Cabinet of Ministers Regulations No. 482 in Riga 2014 (august 19. No 44 21 §) rules concerning protection against ionizing radiation in medical radiation, issued in accordance with the law "on radiation safety and nuclear safety" article 3, third paragraph 1. General questions 1. determines the radiation safety and nuclear safety the implementation of fundamental principles of human protection against ionising radiation medical exposure. 2. The terms used in the following terms: 2.1.-radiation process, during which the person is exposed to ionizing radiation; 2.2. the prescriber, a medical doctor, dentist or other medical person with the appropriate qualifications and privileges to send people to medical exposure. 2.3. a volunteer helper – a person who comes into contact with the patient during the medical irradiation, knowingly and willingly providing patient support if it doesn't fit the person's professional duties; 2.4. the diagnostic standartlīmeņ-ionizing radiation dose levels in the manipulation or radiodiagnostisk total radioactivity levels for transactions with radiopharmaceuticals, making standard size patient studies (body weight of 70 kg) or through standard examinations using a radiological device in accordance with the medical irradiation methods to be used in the description. Standard manipulation, using common and good practice in diagnosis and are technically not exceeding these levels; 2.5. the dose limits – the person expected doses (which may result from a defined source) limit that takes into account the radiation safety planning and optimization of exposure; 2.6. personal injury-damaging effects that are observed after irradiation clinical person or its offspring. Adverse effects after irradiation appear immediately or at a later time, and in this case it is rather tentative than probably expected; 2.7. legal medical manipulation-manipulation of exposure without medical indications, which are made for insurance or legal purposes; 2.8. the clinical audit-radiological manipulation systematic examination or review, to improve the quality of patient care and outcomes. Clinical audit carried out during the structured manipulation and revision of the radiological scored compliance with good clinical practice requirements, as well as the manipulation and the results compared with the accepted standards of radiological manipulation and, if necessary, modify the practices and uses the new standards; 2.9. quality control-quality assurance part that includes a set of actions (planning, coordination, execution) to maintain or improve quality, as well as all equipment include measurable and controllable performance monitoring, evaluation and maintenance of the appropriate level; 2.10 quality assurance – all the planned and systematic activities to provide reasonable assurance that the radiological manipulation will be carried out according to the standards and approved medical technology; 2.11. medical irradiation – the process during which the ionizing radiation medical purposes on human tissues, organs and organisms as a whole; 2.12. technical aspects of medical exposure, radiological training and manipulation, manipulation associated with radiological radiological device and use radiological devices, technical parameter and measurement of physical parameters including radiation doses, patient dosimetry, radiological devices maintenance and conformity assessment functions, film processing and radiopharmaceutical preparation and use; 2.13. medical physics expert – medical physicist with at least a master's degree in medical physics or an expert in radiation physics or radiation technology used in medical irradiation, and has issued a radiation safety expert certificate in medical physics according to the laws and regulations concerning protection against ionizing radiation; 2.14. patient dose: the dose of ionising radiation medical exposure by the time receive the patient or other person; 2.15. patient dosimetry: the patient or other person dosimetry (dose rate), subject to medical exposure. 2.16. the medical practitioner, certified medical person who has the right to carry out radiological manipulation and which is responsible for the choice and the radiological manipulation of each medical irradiation (for example, the therapist, the radiologist radiologist Diagnosta or dentist); 2.17.-pharmaceutical preparation of radiopharmaceutical: any medicinal product prepared for use in a way which contains one or more radionuclides-radioactive isotopes except isotopes from closed sources, intended for medical purposes; 2.18. radiodiagnostisk manipulation – medical examination using radionuclides or other sources of ionizing radiation diagnostic purposes only (such as nuclear medicine diagnostic manipulation, General Radiology Department, computed tomography, interventional radiology, and dental radiology); 2.19. radiodiagnostisk — pertaining to in vivo diagnostic nuclear medicine, medical diagnostic radiology, and dental radiology. 2.20. radiological manipulation-manipulation associated with medical radiation exposure. Radiological manipulation is divided into the radiodiagnostisk and radiotherapeutic manipulation; 2.21. radiological devices – Radiology-medical device that generates ionizing radiation or content sources; 2.22. radiological – pertaining to radiodiagnostic and radiotherapeutic manipulation, as well as invasive Radiology or other planning and guiding Radiology. 2.23. in radiotherapeutic manipulation-treatment using radionuclide or other sources of ionizing radiation (such as nuclear medicine therapeutic manipulation, accelerators and other sources of ionising radiation is radiation therapy and the Interventional Radiology); 2.24. in radiotherapeutic: pertaining to radiotherapy including nuclear medicine for therapeutic, purposes; 2.25. the screening examination – procedure using radiological devices early diagnosis in population groups with a high risk. 3. the rules apply to the following medical exposure: 3.1 persons exposure associated with the diagnosis or treatment, or health check; 3.2. the mandatory employee exposure health checks and inspections; 3.3. radiation of the person who voluntarily participating in medical, biomedical, diagnostic or therapeutic research program; 3.4. personal exposure associated with legal medical manipulation; 3.5. the voluntary Assistant irradiation. 4. Medical irradiation using methods approved in accordance with the laws and regulations on treatment of medical technology used in the approval and implementation of new medical technologies, as well as medical devices, which have been under the legislation on the registration of medical devices.

5. the medical practitioner clinical responsibility in relation to medical exposure are: 5.1 assess medical irradiation; 5.2. to provide medical irradiation optimization: 5.2.1 choosing the manipulation of the radiological nuclear device; 5.2.2. get radiodiagnostisk information or provide a radiotherapeutic outcome; 5.2.3. involved in the technical aspects of medical exposure evaluation to reduce personnel and other persons to radiation; 5.2.4. to assess the radiological dose and patient manipulation; 5.3. to assess the medical radiation radiodiagnostisk the information obtained or radiotherapeutic outcome; 5.4. to cooperate with other professionals associated with medical radiation exposure (e.g. medical physicists, radiologist Assistant, or radiogrāfer), in relation to medical exposure in the technical aspects, particularly with regard to the manipulation radioloģiskaj pregnant women and mothers who are breastfeeding, volunteers in research and helping persons; 5.5. to the extent possible, to get information about the person above you radioloģiskaj manipulation and take into consideration these data to avoid undue medical irradiation; 5.6. to put other people to treatment, including practitioners and other prescribers, information about the person you radioloģiskaj manipulation, as well as, if necessary, information on the history of the disease, to reduce the personal damage that may lead to unfounded medical irradiation; 5.7. provide patients and volunteers with information about potential harmful ionizing radiation effects. 6. If you run the radiological manipulation according to the standard radiodiagnostiskaj manipulation, the right to carry out radiological manipulation is also another specialty certified doctor trained in the manipulation and radiation safety. 7. The Operator shall ensure: 6.6. radiation safety quality assurance program development and implementation; 7.2. clinical audit at least once every five years, except for dental care. A clinical audit of the operator involved in organizing doctors practicing medical physicist and quality control workers, to implement the specifics of the authority for the diagnostic standartlīmeņ and clinical protocols, including: 7.2.1. using this provision in the proposed annex 1 standartlīmeņ; 7.2.2. the patient dose or associated radiological measurements of parameters manipulation standard size patient (body weight of 70 kg); 7.2.3. setting the size of controls as the patient dose or associated parameters, which can be derived by measuring equipment belonging to the authority; 7.3. medical physics expert and medical physicist involved in manipulation of radiological (including patient dosimetry and optimization, quality assurance including quality control) according to the rules specified in annex 2 of the medical physics expert and medical physicist minimum working loads. Medical physics expert, if necessary, involve others in radiological manipulation; 7.4. the medical exposure of patients and staff deployment and manipulation of radiological radiation safety requirements according to the premises; 7.5. the radiation safety instructions the availability of volunteer helpers; 7.6. the provision of information to other medical institutions upon the written request of the patient to perform medical irradiation; 7.7. work organisation and responsibilities according to the special permission (license) activities with ionizing radiation sources. 8. quality assurance of radiation safety program establishes the following requirements: 8.1. radiological equipment, acquisition of equipment, protection against ionizing radiation and ionizing radiation generated by the related technical specifications of equipment conditions and the frequency of checks, as well as technical service conditions of service; 8.2. medical irradiation with the radiological device that meets the technical provisions of annex 3 of the mentioned technical radiological device parameter; 8.3. the correlation between radiodiagnostisk or radiotherapeutic purpose of manipulation and medical radiation, radiological devices used in technical ability; 8.4. the written procedure (Protocol) for each radiological device for the manipulation of the type radiodiagnostisk; 8.5. the requirements for the control of patient dosimetry and medical radiation measuring equipment, control equipment, including the daily performance of the instrument; 8.6. additional requirements for the regular quality control checks the child in medical and patient exposure dose or radiological evaluation of manipulation kids, involving experts from the related authorities; 8.7. information accessible for filtering, focus field sizes, distance from its source to the image receptor size indication field, as well as other parameters that characterize the work of the radiological devices; 5.5. requirements for personal protection (including apkakļ and apron) for use and testing; 5.5. requirements for quality assurance program established in other legislation concerning protection against ionizing radiation. 9. Medical irradiation uses ionizing radiation associated with medical technology, which the national health service approved under the regulations on treatment of medical technology used in the approval and introduction of new medical technology. This technology is used in these regulations, subject to the specific radiation safety and nuclear safety principles of human protection against ionizing radiation. 10. National Environment services of the radiation safety Centre (hereinafter referred to as the Centre): 10.1. to raise the level of radiation safety in the country, in cooperation with the professional associations concerned, make recommendations on the training programmes included in the topics related to radiation safety in medical radiation, including quality assurance issues; 10.2. collect information on patient dose in assessing the total radiation dose to individual groups of the population; 10.3. analyse opportunities to reduce patient dose according to the available technologies and methods; 10.4. once a year the national health service and the Centre for disease prevention and control provides information about operators and granted special permission withdrawn (licenses) for transactions with sources of ionizing radiation in medicine. 11. the health inspection for medical supervision and control, the operator has the right to request proof of radiological devices and electrical safety compliance testing function.
2. the grounds for medical exposure

12. The prescriber fill out referral to perform radiological manipulation, stating the medical necessity of exposure. 13. The practitioner evaluates the physician provided medical irradiation of dispatch grounds and, if it has sufficient permissions to perform the medical exposure. 14. Medical irradiation without the grounds is prohibited. Cancer screening studies comply with the laws and regulations of the health care organization and financing arrangements in certain requirements for cancer screening. 15. These rules 12, 13 and 14 of the type referred to in paragraph 1 does not apply to medical research and legal medical manipulations. 16. The practitioner the basis and assessing the need for medical exposure: comparison of the patient was cured, 16.1, the expected reduction of pain, treatment options for building or extending life expectancy with possible individual harm to medical exposure can cause. By comparison, also take into consideration the effectiveness, benefits and risks arising from the use of the available alternative methods that have the same goal, but they are not associated with or linked to less exposure (e.g., ultrasound examination and chemotherapy); 16.2. take into account the objectives of the medical exposure and physical characteristics of the person; 16.3. take note of the diagnostic standartlīmeņ, specified in annex 1 of these rules, and institutions for appropriate diagnostic standartlīmeņ nature, if any; 16.4. take note of the above information or for radiodiagnostisk disease history data associated with medical radiation exposure; 16.5. you can set limits or reject radiological manipulation if: 16.5.1. medical institution started to use a new radiological manipulation; 16.5.2. is evidence of the manipulation of the radiological insufficient effectiveness or possible adverse side effects; 16.5.3. medical irradiation is not directly on a person's health or therapeutic diagnostic benefit (even if the person requesting it make itself). In such cases, medical irradiation may be carried out, taking into account the practitioner's limits, except where such exposure causes significant risks to personal health or risk to life. 17. The practitioner based volunteer assistant medical irradiation, take into account the direct benefit to the patient's health and possible irradiation injury volunteer Assistant and patient.  18. If the use of a radiological manipulation in General is not based, doctor of konsilij in some cases, assessing the ability to benefit the patient's health and the possible exposure of the individual damage, may decide to allow the medical exposure. 19. the screening examinations are allowed only if the expected benefits of medical exposure of the population group concerned or for the entire population to compensate for the economic and social costs, which may result in harmful effects of ionising radiation, and takes account of the following possibilities for exposure to disease detection, detect disease treatment options and the public benefit of this disease from spreading. 20. it is prohibited to irradiate a person in medical or biomedical study (hereinafter study), except when the Medical Ethics Committee has agreed to study the program started and apstarojam person is informed of the expected risks and given its consent in writing to participate in the study. Medical Ethics Committee to research and medical radiation is involved, the number of persons subject to the smallest, but sufficient to get the accurate and reliable information. 21. study of exposure Before a person's need to evaluate potential diagnostic or therapeutic benefits which a person could gain by participating in this study, and receive her treating physician's written consent. 22. Before the adoption of the decision on personal exposure study in medical ethics Committee checks whether the person intended to involve the study and expose the medical exposure: 22.1. is independent of the investigator of the study; 22.2. to participate in the study are not accepted for payment, except for direct compensation for participating in the study, or been otherwise affected. 23. the study investigator is responsible to: 23.1. a person supposed to involve the study and expose the medical exposure, at least the day before the irradiation is writing her understandable way informed of possible risks; 23.2. the person, which is expected to involve the study and expose the medical exposure, obtain information about the study's potential effects on health, as well as the side effects that may occur during or after the study; 23.3. to ensure confidentiality of the information on the parties involved in the research; 23.4. the study involved be able at any time to refuse from participation in the study, without giving the reasons for refusal.
3. Radiological manipulation

3.1. General requirements 24. radiological manipulation provides (depending on the purpose of irradiation and apstarojam in an organ or tissue) of protection against ionizing radiation sensitive organs that are part of the body apstarojam and which may be affected by ionizing radiation (small pelvis organs, mammary glands or thyroid). 25. The practitioner: 25.1. is responsible for the decision to allow or disallow the radiological manipulation; 25.2. make any necessary adjustments in the performance of medical exposure, if the overall radiological manipulation does not provide the information or radiodiagnostisk radiotherapeutic outcome; 25.3. take steps to further reduce overall: 25.3.1. individual medical exposure, if the patient dose radiodiagnostisk manipulation in constantly exceeding diagnostic standartlīmen; 25.3.2. reduce medical irradiation, if the person is not a standard study carried out; 25.4. ensure that voluntary Assistant received ionizing radiation dose does not exceed 5 mSv in a year. 26. If a voluntary helper estimated radiation dose may exceed 5 mSv in a year, volunteers treated the employee who carries out activities with ionizing radiation sources, and he provides the operator the individual dosimetry. 27. Students, residents and physicians not certified individuals who acquire the appropriate training programs can perform radiological manipulation or part of it according to the regulations on the treatment of the person and student learning a first or second level professional higher medical education programs, expertise and treatment of these individuals theoretical and practical knowledge. 28. The practitioner, radiologist Assistant, and medical physicist medical radiation, the patient controls and provides documentation of the specific manipulation of the radiological relevant medical document forms according to the legislation on medical document management procedures. 29. The Operator shall ensure that the personal protection lead equivalent check after the time limit specified by the manufacturer, but if this is not specified,-at least every two years, take a laboratory accredited national accreditation body according to the laws and regulations on assessment of conformity assessment bodies, accreditation and supervision or other Member States of the European Union accreditation institution. 3.2. Medical irradiation for 30 radiodiagnostisko the practitioner is responsible for the manipulation of radiodiagnostisk: 30.1. to be irradiated with minimum dose, medical exposure taking into account economic and social factors and choosing the parameters of medical exposure, which provides high-quality image acquisition; 30.2. to take into account the technical characteristics of the radiological devices; 30.3. to avoid additional medical irradiation, making maximum use of the previous medical radiodiagnostisk information gained in exposure. 31. in order to reduce patient dose, and at the same time ensure the required radiodiagnostisk the information in planning and carrying out the radiodiagnostisk manipulation, the following shall be taken into account in medical irradiation parameters: 31.1. the size of the field; 31.2. the number of digital pictures, company size and number of study time or cut the number of CT; 31.3. the image, so the receiver sensitivity and resolution; 19.5. omnidirectional radiation detection grid existence; 31.5. the primary beam collimation; 19.6. image enhancement technique in the dynamic display, including the number of images per second; 19.7. the developer temperature image reconstruction algorithm and other image processing; 19.8. rentgenspuldz high-voltage discharges to the strength, power, and other radiological equipment technical parameters; 19.8. the patient's physical characteristics. 32. Mobile radiological device outside the Office in radiodiagnostisk radiodiagnostisk manipulation is used when medical contraindication due the patient may not be moved to the radiodiagnostisk Office. 3.3. medical exposure in diagnostic nuclear medicine manipulation and radioterapeitisko purposes in nuclear medicine radiologist Diagnosta 33. diagnostic manipulation check in: 33.1. radionuclide with the shortest half-life; 33.2. choose the input dose total radioactivity and acquisition algorithm to provide a minimum combination of patient dose and image quality; 33.3. takes into account the total radioactivity diagnostic standartlīmeņ; 20.8. introducing additional requirements needed in patients with organ or organ system function impairment; 20.8. using methods that speed up the Elimination of pharmaceutical preparations; 20.9. If nuclear medicine diagnostic manipulation requires the child to take the drug to the patient dose adjustment of total activity, taking into account the child's physical parameters, and choose the appropriate size between the minimum dose of pharmaceutical preparations, child (1.7 and 8) and the maximum adult dose (1.6;) 20.9. ensure that radioactive pharmaceutical prepare patient drug dose total radioactivity is measured and recorded just before executing the radiological manipulation; 33.8. deploy patients who entered the pharmaceutical preparation, specially equipped rooms. 34. The radiologist therapist medical physicists, in cooperation with the relevant parts of the medical irradiation in the manipulation of the individual planning radiotherapeutic to ionizing radiation dose rate in tissue other than the surrounding medical irradiation facilities, would be as low as it is possible in practice according to the intended radiotherapeutic purpose. 35. in Radiotherapeutic manipulation in every patient or medical physicist physics technician prepares medical irradiation, which another medical physicist or a medical physics expert. The plan approved by the radiologist therapist. Medical irradiation plan include: 21.8. the total dose of ionizing radiation exposure in medical facilities, the surrounding tissues and to ionizing radiation in sensitive organs; 35.2. medical irradiation topographical scheme; 35.3. sources of ionising radiation, ionizing radiation types and energy apstarojam geometric parameters of the field, the field modifiers, monitorvienīb and apstarojam parameters in the field; 35.4. the fraction of medical exposure, the number of doses of ionising radiation power and time radiation in each fraction. 36. The radiologist therapist nuclear medicine therapeutic manipulation: 36.1. chooses the appropriate radionuclide; 36.2. Special requirements for patient with organ or organ system function impairment; 36.3. is responsible to: 36.3.1. medical irradiation planned target (object) used to obtain the required dose of ionizing radiation, protecting the other organs and tissues; 36.3.2. radiopharmaceutical used in prepared, patient drug dose total radioactivity is measured and recorded just before the manipulation; 36.3.3. the patient who has undergone a manipulation room, special inserts to protect employees, the medical irradiation, other patients and visitors against ionizing radiation, and determined the following dose limits: 36.3.3.1. ionizing radiation dose received by the visitor from the patient who is or has been subject to the manipulation of nuclear medicine radiological protection must not exceed 5 mSv per year for the entire body; 36.3.3.2. If the visitor is under 18 years of age, the radiation dose received by the visitor from the patient who is or has been subject to the manipulation of nuclear medicine radiological protection must not exceed 1 mSv per year for the entire body. 37. in order to limit the exposure of the patient who has made nuclear medicine therapeutic manipulation, the operator shall ensure that the patient does not extract and released from the hospital, up to the total radioactivity of his body not less than 400 MBq I-131, but if a patient lives together (one room) with children up to the age of 14,-200 MBq I-131. If you use other radionuclides, the specific radioactivity of common size determines the radiologist therapist, taking into account their personal protection against ionizing radiation, in which the patient lives or work together, and that the estimated dose should not exceed 0.1 mSv/year, if patients comply with treatment services. 38. If the patient has been exposed to the manipulation of nuclear medicine radiological, radiologist:

38.1. inform the patient about the rules of residence up to the end of the manipulation of radiodiagnostisk; 38.2. provide the patient with information about the visitors to the ionizing radiation potential harmful effects; 23.8. when the patient from the hospital, the patient shall be issued or his family member, custodian or legal guardian with written instructions for measures for protection against ionizing radiation and for information about potential radiation dose that other people can get from the patient. 39. The Operator in nuclear medicine radiological manipulation is responsible: 24.3. the operator of a controlled area the resulting radioactive waste (for example, patient secretions), radioactive materials and contaminated reusable items, storage, labelling, pick up the radioactive decay in accordance with the requirements of the legislation on transactions with radioactive waste and the related material or discharge into the environment, arising out of or in connection with patients patients who performs or has performed in the nuclear medicine radiological manipulation; 24.4. for regular dozimetrisk measurements in rooms that carry out radiological or nuclear medicine manipulation in which the patients who carry out or have carried out the radiological nuclear medicine manipulation.
4. a radiological device 40. The Operator shall ensure that the use of radiological radiodiagnostisk manipulation device and its equipment shall comply with the following requirements: 24.9. medical irradiation is maintained according to the diagnostic standartlīmeņ that allows you to obtain sufficient information radiodiagnostisk; 40.2. the radiological devices or attached by the manufacturer in the instructions for use of the x-ray tube voltage is specified, the current strength and exposure time or the power strength and exposure time product; 40.3. radiological device is equipment that automatically stops generating ionising radiation after a certain period of time, as well as the estimated radiation dose rate achieved; 40.4. radiological device and its equipment are appropriate and sufficient to provide opportunities to reduce patient dose, medical radiation health checks, as well as through the medical irradiation, which received large doses of the patient, including the radiology and Interventional CT; 25.2. rentgendiagnostik device is equipped with a patient's dose-measuring device. If it is not possible to rentgendiagnostisk the device be equipped with patient dose measurement device, patient dosimetry is performed using other methods. 41. in order to reduce the exposure of children to medical, the operator shall ensure that the following examinations in specialized health care institutions use: 25.5. radiodiagnostisk device, in addition to the equipment used for 2.5 mm aluminium filter is equipped with 0.1 mm and 0.1 mm aluminium or 0.2 mm copper filter can filter, and is able to unlock the power automatic adjustment of doses; 41.2. datortomogrāf, which ensures that the patient dose did not differ from the ex-dose by more than ± 15% of children study in the established diagnostic parameters. 42. Diagnostic studies: 42.1. are prohibited: no image 42.1.1. streak amplification devices or similar equipment; 42.1.2. digital image processing device screening study programs; 42.1.3. without a dose capacity automatic regulating devices screened; 26.2. the dose of power off Auto Tuning device is allowed: 42.2.1. investigation of small body parts, including the limbs; 42.2.2. investigating a child who is not older than 5 years, or the weight of which does not exceed 12 kilograms; 42.2.3. in other cases, if warranted by the radiological devices technical capabilities. 43. The Operator will ensure that the manipulation of radiotherapeutic radiological device and its equipment shall comply with the following requirements: 43.1. using the device and its equipment are fitted with devices that provide medical irradiation performance of choice and maintenance according to the purpose of use, as well as continuous and unambiguous indication of the radiological devices technical parameters as types of ionising radiation, energy, primary beam modifiers, including filters, the distance to the patient the size of the field, apstarojam, beam orientation, medical irradiation time and patient dose; 43.2. in the event of a failure in the electrical power supply, sources of radiological device is automatically switched off (turns off generation or ionizing radiation ionizing radiation source is moved from position to position, secure storage or in any other way provided termination or substantial exposure reduction) so that the beam control mechanism can only be switched on from the control panel; 43.3. radiological device that has a high power source is equipped with a blocker or other means that prevent radiological device used otherwise as specified on the Control Panel, and it is provided with at least two mutually independent safety systems device disruption; 43.4. Security blockers use in the design of physical protection systems as codes and keys, which guarantees that the operation of the radiological devices to turn off the lock, making repairs or calibration is only possible operational staff directly using the control lock two mutually independent systems that turn off two professionals at the same time; 43.5. control equipment immediately notifies you of any deviations in the radiological device and interrupt if this deflection exceeds the safe operating parameters. 44. The Operator shall ensure that: 44.1. any radiological damage device components are detected as soon as possible, but the damage that can cause large dose of ionising radiation are detected immediately and, if technically possible, ensure that the source wouldn't be working condition; 44.2. human error probability of ionizing radiation sources should be kept to a minimum; 44.3. the radiological device are made for electrical safety and function testing and conformity assessment (technical parameters evaluation);

27.6. the dose limits be imposed in connection with the use of a radiological device so that the potential dose from one facility at maximum operational parameters do not exceed 1/3 of the dose limits per year (employees-6 mSv, the volunteer helpers – 1.5 mSv, but visitors-0.3 mSv). If the room at the same time use more equipment, the dose limits laid down by all the equipment together. 45. Radiological examination of electrical safety of the device and the function of compliance testing and evaluation with regard to the technical characteristics listed in this provision of the annex tables 1 and 2, carry out the inspection body which is accredited by the national accreditation body according to the laws and regulations on assessment of conformity assessment bodies, accreditation and supervision or other Member States of the European Union accreditation institution: 45.1. entering a radiological device; 45.2. after each use, maintenance and repair procedures that affect radiological technical parameters of the device; 45.3. use dental equipment not less frequently than every three years, to other radioloģiskaj devices-not less frequently than once a year.   46. in addition to the provisions laid down in paragraph 45, the operator shall ensure that the provisions of annex 3 table 3 technical specifications referred to in the assessment of the quality assurance program requirements and in regularity: 46.1. use radioloģiskaj in radiodiagnostisk manipulation devices, inspection body, radiation safety Department, medical physicist, medical physicist expert or business manager; 46.2. in radiotherapeutic manipulation in radioloģiskaj-to-use devices, inspection body or medical physicist expert. 47. This provision table 2 of annex 3 of title I, paragraph 8 of the dose area product meter calibration at least every two years carried out a laboratory accredited national accreditation body according to the laws and regulations on assessment of conformity assessment bodies, accreditation and supervision or other Member States of the European Union accreditation institution. 48. The inspection body shall have the following responsibilities: 29.9. not less than four times per year (up to the current year's 15 April, 15 July, 15 October and 15 January) writing to inform the Centre on radioloģiskaj devices, electrical safety checks carried out and the function of compliance testing and evaluation (the evaluation of technical parameters), indicating the following information: 48.1.1. operator's name and registration number; 48.1.2. radiological device name and its location (address); 48.1.3. radiological devices feature compliance testing and evaluation (technical parameters evaluation) report date and number; 48.2. upon compliance with the radiological device testing and evaluation report is issued to the operator in writing promptly to inform the Centre for radiological examination of the electrical safety of the device and the function of compliance testing and evaluation (technical parameters evaluation) identified discrepancies. 49. the Centre, monitoring radiation safety and nuclear safety: 30.5. assess the probability of use of radiological devices according to the planned objectives; 30.6. the quality control program that is included in the annex referred to in table 3 technical specifications conformity assessment frequency and, if necessary, require the operator to specify the periodicity of the evaluation; 30.6. If necessary, require the operator to improve the technical characteristics of the radiological devices or defective; 49. requests to stop the use of radiological devices to remedial action or termination of the device, if the operation does not meet the requirements of radiation safety, radiological devices technical characteristics do not meet the eligibility requirements (annex 3) or radiological device does not provide the required information or radiotherapeutic radiodiagnostisk. 50. the Centre for the decision to ban the use of radiological devices shall inform the State Agency of medicines, health inspectorate and the national health service.
5. protection against ionising radiation pregnant women, breastfeeding mothers and children in 51. If medical irradiation for reproductive-age women, the prescriber or the practitioner whether she is pregnant or the mother is breastfeeding, and amend the entry medical document and posting. Woman with a captions stating that her the information provided is true. 52. If the medical radiation requires a pregnant woman, especially if exposure is prone to abdominal and pelvic organs, the prescriber and the practitioner medical irradiation in addition to assess the justification of medical urgency and medical radiation exposure optimization, also taking into account the exposure of the fruit. 53. Any medical radiation exposure of pregnant woman planning her to get the minimum patient dose. The practitioner shall inform pregnant women about the potential risk to the fetus. 54. If the mother is breastfeeding, the prescriber and the practitioner of irradiation in kodolmedicīnisk in addition to evaluate the urgency and optimization of exposure, taking into account the child's expected exposure. The practitioner medical irradiation plan so the mother and child receive minimum patient dose. 55. If the manipulation of radiological mother is breastfeeding, the practitioner uses radionuclides, the mother stops nursing, and continues only after the quantity of the pharmaceutical preparation in breast milk are lower than the allowable total radioactivity. Allowable radioactive pharmaceutical common activity limits for breast milk are specified in annex 4 of these rules. 56. The medical authorities organise events that women of reproductive age, pregnant women and mothers who are breastfeeding are warned about the potential dangers of ionising radiation, including the preparation and appropriate places in the respective medical institutions placed material on these issues. 57. The practitioner shall ensure that, by making the child medical irradiation is used only for children appropriate radiological device and auxiliary equipment, including patient immobilization equipment, as well as compliance with this provision, paragraph 2, of annex 1 and annex 1, paragraph 7 and 8 set out in diagnostic standartlīmeņ.
6. Unplanned exposure

58. to reduce the risk of unscheduled exposures and prevent radiation accidents, the operator shall ensure that potential radiation accident analysis, identify possible radiological equipment damage and employee error, which may encourage unintended exposure of the person. 59. The practitioner shall immediately inform the operator about the non-compliance of these rules or radiation accidents and ensure the necessary protection measures medical during irradiation to reduce patient exposure risk of unplanned and size. 60. The Operator shall immediately investigate such radiation accidents and cases of unjustified exposure: 60.1. medical irradiation radioterapeitisko purposes that caused damage to the individual patient if: used inappropriate 60.1.1. pharmaceutical preparation; 60.1.2. personal medical radiation ionizing radiation dose or dose fractionation process differs from the prescribed doses; 60.1.3. patient medical radiation can cause unexpected acute effects outside the target volume; 60.1.4. total patient dose by 5% more than the prescribed dose a radiologist therapist; 60.2. radiodiagnostisk exposure of 30% different from diagnostic standartlīmeņ (greater than) (annex 1); 60.3. undue patient medical irradiation repetition; 60.4. radiological device damage or other unexpected event that radiodiagnostisk exposure of the patient by more than 20% different from the proposed irradiation; 60.5. medical irradiation, carried out by the person to whom the medical manipulation was not required.  61. where these regulations occurred 60 paragraph radiation accident or undue exposure of the operator, together with the practitioner and medical physics expert: 61.1. calculation or evaluate the patient received the dose and its distribution in the body of the patient, as well as inform the doctor and patient on the dose and the possible consequences of the accident; 61.2. determine and take remedial action to prevent the recurrence of such accidents; 38.1. within 24 hours, notify the Centre of any radiation accidents that may cause health problems for the patient or the patient's death; 61.4. within 30 days after the accident, the radiation which can cause health problems for the patient or the death of a patient, shall submit a written report to the Centre setting out the reasons for the incident, provide information about the patient's dose used, the measures taken and any other relevant information; 61.5. report to the State Agency of medicines of incidents associated with radiological medical equipment use in accordance with arrangements laid down in the regulations on the requirements of the medical devices vigilanc system.
7. Radiodiagnostisk use of legal manipulation of medical manipulation with consideration of 62. Radiation of the person or his or her guardian's written consent can be made to the following legal medical manipulation without medical indications: 62.1. to detect human body hidden items; 38.6. in accordance with the guide of the process or the decision of the Court to ascertain hidden injury or otherwise undetectable damage to health; 38.7. forensic medicine. 63. The irradiation target persons without written consent can make serious threats to public security. 64. Legal manipulation of medical practitioner or work driver before any exposure with the doctor shall inform the person of the sending of the manipulation and the possible adverse impact. 65. the legal Exposure of children in medical manipulation, in order to determine the consequences of physical violence, when there is no clinical indication, shall be permissible only in exceptional cases, if you cannot use the alternative method.
8. concluding issues 66. Be declared unenforceable in the Cabinet of Ministers of 5 March 2002 No. 97, the provisions of the "rules on protection against ionising radiation medical exposure" (Latvian journal, 2002, nr. 38.; 2005, 176. no).
67. the rules shall enter into force on the 1 October 2014. 68. in paragraph 29 of these rules defined for the laboratory accreditation shall enter into force on 1 September 2015. 69. This provision, paragraph 47 and the annex shall enter into force on 1 September 2015. Radiological devices, electrical safety and function testing and evaluation of conformity pursuant to this provision and paragraph 45.46 to 31 august 2015 shall be carried out according to the accreditation of inspection bodies, carried out up to the date of entry into force of the provisions.
Informative reference to European Union directives, the regulations include provisions resulting from: 1) of the Council of 30 June 1997 Directive 97/43/Euratom on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure, and repealing Directive 84/466/Euratom; 2) Council 13 May 1996 of Directive 96/29/Euratom laying down basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionizing radiation. The Prime Minister is the Rapidity of the Newsletters of the protection of the environment and regional development Minister novel Naudiņš annex 1: Cabinet of Ministers on 19 august 2014. Regulations No diagnostic 1 standartlīmeņ 482. standartlīmeņ x-ray diagnostic for no. p. k. The target object of the entrance surface of the projection doza1 single patient x-ray (mGy) 1. Mugurēj lumbar vertebrae (AP) projection of 10 side (LL) projection of 30 Lumbosakrāl transition with sloping cranial focused beam 40 2. Abdominal cavity in Mugurēj (AP) projection of 10 3. Mugurēj in the pelvis (AP) projection 10 4. Hip joint in Mugurēj (AP) projection of 10 5. The Front of the chest (PA) projection of 0.4 side (LL) 1.5 projection of 6.   The milk gland Kraniokaudāl (CC) projection (with grid) 10 Mediolaterāl (ML) in a sloping plane (with a grid) of 10 side (LL) projection (with grid) 10 7. Urinary system: 7.1. before the contrast medium input 10 7.2. by contrast medium input 10 8. Vertebrae in the thoracic Mugurēj (AP) projection of 7 side (LL) projection of 20 9. Teeth Intraorāl projection 7 Mugurēj (AP) projection 5 10. The head of the front (PA) projection 5 side (LL) projection of 3 Note. 1 ionizing radiation dose (mGy) in the air with scattered radiation at the entrance surface corresponds to the movie screen combination with relative sensitivity high sensitivity 200. movies screen combination (400-600) value to be reduced in two to three times.
2. standartlīmeņ x-ray diagnostic for pediatrijā1 in Nr. p. k. The target object of the entrance surface of the projection doza2 single patient x-ray (mGy) 1. The Front of the chest (PA) projection Mugurēj 0.10 (AP) projection of 0.10 side (LL) projection of 0.20 Mugurēj (AP) projection of neonate 0.08 2. The front head/mugurēj (PA/AP) projection of the side 1.50 (LL) projection of 1.00 3. Pelvis (AP) Mugurēj projection Mugurēj (HR) 0.90 projection infants 0.20 4. Abdominal cavity in Mugurēj/front (AP/PA) projection with vertical/horizontal beam 1.00 notes. 1 ionizing radiation dose (mGy) in the air for five years old child, otherwise made adjustments, taking into account the patient's age and weight. 2 ionizing radiation dose (mGy) in the air with scattered radiation at the entrance surface corresponds to the movie screen combination with relative sensitivity high sensitivity 200. movies screen combination (400-600) the value of the reduced two to three times.
3. Diagnostic CT of standartlīmeņ no p. k. One type of manipulation (much cut) mean ionizing radiation doza1 (mGy) 1. Head 50 2. 35 3 lumbar vertebrae. Abdominal cavity in note 25. 1 determine the measurements of the water equivalent material made a head Phantom, whose length along the axis of rotation is 15 cm, diameter: 16 cm, and of water equivalent material made abdominal phantom whose length is 15 cm, diameter: 30 cm. 4. Diagnostic mammography, standartlīmeņ no p. k. The mammary of average radiation dose in each kraniokaudāl projekcijā1 (mGy) 1. With grid 3 2. No grid 1 note. 1 dose specified using movies and screen system rentgenspuldz with a molybdenum anode and molybdenum filter, the breast, which crushed to 4.5 cm in thickness and is composed of 50% and 50% fat dziedzeraud.
5. Diagnostic standartlīmeņ in fluoroscopy no p. k. Transaction type power input virsmai1 Dose (mGy/min) 1. Fluoroscopy with a normal load of 25 2. Fluoroscopy with large beam 100 slodzi2 notes. 1 ionizing radiation dose (mGy) in the air with the ambient ionizing radiation at the entrance surface. 2 Diagnostic studies, which radiological equipment in addition to the facilities provided for the opportunity to perform with big star of fluoroscopy load, which is often used in interventional radiology.
6. in the nuclear medicine diagnostic standartlīmeņ

Nr. p. k. The organ or type of Radionuclide scintigraphy in the chemical form of Injectable dose maximum total radioactivity in one study (MBq) 1. Skeleton 99mTc phosphates and other phosphorus compounds 600 2. Skeleton (vienfoton emission tomography SPEC) 99mTc phosphates and other phosphorus compounds 800 3. Red bone marrow 99mTc colloidal 400 4. Cerebrum (static) 99mTc is sodium pertehnetāt 99mTc-triamin-500 Dietilēn-Penta acetate (dtpa), and glukoheptonāt of gluconate 500 5. Brains (vienfoton emission tomography SPEC) 99mTc is sodium pertehnetāt 99mTc-triamin-800 Dietilēn-Penta acetate (dtpa), glukoheptonāt of 99mTc gluconate, 800 Eksametazīm for 500 6. Cerebral radionuclide angiography 133X of sodium chloride isotonic solution of the oksīm 400 Heksametilpropilēn 99mTc Amine (HMPA) 500 7. Cisternogrāfij-111In-Dietilēn-triamin-Penta acetate (dtpa) 40 8. Tear glands and their drainage 99mTc sodium pertehnetāt 4 4 9 99mTc marked colloid. Thyroid sodium pertehnetāt of 99mTc 200 123 in iodine 20 10. Thyroid metastasis of iodine 131 400 11. 201Tl chloride Epitēlijķermenīš of Thallium 80 12. Lung perfusion of aqueous solution of 6000 99mTc 81mKr human serum albumin (makroagregāt or mikrosfēr) 100 133X of sodium chloride isotonic solution of sodium chloride in 200 127X isotonic solution 200 13. Lungs (vienfoton emission tomography SPEC) 99mTc-makroagregāt of human serum albumin (MAA) 200 14. Lung ventilation 81mKr gas Dietilēn 99mTc-triamin-6000-Penta acetate (dtpa)-aerosol 80 400 127X 133X gas gas 200 15. Liver 99mTc colloid 80 16. Liver (vienfoton emission tomography SPEC) 99mTc colloid 200 17. Liver and žultsceļ in Iminodiacetāt 99mTc derivatives (ID) 150 18. Lean 99mTc denatured red 100 19. The first passage of blood through the heart of 99mTc sodium pertehnetāt 99mTc-triamin-800 Dietilēn-Penta acetate (dtpa), glukoheptonāt of 99mTc gluconate, 800-makroagregāt globulin (MAG3) 400 20. Heart cavity and blood vessels of human serum albumin 99mTc 800 99mTc highlighted red 800 21. Myocardium of 99mTc phosphonates and phosphate compounds Izonitril 300 22 of 99mTc. Myocardium (vienfoton emission tomography SPEC) 201Tl chloride and phosphate 99mTc phosphonates 100 compounds in Izonitril 99mTc 800 600 23. Salivary gland and stomach pertehnetāt of 99mTc sodium 40 24. The divertikul of 99mTc Mekel sodium pertehnetāt in 400 25. Stomach and intestinal bleeding 99mTc colloid 400 99mTc red 400 26. The stomach empties Not absorbable 99mTc compounds Not absorbable compounds 111In 12 12 12 27 Not absorbable 113mIn compounds. Esophageal and atviln the arcade Not absorbable 99mTc compound colloid 99mTc 40 28 40. Renal scintigraphy of the static Dimerkapt 99mTc-sukcīnskāb (DMS) 160 29. Radionuclide angiography of renal dynamic scintigraphy and 99mTc-Dietilēn-triamin-Penta acetate (dtpa), and glukoheptonāt of 350 99mTc gluconate globulin-3 makroagregāt (MAG3) 100 O-jodhipurān 20 30 of 123. The 75S-Selena-adrenal holesterol to 8 31. A tumor or abscess 67 g citrate 300 201Tl chloride 99mTc-sukcīnskāb 100 Dimerkapt (DMS) 400 32. Abscesses With 99mTc-marked eksametazīm white 111In white marked 400 20 33. 99mTc-sukcīnskāb tumor Dimerkapt (DMS) 400 34. The tumors are not iroektodermāl 123 meta-iodine-benzyl-Guanidine (MIBG) 400 meta-iodine 131i-benzyl-Guanidine (MIBG) 20 35. Lymph nodes 99mTc marked colloid 80 36. The 111In is highlighted in the clotting platelets in diagnostic nuclear medicine 20 7. paediatric standartlīmeņ in No. p. k. Radionuclide dose that can be entered into the minimum total baby radioaktivitāte1 (MBq) 1. 67 g-citrate (tumors) 10 2. 123: amphetamine (brain) 18 3. 123: hipurān (kidney) 10 4. 123: iodine (thyroid) 3 5. 123: meta-iodine-benzyl-Guanidine (MIBG) (tumor) 35 6. 131: meta-iodine-benzyl-Guanidine (MIBG) (tumor) 35 7. 99m Tc-albumin (heart) 80 8. 99m Tc-colloid (liver, spleen and bone marrow red) 15 9. 99mTc-colloid (gastric atviln) 10 10. 99mTc-dietilēn-triamin-Penta-acetate (dtpa) (kidney) 20 11. 99mTc-dimerkapt-sukcīnskāb (DMS) (kidney) 15 12. 99mTc-phosphorus (skeleton) 40 13. 99mTc-red cells are denatured (lean) 20 14. 99mTc-ID of the derivatives (bile izvadceļ) 20 15. 99mTc-heksametilpropilēn-Amine (HMPA) of oksīm (brains) 100 16. 99mTc-heksametilpropilēn-Amine (HMPA) of oksīm (inflammation) 40 17. 99mTc-makroagregāt of human serum albumin (MAA) or mikrosfēr (lungs) 10 18. 99mTc-globulin-3 makroagregāt (MAG3) (kidney) 15 19. 99mTc-pertehnetāt (mikcij-cistouretrogrāfij) 20 20. 99mTc-pertehnetāt (the first arcade) 80 21. 99mTc-pertehnetāt (the divertikul and the ektopisk Mekel gastric mucosa) 20 22. 99mTc-pertehnetāt (thyroid) 10 23. 99mTc-labelled in red cells (blood bed visualizing) 80 note. 1 1/10 of the total radioactivity, for adult.
8. Patients injectable dose conversion factor of the total radioactivity in children No. p. k. Child's weight (kg) conversion factor 1. 3 0.10 2. 4 3 0.14. 6 0.19 4. 8 0.23 5. 10 0.27 6. 12 0.32 7. 14 0.36 8. 16 0.40 9. 18 0.44 10. 20 0.46 11. 22 0.50 12. 24 0.53 13. 26 0.56 14. 28 0.58 15. 30 0.62 16. 32 0.65 17. 34 0.68 18. 0.71 36 19. 0.73 38 20. 40 0.76 21. 42 22 0.78. 0.80 44 23. 0.82 46 24. 25 48 0.85. 50 0.88 26. 52-54 27 0.90. 56-58 28 0.95. 60-62 1.00 environmental protection and regional development Minister novel Naudiņš annex 2 Cabinet of 19 august 2014 regulations No 482 medical physicists and medical physics expert minimum working load with radiological device to No. p. k. Medical radiological device physicist minimum of medical physics expert slodze1 minimum slodze1 1. Accelerator 0.88 0.37 2. Radiological device (with the sealed sources) 0.34 0.14 3. Medical Rentgeniekārt 0.07 0.03 4. Radiological device that is used for the medical exposure of body cavities 0.42 0.18 5. Simulator 0.30 0.13 6. Radiation planning system: 6.1. external radiation therapy 0.38 0.16 6.2. brahiterapij 0.08 0.04 for 7. 100 patient gadiem2:7.1. external radiation therapy 0.27 0.11 7.2. brahiterapij 0.22 0.09 for 8. Activities with radioactive substances (each TBq) 0.40 0.20 9. Portable or mobile radiological device 0.30 0.15 10. Radiotherapy device which ionizing radiation source operating condition outside the unit 0.50 0.30 notes. 1 a full work load is assumed about 1.2 100 patient years, refers to the patients in question is the first medical radiological manipulation or repeated manipulation, or a new type of manipulation (including medical radiological manipulation if the irradiation target is changed). Environmental protection and regional development Minister novel Naudiņš annex 3 of the Cabinet of Ministers on 19 august 2014. Regulations No 482 radiological equipment technical parameters and measuring conditions table 1 radiological devices electrical safety checks in the parameters evaluated, their minimum eligibility criteria and measurement nosacījumi1 no p. k. Parameter to evaluate compliance with the criterion of measurement conditions 1. Aizsargvadītāj resistance < measurements are performed on Ω 0.3 radiological devices mode according to the manufacturer's specified connection diagram 2. Enclosure leakage currents < measurements are performed on 0.1 mA radiological devices mode according to the manufacturer's specified attachment scheme

Note the. 1 electrical safety inspections of conditions apply to radioloģiskaj devices referred to in annex 3 to these regulations table 2.
table 2 radiological equipment technical parameters, their minimum eligibility criteria and measurement conditions for testing and evaluation of the function no p. k. Technical specifications conformity measurement conditions i. Criteria1, Parameter 1 iekārtai2 medical radiography. X-ray tube voltage accuracy of: 1.1. the measured voltage on the scale of compliance specifications and high voltage deviation measurements repeated ≤ ± 10%: 1) with the following voltage values: 60, 80, 100 and 120 kV. If it is not possible to set these values, use the nearest possible size. At ~ 80 sq measurements must be carried out also at the minimum power value and 80% of maximum current values; 2) anodstrāv ~ 50% of the maximum value of anodstrāv. Generators that have the option to install only the mass values, set the power and the time the product of great focus, but the little mass 32 ~ focus ~ 20 masses; 3) exposure time: 100 ms; 4 all the focus of x-ray tube) of 1.2. high repeatability, changing the current strength of the x-ray tube