DHS 157.74(2)(f) (f) Persons may not be exposed to the useful beam except for healing arts purposes and unless such exposure has been authorized by a licensed practitioner of the healing arts or a Wisconsin licensed physical therapist. Deliberate exposure for any of the following purposes is prohibited:

DHS 157.74(2)(f)1. 1. Exposure of a person for training, demonstration or other non-healing arts purpose, except as authorized by the department.

DHS 157.74(2)(f)2. 2. Exposure of a person for healing arts screening, except as authorized by the department.

DHS 157.74 Note Note: The procedure for requesting permission to conduct screening x-ray examination is in ch. DHS 157 Appendix M.

DHS 157.74(2)(fm) (fm) Registrants may conduct medical research that includes exposure to radiation and are exempt from obtaining individual project authorization from the department under all the following conditions:

DHS 157.74(2)(fm)1. 1. The use of radiation-generating equipment to conduct research on human beings has been approved by an institutional review board as required by 45 CFR 46 and 21 CFR 56.

DHS 157.74(2)(fm)2. 2. The institutional review board’s review of the research project includes a radiation safety review by qualified radiation personnel.

DHS 157.74(2)(fm)3. 3. All research projects using radiation need to be identified and documentation shall be made available to the department upon request.

DHS 157.74(2)(fm)4. 4. The number of facilities and exam types used by the registrant are reported to the department annually.

DHS 157.74(2)(fm)5. 5. Nothing in this paragraph relieves registrants from complying with the other requirements of this subchapter.

DHS 157.74(2)(g) (g) When a patient or film must be provided with additional support during a radiation exposure, all of the following applies:

DHS 157.74(2)(g)1. 1. The human holder shall be instructed in personal radiation safety and protected as required by subd. 2. Written safety procedures are required.

DHS 157.74(2)(g)2. 2. In those cases where the patient must hold the film, any portion of the body other than the area of clinical interest struck by the useful beam shall be protected by not less than 0.5 millimeter lead equivalent material.

DHS 157.74(2)(g)3. 3. Each facility shall have leaded shielding garments and devices available in sufficient numbers to provide protection to all personnel who are involved with x-ray operations and who are otherwise not shielded.

DHS 157.74(2)(g)4. 4. Leaded shielding garments and devices shall be fluoroscopically or radiographically inspected at least every 2 years for defects and replaced if defective.

DHS 157.74(2)(g)5. 5. If visual inspection reveals possible defects, radiographic or fluoroscopic inspections shall be performed.

DHS 157.74 Note Note: Leaded shielding garments and devices include aprons, gloves, vests, skirts, thyroid shields and gonadal shields.

DHS 157.74(2)(h) (h) Procedures and auxiliary equipment designed to minimize patient and personnel exposure commensurate with the needed diagnostic information shall be utilized, as follows:

DHS 157.74(2)(h)1. 1. The speed of the image receptor used shall be of a speed consistent with the diagnostic objective of the examinations. Film cassettes without intensifying screens may not be used for any routine diagnostic radiological imaging, with the exception of veterinary radiography and standard film packets for intra-oral use in dental radiography.

DHS 157.74(2)(h)2. 2. The radiation exposure to the patient shall be the minimum exposure required to produce images of good diagnostic quality.

DHS 157.74(2)(h)3. 3. An x-ray system may not be utilized in a procedure where the source to patient distance is less than 30 centimeters, except for a veterinary system, bone density unit or a unit granted an exemption by the US food and drug administration.

DHS 157.74(2)(h)4. 4. If grids are used between the patient and the image receptor to decrease scatter to the film and improve contrast, the grid shall meet all of the following requirements:

DHS 157.74(2)(h)4.a. a. Be positioned with tube side facing the in right direction, and grid centered to the central ray.

DHS 157.74(2)(h)4.b. b. Be of the proper focal distance for the SIDs being used. Grids shall be of the proper ratio to adequately reduce scatter for the procedure being performed.

DHS 157.74(2)(h)4.c. c. Anti-scatter grids or an appropriate air gap technique to reduce scatter to the image receptor shall be used for all x-ray examinations of the human torso utilizing stationary x-ray equipment for patients 12 years of age or older.

DHS 157.74(2)(i) (i) All persons associated with the operation of an x-ray system are subject to the requirements of s. DHS 157.22 (1), (5), (7) and (8).

DHS 157.74(2)(j) (j) A person proposing to conduct a healing arts screening program may not initiate a program without the department’s prior approval. When requesting approval, the person shall submit the information outlined in ch. DHS 157 Appendix M. If any information submitted to the department becomes invalid or outdated, the department shall be immediately notified.

DHS 157.74(2)(k) (k) All facilities performing mammography shall meet the requirements of 21 CFR 900, US food and drug administration, Mammography Quality Standards Act.

DHS 157.74(2)(L) (L) A registrant that uses two or more therapeutic radiation machines for human use shall establish a radiation safety committee consisting of at least three members to oversee the use of all therapeutic radiation machines. The committee shall include an operator authorized by the registrant, a representative of the institution’s management, and the radiation safety officer. If the institution has a radiation safety committee established under s. DHS 157.61 (1) (e), this committee may be designated to oversee the use of all therapeutic radiation machines, if an operator authorized by the registrant is appointed to this committee.