The U.S. Environmental Protection Agency (EPA) on Monday issued new guidance on radiation protection during diagnostic and interventional x-ray procedures.
The guidance offers recommendations for federal facilities that use diagnostic and interventional x-ray equipment to keep patient doses as low as reasonably achievable without compromising the quality of patient care. Referred to as Federal Guidance Report No. 14: Radiation Protection Guidance for Diagnostic and Interventional X-Ray Procedures (EPA 402-R-10003, November 2014), the new guidelines update the 1976 x-ray guidance in Federal Guidance Report No. 9.
The draft guidelines were developed by medical and radiation protection professionals from the EPA, the U.S. Department of Health and Human Services, the Department of Veterans Affairs, the Department of Defense (Departments of the Army, Navy, and Air Force), the Occupational Safety and Health Administration, and the Commonwealth of Pennsylvania. They were initially published in the Federal Register in April 2013.
The new recommendations are not binding; rather, they are a guide to be used at an agency's discretion and to be incorporated into standard operating procedures as needed, the agency wrote. The EPA said it hopes that states and private-sector healthcare providers will find them useful for improving the safety of diagnostic and interventional imaging.
The guidelines provide recommendations for all radiation-bearing imaging modalities, including radiography, CT, nuclear medicine, and dental imaging. The document can be accessed in its entirety here.
![Axial images from unenhanced calcium score cardiac CT (left) and curved planar reformation images from CT angiography (right) show that higher long-term exposure to air pollution is associated with greater coronary artery calcium and more obstructive coronary artery disease (CAD). Top row: Images in a 68-year-old male patient with higher 10-year mean ambient air pollution exposure (7.9 μg/m3 for particulate matter measuring ≤2.5 μm in diameter [PM2.5] and 17.4 parts per billion [ppb] for NO2) with extensive CAD (coronary artery calcium score [CACS] >1,000 and obstructive CAD [≥70% diameter stenosis]). Bottom row: Images in a 57-year-old female patient with lower 10-year mean ambient air pollution exposure (6.3 μg/m3 for PM2.5 and 4.6 ppb for NO2) with no CAD (CACS = 0 and no obstructive stenosis).](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/06/hanneman.r6SMLzkezo.png?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
