Occupational Health Hazards in the Interventional Laboratory: Time for a Safer Environment

Radiation shielding assessment for interventional radiology personnel: Geant4 dosimetry of lead-free compositions

The inherent biological hazards associated with ionizing radiation necessitate the implementation of effective shielding measures, particularly in medical applications. Interventional radiology, in particular, poses a unique challenge as it often exposes medical personnel to prolonged periods of high x-ray doses. Historically, lead and lead-based compounds have been the primary materials employed for shielding against photons. However, the drawbacks of lead, including its substantial weight causing personnel's inflexibility and its toxicity, have raised concerns regarding its long-term impact on both human health and the environment. Barium tantalate has emerged as a promising alternative, due to its unique attenuation properties against low-energy x-rays, specifically targeting the weak absorption area of lead. In the present study, we employ the Geant4 Monte Carlo simulation tool to investigate various formulations of barium tantalate doped with rare earth elements. The aim is to identify the optimal composition for shielding x-rays in the context of interventional radiology. To achieve this, we employ a reference x-ray spectrum typical of interventional radiology procedures, with energies extending up to 90 keV, within a carefully designed simulation setup. Our primary performance indicator is the reduction in air kerma transmission. Furthermore, we assess the absorbed doses to critical organs at risk within a standard human body phantom protected by the shield. Our results demonstrate that specific concentrations of the examined rare earth impurities can enhance the shielding performance of barium tantalate. To mitigate x-ray exposure in interventional radiology, our analysis reveals that the most effective shielding performance is achieved when using barium tantalate compositions containing 15% Erbium or 10% Samarium by weight. These findings suggest the possibility of developing lead-free shielding solutions or apron for interventional radiology personnel, offering a remarkable reduction in weight (exceeding 30%) while maintaining shielding performance at levels comparable to traditional lead-based materials.

Assessment of Health Professionals' Attitudes on Radiation Protection Measures

(1) Background: Health professionals' knowledge, beliefs and perceptions concerning radiation protection may affect their behaviour during surgery and consequently influence the quality of health services. This study highlights the health professionals' average knowledge level and captures the beliefs, perceptions, and behaviours in a large public Greek hospital. (2) Materials and Methods: A cross-sectional study was carried out, including health professionals working in operating rooms. One hundred thirty-two staff members participated by responding to an original questionnaire. The sample consisted of nurses, radiographers and medical doctors of various specialties involved daily in surgical procedures where ionizing radiation is required. The survey was conducted from March to June 2021, and the response rate was 97%. (3) Results: The level of overall knowledge of health professionals regarding radiation protection safety was not satisfactory. Females and employees with a lower level of education had more misconceptions about radiation and radiation protection. Employees of younger ages and with less previous experience were more likely to have negative emotions towards radiation exposure. Finally, employees with fewer children tended to express physical complaints caused by their negative emotions due to radiation exposure. (4) Conclusions: Health professionals' lack of basic and specialized knowledge concerning radiation protection safety had a negative impact on the provision of health services. The continuing training of the staff seemed to be the only solution to reverse this trend. The training should highlight how radiation exposure can be minimized, safeguarding health professionals' trust and sense of security by significantly improving their working environment.

Analysis of Interventionalists' Natural Behaviors for Recognizing Motion Patterns of Endovascular Tools During Percutaneous Coronary Interventions

Many robotic platforms can indeed reduce radiation exposure to clinicians during percutaneous coronary intervention (PCI), however, interventionalists' natural manipulations are rarely involved in robot-assisted PCI. This requires more attention to analyze interventionalists' natural behaviors during conventional PCI. In this study, four types of natural behavior (i.e., muscle activity, hand motion, proximal force, and finger motion) were synchronously acquired from ten subjects while performing six typical types of guidewire manipulation. These behaviors are evaluated by a hidden Markov model (HMM) based analysis framework for relevant behavior selection. Relevant behaviors are further used as the input of two HMM-based classification frameworks to recognize guidewire motion patterns. Experimental results show that under the basic classification framework (BCF), 91.01% and 93.32% recognition accuracies can be achieved by using all behaviors and relevant behaviors, respectively. Furthermore, the hierarchical classification framework can significantly enhance the recognition ability of relevant behaviors with an accuracy of 96.39%. These promising results demonstrate great potential of proposed methods for promoting the future design of human-robot interfaces in robot-assisted PCI.

Radiation Protection for the Fluoroscopy Operator and Staff

OBJECTIVE

The purposes of this article are to review available data regarding the range of protection devices and garments with a focus on eye protection and to summarize techniques for reducing scatter radiation exposure.

CONCLUSION

Fluoroscopy operators and staff can greatly reduce their radiation exposure by wearing properly fitted protective garments, positioning protective devices to block scatter radiation, and adhering to good radiation practices. By understanding the essentials of radiation physics, protective equipment, and the features of each imaging system, operators and staff can capitalize on opportunities for radiation protection while minimizing ergonomic strain. Practicing and promoting a culture of radiation safety can help fluoroscopy operators and staff enjoy long, productive careers helping patients.