Requiring as much as 1.5 million pounds of concrete, a radiation shielding project is not a construction job that should be taken lightly.

These expensive and time-consuming endeavors call for a team effort and the leadership of a specialist. HealthCare Business News went around the industry to get tips and insights from some of the experts in the field.

“The first thing I always advise is to get the physicist involved as early as possible in the planning process,” said Adam Evearitt, co-owner of Atom Physics, a company that specializes in X-ray equipment and radiation safety consulting. “I often can help in the design of a room or project to minimize the shielding or the cost that’s going to be involved with the shielding just by the way the machines are oriented in the room.”

He says that too often he receives calls from facilities seeking help at the last minute when a project is almost complete. Usually this happens when the vendor is about to install the machines and, when asked for the shielding design specifications, the administrators aren’t prepared.

Robert J. Farrell, CEO of Veritas Medical Solutions, stresses that there is a big difference between general construction and a specialty company that focuses on radiation protection.

“I met with a contractor today,” he said. “The group is very well qualified as a general contractor, but they have not designed or constructed a project requiring radiation shielding in over seven years.”

Making sure you have the right team members involved in a shielding job is the best way to ensure costly problems don’t arise along the way or in the aftermath of installation. Trying to go it alone, or cutting corners as a way to keep costs down, is one of the surest ways to wind up paying more in the long run.

Things to consider
Regardless of the specific project, the most common advice Frank Heinz, owner of H&H Design-Build, provides to his clients is to focus on safety.

“It’s important for them to understand the impact of the project on their facility,” he said. “Radiation shielding is a function of patient, staff and public health and safety. Depending on the type of project — diagnostic, cancer treatment, cyclotron or hybrid operating room — the requirements can be all over the board.”

Farrell recalled a facility Veritas worked with in the past that gave no consideration in the design phase to the occupied space below the proposed treatment room. The design team was well-versed in construction but since they didn’t understand shielding, they didn’t plan how they were going to shield the public in the area below the room.

“They also did not consider the massive weights as well as the logistics involved in a shielding project,” said Farrell. “This lack of familiarity led to a failure to take precautions for adequate support of the treatment level floors, where material deliveries and future service requirements would be required.”

The purpose of radiation shielding is twofold, and what’s going to happen in the room itself is no less important than what’s going to be happening in the neighboring rooms.

“It really matters if the other side of the wall is a parking lot, where you don’t need to shield as much, rather than if you are next to a daycare center or an administrative office,” said Evearitt.

For an interventional suite or a CT room, the workload is key to determining how much shielding is required. Therefore, it’s advisable to also plan for a potential increase in workload.

“If you are building a new X-ray room and you are not a very busy center, you shield based on 25 exams per week. But five years from then, business could quadruple and you’re doing hundreds of exams per week,” said Evearitt. “With that increased workload, you may then need to go back and add shielding in, and that is always extremely expensive.”

Paying for extra shielding during the initial construction job is a way to save money down the line, while also banking on the success of your new facility and a heightened demand for services.

As with anything, it may be tempting to go for the cheapest option, but Farrell warns that the least expensive solution is rarely going to save money in the long run.

“A project we were asked to provide pricing for decided to save money by choosing a different method than we offered. It was the least expensive option that was presented them,” said Farrell. “They called us nearly 11 months later, having just completed their project because they had problems. The shielding they constructed did not work.”

The facility had to spend over $150,000 on shielding remediation in order to be safe and compliant, and the project took an additional eight months, according to Farrell.

According to Kevin Milne, president and CEO of MarShield, the best thing a radiation shielding client can do is bring as much logistical information as possible to the chosen shielding company. This preparation, even before the project begins, will help ensure a smoother job.

That means figuring out how much protection they need, what lead shielding equivalency they require, the dimensions and application of the room, the availability of off-loading, handling of the weight and demographics of the install.

Lead or no lead?
Even though people equate lead to shielding, shielding today does not necessarily have to be made of lead. This is a good thing, considering the Department of Health and Human Services, Environmental Protection Agency and the International Agency for Research on Cancer have determined that lead is “probably cancer-causing” in humans.

“Lead is a hazardous material so the cost of shipping it, installing it and ripping it out can get pretty expensive,” said Evearitt.

Several companies now offer non-lead-based materials for shielding. For Atom Physics projects, Evearitt uses Artemis Shielding’s patented, nontoxic lead placement, which is a tungsten-based material that is embedded into a rubbery substance.

“It’s more flexible and can be applied straight onto things,” he said. “With my company, we use that in particular when we don’t want to rip out a wall and have those construction costs. We get this Artemis Shielding material and slap it on the back of some paneling and then we can place that onto the wall.”

He added that it may cost a little more upfront to purchase this material, but in the long-run it will save money.

MarShield offers a non-lead alternative called T-Flex, which is made of a bismuth tungsten base. Milne said it’s ideal for applications that require custom moldable shapes such as small-bore pipes, elbows and valves, but it’s also available as blankets, ribbon wrap, pipe shields, floor tiles and magnetic tiles.

Still, not everyone agrees that it’s time to abandon lead for radiation shielding. Companies like Calder Industrial Metals, for example, assert that it offers advantages that continue to make it the best option.

“Lead is very quick and easy to install and the room is ready to use straight away,” said Andy Carr, head of external sales at Calder. “You don’t have to wait for the lead to harden or set.”

In the case of a room being relocated, Carr said lead offers unique advantages in that it can be quickly disassembled. It is also recyclable and can be melted and reused.

Radiation therapy rooms
In early 2010, Mount Vernon Cancer Centre in the U.K. began a project to install its first Accuray CyberKnife. For Calder, it was a particularly demanding radiation shielding project.

The architects determined that in order to construct a safe room, while minimizing the impact on the existing hospital structure, lead radiation shielding was the most effective material to use. Calder’s Chevron Rail System was installed and depending on the location within the room, the thickness of the lead varied between 30 millimeters to 300 millimeters.

In total, 102 tons of lead was installed. The overall budget was £3.8 million and the project was completed in eight months.

Designing a vault for a radiation therapy system was also one of the biggest projects Evearitt has worked on. The design process took Atom Physics about a month, but the entire install project took approximately a year.

He explained that the difference with radiation therapy machines is that once you get above 10 megavolts, you are producing neutrons.

“Not only do you have to protect from the X-rays that are a thousand times higher than a typical X-ray machine, but they create neutrons, which are much harder to stop,” he said. “So you have to have several feet of concrete in place in each of the walls and ceiling.”

MarShield’s biggest project was supplying over 245,000 pounds of high-density concrete shielding blocks to Princess Margret Hospital in Toronto for its cancer treatment therapy room expansion project.

These high-density concrete blocks are dry-stacked and require half the space of concrete vaults. According to the company, the blocks interlock to form a tight, leak-free therapy room of any size or shape.

This option is also suitable for proton therapy facilities because they can cut months off of the average construction schedule.

“The high density block systems have replaced concrete as we all know it,” said Milne. “For assessable locations and large projects for high-dose therapy rooms, this is the way to go.”