monitoring the radiation dose rate at personnel workplaces, in rooms and areas adjacent to the X-ray room. It is carried out during technical certification of the X-ray room, obtaining a sanitary and epidemiological report;

Monitoring the technical condition and protective effectiveness of mobile and personal radiation protection equipment. Conducted at least once every two years;

Individual radiation monitoring of group A personnel. It is carried out continuously with registration of measurement results once a quarter (in agreement with the state sanitary and epidemiological inspection body - once every six months);

Individual radiation monitoring of persons periodically participating in special X-ray examinations (surgeons, anesthesiologists, etc.) is carried out in the same way as for group A personnel; the assessment of radiation doses of a given contingent may be carried out using a calculation method;

Control of patient dose loads. It is carried out with every x-ray examination.

As part of the implementation of the production control program The administration of the institution determines:

List of employees for whom individual or group dosimetry monitoring is required;

The procedure for conducting group dosimetric monitoring, indicating the workplaces where dose rate measurements are required;

The procedure for conducting individual dosimetric monitoring, indicating the number of individual dosimeters and where they are worn on the employee’s body;

The procedure for monitoring the correct wearing of personal dosimeters and the use of personal protective equipment;

List of actions when exceeding control levels is detected.

According to the established practice of dosimetric monitoring in medical organizations, measurements and recording of results are usually carried out by third-party organizations - testing laboratory centers, radiation monitoring laboratories, etc., accredited in the prescribed manner.

For medical personnel who are not in close proximity to the radiation source or X-ray beam (control room, darkroom, adjacent rooms) who are subject to uniform irradiation, one individual dosimeter located on the surface of the body (for example, in the breast pocket of a robe) is enough to indications, using the appropriate transition coefficient, estimate the value of the effective dose. Medical staff, conducting special X-ray examinations under the control of X-ray radiation, by the nature of his activity must be close to the patient, that is, in close proximity to the radiation source or X-ray beam. The exposure of this category of personnel is uneven. According to data from phantom and full-scale measurements on the front surface of the body, such workers have a more than 10-fold excess dose, and the dose gradient in the body is much greater. The distribution of surface and deep doses also depends on additional shielding of the body protective apron. In this case, to correctly assess the standardized values, it is necessary to use two individual dosimeters on the surface of the worker’s body.

In accordance with clause 3.13.7 OSPORB-99/2010, in a medical organization that uses sources of ionizing radiation, a card is issued for each employee classified as group A personnel accounting of individual doses. It reflects the following information:

Information about the employee: last name, first name and patronymic, date of birth, gender, home address, telephone number;

Information about professional activity employee: position, nature of work, work experience in radiation hazardous conditions;

Information about radiation doses:

  • quarterly radiation doses;
  • total annual radiation doses;
  • total radiation dose at the time of filling out the card;
  • radiation dose received during the period of secondment to other organizations;
  • radiation dose received as a result of radiation accidents and planned increased exposure.

If an employee moves to another institution where work with radiation sources is carried out, a copy of the individual dose record card is transferred to the new place of work. The original is stored on same place work for 50 years.

Recently, the sanitary and hygienic requirements for dental clinics have been significantly changed. The basic law regulating the activities of medical institutions ( SANPIN 2.1.3.2630-10) there is a whole section ( Sanitary and hygienic requirements for dental medical organizations ), dedicated to dental medical institutions.
Any medical professional can easily read the requirements for dental clinics and select a room suitable for this dental clinic for one or more chairs. As a rule, this is exactly what everyone does. It is also not difficult to prepare the premises without developing some sections of the design documentation, for example VC, AR, EOM, etc.

We want to focus your attention on the development x-ray room project or as it is also called x-ray project. X-ray design office and all further work with sources of ionizing radiation in dentistry is regulated by Sanitary Rules and Norms SANPIN 2.6.1.1192-03. It also establishes standards and requirements for lighting, ventilation, room area, handling of X-ray equipment, etc.

Project of an x-ray room in dentistry

Nowadays, in almost every dental clinic exists x-ray room(s). Depending on the scale of the clinic, the number of medical services they provide, bandwidth, X-ray machines can be located either in a separate room or directly in treatment rooms. True, this does not apply to everyone x-ray units. For example, dental units can be located directly in treatment rooms, while the area of ​​the treatment room does not increase, but orthopantomographs do not. They require a separate room.

If you decide to equip your dental clinic x-ray, then you must definitely understand that placement of x-ray machines directly to treatment room may not always be the best solution, and sometimes even simply unacceptable. Only dental units can be placed directly in the treatment room. But, if you have more than one dental chair in your office, then most likely you will have to organize X-ray protective partitions to prevent exposure of one of two patients simultaneously in this X-ray treatment room. The pursuit of saving space will lead to clutter in the procedural x-ray room, and is unlikely to create coziness, tranquility and a comfortable stay for both patients and staff. And as already mentioned, placing an orthopantomograph in an office with dental chairs is simply unacceptable.

One could list endlessly the requirements for x-ray rooms in dentistry, including requirements for the design of x-ray rooms, To placement of X-ray machines, citing various excerpts from SANPIN, but The best decision ask a question X-ray room design to us.

X-ray room project - scope of work

IN x-ray project includes:
- inspection of the premises / set of premises (if necessary);
- development of medical and technical specifications for x-ray room project;
- development of the x-ray room project- specialized section of the Technological part of the project documentation, Technological solutions (TX);
- approval by the State Budgetary Institution Scientific and Practical Center for Medical Radiology of the Moscow City Health Department (for Moscow institutions) or in the State Budgetary Institution of the Moscow Region MONIKI named after. M. F. Vladimirsky (for institutions of the Moscow region).

If you are interested, we are ready to assist in obtaining and Sanitary and epidemiological report on the type of activity radiology.

What is included in a dental x-ray project?

B (specialized section of the Technological part of the project) for X-ray rooms in dentistry includes:

I. Medical and technical specifications for the development of a project for an x-ray room in a dental clinic(document base for x-ray room design);

II. Explanatory note:
- 1. General information and requirements for compliance with the design of an x-ray room in dentistry regulatory framework;
- 2. Initial data for design;
- 3. Technological solutions:
- a. Requirements to technological equipment and compliance with standards;
- b. Radiation safety calculation parameters;
- c. Climate requirements separate x-ray room or treatment room with x-ray;
- d. Lighting requirements in x-ray room;
- e. Requirements for water supply and sewerage in X-ray of the procedure room;
- f. Power requirements for x-ray equipment;
-g. Fire safety requirements;
- h. Waste disposal requirements;
- i. Requirements for the organization of x-ray examinations;
- j. Measures to prevent radiation accidents;
- k. Requirements for decommissioning an X-ray machine;
- 4. Conclusions.

III. Office plan with arrangement of technological equipment;

IV. Table for calculating the required additional protection enclosing structures;

V. Schematic diagram of the re-grounding circuit

VI. Plan for arrangement of cable channels and concrete foundations as necessary, depending on the X-ray machine;

VII. List of finishing of dental X-ray rooms;

VIII. Hardware Specification.

X-ray room project for dentistry, cost of work

Specified cost for development dental office x-ray project does not depend, as many do, on the number of X-ray machines in one room and already includes all the necessary approvals.

Price for designing x-ray rooms (x-ray project)

Price for x-ray room project at the dental clinic fixed. Do you want to place it in one room? one or two dental x-ray units? Contact me, this will be one x-ray project, because there is only one room, and the indicated price will not change.

The result of our work is an agreed project for an x-ray room

As a result of our work, you will receive developed and approved project documentation ( x-ray project) for the placement of sources of ionizing radiation that you will need to obtain Sanitary and epidemiological certificate for work with sources of ionizing radiation and for the type of activity radiology.

Additional/related services

If you are interested or necessary, we are ready to:
- develop other sections of project documentation;
- provide assistance in obtaining a Sanitary and Epidemiological Certificate for working with sources of ionizing radiation and a Sanitary and Epidemiological Certificate for the type of activity - radiology.