Responsibilities and Training
When patients go to a doctor’s office or hospital for testing, treatment, or as a prelude to surgery, one of the procedures they may undergo is an x-ray screening, magnetic resonance imaging (MRI) or computed tomography (CT) scan of one or more areas of the patient’s body. The medical professional who performs the procedure is likely a radiation technologist, commonly known as an X-ray technician.
The X-ray technician also prepares patients for the procedure, including positioning their bodies to obtain the best possible images, while shielding the parts of their bodies that don’t need examination from possible exposure to radiation. He or she also examines the images to ensure that the attending physician has a clear view, and maintains patient records. X-ray technicians in the United States receive specialized training in the classroom and in hands-on settings. In addition to their technical training, many X-ray technicians receive instruction in patient care, for instance, calming the fears of patients facing a possible diagnosis of cancer.
Most x-ray technicians earn associate’s degrees, although some technicians complete certificate programs while others pursue bachelor’s degrees. Depending on the technician’s specialization, he or she may work with X-ray, MRI or CT equipment. Technologists may also specialize in more than one area. Most states require X-ray technicians to complete training through programs accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT). A majority of states also require X-ray technicians to become certified by passing an examination issued by the state or by the American Registry of Radiologic Technologists (ARRT).
In addition to shielding patients from unnecessary radiation, X-ray technicians take precautions to shield themselves from radiation exposure. X-ray technicians wear lead aprons and gloves while performing procedures. They also stand behind shields while machinery is in use, and keep track of their exposure through monitoring equipment installed along with the machinery they use.
However, X-ray technicians who were active in their professions during the 1950s and earlier faced heightened risk of radiation exposure due to inadequate protection. As a result, reported cancer rates among older X-ray technicians are higher than for the general population.
For example, researchers examined more than 143,000 records compiled by ARRT from its establishment in 1926 through 1982 of more than active and retired radiologic technologists. At the time of the study, more than 6,000 practitioners had died. The researchers gathered questionnaire results from more than 104,000 respondents, in addition to compiling radiation exposure records from employers and other sources.
Among the respondents, nearly four percent reported suffering some form of cancer. Skin cancer was the most common (1517 respondents); breast cancer (665 respondents) and cervical cancer (726 respondents) were also widely reported.
A 2002 study conducted among 69,525 female radiologic technicians certified between 1926 and 1982 inspected breast cancer rates through 1997. The researchers found that technicians who had been active in the profession before 1940 reported higher rates of breast cancer than technicians who entered the field after 1960. The researchers also found that cumulative exposure increased the instance of breast cancer among the technicians in the study. These findings are in line with the high risks undertaken by technologists prior to 1950, as well as the effects of stricter exposure standards in lowering the risk for X-ray technicians of developing cancer through workplace exposure.
The first recommendations for “Tolerance Doses” for X-ray technicians and other related medical professionals were developed during the 1920s. The accepted levels of radiation exposure were lowered several times during following decades as more knowledge became available. During the 1950s, “Tolerance Doses” were lowered even further, along with the growing acceptance that exposure levels should be kept as low as possible. This recognition shaped the formation of the recommendations still in use by organizations such as the International Commission on Radiological Protection (ICRP) and the National Council on Radiation Protection and Measurements (NCRP).
The guiding principles for radiation exposure in place since the 1950s are that levels of exposure should be maintained “as low as reasonably achievable”, otherwise known as the ALARA principle. Applying the ALARA principle means that each potential radiation exposure is evaluated to determine its necessity, and in light of previous radiation exposures, to avoid overexposure either through a single procedure or through cumulative effect of radiologic procedures conducted over time. In addition, X-ray technologists are protected by regulatory agencies developed to safeguard radiation workers, that is, those workers whose professions place them in regular exposure to radiation, whether at regular low doses or potentially high levels.
Along with these guiding principles, X-ray technicians of the 21st century are better trained in the use of their equipment than in previous decades, and are also subject to strict workplace regulations. In addition to the requirement to wear protective gear and radiation monitoring badges, workers and employers are required to maintain exposure records for workers that follow them to future workplaces. Workers are also instructed to work as quickly as possible while using radiation emitting equipment to limit exposure – while maintaining high quality results and adhering to safety standards. Worn and outdated lead aprons and other protective gear are regularly examined and replaced when they begin to show signs of wear.