Example: CT exam of chest x 3 Every 8 weeks 1 2 3 4 5 6 7 8 *Where the exact number of examinations is not known, please indicate the anticipated average and maximum number likely to be performed over the duration of the research. Indicate & next to value stated. “(Avg)” “(Max)” Additional Comments (if necessary) 4.4 Radiation assessment (a) Has an approved medical physicist assessed the application and written a report on the doses and risks involved? Yes No If provide the medical physicist’s details and Yes, attach a copy of the written report Medical Physicist Institution If No, please organise to have an assessment carried out in order for it to be forwarded to the HREC Secretariat. Note: The ARPANSA Code of Practice Exposure of Humans to Ionising Radiation for Research – Purposes Radiation Protection Series Publication No. 8 (May 2005) requires that: The investigators submit to HRECs calculations of the total effective dose, relevant organ doses • and associated risk information for provision to participants. Dose calculations and risk assessments submitted to HRECs must be independently verified by • a medical physicist (approved to perform that type of assessment by the Department of Health and Human Services, Radiation Team). Verification of the doses by a second medical physicist must also be obtained where doses are • in excess of the dose constraints. (b) Attach a copy of the medical physicist’s written report. Have the dose constraints been exceeded? (c) Yes No If Yes, provide the details of the second medical physicist that has verified the initial dosimetry calculations performed Second Medical Physicist Institution
Example: CT exam of chest x 3 Every 8 weeks 1 2 3 4 5 6 7 8 *Where the exact number of examinations is not known, please indicate the anticipated average and maximum number likely to be performed over the duration of the research. Indicate “(Avg)” & “(Max)” next to value stated. Additional Comments (if necessary) 4.4 Radiation assessment (a) Has an approved medical physicist assessed the application and written a report on the doses and risks involved? Yes No If Yes, provide the medical physicist’s details and attach a copy of the written report Medical Physicist Institution If No, please organise to have an assessment carried out in order for it to be forwarded to the HREC Secretariat. Note: The ARPANSA Code of Practice – Exposure of Humans to Ionising Radiation for Research Purposes Radiation Protection Series Publication No. 8 (May 2005) requires that: • The investigators submit to HRECs calculations of the total effective dose, relevant organ doses and associated risk information for provision to participants. • Dose calculations and risk assessments submitted to HRECs must be independently verified by a medical physicist (approved to perform that type of assessment by the Department of Health and Human Services, Radiation Team). • Verification of the doses by a second medical physicist must also be obtained where doses are in excess of the dose constraints. (b) Attach a copy of the medical physicist’s written report. (c) Have the dose constraints been exceeded? Yes No If Yes, provide the details of the second medical physicist that has verified the initial dosimetry calculations performed Second Medical Physicist Institution
Section-4-Use-of-Ionising-Radiation-January-2015.docx