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Lee WJ, Jang EJ, Kim KS, Bang YJ. Underestimation of Radiation Doses by Compliance of Wearing Dosimeters among Fluoroscopically-Guided Interventional Medical Workers in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148393. [PMID: 35886244 PMCID: PMC9318991 DOI: 10.3390/ijerph19148393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 02/05/2023]
Abstract
This study aimed to estimate the level of underestimation of National Dose Registry (NDR) doses based on the workers’ dosimeter wearing compliance. In 2021, a nationwide survey of Korean medical radiation workers was conducted. A total of 989 medical workers who performed fluoroscopically-guided interventional procedures participated, and their NDR was compared with the adjusted doses by multiplying the correction factors based on the individual level of dosimeter compliance from the questionnaire. Ordinal logistic regression analysis was performed to identify the factors for low dosimeter wearing. Based on the data from the NDR, the average annual effective radiation dose was 0.95 mSv, while the compliance-adjusted dose was 1.79 mSv, yielding an 89% increase. The risks for low compliance with wearing a badge were significantly higher among doctors, professionals other than radiologists or cardiologists, workers not frequently involved in performing fluoroscopically-guided interventional procedures, and workers who did not frequently wear protective devices. This study provided quantitative information demonstrating that the NDR data may have underestimated the actual occupational radiation exposure. The underestimation of NDR doses may lead to biased risk estimates in epidemiological studies for radiation workers, and considerable attention on dosimetry wearing compliance is required to interpret and utilize NDR data.
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Data integration of National Dose Registry and survey data using multivariate imputation by chained equations. PLoS One 2022; 17:e0261534. [PMID: 35704606 PMCID: PMC9200363 DOI: 10.1371/journal.pone.0261534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 12/06/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction
Data integration is the process of merging information from multiple datasets generated from different sources, which can obtain more information in comparison to to one data source. All diagnostic medical radiation workers were enrolled in National Dose Registry (NDR) from 1996 to 2011, linked with mortality and cancer registry data. (https://kdca.go.kr/) Survey was conducted during 2012-2013 using self-reported questionnaire on occupational radiation practices among diagnostic medical radiation workers.
Methods
Data integration of NDR and Survey was performed using the multivariate imputation by chained equations (MICE) algorithm.
Results
The results were compared by sex and type of job because characteristics of target variables for imputation depend on these variables. There was a difference between the observed and pooled mean for the frequency of interventional therapy for nurses due to different type of medical facility distribution between observed and completed data. Concerning the marital status of males and females, and status of pregnancy for females, there was a difference between observed and pooled mean because the distribution of the year of birth was different between the observed and completed data. For lifetime status of smoking, the percentage of smoking experience was higher in the completed data than in the observed data, which could be due to reasons, such as underreporting among females and the distribution difference in the frequency of drinking between the observed and completed data for males.
Conclusion
Data integration can allow us to obtain survey information of NDR units without additional surveys, saving us time and costs for the survey.
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Lee D, Lim WY, Park S, Jin YW, Lee WJ, Park S, Seo S. Reliability and Validity of a Nationwide Survey (the Korean Radiation Workers Study). Saf Health Work 2021; 12:445-451. [PMID: 34900363 PMCID: PMC8640590 DOI: 10.1016/j.shaw.2021.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background This study aimed to evaluate the reliability and validity of the self-administered questionnaire for Korean radiation workers. Methods From May 24, 2016, to June 30, 2017, 20,608 participants completed the questionnaire, providing information on sociodemographics, lifestyle, work history and practices, medical radiation exposure, and medical history, which was linked to the National Dose Registry and the National Cancer Registry. The validity of the questionnaire was evaluated using the responses of 20,608 workers, and reliability was evaluated using the responses of 3043 workers who responded to the survey twice. Results Responses concerning demographic characteristics and lifestyle showed reliability with a moderate-to-high agreement (kappa: 0.43–0.99), whereas responses concerning occupation and medical radiation exposure had a wide range of agreement (kappa: 0.05–0.95), possibly owing to temporal variability during employment. Regarding validity, responses to the question about the first year of employment had an excellent agreement with the national registry (intraclass correlation coefficient = 0.9); however, responses on cancer history had a wide range of agreement (kappa: 0.22–0.85). Conclusion Although the reliability and validity of the questionnaire were not distinguished by demographic characteristics, they tended to be low among participants whose occupational radiation exposure was minimal. Overall, the information collected can be reliable for epidemiological studies; however, caution must be exercised when using information such as medical exposure and work practices, which are prone to temporal variability.
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Affiliation(s)
- Dalnim Lee
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, 01812, Republic of Korea
| | - Wan Young Lim
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, 01812, Republic of Korea
| | - Soojin Park
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, 01812, Republic of Korea
| | - Young Woo Jin
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, 01812, Republic of Korea
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, 02841, Republic of Korea
| | - Sunhoo Park
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, 01812, Republic of Korea
| | - Songwon Seo
- Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, 01812, Republic of Korea
- Corresponding author. Laboratory of Radiation Epidemiology, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowongu, 01812, Seoul, Republic of Korea.
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Kang S, Cha ES, Bang YJ, Na TW, Lee D, Song SY, Lee WJ. Radiation exposure and fluoroscopically-guided interventional procedures among orthopedic surgeons in South Korea. J Occup Med Toxicol 2020; 15:24. [PMID: 32793295 PMCID: PMC7418415 DOI: 10.1186/s12995-020-00276-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 08/03/2020] [Indexed: 11/13/2022] Open
Abstract
Background The use of fluoroscopically-guided interventional (FGI) procedures by orthopedic surgeons has been increasing. This study aimed to investigate the occupational radiation exposure among orthopedic surgeons in South Korea. Methods A nationwide survey of orthopedic surgeons was conducted in South Korea in October 2017. The dosimetry data of the participants were obtained from the National Dosimetry Registry. The orthopedic surgeons were categorized by job specialty [spine or trauma specialists, other orthopedic specialists, and residents], and descriptive statistics for the demographics and work-related characteristics were presented. Multivariable logistic regression analysis was used to evaluate the risk factors for the orthopedic surgeons who were not linked with the dosimetry data. Results Among the total participants (n = 513), 40.5% of the orthopedic surgeons spent more than 50% of their time working with the FGI procedures when compared with their overall work. The average frequency of the FGI procedures among the orthopedic surgeons was 12.3 days per month. Less than 30% of the participants were regularly provided with radiation monitoring badges. The proportion of subjects who always wore lead aprons and thyroid shields were 52 and 29%, respectively. The residents group experienced more unfavorable working conditions of radiation exposure than the other specialists. The dosimetry data were not significantly linked among the residents (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.11–3.95) and orthopedic surgeons working at small hospitals (OR 4.76, 95% CI 1.05–21.51). Conclusions Although orthopedic surgeons often performed FGI procedures, they wore protective gear less frequently, and a large proportion of orthopedic surgeons were not monitored by the national radiation dosimetry system. As the number of radiation procedures performed by the orthopedic surgeons increases, more intensive approaches are needed to reduce radiation exposure, especially for spine and trauma surgeons.
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Affiliation(s)
- Seonghoon Kang
- Department of Occupational and Environmental Medicine, COMWEL Ansan Hospital, Korea Workers' Compensation & Welfare Service, Gyeonggi-do, South Korea.,Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, South Korea
| | - Eun Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841 South Korea
| | - Ye Jin Bang
- Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, South Korea.,Department of Preventive Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841 South Korea
| | - Teresa W Na
- Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, South Korea.,Department of Policy and Administration, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Dalnim Lee
- Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, South Korea.,Department of Radiation Effects Research, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Sang Youn Song
- Department of Orthopedic Surgery, Gyeongsang National University Hospital, Jinju, South Korea
| | - Won Jin Lee
- Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, South Korea.,Department of Preventive Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841 South Korea
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Choi Y, Shil Cha E, Jin Bang Y, Ko S, Ha M, Lee C, Jin Lee W. ESTIMATION OF ORGAN DOSES AMONG DIAGNOSTIC MEDICAL RADIATION WORKERS IN SOUTH KOREA. RADIATION PROTECTION DOSIMETRY 2018; 179:142-150. [PMID: 29106680 PMCID: PMC6257005 DOI: 10.1093/rpd/ncx239] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/02/2017] [Accepted: 10/10/2017] [Indexed: 06/07/2023]
Abstract
This study aimed to estimate the radiation organ doses from occupational exposure in 94 396 Korean medical radiation workers. Data on badge doses (i.e. personal dose equivalent at 10 mm) between 1996 and 2011 obtained from a national dosimetry registry, survey data from 2012 to 2013, and organ dose conversion coefficients provided by the International Commission on Radiological Protection (ICRP) were used for the estimation. The highest mean cumulative badge doses (26.87 mSv) were observed in radiologists, followed by radiologic technologists (15.96 mSv). Male workers exhibited higher mean cumulative badge doses, across occupational groups. The estimated organ doses showed similar trends with those of badge doses. Organs located outside the apron's coverage such as the thyroid showed higher mean organ doses than those protected by the apron. Our findings could contribute to future radiation epidemiologic studies to investigate health effects from occupational radiation exposure in Korea.
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Affiliation(s)
- Yeongchull Choi
- Department of Preventive Medicine, Korea University College of Medicine,
Seoul, Korea
| | - Eun Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine,
Seoul, Korea
| | - Ye Jin Bang
- Department of Preventive Medicine, Korea University College of Medicine,
Seoul, Korea
| | - Seulki Ko
- Department of Preventive Medicine, Korea University College of Medicine,
Seoul, Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine,
Cheonan, Korea
| | - Choonsik Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute,
National Institutes of Health, Shady Grove, MD, USA
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine,
Seoul, Korea
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Brun A, Mor RA, Bourrelly M, Dalivoust G, Gazazian G, Boufercha R, Lehucher-Michel MP, Sari-Minodier I. Radiation protection for surgeons and anesthetists: practices and knowledge before and after training. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2018; 38:175-188. [PMID: 29182150 DOI: 10.1088/1361-6498/aa9dbd] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The use of radiological activity in the operating room (OR) and a regulatory decrease of the eye lens dose warrant an assessment of how medical staff are protected from radiation. This study aims to evaluate practices and knowledge in radiation protection (RP) for OR doctors before and after training. A descriptive study of surgeons and anesthetists in a French public hospital center was conducted in 2016. An ad hoc questionnaire concerning occupational practices and knowledge about RP was distributed before and one month after RP training. Among 103 doctors attending the training, 90 answered the questionnaire before the training. Results showed a lack of knowledge and good practice in RP. Most of the participants (86.7%) had never been trained in RP and recognized insufficient knowledge. Most of them (92.2%) wore a lead apron, 50.0% a thyroid-shield, 5.6% lead glasses, 53.3% a passive dosimeter and 17.8% an electronic dosimeter. None of them benefitted from collective protective equipment such as a ceiling suspended screen. The questionnaire following the training was completed by only 35 doctors. A comparison before and after training results showed an improvement in knowledge (scores of correct responses: 5.5/16 before and 9.5/16 after training) but not in RP good practices (scores of correct responses: 3.2/7 before and 3.3/7 after training). One training session appears to be insufficient to improve the application of the safety rules when x-rays are used. Communication needs to be improved regarding RP among anesthetists and surgeons, such as training renewal, workstation analysis in OR related to x-ray use and occupational medical follow-up. Otherwise, radiological risks in OR need to be given better consideration, such as radio-induced cataract risk. It is necessary to encourage the use of dosimeters and protective equipment and to strengthen access to lead glasses and collective protective equipment, such as ceiling suspended screens. All these recommendations ensure the received dose is reduced to as low as is reasonably achievable.
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Affiliation(s)
- A Brun
- APHM, La Timone Hospital, Occupational Medicine and Health Department, F-13385 Marseille, France
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