(Corvalan; Briggs; Zielhuis, 2000, p. 159) The first problem is the distinguishing between health promotion and health education. Work place health actions tend to be concerned about disease prevention. So far it was up to the institutions to take care of workplace hazards. There were no proper evaluation methods. In Britain safety and health was not given any importance and this trend is changing with the claims filed by employees for damage. Today employers are more concerned with health issues, and health promotion has gone beyond occupational health promotion. (Wilkinson, 2001, p. 50) the management of risk begins with the evaluation of the risk qualitatively and quantitatively. The quantitative analysis of risks for environmental hazards has not yet been attempted in a larger context. There is a difficulty in assessing the acceptable levels of risk, and how to frame the risk reduction policy. Objective analysis when contrasted against the intuitive reasoning of people appears to be at tangents. The cost factor also enters the scene and technical risk analysis becomes subjective. (Smith, 2004, p. 35)

The type of perceptions of risk varies from location, gender, individuals and the lifestyle and usage. Technological hazards are often man made in the sense that they occur by the action of human beings or their inaction. Today terrorism is also to be considered as a possible hazard using the technology for destruction. (Smith, 2004, p. 35) There are no developed methods or program especially for non-ionizing radiation safety. Firstly there are no state regulations, and secondly the standards are based on industry consensus and therefore the methods to measure 'actual or potential exposure' and the myriad of tasks like establishing controls, training and implementation and the norms of safety are all at the research stage. (Lewandowski; Hinz; Entwistle, 2004, p. 31)

3. State the relevant general Hospital UK legislative requirements Occupational health and safety radiation relating to the control of the risks relating to these hazards

The regulation passed by the government is embodied in the Ionising Radiation (Medical Exposure) Regulations 2000 which became an act in 2001. The act seeks to bring about measures of safety in relation to the radioactive substances as well as ionizing radiation and the regulations of the act bind the persons who fall under the defined categories in the act. Along with the 'Ionising Radiations Regulations 1999 (S.I. 1999/3232)' which is implemented in Great Britain, the laws of health protection and avoiding the hazards pertaining to the ionising radiation in the field of medical practice also exist. The sections of the act namely section (2) with various sub-sections have clearly defined terms like 'adequate training', 'roles of the employer and employee etc. (Statutory Instrument 2000 No. 1059: The Ionising Radiation (Medical Exposure) Regulations 2000) for example Section 3 of the act makes the act applicable to "(a) the exposure of patients as part of their own medical diagnosis or treatment; (b) the exposure of individuals as part of occupational health surveillance; - the exposure of individuals as part of health screening programs; (d) the exposure of patients or other persons voluntarily participating in medical or biomedical, diagnostic or therapeutic, research programs and (e) the exposure of individuals as part of medico-legal procedures." (Statutory Instrument 2000 No. 1059: The Ionising Radiation (Medical Exposure) Regulations 2000)

The law casts duties on the employers to the extent that they ought to make sure that there are written procedures and manuals that they shall ensure compliance by the staff, and written protocols are displayed for radiological practices. There are adequate rules for medical exposures. For example regulation 4 requires a sole medical practitioner to frame and follow his or her own guidelines. However there are requirements common to all enumerated in the schedule one of the act which all practitioners are bound to follow. The schedule requires that there must be standard procedures to identify the persons who are at risk of being exposed to radiation, and a clear documented list of the procedures that ought to be followed by the risk group in the operation of the hazardous equipment. There must be methods of ascertaining if female patients are pregnant and the effect of the radiation on the breast feeding issues are settled before procedures involving radiation are conducted. (Statutory Instrument 2000 No. 1059: The Ionising Radiation (Medical Exposure) Regulations 2000)

The schedule also requires that quality assurance and the diagnostic reference levels for radio diagnostic examinations are well within the definitions and scope of regulation (3) and sub-sections. There...

The employer is bound to take adequate steps to ensure that clinical records are available for each exposure that occurs during the course of practice. That there ought to be adequate experts for consultation and the hospital ought to keep proper inventory of the hazardous substances which ought to be at all times be limited to the minimum necessary amount. The practitioners and staff are enjoined to follow all regulations and guidelines and framework procedures set by the industry or the employer and the operators are made responsible for their own and the patient's safety. (Statutory Instrument 2000 No. 1059: The Ionising Radiation (Medical Exposure) Regulations 2000)
Regulation (5) covers this aspect and prohibits any person from exposing himself or a patient to radiation except by the authorized prescription of a medical practitioner and with adequate data. Regulation seven caters to the optimization procedure, "which involves ensuring that doses arising from exposures is kept as low as reasonably practicable. The practitioner and the operator are responsible for elements of the optimization of medical exposures as specified in regulation seven." (Statutory Instrument 2000 No. 1059: The Ionising Radiation (Medical Exposure) Regulations 2000) "Regulations (6) and (7) provide that special attention be given to exposures in medico-legal procedures, health screening or voluntary participation in research, where no direct medical benefit is expected from the exposure or where exposure involves high doses, pregnant or potentially pregnant or breastfeeding females and children. Regulation seven also provides that certain information and instructions be given where radioactive medicinal products are administered." (Statutory Instrument 2000 No. 1059: The Ionising Radiation (Medical Exposure) Regulations 2000)

The important regulation which brings about compliance are regulation eight to ten which makes it mandatory for institution sand practitioners to have a clinical audit and also ensure that clinical audit to be carried out in consultation with 'medical physics experts' and maintaining of proper inventory of all equipments and that the equipments are limited to what is absolutely necessary. These mandatory provisions also bar the untrained personnel from handling equipments or prescribing or in anyway being involved with the radiation process. The act has also identified various radiation sources and prescribes specific rules for the same. This act overrides the "Ionising Radiation (Protection of Persons Undergoing Medical Examination or Treatment) Regulations 1988 (S.I. 1988/778)." (Statutory Instrument 2000 No. 1059: The Ionising Radiation (Medical Exposure) Regulations 2000)

4.Outline a Suitable Control Strategy that will:

a) adequately control the risks

The most important aspect of controlling risk is informing and education all concerned staff and practitioners about the hazards. Radiation protection is a subject that is now current with people, at least with patients. Patients are becoming aware of radiating risks. Strict procedures ought to be adopted to avoid unnecessary radiation exposure. (Raza, 2006) Education on radiation hazard for doctors and hospital staff is woefully inadequate. Steps must be taken not only to educate the people on the hazard but also train then adequately in monitoring and controlling the use of radiation equipments.

A b) clearly specify what actions need to be taken

The importance of making medical practitioners and staff regarding the hazards cannot be overstressed. In a research conducted by surgeons and radiologists, like S. Shiralkar, consultant surgeon, a Rennie, and others, the startling fact was revealed that in the sample population of doctors taken for study of their knowledge regarding radiation and its effects, very few had any idea of the hazard. The doctors subject most patients to one X-ray investigation at least. They were woefully unaware of the ionizing risk of radiation from X-rays. The survey was conducted in two regions in the United Kingdom. The study revealed that most doctors do not have any idea of the risks of radiation on the patients, and the doctors had undergone a radiation protection course which would it is believed have apprised them of the issue. The research found that there was a great lack of awareness among doctors and the patients receive more than one prescription for X-Ray in the course of treatment. (Shiralkar; Rennie; Snow; Galland; Lewis; Gower-Thomas, 2003, p. 371)

The most important thing to do is therefore to create a national campaign in the matter…