A Review of Healthcare Failure Mode and Effects Analysis (HFMEA) in Radiotherapy

This paper presents a review of risk analyses in radiotherapy (RT) processes carried out by using Healthcare Failure Mode Effect Analysis (HFMEA) methodology, a qualitative method that proactively identifies risks to patients and corrects medical errors before they occur. This literature review was performed to provide an overview of how to approach the development of HFMEA applications in modern RT procedures, comparing recently published research conducted to support proactive programs to identify risks. On the basis of the reviewed literature, the paper suggests HFMEA shortcomings that need to be addressed.

Risk assessment of component failure modes and human errors using a new FMECA approach: application in the safety analysis of HDR brachytherapy

Failure mode, effects and criticality analysis (FMECA) is a safety technique extensively used in many different industrial fields to identify and prevent potential failures. In the application of traditional FMECA, the risk priority number (RPN) is determined to rank the failure modes; however, the method has been criticised for having several weaknesses. Moreover, it is unable to adequately deal with human errors or negligence. In this paper, a new versatile fuzzy rule-based assessment model is proposed to evaluate the RPN index to rank both component failure and human error. The proposed methodology is applied to potential radiological over-exposure of patients during high-dose-rate brachytherapy treatments. The critical analysis of the results can provide recommendations and suggestions regarding safety provisions for the equipment and procedures required to reduce the occurrence of accidental events.

EPR/alanine pellets with low Gd content for neutron dosimetry

This paper reports on results obtained by electron paramagnetic resonance (EPR) measurements and Monte Carlo (MC) simulation on a blend of alanine added with low content of gadolinium oxide (5 % by weight) to improve the sensitivity to thermal neutron without excessively affecting tissue equivalence. The sensitivity is enhanced by this doping procedure of more an order of magnitude. The results are compared with those obtained with the addition of boric acid (50 % by weight) where boron is in its natural isotopic composition in order to produce low-cost EPR dosemeters. The gadolinium addition influences neutron sensitivity more than the boron addition. The presence of additives does not substantially change the fading of the EPR signal induced by neutrons. The MC simulations agree the experimental results in case of gadolinium addition.

Neutron ESR dosimetry through ammonium tartrate with low Gd content

This paper continues analyses on organic compounds for application in neutron dosimetry performed through electron spin resonance (ESR). Here, the authors present the results obtained by ESR measurements of a blend of ammonium tartrate dosemeters and gadolinium oxide (5 % by weight). The choice of low amount of Gd is due to the need of improving neutron sensitivity while not significantly influencing tissue equivalence. A study of the effect of gadolinium presence on tissue equivalence was carried out. The experiments show that the neutron sensitivity is enhanced by more than an order of magnitude even with this small additive content. Monte Carlo simulations on the increment of energy release due to gadolinium presence were carried, and the results were in good agreement with the experimental data.

A radiometric and petrographic approach to risk assessment at Alte Madonie Mounts region (Sicily, Italy)

The main goal of this work was to assess the radiological hazard at Alte Madonie Mounts region (north-central Sicily, Italy) in response to rumours of an increase in the incidence of cancer in this area. A correlation between the natural radionuclide contents and the petrographic features of the soil and rock samples was also evaluated. A total of 41 samples of selected soils and rocks were collected, powdered, dried and sealed in 'Marinelli' beakers for 20 d prior to measurement to ensure that a radioactive equilibrium between (226)Ra and (214)Bi had been reached. A gamma-ray spectrometer was used to quantify the radioactivity concentrations. To determine (238)U and (232)Th activities, the 609.3-keV line from (214)Bi in secular equilibrium with (226)Ra and the 911-keV line from (228)Ac, with which (232)Th can be assumed to be in equilibrium, were used, respectively. The gamma transition of 1461 keV was used to determine (40)K activity. The average values of the concentrations of (214)Bi, (228)Ac and (40)K were 30, 17 and 227 Bq kg(-1), respectively, whereas the greatest values were 134, 59 and 748 Bq kg(-1), respectively. A linear relationship was found between the activity values of (214)Bi, (228)Ac and (40)K. An exception was found for a group of samples in which the (214)Bi activities were much higher than expected. The chemical compositions and mineralogical features of the samples permitted the justification of these anomalies. The results of the primordial radionuclide contents are reassuring from a radiation protection point of view because the activities of the uranium and thorium series products and of the (40)K do not present a significant radiological hazard.

A radiometric and petrographic interpretation of discrepancies on uranium content in samples collected at Alte Madonie Mounts region (Sicily, Italy)

The main goal of this work is to evaluate a correlation between anomalous Uranium (U) content and petrographic features of some soil and rock samples collected at Alte Madonie Mounts region (North-central Sicily, Italy). A total of 41 samples of selected soils and rocks were collected, powdered, dried and sealed in "Marinelli" beakers for 20 days before the measurement to ensure that radioactive equilibrium between (226)Ra and (214)Bi was reached. Gamma-ray spectrometric analysis was used to quantify radioactivity concentrations. Mineralogical and chemical features of the samples were determined by X-ray Fluorescence (XRF), X-ray Diffractometry (XRD), Attenuated Total Reflection-Fourier Transform Infrared (ATR-FTIR) and Scanning Electron Microscope - Energy Dispersive Spectrometry (SEM-EDS) analyses. The average values of concentrations of (226)Ra, (228)Ac and (40)K were respectively 30, 17 and 227 Bq kg(-1) while the greatest values were 134, 59 and 748 Bq kg(-1). Linear relationships were observed between (226)Ra, (228)Ac and (40)K concentrations: the activities of (226)Ra and (228)Ac were comparable, while those of (40)K were about 10 times greater. An exception was highlighted for a group of samples where (226)Ra activities were much higher than expectations. Chemical compositions and mineralogical features of the samples have made it possible to justify these anomalies.

Radionuclide concentrations in air particulate at Palermo (Italy) following Fukushima accident

Following the Fukushima accident, a series of samplings were carried out with a daily frequency to detect the arrival of radioactive contamination in air at Palermo (Italy) and to follow its evolution during the time. Air particulate collection was performed by suction of atmospheric air through cellulose filter paper by means of a high-volume air sampler (∼15 000 m(3) d(-1)). Spectrometric analysis of the filters highlights the presence of (131)I, (134)Cs, (137)Cs and, only for a few samples, traces of (132)Te-(132)I and (136)Cs. Maximum airborne concentrations were 883 μBq m(-3) for (131)I (only particulate), 81 μBq m(-3) for (137)Cs and 70 μBq m(-3) for (134)Cs. From a dose to population point of view, no significant values were obtained. The concentration values are from 1000 to 100 000 times lower than the ones measured after the Chernobyl accident, while, for only (137)Cs, are comparable with the ones highlighted after the Algeciras accident (Spain, 1998).

A chamber to test the response of radon detectors to changing environmental conditions

Radon risk assessment is carried out by means of accurate measurements with active or passive instrumentation. All radon detectors must be calibrated and tested using a radon chamber containing a known concentration of radon produced by specific sources of (226)Ra. Some chambers can also be used to test the response of detectors as a function of environmental conditions. In this case, a calibration curve can be inferred with respect to change in one of the considered parameters. For this aim, a new radon chamber was designed and realised to perform calibration and to study the detector response in a large range of variation of the environmental parameters (pressure, 700-1100 mbar; temperature, 5-50°C; humidity, 10-90 %). The first experiments conducted to study the influence of environmental parameters on the detector response have shown flexibility and ease of use of the chamber.

Risk analysis using fuzzy set theory of the accidental exposure of medical staff during brachytherapy procedures

Using fuzzy set theory, this paper presents results from risk analyses that explore potential exposure of medical operators working in a high dose rate brachytherapy irradiation plant. In these analyses, the HEART methodology, a first generation method for human reliability analysis, has been employed to evaluate the probability of human error. This technique has been modified on the basis of fuzzy set concepts to take into account, more directly, the uncertainties of the so-called error-promoting factors on which the method is based. Moreover, with regard to some identified accident scenarios, fuzzy potential dose was also evaluated to estimate the relevant risk. The results also provide some recommendations for procedures and safety equipment to reduce the occurrence of radiological exposure accidents.

Virtual point detector: application to coincidence-summing correction in gamma-ray spectrometry

The use of an efficiency transfer method based on the virtual point detector approximation to evaluate coincidence-summing correction values for point and volume sources was examined. The method was validated by means of a comparison with experimental efficiency determinations.

Concentration measurements of 7Be at ground level air at Palermo, Italy-comparison with solar activity over a period of 21 years

Air activity concentrations of (7)Be in Palermo determined for the period January 1995-December 2002 by gamma-ray spectrometric analysis of particulate samples collected on paper filter by a high-volume sampler (approximately 900 m(3) h(-1)) are reported. The temporal behaviour of (7)Be concentration presents the same characteristics already observed in the measurements carried out over the previous 13-year (1982-1994) investigated period. The mean value of 5.06 mBq m(-3) obtained from the analysis of the 4636 particulate samples collected from 1982 to 2002 can be considered a representative value of (7)Be air concentration at ground level in our geographical zone. The comparison of long-term variation in the (7)Be concentrations with the cyclic solar activity-extended to the whole period of 21 years-confirms the inverse correlation between the two quantities.

A low-level spectrometer with a planar low-energy HPGe: shielding arrangement tests and system performance for 210Pb determination in air filter samples

A system for low-energy photon spectrometry using a planar germanium detector with appropriate specifications is presented. A spectrometric background investigation has been carried out with various detector shielding arrangements. The characteristics of the system for measurements of 210Pb in air-particulate matter on filters have been determined.

Determination of 210Pb concentration in the air at ground-level by gamma-ray spectrometry

210Pb activity concentrations in the air of Palermo were determined by gamma-ray spectrometric analysis of 323 particulate samples collected in the period September 1995-December 1996. For each sample, the air filtered through a cellulose filter paper was 8600 m3 on average. The values of the daily activity concentration of 210Pb were ranging from 136 to 3390 microBq/m3.