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Entering the Hot Lab

The preparation of radiopharmaceuticals in a hospital radiopharmacy requires special attention and special precautions. As a result, a radiopharmacy is a restricted area to which public and patients do not have access. The authorized personnel must have received special training in the handling of unsealed radioactive sources and in the preparation of sterile and pyrogen-free pharmaceuticals for two reasons:

Patient Safety:

Most radiopharmaceuticals (such as 99mTc-medronate (=99mTc MDP, 99mTc methylene diphosphonate) are solutions intended for intravenous injection and therefore must be sterile in order to ensure the safety of patients. The radiopharmacist/technician who prepares the radiopharmaceutical therefore must:

  • use only sterile equipment and sterile licensed starting materials

       

      

    Sterile equipment and materials (absorbing paper, labelling vial, elution vial, disposabel needles, disposable syringes, sterile saline solution

  • adhere to strict aseptic working techniques; this includes:
    • performing the preparation in a laminar air flow (LAF) cabinet

       

      Laminar air flow (LAF) cabinet

    • wearing a special dust-free lab-coat
    • wearing a mouth mask and a hat during the work at the LAF cabinet, although this is not always used if a LAF cabinet with vertical air flow is used (see Radiopharmacy Design for further information about LAF cabinets). Here you can read about Selection of Accessory Materials.

       

      Dust-free lab-coat, mouth mask and hat

Personnel Safety:

Radiopharmaceuticals contain radioactive material and the manipulation of radioactivity is subject to several rules, in order to ensure the safety of the personnel working with the radioactive materials:

  • the manipulator should wear a personal dosimeter (usually a film badge or thermoluminescent dosimeter) in order to monitor the radiation dose the manipulator receives to his whole body during his work with radioactive materials.

      

    Examples of thermoluminescent whole body dosimeter (left image), directly readable electronic dosimeter (G-M type, right image) and both dosimeters attached to lab coat (middle image)


  • it is advisable that the manipulator also wears a ring dosimeter on one or both hands if he has to manipulate high levels of activity (such as for the preparation of radiopharmaceuticals). This allows the manipulator to monitor the radiation dose to his fingers, which are most likely to receive the highest radiation dose during manipulation of radioactive materials.


    Examples of a thermoluminescent ring dosimeter


  • the manipulator should wear disposable gloves during the manipulation of radioactive materials to protect himself from radioactive contamination. The gloves should be checked frequently for a potential radioactive contamination using a radioactivity monitor such as a Geiger-Muller counter. For more information on the Geiger-Muller counter and its operation, please see the Radiation Monitoring and Decontamination section in this module. The manipulator´s gloves must always be checked after completion of the work. See Exiting the Hot Lab for information on how to do this.

    Example of disposable gloves


  • the manipulator should put on special shoes or overshoes before he/she enters the hot lab. In this way he will protect his own shoes from a potential contamination with radioactivity and also avoid spread of potential radioactive contamination outside the hot lab, as these overshoes should be left in the changing room when exiting the hot lab.

    Example of overshoes


  • eating, drinking or smoking in a hot lab is not allowed as this would involve a real risk of ingestion or inhalation of radioactive material.
    Watch a video of someone entering the hot lab, below
Thus, before entering the hot lab, the radiopharmacist/technician will enter a changing room in order to:
  • leave behind all unnecessary or prohibited materials before entering the hot lab (for example, bag, coat, food, drinks, cigarettes)
  • put on a special (dedicated) lab coat, mouth mask and hat
  • put on special shoes or overshoes
  • put on a personal dosimeter and if possible also one or two ring dosimeters.
  • put on gloves (this can also be done in the hot lab)

Dedicated clothing and changing room for entering the hot lab

Practise entering a hot lab with the interactive animation.