Requirements for the placement of an X-ray room. What are the rules and regulations for the new SanPiN for x-rays? Sample description of the premises of the X-ray room

The new X-ray Sanpin represents the main normative document, which is aimed at regulating requirements relating to radiation safety in the field of radiology, as well as compliance sanitary rules in dental clinics.

What is the document?

SanPiN literally stands for: sanitary rules and regulations. This document is a vault certain rules, which are presented to x-ray rooms. It regulates sanitary and hygiene requirements regarding the design and use of x-ray rooms, specialized equipment and the implementation of x-ray examinations. Compliance with the rules and regulations specified in the presented document is an indispensable condition for obtaining a license for each clinic.

The rules and regulations presented in the document are intended to comply with and ensure radiation safety of both patients and medical personnel who work in them during X-ray studies.

SanPiN sets the maximum acceptable standards and radiation dosages, exceeding which can pose a serious threat to human health and life, and therefore is strictly prohibited.

The document also specifies certain requirements for the design of rooms and the rules for operating specialized X-ray equipment.

Cabinet design rules

According to SanPiNA standards, there are certain requirements regarding the design and equipment of dental offices that provide X-ray procedures to the population:

The X-ray department is prohibited from being located in children's institutions or residential buildings. The exception is clinics that are built into residential buildings, where the premises are not considered private property and people do not live on its territory.
It is strictly forbidden to place the X-ray room in areas where there is a possibility of water leakage. That is, if the office is located in a residential building, then rooms such as a bathroom, shower room, and toilet should not be located above it.
If a dental office is intended exclusively to serve a clinic, hospital, or hospital, it should be located at the end of the building.
It is prohibited to locate an X-ray room next to wards intended for children or pregnant women.
The room in which the dental office with the X-ray department is located should not be a walk-through area.

If, during a routine or specialized inspection, specialists of the sanitary and hygienic service discover non-compliance with the requirements regarding the location and equipment in the X-ray room, its activity and operation is terminated

Security measures

Given the fact that radiographic procedures are associated with the risk of excessive radiation exposure, the rules for using specialized equipment and ensuring maximum safety during its operation are considered one of the key ones in modern dentistry.

Let's look at them in more detail:

The flooring in the office must be made of materials with electrical insulating properties. It is best to give preference ceramic tiles or porcelain stoneware.
The walls and ceilings in the X-ray room should be covered with materials intended for frequent use. wet cleaning and disinfection without glare.
The procedural room must be protected from direct penetration sun rays. Therefore, according to SanPiN rules, it is equipped with special light-protective devices.
Before entering the room for radiography, there must certainly be a white-red light table with the inscription “Do not enter!”, which will automatically light up in response to the switching on of the anode voltage.
The X-ray machine, according to the requirements of SanPiN, must be located in the office so that its main radiation is aimed towards the wall behind which there is a room with a small number of visitors.
When operating equipment and carrying out procedures of a research, therapeutic or preventive nature, the use of special protective clothing is mandatory.
To use any type of sources ionizing radiation an appropriate permit must be obtained in accordance with SanPiN standards.
Personnel must be specially trained to operate the equipment and strictly follow the rules for its operation.

How to ensure safety?

The SanPiN rules governing the radiographic industry of dentistry were created specifically to protect the population and ensure their maximum safety.

How can these goals be achieved?

Comply with the requirements regulated in the document when equipping the office and conducting procedures.
Use equipment that complies with the established sanitary standards and radiation safety rules.
When performing radiographic procedures, use optimal parameters operation of the equipment, allowing not to exceed the maximum permissible dose of radiation, in accordance with the established requirement.
Strictly control radiation doses to patients and dental office staff.

Compliance with SanPiN rules for x-rays contributes to the most effective and efficient safe operation X-ray rooms and conducting relevant studies.

Requirements and rules for using x-rays in dental office.

Do I need to obtain permission to install this equipment?

Yes, we should. It is necessary to invite a specialist from the State Sanitary and Epidemiological Supervision Center for Radiation Hygiene, who supervises the use of ionizing radiation sources, to approve the installation in the clinic premises. On the basis of Federal Law dated 01/09/96 N 3-FZ “On Radiation Safety of the Population” and Federal Law dated 03/30/99 N 52-FZ “On Sanitary and Epidemiological Welfare of the Population”, without permission from the State Sanitary and Epidemiological Service for installation, the cabinet is closed and imposed administrative liability in the form of a fine.

Which dental x-ray machine should I buy?

You should be aware that not all types of dental X-ray machines can be used in clinics located in residential buildings. This depends on the purpose of the device, its workload and the nominal value of the anode voltage. Restrictions on these parameters are specified in SanPiN 2.6.1.802−99 “Hygienic requirements for the design and operation of X-ray rooms, devices and the conduct of X-ray examinations.” Currently, dental X-ray systems with image recording on film are being replaced by more modern computer systems with digital image recording methods.

The digital dental radiography system allows you to conduct research using solid-state X-ray detectors inserted into the oral cavity. This system is often called . It allows you to reduce the patient’s radiation dose by 2–4 times.

Another type of dental X-ray machines - orthopantomographs - cannot be placed in the premises of a dental clinic adjacent to residential premises.

What documents must be provided to you by the manufacturer when selling dental x-ray equipment?

X-ray machines from various manufacturers, both domestic and foreign, must have a sanitary and epidemiological certificate from the Department of State Sanitary and Epidemiological Surveillance and a registration certificate from the Ministry of Health of Russia.

A database of X-ray machines registered with the Russian Ministry of Health is available at the Center for Standardization and Certification of the Russian Ministry of Health.

However, there are cases when dental clinics use exclusive copies of X-ray diagnostic equipment that lack the listed documents. In this case, this X-ray machine must undergo radiation hygiene tests. Tests must be carried out only by an organization accredited for these types of work.

How and where to install an X-ray machine?

One of the following accommodation options is possible X-ray machine: The X-ray machine is installed in a separate room, the area of which must be at least 6 square meters. Otherwise, the patient will receive an unreasonably high radiation dose.

The X-ray machine is installed in the dental office near the dental chair. In this case, the office area must be at least 14 square meters. Regardless of the chosen option, the room where it will be placed will now be called an X-ray room or an X-ray dental room.

Who can you trust to develop a technological project for an X-ray room?

Not every design, and subsequently construction, organization has the right to carry out such work. In accordance with Federal law“On radiation safety of the population”, Art. 10, a license is required for the relevant types of activities with sources of ionizing radiation, and therefore the annex to the license must contain a record of the technological design (construction) of healthcare institutions and specifically medical X-ray rooms. The same applies to the dental clinic. She must have a license giving her the right to carry out all types of dental care(therapy, surgery, orthopedics), including X-ray and dental examinations.

What must be reflected in the technological part of the project from the point of view of radiation safety?

First of all, the calculation of stationary radiation protection of all premises located horizontally and vertically adjacent to the X-ray dental room. Project working drawings should show the placement of the x-ray machine, indicate the thickness, material and lead equivalent of existing guardrails and interfloor ceilings, placement of mobile radiation protection equipment, indicating the required protection efficiency, as well as ventilation and lighting requirements.

If a separate X-ray room (without a dental chair) is selected, to protect personnel performing X-ray dental examinations, it is necessary to either install an X-ray protective screen made of material with the required lead equivalent, or move the X-ray machine control panel (anode voltage switch button) to the separate room(control room). In any case, it must be possible to monitor the patient through a protective viewing window or the room must 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 the patient from x-ray radiation, it is imperative to purchase and use a special protective apron dental, protective cape (cape) and collar.

If the X-ray machine is located in a dental office located on the ground floor, and the distance to neighboring buildings is less than 30 m, the windows must be screened with protective shutters to a height of at least 2 m from the floor level.

Depending on its design (mobile or stationary), the X-ray machine should be placed in such a way that the X-ray beam falls in the direction of rooms where people spend less time and the number of people is small.

If a clinic has several dental offices, and an X-ray machine is installed in one of them, then a stationary placement of the X-ray machine is necessary to avoid its possible movement to other rooms that do not have appropriate stationary or mobile radiation protection equipment.

Due to the wide range of modern building materials, on the one hand, and the different capabilities of dental clinics, on the other hand, for the manufacture of stationary protection, you should choose those that have reliable structural protective properties. There are cases when the cabinet is made from materials protective properties which are unknown. This may cause additional difficulties in the calculation and assessment of radiation protection.

It should be noted that actually existing Construction Materials protective fences and interfloor ceilings in most cases provide the necessary attenuation factor for x-ray radiation, and residents of apartments located adjacent to the x-ray dental room will not be 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 adjacent to the premises where X-ray dental examinations are carried out are observed within these premises, and with a significant margin.

In some cases, these adjacent residential premises are occupied by the owners of dental clinics themselves, which sometimes serves as a compelling argument for the population regarding the reliability of radiation safety. It is especially important to know the material and thickness of interfloor ceilings in old residential buildings, since they often have preserved wooden floors. Since wood is practically transparent to X-ray radiation, in this case it becomes necessary to create a special protective ceiling in the X-ray dental room.

The next stages are organizational measures in relation to employees who will conduct X-ray dental examinations. These employees, in accordance with sanitary rules, are called “Group A personnel”, and those people who do not themselves work with, but are in the area of exposure to x-ray radiation (other dentists, nurses) are called “Group B personnel”.

Firstly, medical staff, classified as Group A personnel, must undergo a medical examination, after which the conclusion of the medical commission must note not only that the person being examined is practically healthy, but also that he has no contraindications for working with a source of ionizing radiation.
Second, these medical personnel must be trained in radiation safety. X-ray procedures can be performed either by a radiographer or radiographer who has the appropriate certificate. Usually, problems with this contingent do not arise, since the training program for these specialists includes issues of ensuring radiation safety. It is more difficult when X-ray dental examinations are carried out by a dentist or nurse who have appropriate certificates in these specialties. Perfect option, when the doctor has a dentist certificate and a radiologist certificate.
Thirdly, it is necessary to conclude an agreement with an accredited organization to monitor individual radiation doses of personnel conducting X-ray dental examinations.

The work of a modern hospital cannot be imagined without specially equipped x-ray room. The X-ray room can be one of the following types:

diagnostic x-ray room – fluorographic, mammographic,
dental, computed tomography room, radiographic;
therapeutic x-ray room;
operating x-ray room;
stationary, portable and portable x-ray machines.

In the article we will consider the basic requirements for X-ray rooms as sources of increased danger in accordance with the requirements of the current SanPiN.

The dangers of X-ray machines

X-ray machines are sources of increased danger because they project ionizing radiation, which is generated when turned on high voltage. In this regard, owners of X-ray machines must exercise special caution and caution when using them. All X-ray rooms are class 4 radiation hazard Therefore, special requirements are placed on them in order to protect patients, medical staff and the environment from ionizing radiation.

Licensing of activities

One of the conditions for compliance with radiation safety is the licensing of activities related to the operation of sources of ionizing radiation. In general terms, licensing is the process of obtaining special permission to carry out certain activities from the regulatory authority.

It is obtaining a license when organizing an X-ray room that is the main requirement for admission to activity. This is due to the fact that the operation of an X-ray room in a medical institution should bring maximum benefit from the procedure, but at the same time guarantee radiation safety to the patient and medical staff. This is guaranteed by obtaining the appropriate license.

Algorithm for organizing the work of the X-ray room

In order to make the procedure for organizing the work of the office clear, let’s imagine this process in the form of several stages:

choosing an X-ray machine that is suitable for work in a medical institution;
development and implementation of a project for the future office;
obtaining a sanitary and epidemiological certificate for carrying out activities;
obtaining a license for activities with sources of ionizing radiation;

Let's consider these stages in detail.

Choosing an X-ray machine
First of all, the management of a medical institution must determine the tasks that are of primary importance to the radiology department of the hospital, determine the composition of the studies performed and the purpose of the device. Based on this, it is determined specifications of the future device, as well as the possibility of placing it in a hospital. There are a number general requirements, which are presented to X-ray machines for medical use. In particular, they must have:

registration certificate from the Ministry of Health of the Russian Federation;
sanitary and epidemiological conclusion that the device complies with SanPiN 2.6.1.1192-03 (X-ray rooms), as well as radiation safety requirements;
certificate of compliance with regulatory and technical documents.

Let us note that the sanitary-epidemiological report must contain an indication of whether the device must be equipped with a means for changing the individual radiation dose during research. This requirement is contained in SapPiN 2.1.6.1192-03.

In addition, the use of fluoroscopy machines is not permitted unless the machine is equipped with an X-ray image intensifier.

After the required model of the device has been selected, its documentation has been studied, it is necessary to coordinate its purchase with the authorized organization - the territorial governing body of the State Sanitary and Epidemiological Supervision.

Coordination will subsequently help you correctly draw up medical and technical specifications for the installation and design of an X-ray room and avoid problems when coordinating many other details: choosing a room, approving a project, etc.

After purchasing an X-ray machine, the medical institution must ensure its safety, as well as monitor compliance with the conditions for its receipt, use, storage, and write-off. The conditions must be such that the possibility of damage, loss and uncontrolled use of devices is completely excluded.

If the X-ray machine is not yet in use, it must be stored in a specially equipped room (storage) in which their safety will be ensured and access by third parties will be excluded.

Development of an X-ray room project
The project must be developed in the following cases:

during the construction of a new hospital, department, etc.;
when organizing a new X-ray room in a hospital;
at major renovation, refurbishment or redevelopment of an existing office;
when changing examination technology and replacing equipment.

If a new hospital or department is being built, the X-ray room design is developed within the framework common project hospitals according to medical and technical specifications. Institutions that have a license giving the right to design sources of ionizing radiation may be allowed to create a project. The administration of the medical institution issues a medical project to a specialized organization. terms of reference, on the basis of which the cabinet design is developed. The assignment from the medical institution must contain the following information:

for which object it is necessary to draw up a project;
what area is allocated for the project;
what equipment is planned to be placed in the X-ray room;
what technological procedures will be used in the work of the office.

Requirements for the placement of an X-ray room
When drawing up technical specifications, it is necessary to take into account the requirements for the placement of the office, the area of the premises, etc.

The premises for the X-ray room are selected by the hospital management in agreement with the authorized organization (State Sanitary and Epidemiological Supervision).
X-ray rooms cannot be placed in children's institutions and residential buildings, but the operation of the office is permissible in clinics that are built into residential buildings. In this case, the rooms adjacent to the office should not be residential or located on the ground floor or in an extension to the office. residential building.
In this case, the entrance to the X-ray room must be separate.
Let us note that SanPiN 2.6.1.1192-03 and SNiP 31-01-2003 contain contradictory norms: the first document says that X-ray and dental rooms can be placed in residential buildings, and the second document says that any X-ray rooms.
Please note that the requirements for X-ray rooms contained in these documents must, in any case, be carefully studied before drawing up the project.
Therefore, we believe that the decision on the location of an x-ray and dental office should be made by the controlling organization. Cabinets cannot be placed under rooms with increased level humidity, which includes swimming pools, bathtubs and toilet rooms, baths
X-ray treatment rooms should not be adjacent to wards for pregnant women and newborns.

Office area and set of premises
All requirements for X-ray rooms in terms of their area and set of premises are set out in Appendix No. 5 to SanPiN No. 2.6.1.1192-03.

In addition, when drawing up a project for operating X-ray rooms, it is also necessary to take into account the requirements of SanPiN No. 2.1.3.2630-10, SNiP 06/31/2009. The following requirements are imposed on the X-ray room:

The distance from the walls of the room to the medical staff’s workplace behind a small screen should be at least 1.5 meters;
at least 0.6 meters should be the distance from the walls of the room to the medical staff’s workplace behind a large screen;
The distance from the walls of the room to the image table or tripod table must be at least 1 meter;
The distance from the nearest wall to the photo stand must be at least 10 centimeters;
The distance from the viewing window to the X-ray tube must be at least 2 meters;
the distance from the equipment elements to the technological passage for the medic must be at least 80 centimeters;
gurneys must be placed in an area of at least 1.5-2 meters;
the additional area required to bring the gurney into the treatment room must be at least 6 square meters. m.

The equipment manufacturer's design proposals contained in the technical documentation to devices, however they do not replace the development of your own project.

prevention of possible radiation accidents;
calculation of stationary radiation protection.

Further finished project must undergo a sanitary-epidemiological examination, which decides whether its content meets the requirements of sanitary standards.
Such an examination is carried out by a special body - the territorial center of hygiene and epidemiology.

More information about sanitary and epidemiological examination
The essence of the examination is to establish compliance of design and other documentation, products, services, works (Federal Law “On the Sanitary and Epidemiological Welfare of the Population”) with state rules, standards and technical regulations.
Experts are given 2 months to review the project and document the results of the examination, after which they accept a positive or negative expert opinion.
If the experts’ decision is negative, it should list the complete deficiencies that the medical institution must eliminate in the project.
If the terms of the examination are violated, the medical institution has the right to file a complaint with a higher organization.
After approval of the project, the authorized organization issues a “Sanitary and Epidemiological Conclusion” on the compliance of the project sanitary requirements. After this, the project can be implemented.

Equipment installation
As we have already said, after receiving a positive sanitary and epidemiological conclusion for the X-ray room project, the medical institution can carry out all the necessary measures.
In particular, the premises are being repaired or reconstructed, and other activities provided for by the project are being implemented. After this, you can begin installing the equipment. Installation activities are carried out by a specialized organization or representatives of the equipment manufacturer.
Please note that equipment that was not provided for in the design documentation cannot be placed in the office.
All organizations that are involved in construction and installation work, must have appropriate licenses and other permits provided for by law.

Commissioning of the X-ray room
Before accepting the X-ray room, it is necessary to check the compliance sanitary rules ventilation systems, sewerage, lighting, noise, microclimate systems, radiation control of the premises and other systems.
Such checks are carried out by organizations that are accredited to conduct such studies. They carry out the necessary research and measurements, after which they draw up the appropriate act.
After all the work is completed, it is necessary to assemble a commission that will commission the X-ray room into operation. The commission includes:

representatives of the medical institution (chief physician, his deputies, etc.);
representatives of the State Sanitary and Epidemiological Supervision Service;
representatives of the X-ray center;
representatives of the construction and installation organization.

The commission establishes the compliance of the actual work performed with the content of the project, studies the acts and protocols of the studies and measurements carried out, establishes the presence of all necessary documents listed in Appendix No. 7 to SanPiN No. 2.6.1.1192-03. After a successful inspection, the commission signs an acceptance certificate for the x-ray room in triplicate (for the medical institution, x-ray center and authorized organization).

Obtaining a technical passport for the office
The medical institution must receive technical certificate office. This document certifies the technical condition of all equipment located in the X-ray room.
In addition, it confirms that staff workplaces and premises comply with legal requirements.
A passport must be obtained for each room for tomography, diagnostics, x-ray therapy, osteometry, etc. It is filled out by the chief X-ray radiologist of the territory, after which it is certified by his signature and seal.
The passport has a validity period of 3 years, which can be renewed no more than three times.
If insignificant deviations of the devices from the passport data are identified, it can be issued from six months to a year.
If serious violations are detected in the operation of the equipment, the work of the office and equipment is suspended until completion. repair work or replacement of equipment.
In addition, the technical passport can be replaced before the expiration date if the complete set of the device changes, if the design of the X-ray room changes, as well as in case of wear and tear of the equipment and the emergency condition of the room.

Effect of sanitary-epidemiological conclusion
This document gives the right to operate and store X-ray equipment and is issued for the first time on the basis of the act of acceptance of the X-ray room into operation. This document is valid for 5 years from the date of its issuance; after expiration of the validity period, the medical institution is required to issue a new conclusion. In order to obtain a new conclusion, the medical institution contacts the Center for Hygiene and Epidemiology so that the agency conducts a new sanitary and epidemiological examination. One conclusion is issued per medical institution. It indicates all X-ray rooms and devices (stationary and mobile) to which it applies. The annex to the sanitary-epidemiological report specifies the restrictive conditions for the use of equipment and the conditions for its operation. If control organizations subsequently reveal a violation of the requirements of sanitary and epidemiological rules, the current conclusion must be revoked.

Obtaining a license to operate with sources of ionizing radiation
After passing all the previous stages (not earlier), the medical institution must obtain a license to carry out activities related to sources of ionizing radiation.
Such a license is issued by executive authorities authorized to carry out state sanitary and epidemiological supervision.
To obtain a license, a medical institution submits a package of documents to the licensing authority:

application for a license. The application must indicate: the name of the medical institution, its location and other contact information;
copies of the constituent documents of the medical institution;
copies of medical institution licenses to carry out medical activities;
a list of specific sources of radiation that are planned to be used in a medical institution. This list is accompanied by copies of documents for these sources, as well as a sanitary and epidemiological certificate for working with such sources;
copies of educational documents of medical workers that confirm their qualifications to work with sources of radiation;
receipt of payment of the license fee for consideration of the application for issuance of a permit.

All provided copies must be notarized.

License terms

compliance with the legislation of the Russian Federation and SanPiN requirements;
the presence in the medical institution of structures and premises that meet the requirements for placing X-ray rooms in them;
compliance of design and other documentation, operating conditions, storage and operation of ionizing radiation sources with radiation safety requirements;
the presence of employees who have the appropriate qualifications to carry out work in the field of using ionizing radiation sources;
conducting radiation safety certification for all employees who work with radiation sources;
existence of an action plan aimed at protecting medical institution employees and citizens in the event of a radiation accident.

The licensing authority reviews the documents, conducts the necessary studies, examinations and other activities, after which, within a period not exceeding 60 days, it makes a decision to issue a license. A license for a medical institution is issued for a period of 5 years, after which it, in the absence of changes in licensing conditions and requirements, can be extended. If a medical institution has violated licensing requirements, the licensing authority has the right to suspend the license to eliminate these violations or go to court to cancel it.

X-ray department (office) not allowed placed in residential buildings and child care institutions. The exception is X-ray dental rooms (devices). Allowed to operate X-ray rooms in clinics built into residential buildings, if the vertically and horizontally adjacent rooms are not residential. It is allowed to place X-ray rooms in an extension to a residential building, as well as in the basement floors, while the entrance to the X-ray department (room) must be separate from the entrance to the residential building.

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 are located separately.

An X-ray department serving only a hospital or only a clinic should be located in the end parts of the building. The department should not be walk-through. Entrances to the X-ray department for inpatient and outpatient department patients are separate.

The composition and area of the general and special rooms of the X-ray room vary depending on the type and number of X-ray machines (from 16 to 45 sq.m.).

The surfaces of the walls and ceilings in the treatment room and control room should be smooth, easy to clean and allow wet cleaning. Finishing materials must have a sanitary and epidemiological certificate allowing their use in residential and public buildings.

The X-ray machine is placed in such a way that the primary beam of radiation is directed towards main wall, behind which there is a less visited room. The direct beam of radiation should not be directed towards the viewing window (control room, protective screen).

The control panel for X-ray machines is located in the control room.

To ensure the possibility of monitoring the patient's condition, an observation window and a speakerphone intercom are provided. It is permitted to use television and other video systems to monitor the patient.

To the number main physical and technical factors, which determine not only the radiation dose, but also the quality of the X-ray image, include:

skin-focal distance;

irradiation area;

primary beam filtration;

voltage applied to the X-ray tube;

exposition;

quality of X-ray film, intensifying screens and transillumination screen;

X-ray image processing technology;

the presence of a screening grid.

The amount of radiation exposure also depends on the characteristics of the patient’s body (the thickness of the tissue being examined and the depth of the location of the organs being examined).

Let's take a closer look at some of the listed patterns.

Skin-focal distance – the distance between the X-ray tube and the patient’s skin. Its increase is accompanied sharp decrease surface exposure dose (inversely proportional to the square of the distance). However, this also sharply reduces the output dose of radiation and, accordingly, the quality of the image on the film (screen) deteriorates. In addition, the irradiation area increases, which may be accompanied by an increase in the dose load on the gonads. Therefore, the skin focal length must be standardized for various types research and, as a rule, do not exceed 100 cm (except in individual cases).

Irradiation field area . With increasing size of the irradiation field increases not only the radiation exposure to the patient's skin, but also the gonadal dose. As the irradiation area increases, image quality deteriorates (its contrast decreases and blurriness increases) and scattered radiation in the patient’s body increases. Thus, to reduce radiation exposure and improve image quality, it is necessary to limit the irradiation area to a value that ensures the diagnostic significance of the study.

Filtration of the primary radiation beam . The beam of radiation emitted by the X-ray tube (i.e., the primary beam) has a continuous spectrum that contains radiation of various wavelengths, both short (hard X-rays) and long (soft X-rays). Predominantly hard radiation takes part in the formation of the final image. Soft radiation is predominantly scattered in the patient’s tissues, increasing its dose load, and at the same time deteriorating the image quality. Therefore, the long-wavelength component of the primary beam should be filtered, for which a filter made of aluminum or copper (2–4 mm thick) is installed at the output of the X-ray tube.

Voltage , supplied to the X-ray tube. Promotion it leads to decrease radiation exposure. This happens primarily due to the beneficially changing ratio between the input and output doses. In addition, the radiation becomes more “hard”, the current supplied to the tube decreases and the skin-focal distance increases. The image quality also improves. The voltage value is standardized for various types of research and changes only depending on the thickness and density of the transilluminated object.

Exposition is the amount of electricity passed through R-the handset during the shooting. Expressed in milliamps per second (mAs). Increase exposure leads to increase radiation exposure of patients. The choice of exposure is determined by many factors, the main of which are the thickness of the object, the radiation sensitivity of the X-ray film, the presence of a screening grating, the thickness of the filters, the amount of voltage used, etc.

The use of protective devices (screens) to protect radiation-sensitive organs has a great influence on the formation of radiation exposure in patients.

The requirements for the placement of X-ray machines in a dental clinic have some differences from other medical and preventive organizations that use sources of ionizing radiation, and are defined in section 5 of SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities.”

Selection of equipment and its location

Depending on the X-ray equipment used in the dental clinic, X-ray examinations can be carried out either in a separate X-ray room or directly in the dental office (Figure 1).

Picture 1.

Dental devices with conventional film without an intensifying screen, as well as panoramic devices and tomographs are allowed to be placed only in the X-ray department (office), while targeted devices with digital image processing are allowed to be placed both in a separate X-ray room and in a doctor’s office - dentist At the same time, when installing more than one dental X-ray device in a treatment room, the area of the room should increase depending on the type of device, but not less than 4 m2 for each additional device.

In a dental office (including one located in a residential building, including in adjacent residential premises, subject to the requirements of radiation safety standards for the population within the premises in which X-ray dental examinations are carried out), an X-ray machine for targeted images with digital image receiver that does not require darkroom processing, and with a workload of up to 40 (mA x min.)/week. Such equipment also includes portable X-ray machines that look like a camera.

If several devices for X-ray dental examinations are installed in the room, then the anode voltage switching system should provide for the possibility of operating only one device at a time.

Advantage of this equipment(portable devices) is that during operation the device can be positioned in any position in relation to the patient. This is convenient for working in extreme situations and when working with immobile patients, especially in situations where the provision of medical care is carried out outside the walls of a treatment and prevention organization. When using the equipment in a medical-prophylactic organization, the portable X-ray machine is equipped with a tripod and an external control button. The requirements for this equipment are no different from the requirements for other models and types of dental X-ray machines. Unfortunately, we have noticed some dishonesty among the sellers of such devices, who convey distorted information to buyers, assuring the latter that such devices can be used even without the use of an X-ray protective apron, because they are the safest from the point of view of X-ray radiation. Unfortunately, this is not at all true and portable devices operate with the same anode voltage of 70 kV as most of classic targeted dental devices.

The placement of the X-ray machine in a separate X-ray room is carried out in accordance with the requirements of 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.” It is also necessary to remember about the Radiation Safety Standards (NRB-99/2009), approved by Resolution of the Chief State Sanitary Doctor of the Russian Federation dated July 7, 2009 No. 47.

The X-ray machine is located in the treatment room (the room where the research is directly carried out) so that the primary beam of radiation is directed towards the main wall, behind which there is a less-visited room. The direct beam of radiation should not be directed towards the viewing window (control room of the protective screen). When placing the cabinet on the first or ground floors The treatment room windows are screened with protective shutters to a height of at least 2 m from the level of the building blind area. When placing the X-ray room above the first floor at a distance from the treatment room to residential and office premises of a neighboring building less than 30 m away, the windows of the treatment room are screened with protective shutters to a height of at least 2 m from the finished floor level.

When there is more than one X-ray diagnostic device in the treatment room, a device is provided to block the simultaneous activation of two or more devices.

In addition to the treatment room, where the X-ray machine itself is located, a control room is equipped in which can be located: a control panel for X-ray machines, an additional X-ray television monitor, and a workstation for the radiologist and X-ray technician.

To ensure the possibility of monitoring the patient's condition, an observation window and a loudspeaker intercom are equipped between the control room and the treatment room. Minimum size protective viewing window in the control room 24x30 cm. It is allowed to use television and other video systems to monitor the patient. A control room is only required when using film equipment.

NOTE!!! In order to protect personnel, patients, as well as persons in adjacent rooms and buildings from ionizing radiation, the X-ray room itself must be designed and constructed in such a way that the walls, floor, ceiling, protective doors, viewing windows, shutters, etc. weaken the X-ray radiation to the required level. That is why an organization that has the necessary license to design radiation sources has the right to design X-ray rooms.

By submitting an application, you agree to the terms of processing and use of personal data.

The X-ray machine in the dental office is intended for patient use only. of this office. The device can be located directly at the dentist’s workplace or in close proximity. Thus, separate treatment and control rooms are not required. Therefore, it is not required additional areas for placing an X-ray machine in a dental office. There are also no additional requirements for lighting, ventilation, or heating. Please note that individual X-ray rooms must be provided with autonomous supply and exhaust mechanical ventilation.

In order to protect the patient's skin during X-ray procedures, the length of the tube of the X-ray dental device must provide a skin-focal distance of at least 10 cm for a device with rated voltage up to 70 kV and 20 cm at higher anode voltages.

Control of X-ray machines approved for use in dentists’ offices is carried out in the X-ray examination room using remote control controls at a distance of at least 2.5 m from the X-ray emitter unless otherwise provided in the equipment operating instructions.

Since an X-ray machine, even located directly in a dentist’s office, is a source of ionizing radiation, when placing an X-ray machine in a dental office, it is necessary to develop in advance a layout of the X-ray machine and calculate the radiation protection of personnel workplaces, adjacent rooms, and places of placement of other patients ( if there may be other patients in the office during the X-ray examination), the surrounding area.

NOTE!!! When working with x-ray equipment Radiation protection and dosimetric monitoring means are used.

We bring to your attention a number of thematic articles:

Article 6.3. Code Russian Federation on administrative offenses provides for punishment for violation of legislation in the field of ensuring the sanitary and epidemiological well-being of the population, expressed in violation of current sanitary rules and hygienic standards, failure to comply with sanitary, hygienic and anti-epidemic measures in the form of a warning or the imposition of an administrative fine on citizens in the amount of one hundred to five hundred rubles ; for officials - from five hundred to one thousand rubles; on persons carrying out entrepreneurial activity without forming a legal entity - from five hundred to one thousand rubles or administrative suspension of activities for a period of up to ninety days; on legal entities- from ten thousand to twenty thousand rubles or administrative suspension of activities for up to ninety days.