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Guidance Documents for X-ray Radiation Shielding Published by X-ray Inspection Services (XRIS), Ontario Ministry of Health and Long Term Care (MOHLTC)

Legislated Regulations for X-ray Radiation Shielding in Medical Facilities in Ontario

Forms for X-ray Radiation Shielding by Ontario MOHLTC
To use the forms, right click on the below links, save files on your computer and open the saved files from your computer.

Various Other Regulations for X-ray Radiation Safety

Frequently Asked Questions
For Form 3
Qs: What is Make and Model of the X-ray Film Image Receptor?
Ans: The Make is Manufacturer's Brand Name, such as, "Kodak Ultra Speed", ... and the Model is Film Speed, such as, "D", "E", "F", ... .
Qs: What is Material 1 and Material 2?
Ans: "Lead" has a separate column so it cannot be Material 1 or 2. Material 1 is often Gypsum/Drywall but can be Brick, Glass, ... . Material 2 can be Glass for window, Concrete, Brick, ... .
Qs: What is thickness of a material?
Ans: The thickness of a material doesn't include hollow space. For example, if there are two sheets of Drywall and each sheet is about 12.5mm, then the total thickness is about 25mm. Similarly if a Glass window has two Glass layers of 5mm each then the total Glass Thickness is about 10mm.
Qs: What is Occupancy of the Adjacent Space?
Ans: The occupancy baseline is given in Safety Code 20A (referenced above). Those occupancies should be modified according to a local healthcare environment. For example, Occupancy of the hallway can be 100% if there is office or reception located across a narrow hallway.
Qs: How Exposure Number and Workload are determined?
Ans: In most situations, exposure number and workload should be pro-rated for the established 2 to 5 year practice and not for the new office.

For Plan
A floor plan drawn to a scale of not less than one to fifty that indicates:
  1. The name and address of the owner of the facility.
  2. The number or identifying name of the x-ray room for which approval of installation is sought.
  3. The date plan is drawn or verified.
  4. The compass pointing North.
  5. The limits of travel of the x-ray tube within the room, excluding Intra-Oral x-ray.
  6. The location of the control booth or the exposure switch.
  7. The position of each horizontal or erect x-ray film cassette holder, excluding Intra-Oral X-ray.
  8. The location of the darkroom and storage of unprocessed film, if applicable.
  9. The position of the head of the person being irradiated, for Dental only.

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