Region 03 · Licensingbodycomposition.com.au
Who may run a DXA scan
Licences to operate ionising radiation equipment are a state issue, and the requirements vary across states and territories, says a clinical committee report published by the federal Department of Health. In Victoria, a person needs a use licence to operate a radiation source, and may not use one before the licence certificate has arrived.
- Licensing
- Each state and territory
- Victoria
- A use licence, under the Radiation Act 2005
- Body composition
- Victoria’s management licence condition M1758
General information Not medical advice. Call Triple Zero (000) in an emergency, or go to the emergency department of your nearest hospital. For health information, see healthdirect; for radiation safety, see ARPANSA: Code for Radiation Protection in Medical Exposure (RPS C-5).
National licensing
A licence from each state or territory
Generally, the Department of Health’s report says, state and territory law requires a licensee to know the principles and practices of radiation protection that apply to the use the licence is for. It notes that specific licences exist for bone mineral or body composition analysis using DXA machines, each with its own prerequisites and DXA course requirements. It also notes that there is no nationally agreed definition of an “appropriately trained” technician.
A working group in the same report, dated August 2016, recommended that, as has usually been the practice, a radiation licence from the relevant state or territory be required to perform a DXA scan, under the supervision of an appropriate specialist or consultant physician. That is a review’s recommendation. The rules themselves are the state’s or territory’s licence and, for Medicare, the item rules below.
Medicare
Medicare’s rule for its bone density items
For the Medicare bone densitometry items, MBS Online’s fact sheet of October 2017 said that, from 1 November 2017, the DXA items would require the scan to be performed by one of two people:
(a) A physician
A specialist or consultant physician.
(b) A licence holder
A person who holds a radiation licence, as state or territory law requires, with the scan performed under the supervision of an appropriate specialist or consultant physician.
For all DXA and QCT items, the fact sheet adds, a specialist or consultant physician must provide the interpretation and the report. QCT, quantitative computed tomography, is another way of measuring bone density; the fact sheet says the Taskforce behind the changes recommended removing two QCT items because QCT gives lower value care than DXA, which it calls the superior test for bone densitometry. It says the changes align the items with clinical best practice and are meant to make sure the services are performed by suitably qualified practitioners. These are the rules for Medicare’s bone density items; Before a DXA scan sets out who is eligible for them.
Victoria
Victoria’s use licence
Victoria’s Department of Health publishes its requirements for bone mineral densitometer operators. As it sets them out:
| Point | Victoria’s requirement |
|---|---|
| Requirement | A use licence is required to operate radiation sources in Victoria. |
| Scope | An individual may use specific types of radiation source for a specific purpose. A use licence can authorise people in the medical profession to use a bone mineral densitometer. |
| Licence certificate | No one may use a radiation source until their licence certificate has arrived. |
| Offence | Not holding the use licence you need is an offence under Victoria’s Radiation Act 2005. |
| Prerequisites | Applicants must meet prerequisites before a licence is issued. One the department lists is having satisfactorily completed a recognised course in the safe use of bone mineral densitometers. |
| Exemptions | Some people are exempt from holding a use licence; the department asks applicants to read the full exemptions first. |
| Condition | Use licences issued to bone mineral densitometry operators carry a condition: complying with the code of practice on radiation protection in the medical applications of ionizing radiation that the department’s page names. ARPANSA calls that code RPS 14, and has since superseded it with its Code for Radiation Protection in Medical Exposure (RPS C-5, 2019), together with RPS C-1. |
| Applying | Supporting documents are required with an application for a use licence, and applicants upload the prerequisites and pay the prescribed fee. There is no fee to vary a use licence. |
| Enquiries | The department recommends that anyone unsure whether they need a licence email it a description of the proposed activity before applying. |
| Mutual recognition | Someone registered in an equivalent occupation elsewhere in Australia or in New Zealand may be able to apply under the Commonwealth Mutual Recognition Act 1992. |
Victoria
Victoria’s condition for body composition scans
Victoria keeps a separate document for body composition. Management licence condition M1758 requires management licence holders to comply with the department’s document titled “Requirements for the assessment of body composition using DXA”. The department’s page on these requirements gives an email address for questions about them.
Other states
Outside Victoria
The rules above are Victoria’s and apply in Victoria. Each other state and territory sets its own licence requirements, and they vary.
ARPANSA’s 2016 statement adds a requirement of a different kind: it said DXA as a medical procedure was regulated by its code RPS14, which required appropriate referral, justification and approval by appropriately qualified medical practitioners. ARPANSA has since superseded RPS14 with its Code for Radiation Protection in Medical Exposure (RPS C-5, 2019), together with RPS C-1. DXA and radiation sets that requirement beside the committee’s view of scans for body fat.