Organizations overseeing and governing the population’s radiation exposure include the National Council for Radiation Protection (NCRP) and the International Atomic Energy Association (IAEA). These bodies assert that there is no acceptably safe radiation dose threshold and recommend adhering to the “as low as reasonable achievable” (ALARA) principle. This implies that any dose of radiation may result in an undesirable effect though this effect may be too slight to measure. Therefore, in order to reduce the risk to patients and practitioners, radiation doses should be kept as low as reasonably achievable. Radiation monitoring devices (radiation dosimeter) are worn by individuals who may receive doses of ionizing radiation that exceed 10 % of the annual applicable allowable limit, and this includes clinicians who perform VFSS . The total effective dose equivalent (TEDA) is 0.05 Sv and represents the annual whole-body occupational external radiation limit. Women who are pregnant must declare so and may wear a fetal dosimetry badge. A pregnant woman’s annual allowable ionizing radiation limit is 1 mSv. A radiation safety checklist is presented in Table 1.2.

Factors directly influencing the amount of radiation delivered to a patient include X-ray tube characteristics of peak voltage (kVp), milliamperage (mA), collimation, and filtration. Additionally, exposure time, image field size, and distance of source to patient and to detector are directly related to the total radiation dose.