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Ohno S, Konta S, Shindo R, Yamamoto K, Isobe R, Inaba Y, Suzuki M, Zuguchi M, Chida K. Effect of backscatter radiation on the occupational eye-lens dose. JOURNAL OF RADIATION RESEARCH 2024; 65:450-458. [PMID: 38818635 DOI: 10.1093/jrr/rrae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/21/2024] [Indexed: 06/01/2024]
Abstract
We quantified the level of backscatter radiation generated from physicians' heads using a phantom. We also evaluated the shielding rate of the protective eyewear and optimal placement of the eye-dedicated dosimeter (skin surface or behind the Pb-eyewear). We performed diagnostic X-rays of two head phantoms: Styrofoam (negligible backscatter radiation) and anthropomorphic (included backscatter radiation). Radiophotoluminescence glass dosimeters were used to measure the eye-lens dose, with or without 0.07-mm Pb-equivalent protective eyewear. We used tube voltages of 50, 65 and 80 kV because the scattered radiation has a lower mean energy than the primary X-ray beam. The backscatter radiation accounted for 17.3-22.3% of the eye-lens dose, with the percentage increasing with increasing tube voltage. Furthermore, the shielding rate of the protective eyewear was overestimated, and the eye-lens dose was underestimated when the eye-dedicated dosimeter was placed behind the protective eyewear. We quantified the backscatter radiation generated from physicians' heads. To account for the effect of backscatter radiation, an anthropomorphic, rather than Styrofoam, phantom should be used. Close contact of the dosimeter with the skin surface is essential for accurate evaluation of backscatter radiation from physician's own heads. To assess the eye-lens dose accurately, the dosimeter should be placed near the eye. If the dosimeter is placed behind the lens of the protective eyewear, we recommend using a backscatter radiation calibration factor of 1.2-1.3.
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Affiliation(s)
- Saya Ohno
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Satoe Konta
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Ryota Shindo
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Keisuke Yamamoto
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Rio Isobe
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Yohei Inaba
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4, Aoba, Sendai 980-8579, Japan
| | - Masatoshi Suzuki
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4, Aoba, Sendai 980-8579, Japan
| | - Masayuki Zuguchi
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Koichi Chida
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4, Aoba, Sendai 980-8579, Japan
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Shindo R, Ohno S, Yamamoto K, Konta S, Inaba Y, Suzuki M, Zuguchi M, Chida K. Comparison of shielding effects of over-glasses-type and regular eyewear in terms of occupational eye dose reduction. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:023501. [PMID: 38701771 DOI: 10.1088/1361-6498/ad4714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/03/2024] [Indexed: 05/05/2024]
Abstract
Given the new recommendations for occupational eye lens doses, various lead glasses have been used to reduce irradiation of interventional radiologists. However, the protection afforded by lead glasses over prescription glasses (thus over-glasses-type eyewear) has not been considered in detail. We used a phantom to compare the protective effects of such eyewear and regular eyewear of 0.07 mm lead-equivalent thickness. The shielding rates behind the eyewear and on the surface of the left eye of an anthropomorphic phantom were calculated. The left eye of the phantom was irradiated at various angles and the shielding effects were evaluated. We measured the radiation dose to the left side of the phantom using RPLDs attached to the left eye and to the surface/back of the left eyewear. Over-glasses-type eyewear afforded good protection against x-rays from the left and below; the average shielding rates on the surface of the left eye ranged from 0.70-0.72. In clinical settings, scattered radiation is incident on physicians' eyes from the left and below, and through any gap in lead glasses. Over-glasses-type eyewear afforded better protection than regular eyewear of the same lead-equivalent thickness at the irradiation angles of concern in clinical settings. Although clinical evaluation is needed, we suggest over-glasses-type Pb eyewear even for physicians who do not wear prescription glasses.
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Affiliation(s)
- Ryota Shindo
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Saya Ohno
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Keisuke Yamamoto
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Satoe Konta
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Yohei Inaba
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4 Aoba, Sendai 980-8579, Japan
| | - Masatoshi Suzuki
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4 Aoba, Sendai 980-8579, Japan
| | - Masayuki Zuguchi
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Koichi Chida
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4 Aoba, Sendai 980-8579, Japan
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Kuriyama T, Moritake T, Nakagami K, Morota K, Hitomi G, Kitamura H. Background Factors Affecting the Radiation Exposure of the Lens of the Eye among Nurses in Interventional Radiology: A Quantitative Observational Study. NURSING REPORTS 2024; 14:413-427. [PMID: 38391077 PMCID: PMC10885035 DOI: 10.3390/nursrep14010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
With the International Commission on Radiological Protection's (ICRP) reduction in the radiation dose threshold for cataracts, evaluating and preventing radiation exposure to the lens of the eye among interventional radiology (IR) staff have become urgent tasks. In this study, we focused on differences in lens-equivalent dose (HT Lens) to which IR nurses in three hospitals were exposed and aimed to identify factors underlying these differences. According to analyses of time-, distance-, and shielding-related factors, the magnitude of the HT Lens dose to which IR nurses were exposed could be explained not by time or shielding but by the distance between the X-ray exposure field and the location of the IR nurse. This distance tended to be shorter in hospitals with fewer staff. The most effective means of reducing the exposure of the lenses of IR nurses' eyes to radiation is to position them at least two meters from the radiation source during angiography procedures. However, some hospitals must provide IR departments with comparatively few staff. In work environments where it is infeasible to reduce exposure by increasing distance, interventions to reduce time by managing working practices and investment in shielding equipment are also important. This study was not registered.
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Affiliation(s)
- Tomoko Kuriyama
- Department of Occupational and Community Health Nursing, School of Health Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan
| | - Takashi Moritake
- Department of Radiation Regulatory Science Research, National Institute of Radiological Sciences, National Institute for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Koichi Nakagami
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu 807-8556, Japan
| | - Koichi Morota
- Department of Radiology, Shinkomonji Hospital, Kitakyushu 800-0057, Japan
| | - Go Hitomi
- Department of Radiological Technology, Kawasaki Medical School Hospital, Kurashiki 701-0192, Japan
| | - Hiroko Kitamura
- Occupational Health Training Center, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan
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Zhou J, Li W, Deng J, Li K, Jin J, Zhang H. Trend and distribution analysis of occupational radiation exposure among medical practices in Chongqing, China (2008-2020). RADIATION PROTECTION DOSIMETRY 2023; 199:2083-2088. [PMID: 37526057 DOI: 10.1093/rpd/ncad215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/09/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023]
Abstract
The personal dose levels of medical radiation workers in Chongqing from 2008 to 2020 were investigated and analysed. The results showed that a total of 68 379 people were monitored from 2008 to 2020. The number of radiation workers increased year by year, and the number of female radiation workers increased rapidly. The monitoring data were analysed by Mann-Whitney test, Mann-Kendall test and Bonferroni method. The annual mean effective dose from 2008 to 2020 showed a decreasing trend (P < 0.0001). At the 5% significance level, six occupational categories showed a significant decreasing trend (P < 0.0001).The average annual effective dose for medical radiation workers in Chongqing in 2020 was 0.4482 mSv and 94.73% of radiation workers received annual doses less than the public dose limit (1 mSv). Personal dose monitoring results for most radiation workers were low. The protection of radiation workers in interventional radiology and nuclear medicine should be concerned.
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Affiliation(s)
- Jinghua Zhou
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Wei Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Jun Deng
- National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kui Li
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Jing Jin
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Huadong Zhang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
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Engström A, Isaksson M, Larsson PA, Lundh C, Båth M. Lead aprons and thyroid collars: to be, or not to be? JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:031516. [PMID: 37678246 DOI: 10.1088/1361-6498/acf76f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/07/2023] [Indexed: 09/09/2023]
Abstract
Wearing lead aprons and thyroid collars for long periods of time has a subjective component: to balance the effective dose reduction with the effort of carrying a heavy load. Occupational radiation exposure has decreased dramatically in the last century within the health care system. During the same period the use of lead aprons and thyroid collars has also gone up. Therefore, a question that may be raised is: how safe is safe enough? In order to promote stakeholder involvement, the aim of the present study was to investigate staff's experience of discomforts associated with wearing lead aprons and thyroid collars for long periods of time, and also to investigate staff's willingness to tolerate personal dose equivalent (expressed as radiation dose) and the corresponding increase in future cancer risk to avoid wearing these protective tools. A questionnaire was developed and given to staff working in operating or angiography rooms at Skaraborg Hospital in Sweden. The results from the 245 respondents showed that 51% experienced bothersome warmth, 36% experienced fatigue and 26% experienced ache or pain that they believed was associated with wearing lead aprons. One third of the respondents would tolerate a personal dose equivalent of 1 mSv per year to avoid wearing lead aprons, but only a fifth would tolerate the corresponding increase in future cancer risk (from 43% to 43.2%). In conclusion, discomforts associated with wearing lead aprons and thyroid collars for long periods of time are common for the staff using them. At the same time, only a minority of the staff would tolerate a small increase in future cancer risk to avoid wearing them. The present study gives an example of stakeholder involvement and points at the difficulties in making reasonable decisions about the use of these protective tools.
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Affiliation(s)
- Andreas Engström
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SE-413 45, Sweden
- Department of Radiology, Skaraborg Hospital, Region Västra Götaland, Skövde, SE-541 85, Sweden
| | - Mats Isaksson
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SE-413 45, Sweden
| | - Per-Anders Larsson
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg SE-413 45, Sweden
- Department of Surgery, Skaraborg Hospital, Region Västra Götaland, Skövde, SE-541 85, Sweden
- Department of Research and Development, Skaraborg Hospital, Region Västra Götaland, SE-541 85 Skövde, Sweden
| | - Charlotta Lundh
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SE-413 45, Sweden
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, SE-413 45, Sweden
| | - Magnus Båth
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, SE-413 45, Sweden
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, SE-413 45, Sweden
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Yamada A, Haga Y, Sota M, Abe M, Kaga Y, Inaba Y, Suzuki M, Tada N, Zuguchi M, Chida K. Eye Lens Radiation Dose to Nurses during Cardiac Interventional Radiology: An Initial Study. Diagnostics (Basel) 2023; 13:3003. [PMID: 37761370 PMCID: PMC10528633 DOI: 10.3390/diagnostics13183003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Although interventional radiology (IVR) is preferred over surgical procedures because it is less invasive, it results in increased radiation exposure due to long fluoroscopy times and the need for frequent imaging. Nurses engaged in cardiac IVR receive the highest lens radiation doses among medical workers, after physicians. Hence, it is important to measure the lens exposure of IVR nurses accurately. Very few studies have evaluated IVR nurse lens doses using direct dosimeters. This study was conducted using direct eye dosimeters to determine the occupational eye dose of nurses engaged in cardiac IVR, and to identify simple and accurate methods to evaluate the lens dose received by nurses. Over 6 months, in a catheterization laboratory, we measured the occupational dose to the eyes (3 mm dose equivalent) and neck (0.07 mm dose equivalent) of nurses on the right and left sides. We investigated the relationship between lens and neck doses, and found a significant correlation. Hence, it may be possible to estimate the lens dose from the neck badge dose. We also evaluated the appropriate position (left or right) of eye dosimeters for IVR nurses. Although there was little difference between the mean doses to the right and left eyes, that to the right eye was slightly higher. In addition, we investigated whether it is possible to estimate doses received by IVR nurses from patient dose parameters. There were significant correlations between the measured doses to the neck and lens, and the patient dose parameters (fluoroscopy time and air kerma), implying that these parameters could be used to estimate the lens dose. However, it may be difficult to determine the lens dose of IVR nurses accurately from neck badges or patient dose parameters because of variation in the behaviors of nurses and the procedure type. Therefore, neck doses and patient dose parameters do not correlate well with the radiation eye doses of individual IVR nurses measured by personal eye dosimeters. For IVR nurses with higher eye doses, more accurate measurement of the radiation doses is required. We recommend that a lens dosimeter be worn near the eyes to measure the lens dose to IVR nurses accurately, especially those exposed to relatively high doses.
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Affiliation(s)
- Ayumi Yamada
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
| | - Yoshihiro Haga
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan; (M.A.); (Y.K.)
| | - Masahiro Sota
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan; (M.A.); (Y.K.)
| | - Mitsuya Abe
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan; (M.A.); (Y.K.)
| | - Yuji Kaga
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan; (M.A.); (Y.K.)
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Masatoshi Suzuki
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Norio Tada
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan;
| | - Masayuki Zuguchi
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
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Badawy MK, Henely‐Smith E, Hasmat S. Radiation exposure to staff during fluoroscopic endoscopic procedures. DEN OPEN 2023; 3:e234. [PMID: 37035033 PMCID: PMC10076694 DOI: 10.1002/deo2.234] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/20/2023] [Accepted: 03/21/2023] [Indexed: 04/09/2023]
Abstract
Objectives Fluoroscopically guided procedures utilize ionizing radiation to assist in the diagnosis and treatment of the patient. The use of ionizing radiation is not without risk to the operator and other staff members present during endoscopic procedures. This study simulates radiation exposure during endoscopic retrograde cholangiopancreatography procedures under different shielded conditions and provides practical radiation safety recommendations, through easy‐to‐use visual guides. Methods We obtained radiation exposure measurements at varying locations with different shielding setups surrounding a mobile C‐arm fluoroscopic unit while imaging a patient equivalent phantom at different heights. Heat maps were generated for the various conditions to provide visual guides for radiation protection. Results Different heat maps detailing various shielding methods have been generated to assist in determining the dose rate at varying locations surrounding the patient. The use of appropriate radiation protection could decrease the staff dose by up to 98%. Conclusion Although minor per procedure, the magnitude of radiation exposure will accumulate over the staff's working life. As such, it is recommended that precautions be taken during fluoroscopically guided endoscopy procedures to ensure radiation is kept as low as reasonably achievable.
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Affiliation(s)
- Mohamed Khaldoun Badawy
- Monash Health ImagingMonash HealthClaytonAustralia
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonAustralia
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Hattori K, Inaba Y, Kato T, Fujisawa M, Yasuno H, Yamada A, Haga Y, Suzuki M, Zuguchi M, Chida K. Evaluation of a New Real-Time Dosimeter Sensor for Interventional Radiology Staff. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23010512. [PMID: 36617110 PMCID: PMC9823962 DOI: 10.3390/s23010512] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/20/2022] [Accepted: 12/28/2022] [Indexed: 06/01/2023]
Abstract
In 2011, the International Commission on Radiological Protection (ICRP) recommended a significant reduction in the lens-equivalent radiation dose limit, thus from an average of 150 to 20 mSv/year over 5 years. In recent years, the occupational dose has been rising with the increased sophistication of interventional radiology (IVR); management of IVR staff radiation doses has become more important, making real-time radiation monitoring of such staff desirable. Recently, the i3 real-time occupational exposure monitoring system (based on RaySafeTM) has replaced the conventional i2 system. Here, we compared the i2 and i3 systems in terms of sensitivity (batch uniformity), tube-voltage dependency, dose linearity, dose-rate dependency, and angle dependency. The sensitivity difference (batch uniformity) was approximately 5%, and the tube-voltage dependency was <±20% between 50 and 110 kV. Dose linearity was good (R2 = 1.00); a slight dose-rate dependency (~20%) was evident at very high dose rates (250 mGy/h). The i3 dosimeter showed better performance for the lower radiation detection limit compared with the i2 system. The horizontal and vertical angle dependencies of i3 were superior to those of i2. Thus, i3 sensitivity was higher over a wider angle range compared with i2, aiding the measurement of scattered radiation. Unlike the i2 sensor, the influence of backscattered radiation (i.e., radiation from an angle of 180°) was negligible. Therefore, the i3 system may be more appropriate in areas affected by backscatter. In the future, i3 will facilitate real-time dosimetry and dose management during IVR and other applications.
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Affiliation(s)
- Kenshin Hattori
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Toshiki Kato
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Masaki Fujisawa
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Hikaru Yasuno
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Ayumi Yamada
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Yoshihiro Haga
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan
| | - Masatoshi Suzuki
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Masayuki Zuguchi
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
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Osawa M, Tawada Y, Kaneda N, Fujita N, Koyama S. EXAMINATION OF LENS EXPOSURE DOSES OF CARDIOLOGISTS, NEUROSURGEONS AND RADIOLOGISTS IN INTERVENTIONAL RADIOLOGY. RADIATION PROTECTION DOSIMETRY 2022; 198:1585-1597. [PMID: 36321327 DOI: 10.1093/rpd/ncac205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
The International Commission on Radiological Protection (ICRP) 118th recommendation significantly reduced the threshold dose for cataract development from 8 to 0.5 Gy. Equivalent dose limits for the crystalline lenses of radiation workers are being reviewed for individual countries. Interventional radiology (IR) procedures are less invasive than surgery and have become widespread; however, there are concerns about exposure not only to patients but also to staff, including operators. Therefore, in this study, we used a human phantom to measure the near-lens dose of the operators (cardiologists, neurosurgeons and radiologists) and estimated the operator's lens dose for every major procedure in each clinical department; this was found to vary. Owing to the different imaging and fluoroscopy conditions of each department, and the varying ratio of fluoroscopy to radiography, it is necessary to measure the lens dose for each condition, as in this study. In addition, this study explains the differences between the protective effect of various safety equipment and the appropriate use of protective plates; it can contribute to the reduction of lens doses for operators.
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Affiliation(s)
- Mitsuharu Osawa
- Department of Radiology, Aichi Medical University Hospital, Nagakute, 480-1195, Japan
| | - Yuka Tawada
- Department of Radiology, Aichi Medical University Hospital, Nagakute, 480-1195, Japan
| | - Naoki Kaneda
- Department of Radiology, Aichi Medical University Hospital, Nagakute, 480-1195, Japan
| | - Naotoshi Fujita
- Department of Radiological Technology, Nagoya University Hospital, Nagoya, 466-8560, Japan
| | - Shuji Koyama
- Brain and Mind Research Center, Nagoya University, Department of Brain and Mind Sciences, Nagoya University Graduate School of Medicine, Nagoya, 461-8673, Japan
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10
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Morishima Y, Chida K, Meguro T, Hirota M, Chiba H, Fukuda H. LENS EQUIVALENT DOSE OF STAFF DURING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY: DOSE COMPARISON USING TWO TYPES OF DOSEMETERS. RADIATION PROTECTION DOSIMETRY 2022; 198:1368-1376. [PMID: 36055968 DOI: 10.1093/rpd/ncac160] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 05/30/2022] [Accepted: 06/12/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to compare the lens equivalent dose (LED) measured during endoscopic retrograde cholangiopancreatography (ERCP) using DOSIRIS™ as a dedicated dosemeter to that measured using glass badges to determine if glass badges can be alternative tools for LED measurement. LEDs for physicians during ERCP were measured using the DOSIRIS™ [3-mm dose equivalent] worn on the outer edge of the eyes and personal dosemeters (glass badges) [0.07-mm dose equivalent] worn on the right and left sides of the neck. The cumulated doses over 6 months for the left eye using DOSIRIS™ were 9.5 and 11.8 mSv for physicians A and B, whereas doses measured using glass badges were 7.5 and 11.6 mSv, respectively. The LEDs of the physicians at the left eye and left neck side showed almost similar values and were significantly correlated (r = 0.95; p < 0.01). For an accurate LED measurement during ERCP, using a dosemeter such as DOSIRIS™ is recommended, although similar LED estimation values were reported using glass badges on the left neck side.
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Affiliation(s)
- Yoshiaki Morishima
- Department of Radiological Technology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai 983-8512, Japan
- Department of Radiological Technology, Tohoku University School of Health Sciences, Sendai 980-8575, Japan
| | - Koichi Chida
- Department of Radiological Technology, Tohoku University School of Health Sciences, Sendai 980-8575, Japan
| | - Takayoshi Meguro
- Gastroenterology Center, Tohoku Medical and Pharmaceutical University Hospital, Sendai 983-8512, Japan
| | - Morihisa Hirota
- Gastroenterology Center, Tohoku Medical and Pharmaceutical University Hospital, Sendai 983-8512, Japan
| | - Hiroo Chiba
- Department of Radiological Technology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai 983-8512, Japan
| | - Hiroshi Fukuda
- Department of Radiology Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai 983-8356, Japan
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11
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Askounis P, Torras Gonzalez A, Ginjaume M, Carinou E. Practical guidelines for personal monitoring and estimation of effective dose and dose to the lens of the eye in interventional procedures. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:031514. [PMID: 35940135 DOI: 10.1088/1361-6498/ac87b8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Estimation of effective dose and dose to the lens of the eye for workers involved in interventional procedures is challenging. The interventional procedures in question involve high doses and, due to this, workers need to wear protective garments. As a result, various methodologies have been developed to assess the effective dose and dose to the lens of the eye. In the present study, measurements from four European dosimetry services, over and under protective garments, have been collected and analysed in order to provide practical guidelines based on the routine use of personal dosemeters from staff in interventional workplaces. The advantages and limitations of using one or two dosemeters are discussed.
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Affiliation(s)
| | | | - Merce Ginjaume
- Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
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12
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Li M, Fan S, Zhang X, Hao S, Zhao Y, Deng J, Sun Q. Assessment of Occupational Exposure to Eye Lens Dosimetry for Interventional Radiology Workers in China during 2017-2019. HEALTH PHYSICS 2022; 123:229-237. [PMID: 35713894 DOI: 10.1097/hp.0000000000001590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
ABSTRACT The eye lens is a sensitive tissue to ionizing radiation and recently has been recognized as more radiosensitive than previously considered. The International Commission on Radiological Protection (ICRP) has recommended a considerable reduction in the equivalent dose limit of eye lens from 150 mSv y -1 to 20 mSv y -1 , averaged over a defined period of 5 y. In this paper, the eye lens dose of interventional radiology workers in China during 2017-2019 is analyzed to understand the current status of eye lens occupational exposure and to provide decision-making suggestions for health supervision departments using data obtained from the National Radiological Health Information Platform in China. A total of 3,026 eye lens dose records of interventional radiology workers were collected. The average annual eye lens dose (AAELD) for interventional radiology workers ranged from 1.07 to 1.51 mSv during 2017-2019 and was 1.44 mSv for all monitored interventional radiology workers, with 2,973 records (98.2%) lower than the public limit of 15 mSv and 33 records (1.1%) exceeding the newly revised occupational eye lens dose limit of 20 mSv y -1 . During the period of 2017-2019, the AAELDs of interventional radiologists (1.61 mSv) and of interventional cardiologists (1.59 mSv) were significantly higher than that of other interventional workers (0.62 mSv); the AAELD of doctors (1.50 mSv) was significantly higher than that of nurses (1.01 mSv); the AAELD of western China (2.00 mSv) was significantly higher than that of eastern (1.11 mSv) and central China (1.27 mSv); and the AAELD of males (1.59 mSv) was significantly higher than that of females (0.84 mSv). The eye lens dose of interventional radiology workers meets the Chinese standard limit of 150 mSv y -1 , while some cases exceed the one recommended by ICRP. The study shows that the interventional radiology workers' eye lens dosimetry data complied with the existing Chinese eye lens dose limits. However, education, training, and supervision of radiation protection also should be strengthened continuously for interventional radiology workers, especially for the interventional radiologists and interventional cardiologists. Significant attention should be paid to the radiation protection of underdeveloped regions in China in future works.
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Affiliation(s)
- Mengxue Li
- National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100088, China
| | - Shengnan Fan
- National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100088, China
| | - Xianpeng Zhang
- Shandong Center for Disease Control and Prevention, Jinan 250014, China
| | - Shuxia Hao
- National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100088, China
| | - Yu Zhao
- Heilongjiang Provincial Center for Disease Control and Prevention, Harbin 150030, China
| | - Jun Deng
- National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100088, China
| | - Quanfu Sun
- National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, Beijing 100088, China
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Sato T, Eguchi Y, Yamazaki C, Hino T, Saida T, Chida K. Development of a New Radiation Shield for the Face and Neck of IVR Physicians. Bioengineering (Basel) 2022; 9:bioengineering9080354. [PMID: 36004878 PMCID: PMC9404996 DOI: 10.3390/bioengineering9080354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 11/20/2022] Open
Abstract
Interventional radiology (IVR) procedures are associated with increased radiation exposure and injury risk. Furthermore, radiation eye injury (i.e., cataract) in IVR staff have also been reported. It is crucial to protect the eyes of IVR physicians from X-ray radiation exposure. Many IVR physicians use protective Pb eyeglasses to reduce occupational eye exposure. However, the shielding effects of Pb eyeglasses are inadequate. We developed a novel shield for the face (including eyes) of IVR physicians. The novel shield consists of a neck and face guard (0.25 mm Pb-equivalent rubber sheet, nonlead protective sheet). The face shield is positioned on the left side of the IVR physician. We assessed the shielding effects of the novel shield using a phantom in the IVR X-ray system; a radiophotoluminescence dosimeter was used to measure the radiation exposure. In this phantom study, the effectiveness of the novel device for protecting against radiation was greater than 80% in almost all measurement situations, including in terms of eye lens exposure. A large amount of scattered radiation reaches the left side of IVR physicians. The novel radiation shield effectively protects the left side of the physician from this scattered radiation. Thus, the device can be used to protect the face and eyes of IVR physicians from occupational radiation exposure. The novel device will be useful for protecting the face (including eyes) of IVR physicians from radiation, and thus could reduce the rate of radiation injury. Based on the positive results of this phantom study, we plan to perform a clinical experiment to further test the utility of this novel radiation shield for IVR physicians.
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Affiliation(s)
- Toshimitsu Sato
- Department of Radiology, Yamagata University Hospital, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan; (T.S.); (C.Y.); (T.H.)
| | - Yoichi Eguchi
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Sendai 980-8575, Japan;
| | - Chika Yamazaki
- Department of Radiology, Yamagata University Hospital, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan; (T.S.); (C.Y.); (T.H.)
| | - Takanobu Hino
- Department of Radiology, Yamagata University Hospital, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan; (T.S.); (C.Y.); (T.H.)
| | - Toshikazu Saida
- Department of Central Radiology, Nara Prefecture Seiwa Medical Center, 1-14-16 Mimuro, Nara 636-0802, Japan;
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Sendai 980-8575, Japan;
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Sendai 980-0845, Japan
- Correspondence: ; Tel.: +81-22-717-7943
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Sánchez R, Vañó E, Fernández JM. Uncertainties in occupational eye lens doses from dosimeters over the apron in interventional practices. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:021508. [PMID: 35114656 DOI: 10.1088/1361-6498/ac5187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
It is relevant to estimate the uncertainties in the measurement of eye lens doses from a personal dosimeter over the protective apron without using additional dosimetry near the eyes. Additional dosimetry for interventionists represents a difficulty for routine clinical practice. This study analyses the estimated eye doses from dosimeter values taken at chest level over the apron and their uncertainties. Measurements ofHp(0.07) using optically stimulated luminescence dosimeters located on the chest over the apron and on the glasses (in the inner and outer part of the protection) were taken from ten interventionalists in a university hospital, in the period 2018-2019 during standard clinical practice. For a total sample of 133 interventional procedures included in our study, the ratio between theHp(0.07) on the glasses (left-outer side) and on the chest over the apron had an average of 0.74, with quartiles of 0.47, 0.64, 0.88. Statistically significant differences were found among operators using the U-Mann-Whitney test. The average transmission factor for the glasses was 0.30, with quartiles of 0.21, 0.25, and 0.32. Different complexity in the procedures, in the quality of the scatter radiation and in the individual operational practices, involve a relevant dispersion in the results for lens dose estimations from the over apron dosimeter. Lens doses may be between a 64% and an 88% of the over apron dosimeter values (using median or 3rd quartile). The use of 88% may be a conservative approach.
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Affiliation(s)
- Roberto Sánchez
- Medical Physics, Hospital Clínico San Carlos, Profesor Martín Lagos sn, 28040 Madrid, Spain
- Fundación para la Investigación del Hospital Clínico San Carlos, Profesor Martín Lagos sn, 28040 Madrid, Spain
- Medicine Faculty, Universidad Complutense de Madrid, Ramón y Cajal sn, 28040 Madrid, Spain
| | - Eliseo Vañó
- Medical Physics, Hospital Clínico San Carlos, Profesor Martín Lagos sn, 28040 Madrid, Spain
- Fundación para la Investigación del Hospital Clínico San Carlos, Profesor Martín Lagos sn, 28040 Madrid, Spain
- Medicine Faculty, Universidad Complutense de Madrid, Ramón y Cajal sn, 28040 Madrid, Spain
| | - José Miguel Fernández
- Medical Physics, Hospital Clínico San Carlos, Profesor Martín Lagos sn, 28040 Madrid, Spain
- Fundación para la Investigación del Hospital Clínico San Carlos, Profesor Martín Lagos sn, 28040 Madrid, Spain
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15
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Occupational eye dose correlation with neck dose and patient-related quantities in interventional cardiology procedures. Radiol Phys Technol 2022; 15:54-62. [DOI: 10.1007/s12194-022-00650-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/14/2022] [Accepted: 01/16/2022] [Indexed: 10/19/2022]
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16
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López-Ángeles D, Gamboa-deBuen I, Martínez-de Los Santos C, Alaniz-Sida K, Vega-Montesinos S, Lopez-Rendon X. Estimation of occupational radiation doses in neuroendovascular procedures. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2021; 41:1304-1316. [PMID: 34348239 DOI: 10.1088/1361-6498/ac1a83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
To estimate the mean effective dose per procedure with multiple dosimetry, to calculate the annual effective dose to personnel working in neuroendovascular procedures and compared with methods reported in the literature and with national and international limits. The radiation dose to personnel was monitored in 20 procedures classified as diagnostic or therapeutic. During each procedure, the equivalent dose to eyes, thyroid, under and over the lead apron at chest level, hands, gonads and knees was measured with lithium fluoride thermoluminescent dosimeter chips (TLD-100). Estimations of the annual effective dose from different methods found in literature that use one or two dosimeters and from this work were compared. Also, a comparison was made with the safety limits recommended in national and international regulations. Radiation exposure to eyes, thyroid, gonads and knees is relevant to the effective dose, and therefore to the annual effective dose estimations. Personnel position is important, as the performing physician, who is closer to the patient, received the highest dose measured. In particular, this was observed in the equivalent dose received over the apron. However, the equivalent dose to the right eye was higher for neuroanaesthesiologists than for performing physicians due to their position relative to the patient. In general, effective doses estimated using one- and two-dosimeter methods found in the literature were, respectively, lower and higher than those obtained with the ten-dosimeter method in this work. The annual effective doses to personnel estimated with the multiple dosimetry algorithm ranged from 1.3 to 1.5 mSv y-1and are within the national and international limits.
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Affiliation(s)
- D López-Ángeles
- Facultad de Ciencias, Universidad Nacional Autónoma de México, A.P. 70-543, 04510 CDMX, Mexico
| | - I Gamboa-deBuen
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, A.P. 70-543, 04510 CDMX, Mexico
| | | | - K Alaniz-Sida
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, CDMX 14269, Mexico
| | - S Vega-Montesinos
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, CDMX 14269, Mexico
| | - X Lopez-Rendon
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, CDMX 14269, Mexico
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17
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Engström A, Isaksson M, Javid R, Lundh C, Båth M. A case study of cost-benefit analysis in occupational radiological protection within the healthcare system of Sweden. J Appl Clin Med Phys 2021; 22:295-304. [PMID: 34505345 PMCID: PMC8504601 DOI: 10.1002/acm2.13421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 11/12/2022] Open
Abstract
The aim of the present study was to demonstrate cases of cost-benefit analysis within healthcare, of how economic factors can be considered in occupational radiological protection, in agreement with the as low as reasonably achievable principle and present Swedish legislations. In the first part of the present study, a comparison of examples within health economics used by authorities and institutes in Sweden was made. The comparison focused on value of a statistical life, quality-adjusted life year, and monetary cost assigned to a unit of collective dose for radiation protection purposes (α-value). By this comparison, an α-value was determined as an interval between $45 and $450 per man-mSv, for the Swedish society in 2021. The α-value interval can be interpreted as following: Less than $45 per man-mSv is a good investment. From $45 to $450 per man-mSv, other factors than costs and collective dose are important to consider. More than $450 per man-mSv is too expensive. In the second part of the present study, seven cases of cost-benefit analyses in occupational radiological protection were provided. The present study focused specifically on cases where the relevant factors were costs and collective dose. The present case study shows a large variation in costs per collective dose from different types of occupational radiological protection, used at Skaraborg Hospital in Sweden.
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Affiliation(s)
| | - Mats Isaksson
- Department of Radiation PhysicsInstitute of Clinical SciencesSahlgrenska Academy at University of GothenburgGothenburgSweden
| | - Reza Javid
- Department of Research and DevelopmentSkaraborg HospitalSkövdeSweden
| | - Charlotta Lundh
- Department of Radiation PhysicsInstitute of Clinical SciencesSahlgrenska Academy at University of GothenburgGothenburgSweden
- Department of Medical Physics and Biomedical EngineeringSahlgrenska University HospitalGothenburgSweden
| | - Magnus Båth
- Department of Radiation PhysicsInstitute of Clinical SciencesSahlgrenska Academy at University of GothenburgGothenburgSweden
- Department of Medical Physics and Biomedical EngineeringSahlgrenska University HospitalGothenburgSweden
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18
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Influence of safety glasses, body height and magnification on the occupational eye lens dose during pelvic vascular interventions: a phantom study. Eur Radiol 2021; 32:1688-1696. [PMID: 34495352 PMCID: PMC8831265 DOI: 10.1007/s00330-021-08231-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/19/2021] [Accepted: 08/02/2021] [Indexed: 11/05/2022]
Abstract
Objective By simulating a fluoroscopic-guided vascular intervention, two differently designed radiation safety glasses were compared. The impacts of changing viewing directions and body heights on the eye lens dose were evaluated. Additionally, the effect of variable magnification levels on the arising scattered radiation was determined. Methods A phantom head, replacing the operator’s head, was positioned at different heights and rotated in steps of 20° in the horizontal plane. Thermoluminescent dosimeters (TLD), placed in the left orbit of the phantom, detected eye lens doses under protected and completely exposed conditions. In a second step, radiation dose values with increasing magnification levels were detected by RaySafe i3 dosimeters. Results Changing eye levels and head rotations resulted in a wide range of dose reduction factors (DRF) from 1.1 to 8.5. Increasing the vertical distance between the scattering body and the protective eyewear, DRFs markedly decreased for both glasses. Significant differences between protection glasses were observed. Increasing magnification with consecutively decreasing FOV size variably reduced the dose exposure to the eye lens between 47 and 83%, respectively. Conclusion The safety glasses in the study effectively reduced the dose exposure to the eye lens. However, the extent of the protective effect was significant depending on eye levels and head rotations. This may lead to a false sense of safety for the medical staff. In addition, the application of magnification reduced the quantity of scattering dose significantly. To ensure safe working in the Cath-lab, additional use of protective equipment and the differences in design of protective eyewear should be considered. Key Points • Eye lens dose changes with physical size of the interventionist and viewing direction. • The use of magnification during fluoroscopic-guided interventions reduces scattered radiation.
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Kato M, Chida K, Munehisa M, Sato T, Inaba Y, Suzuki M, Zuguchi M. Non-Lead Protective Aprons for the Protection of Interventional Radiology Physicians from Radiation Exposure in Clinical Settings: An Initial Study. Diagnostics (Basel) 2021; 11:diagnostics11091613. [PMID: 34573955 PMCID: PMC8469807 DOI: 10.3390/diagnostics11091613] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 01/08/2023] Open
Abstract
Radiation protection/evaluation during interventional radiology (IVR) poses a very important problem. Although IVR physicians should wear protective aprons, the IVR physician may not tolerate wearing one for long procedures because protective aprons are generally heavy. In fact, orthopedic problems are increasingly reported in IVR physicians due to the strain of wearing heavy protective aprons during IVR. In recent years, non-Pb protective aprons (lighter weight, composite materials) have been developed. Although non-Pb protective aprons are more expensive than Pb protective aprons, the former aprons weigh less. However, whether the protective performance of non-Pb aprons is sufficient in the IVR clinical setting is unclear. This study compared the ability of non-Pb and Pb protective aprons (0.25- and 0.35-mm Pb-equivalents) to protect physicians from scatter radiation in a clinical setting (IVR, cardiac catheterizations, including percutaneous coronary intervention) using an electric personal dosimeter (EPD). For radiation measurements, physicians wore EPDs: One inside a personal protective apron at the chest, and one outside a personal protective apron at the chest. Physician comfort levels in each apron during procedures were also evaluated. As a result, performance (both the shielding effect (98.5%) and comfort (good)) of the non-Pb 0.35-mm-Pb-equivalent protective apron was good in the clinical setting. The radiation-shielding effects of the non-Pb 0.35-mm and Pb 0.35-mm-Pb-equivalent protective aprons were very similar. Therefore, non-Pb 0.35-mm Pb-equivalent protective aprons may be more suitable for providing radiation protection for IVR physicians because the shielding effect and comfort are both good in the clinical IVR setting. As non-Pb protective aprons are nontoxic and weigh less than Pb protective aprons, non-Pb protective aprons will be the preferred type for radiation protection of IVR staff, especially physicians.
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Affiliation(s)
- Mamoru Kato
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (M.K.); (Y.I.); (M.S.); (M.Z.)
- Akita Cerebrospinal and Cardiovascular Center (Akita Medical Center), 6–10 Senshu-Kubota Machi, Akita 010-0874, Japan; (M.M.); (T.S.)
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (M.K.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
- Correspondence: ; Tel.: +81-22-717-7943
| | - Masato Munehisa
- Akita Cerebrospinal and Cardiovascular Center (Akita Medical Center), 6–10 Senshu-Kubota Machi, Akita 010-0874, Japan; (M.M.); (T.S.)
- Department of Cardiovascular Medicine, Senseki Hospital, 53-7 Akai, Aza Dai, Higashi Matsushima 981-0501, Japan
| | - Tadaya Sato
- Akita Cerebrospinal and Cardiovascular Center (Akita Medical Center), 6–10 Senshu-Kubota Machi, Akita 010-0874, Japan; (M.M.); (T.S.)
- Department of Cardiovascular Medicine, Saka General Hospital, 16-5 Nishiki-machi, Shiogama 985-8506, Japan
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (M.K.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Masatoshi Suzuki
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (M.K.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Masayuki Zuguchi
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (M.K.); (Y.I.); (M.S.); (M.Z.)
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Imaging diagnosis of canine hip dysplasia with and without human exposure to ionizing radiation. Vet J 2021; 276:105745. [PMID: 34464723 DOI: 10.1016/j.tvjl.2021.105745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/22/2022]
Abstract
Hip dysplasia (HD) is one of the most common hereditary orthopaedic diseases in dogs, with serious implications for the quality of life of the affected animals. Radiographic screening is essential for the selection of breeding stock in some at-risk breeds, and radiography is also used in the diagnosis of clinical HD cases. A definitive diagnosis of HD is based on radiographic examination, and the most commonly used view is the ventrodorsal hip extended projection, sometimes in combination with various hip stress-based techniques. Radiographic images require high quality positioning and dogs are usually anesthetized and often manually restrained to facilitate optimal positioning. The 'as low as reasonably achievable' (ALARA) principle used in human radioprotection is not always fulfilled in veterinary practice, except in the UK, where human exposure to ionizing radiation in veterinary medicine is strictly regulated. While each dose of ionizing radiation is small, doses accumulate over a lifetime, which can eventually result in substantial radiation exposure. Therefore, manual restraint should be avoided and mechanical immobilization, sedation or general anaesthesia should be used. This review examines the biological effects of human exposure to ionizing radiation and common sources of veterinary exposure. The diagnostic quality of imaging methods for the diagnosis of canine HD is compared between manually restrained and hands-free dog positioning. Hands-free radiographic techniques are available to assess hip laxity, degenerative joint changes and hip osseous structure while preserving image quality, and can be used to select animals for breeding or for the diagnosis of HD.
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Livingstone RS, Varghese A. A simple quality control tool for assessing integrity of lead equivalent aprons. Indian J Radiol Imaging 2021; 28:258-262. [PMID: 30050253 PMCID: PMC6038217 DOI: 10.4103/ijri.ijri_374_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Protective lead or lead-equivalent (Pbeq) aprons play a key role in providing necessary shielding from secondary radiation to occupational workers. Knowledge on the integrity of these shielding apparels during purchase is necessary to maintain adequate radiation safety. Aim The aim of the study was to evaluate the lead equivalence in aprons based on simple quality assessment tool. Materials and Methods 0.25 mm and 0.5 mm lead and lead-free aprons from 6 manufacturers were assessed using a calibrated digital X-ray unit. The percentage attenuation values of the aprons were determined at 100 kVp using an ionization chamber and the pixel intensities were analyzed using digital radiographic images of lead apron, copper step wedge tool, and 2 mm thick lead. Results Mean radiation attenuation of 90% and 97% was achieved in 0.25 mm and 0.5 mm lead or lead-free aprons respectively. The pixel intensities from 0.25 mm Pbeq apron correspond to 0.8-1.2 mm thickness of Cu while 0.5 mm Pbeq aprons correspond to 2.0-2.8 mm of Cu. Conclusion Pixel intensity increased with increase in the thickness of copper step wedge indicating a corresponding increase in lead equivalence in aprons. It is suggestive that aprons should be screened for its integrity from the time of purchase using computed tomography (CT), fluoroscopy, or radiography. It is recommended that this simple test tool could be used for checking lead equivalence if any variation in contrast is seen in the image during screening.
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Affiliation(s)
- Roshan S Livingstone
- Department of Radiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Anna Varghese
- Department of Radiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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Endo M, Haga Y, Sota M, Tanaka A, Otomo K, Murabayashi Y, Abe M, Kaga Y, Inaba Y, Suzuki M, Meguro T, Chida K. Evaluation of novel X-ray protective eyewear in reducing the eye dose to interventional radiology physicians. JOURNAL OF RADIATION RESEARCH 2021; 62:414-419. [PMID: 33839782 PMCID: PMC8127654 DOI: 10.1093/jrr/rrab014] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/17/2020] [Indexed: 05/28/2023]
Abstract
The new recommendation of the International Commission on Radiological Protection for occupational eye dose is an equivalent dose limit to the eye of 20 mSv year-1, averaged over a 5-year period. This recommendation is a drastic reduction from the previous limit of 150 mSv year-1. Hence, it is important to protect physicians' eyes from X-ray radiation. Particularly in interventional radiology (IVR) procedures, many physicians use protective lead (Pb) glasses to reduce their occupational exposure. This study assessed the shielding effects of novel 0.07 mm Pb glasses. The novel glasses (XR-700) have Pb-acrylic lens molded in three dimensions. We studied the novel type of 0.07 mm Pb glasses over a period of seven consecutive months. The eye dose occupational radiation exposure of seven IVR physicians was evaluated during various procedures. All IVR physicians wore eye dosimeters (DOSIRIS™) close to the left side of the left eye. To calculate the shielding effects of the glasses, this same type of eye dosimeter was worn both inside and outside of the Pb lenses. The average shielding effect of the novel glasses across the seven physicians was 61.4%. Our results suggest an improved shielding effect for IVR physicians that use these glasses. No physician complained that the new glasses were uncomfortable; therefore comfort is not a problem. The lightweight glasses were acceptable to IVR physicians, who often must perform long procedures. Thus, the novel glasses are comfortable and reasonably protective. Based on the results of this study, we recommend that IVR physicians use these novel 0.07 mm Pb glasses to reduce their exposure.
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Affiliation(s)
- Mime Endo
- Department of Radiological Technology, Tohoku University Graduate
School of Medicine , 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Yoshihiro Haga
- Department of Radiological Technology, Tohoku University Graduate
School of Medicine , 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Department of Radiology, Sendai Kousei Hospital ,
Hirosemachi 4-15, Aobaku, Sendai 980-0873, Japan
| | - Masahiro Sota
- Department of Radiological Technology, Tohoku University Graduate
School of Medicine , 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Department of Radiology, Sendai Kousei Hospital ,
Hirosemachi 4-15, Aobaku, Sendai 980-0873, Japan
| | - Akiko Tanaka
- Department of Cardiovascular Medicine, Sendai Kousei
Hospital , Hirosemachi 4-15, Aobaku, Sendai 980-0873, Japan
| | - Kazuki Otomo
- Department of Radiological Technology, Tohoku University Graduate
School of Medicine , 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Yuuki Murabayashi
- Division of Disaster Medicine, International Research Institute of
Disaster Science, Tohoku University , 6-6-4 Aoba, Sendai 980-8579,
Japan
| | - Mitsuya Abe
- Department of Radiology, Sendai Kousei Hospital ,
Hirosemachi 4-15, Aobaku, Sendai 980-0873, Japan
| | - Yuji Kaga
- Department of Radiology, Sendai Kousei Hospital ,
Hirosemachi 4-15, Aobaku, Sendai 980-0873, Japan
| | - Yohei Inaba
- Department of Radiological Technology, Tohoku University Graduate
School of Medicine , 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Disaster Medicine, International Research Institute of
Disaster Science, Tohoku University , 6-6-4 Aoba, Sendai 980-8579,
Japan
| | - Msatoshi Suzuki
- Department of Radiological Technology, Tohoku University Graduate
School of Medicine , 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Disaster Medicine, International Research Institute of
Disaster Science, Tohoku University , 6-6-4 Aoba, Sendai 980-8579,
Japan
| | - Taiichiro Meguro
- Department of Cardiovascular Medicine, Sendai Kousei
Hospital , Hirosemachi 4-15, Aobaku, Sendai 980-0873, Japan
| | - Koichi Chida
- Department of Radiological Technology, Tohoku University Graduate
School of Medicine , 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Disaster Medicine, International Research Institute of
Disaster Science, Tohoku University , 6-6-4 Aoba, Sendai 980-8579,
Japan
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23
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Souza SP, Silva MF, Tavares OJ, Souza LWG, Silva DC, Santos WS, Belinato W, Perini AP, Neves LP. Monte Carlo evaluation of occupational exposure during uterine artery embolization. Phys Med 2021; 85:50-56. [PMID: 33965741 DOI: 10.1016/j.ejmp.2021.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Uterine fibroids affect women mainly of childbearing age, an alternative for the treatment of these fibroids is uterine artery embolization (UAE), a minimally invasive procedure which uses fluoroscopy, providing radiation doses often high, due to the fact that professionals remain in the room throughout the procedure. In this work, equivalent and effective doses were evaluated for the main physician, for the assistant and for the patient during the UAE procedure. METHODS Doses were calculated using computer simulation with the Monte Carlo Method, and virtual anthropomorphic phantoms, in a typical scenario of interventional radiology with field sizes of 20 × 20, 25 × 25 and 32 × 32 cm2, tube voltages of 70, 80, 90 and 100 kV, and projections of LAO45, RAO45 and PA. RESULTS The results showed that the highest doses received by the professionals were for the LAO45 projection with 32 × 32 cm2 field size and 100 kV tube voltage, which is in accordance with the existing literature. The highest equivalent doses, without the protective equipment, were in the eyes, skin, breast and stomach for the main physician, and for the assistant they were in the eyes, breast, thyroid and skin. When she used the protective equipment, the highest equivalent doses for the main physician were on the skin, brain, bone marrow and bone surface, and for the assistant they were on the skin, brain, red bone marrow and bone surface. CONCLUSIONS Effective doses increased up to 3186% for the main physician, and 2462% for the assistant, without protective equipment, thus showing their importance.
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Affiliation(s)
- Samara P Souza
- Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia, MG, Brazil
| | - Monique F Silva
- Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia, MG, Brazil
| | - Otávio J Tavares
- Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia, MG, Brazil
| | - Lucas W G Souza
- Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia, MG, Brazil; Instituto Maria Ranulfa Ltda, FATRA - Faculdade do Trabalho, Av. Paes Leme Osvaldo, 38408000 Uberlândia, MG, Brazil
| | - Daniela C Silva
- Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia, MG, Brazil
| | - William S Santos
- Instituto de Física, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Walmir Belinato
- Instituto Federal da Bahia (IFBA), Vitória da Conquista, BA, Brazil
| | - Ana P Perini
- Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia, MG, Brazil; Instituto de Física, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Lucio P Neves
- Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia, MG, Brazil; Instituto de Física, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
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24
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Harrison JD, Balonov M, Bochud F, Martin C, Menzel HG, Ortiz-Lopez P, Smith-Bindman R, Simmonds JR, Wakeford R. ICRP Publication 147: Use of Dose Quantities in Radiological Protection. Ann ICRP 2021; 50:9-82. [PMID: 33653178 DOI: 10.1177/0146645320911864] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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25
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Laranjeiro AS, Bohra F, Byun SH, Atanackovic J, Hanu AR. CHARACTERIZATION OF A LANTHANUM BROMIDE DETECTOR FOR EYE LENS DOSIMETRY AT THE CANDU NUCLEAR POWER PLANTS BASED ON DIRECT MEASUREMENTS OF THE GAMMA-RAY SPECTRA. RADIATION PROTECTION DOSIMETRY 2020; 192:309-320. [PMID: 33320200 DOI: 10.1093/rpd/ncaa186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/27/2020] [Accepted: 10/18/2020] [Indexed: 06/12/2023]
Abstract
Gamma-ray spectra were measured using a LaBr$_{3}$(Ce) spectrometer during the outage periods, aiming at quantifying the gamma source term of radiation workers' exposure, at the CANDU nuclear power reactors, for the purposes of eye lens dosimetry. The spectra were measured inside the boiler rooms, of the Bruce Power and Ontario Power Generation (OPG) CANDU nuclear power plants, where workers are exposed to relatively high dose rates radiation fields during the maintenance work. Prior to measurements at the CANDU reactors, the pulse shaping parameters of the gamma spectrometer were optimised for high rates gamma fields, up to an input rates of 120 kcps, in order to accomplish a high output rate with a reasonable energy resolution. In parallel, the response of the LaBr$_{3}$(Ce) detector was characterized by experiments and Monte Carlo simulations. The gamma spectra measured at the CANDU reactors were reported in terms of the gamma-ray fluence rate spectrum. In all measured data, $^{60}$Co and $^{95}$Nb were main contributors of the gamma fields. The measured spectra have been used to calculate the dosimetric quantities of interest: personal dose equivalents H$_{p}$(10) and H$_{p}$(0.07) and eye lens absorbed dose.
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Affiliation(s)
- A S Laranjeiro
- Department of Physics and Astronomy, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - F Bohra
- Department of Physics and Astronomy, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - S H Byun
- Department of Physics and Astronomy, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - J Atanackovic
- Department of Physics and Astronomy, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
- Ontario Power Generation, 1549 Victoria St E, Whitby, ON, L1N 9E3, Canada
| | - A R Hanu
- Department of Physics and Astronomy, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
- Bruce Power, 177 Tie Rd, Tiverton, ON, N0G 2T0, Canada
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26
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Petrucci C. Review of experimental estimates for the protection afforded by eyewear for interventional x-ray staff. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2020; 40:R46-R70. [PMID: 32143203 DOI: 10.1088/1361-6498/ab7d8c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This paper attempts to systematise all published experimental results for the dose reduction factor (DRF) offered by leaded eyewear on clinicians performing interventional procedures. We aim to present a comprehensive analysis of the issue and a comparison of the various equipment models at different exposure geometries. The main purpose of the paper is, however, to clarify the best choice for the DRF within the possible diverse contexts and approaches to eye lens dose assessment. Evidence has been obtained that the lowest estimates of DRF are associated with larger scatter incidence angles and that, except for the slightly better performance exhibited by wraparound eyeglasses, there is no real distinction between the DRFs for the different equipment categories. The dataset as a whole confirms that, when measurements for the concerned eyewear model and irradiation conditions are unattainable, assuming DRF = 2 represents an adequately conservative choice. Nonetheless, this value includes only 17% of all results from the literature, whereas their histogram follows a distribution skewed towards higher values, represented by a median equal to 5. Therefore, if more realistic dose reconstructions are necessary, such as for purposes of epidemiological investigations or compensation decisions, the adoption of this central tendency index appears to be more reasonable. The complexity of characterising the DRF behaviour as a function of the various exposure factors reinforces the consideration of a statistical approach to eye lens dose assessment as a viable alternative. In this perspective, assuming for DRF a lognormal distribution with parameters [Formula: see text] and [Formula: see text] which has been verified to satisfactorily approximate the literature data distribution, should be deemed to be an appropriate option.
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Affiliation(s)
- Caterina Petrucci
- Department of Medicine, Epidemiology, Workplace and Environmental Hygiene, National Institute for Insurance against Accidents at Work (INAIL), via Fontana Candida 1, 00078 Monte Porzio Catone, Roma, Italy
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Asgari A, Parach AA, Mirmohammadi SJ, Mehrparvar AH, Nekoofar Z, Daneshian E, Bouzarjomehri F, SeyedHosseini SM, Andishmand A, Dastmalchi J, Emami M. Occupational eye dose to medical staff in various interventional cardiologic procedures: is the need for lead goggles the same in all groups of radiation workers? Int J Cardiovasc Imaging 2020; 36:1417-1425. [PMID: 32350705 DOI: 10.1007/s10554-020-01864-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
Considering the increased use of interventional cardiologic procedures and concern about irradiation to the eyes, it is necessary to measure eye dose in radiation workers. The assessment of eye dose using collar dose is a routine but inaccurate method. Therefore this study was designed to measure eye dose in the radiation workers of various interventional cardiologic procedures. In this study eye dose was measured for left and right eyes in three groups of radiation workers in angiography ward of Afshar hospital in various procedures using TLD. Measurements were done separately for cardiologists, nurses and radio-technologists in 100 procedures. The nurses functioned as surgical assistants and were usually close to the table. The correlation of staff dose to exposure parameters was also investigated. Eye dose in physicians were higher than other staff in all procedures. Also the left eye dose was considerably higher than right one, especially for physicians. The median equivalent dose per procedure of left eye for physicians, nurses and radio-technologists were 7.4, 3.6, 1.4 µSv (PCI) and 3.2, 3.1, 1.3 µSv (Adhoc) and 3.2, 1.7, 1.1 µSv (CA), respectively. The annual left eye equivalent dose with (without) using lead goggles were 2.4 (15.3), 1.4 (2.2), 1.0 (1.1) mSv for physicians, nurses and radio-technologists, respectively. There were also a positive correlation between eye dose and KAP for procedures without lead goggles. The lead goggles showed lower protection effects for radio-technologists than other staff. Only 30% of physicians received a dose higher than 1/3 of the ICRP annual dose limit, therefor only physician eye dose should be monitored in catheterization labs.
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Affiliation(s)
- Azam Asgari
- Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Asghar Parach
- Department of Medical Physics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Zahra Nekoofar
- Department of Radiation Technology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elahe Daneshian
- Department of Radiation Technology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatollah Bouzarjomehri
- Department of Medical Physics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Abbas Andishmand
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Jalal Dastmalchi
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Emami
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Jaramillo-Garzón W, Morales-Aramburo J, Puerta-Ortiz A, Castrillón-Giraldo W. Dosimetría personal y exposición ocupacional en Cardiología intervencionista. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2019.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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29
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Kato M, Chida K, Ishida T, Sasaki F, Toyoshima H, Osaka H, Kinoshita T. [Evaluating Eye Lens Dose of Neurovascular and Cardiac Electrophysiology Interventional Physician]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2020; 76:26-33. [PMID: 31956184 DOI: 10.6009/jjrt.2020_jsrt_76.1.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE The International Commission on Radiological Protection recommended that interventional radiologies (IRs) have high radiation doses and that staff may also be exposed to high doses. In the present study, we measured the radiation exposure dose [3 mm dose equivalent, Hp (3) ] in the eye using an appropriate dosimeter placed next to the physician' s eye during neurovascular intervention procedure (Neuro-IR) and interventional cardiac electrophysiology procedure (EP-IR). METHOD Physicians wore a direct eye dosemeter just lateral to the left eye and an additional direct eye dosemeter outside the radiation protective glasses close to their left eye. Additionally, a neck badge [0.07 mm dose equivalent, Hp (0.07) ] was worn outside the protective apron to the left of the neck, to compare the direct eye dosimeter estimated doses. The occupational eye lens dose was evaluated over a period of 6-month. RESULTS The maximum Hp (3) of the Neuro-IR physician was estimated 5.1 mSv without the radiation protective glasses and 1.6 mSv with the radiation protective glasses. On the other hand, the maximum Hp (3) of the EP-IR physician was estimated 29 mSv without the radiation protective glasses and 15 mSv with the radiation protective glasses. CONCLUSION Physicians eye lens dose [Hp (3) ] tended to be overestimated by the neck badge measurements [Hp (0.07)]. A correct evaluation of the lens dose [Hp (3) ] using the direct eye dosimeter is recommended. Although we found a positive correlation between Hp (0.07) and Hp (3), the value of R2 in the regression equation is low, we recommended that the eye lens dose estimated carefully from Hp (0.07).
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Affiliation(s)
- Mamoru Kato
- Department of Radiology and Nuclear Medicine, Akita Cerebrospinal and Cardiovascular Center.,Department of Health Science, Tohoku University Graduate School of Medicine
| | - Koichi Chida
- Department of Health Science, Tohoku University Graduate School of Medicine
| | - Takato Ishida
- Department of Radiology and Nuclear Medicine, Akita Cerebrospinal and Cardiovascular Center
| | - Fumiaki Sasaki
- Department of Radiology and Nuclear Medicine, Akita Cerebrospinal and Cardiovascular Center
| | - Hideto Toyoshima
- Department of Radiology and Nuclear Medicine, Akita Cerebrospinal and Cardiovascular Center
| | - Hajime Osaka
- Department of Radiology and Nuclear Medicine, Akita Cerebrospinal and Cardiovascular Center
| | - Toshibumi Kinoshita
- Department of Radiology and Nuclear Medicine, Akita Cerebrospinal and Cardiovascular Center
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30
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Negri P, Campi F, De Crescenzo S, Garlati L, Tambussi O. EXPERIMENTAL VALIDATION OF ALGORITHMS USED TO ESTIMATE EFFECTIVE DOSE DURING INTERVENTIONAL RADIOLOGY PROCEDURES. RADIATION PROTECTION DOSIMETRY 2019; 187:42-49. [PMID: 31111940 DOI: 10.1093/rpd/ncz136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 04/16/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
In IR procedures, in order to evaluate the effective dose, the importance of the double dosemeter has been recognised, one worn above and one under the apron. Over the last few decades several algorithms have been developed to combine the readings of the dosemeters, however currently there is no international consensus on which is the best one. In this work, eight irradiations, corresponding to typical interventional radiology procedures, were carried out in order to experimentally verify the accuracy of the algorithms. The patient was substituted by solid water-equivalent (RW3) layers, while effective dose to personnel was calculated by TLDs inside the Alderson Rando phantom. The results show that most of the algorithms, with a few exceptions, are too conservative, however there are many factors which can affect their accuracy, so it is impossible to achieve a high level of precision in the evaluation of the effective dose.
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Affiliation(s)
- P Negri
- CERAP SA, Cherbourg Octeville, France
| | - F Campi
- Politecnico di Milano, CeSNEF-Nuclear Engineering, Milano, Italy
| | | | - L Garlati
- Politecnico di Milano, CeSNEF-Nuclear Engineering, Milano, Italy
| | - O Tambussi
- Politecnico di Milano, CeSNEF-Nuclear Engineering, Milano, Italy
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31
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Kato M, Chida K, Ishida T, Sasaki F, Toyoshima H, Oosaka H, Terata K, Abe Y, Kinoshita T. OCCUPATIONAL RADIATION EXPOSURE DOSE OF THE EYE IN DEPARTMENT OF CARDIAC ARRHYTHMIA PHYSICIAN. RADIATION PROTECTION DOSIMETRY 2019; 187:361-368. [PMID: 31605141 DOI: 10.1093/rpd/ncz175] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/25/2019] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
Interventional radiology (IR) procedures tend to be complex, which delivers high radiation exposure to patient. In the present study, we measured the radiation exposure dose [Hp(3)] in the eye using a direct eye dosemeter placed next to the physician's eye during procedures. Physicians wore a direct eye dosemeter just lateral to eyes and an additional direct eye dosemeter outside the radiation protective eyeglasses close to their eyes. Additionally, a neck glass badge was worn at the neck. Although we found a positive correlation between the left neck glass badge dose [Hp(0.07)] and the left eye lens dose [Hp(3)], the value of R2 of the regression equation were 0.62 and 0.71 (outside and inside). We thought that the exact eye lens dose might not be estimated from the neck glass badge. In conclusion, a correct evaluation of the lens dose [Hp(3)] using the direct eye dosemeter is recommended for tachyarrhythmia physicians.
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Affiliation(s)
- Mamoru Kato
- Department of Radiology and Nuclear Medicine, Research Institute for Brain & Blood Vessels, Akita, Japan
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takato Ishida
- Department of Radiology and Nuclear Medicine, Research Institute for Brain & Blood Vessels, Akita, Japan
| | - Fumiaki Sasaki
- Department of Radiology and Nuclear Medicine, Research Institute for Brain & Blood Vessels, Akita, Japan
| | - Hideto Toyoshima
- Department of Radiology and Nuclear Medicine, Research Institute for Brain & Blood Vessels, Akita, Japan
| | - Hajime Oosaka
- Department of Radiology and Nuclear Medicine, Research Institute for Brain & Blood Vessels, Akita, Japan
| | - Ken Terata
- Department of Cardiology, Division of Internal Medicine, Research Institute for Brain and Blood Vessels, Akita, Japan
| | - Yoshihisa Abe
- Department of Cardiology, Division of Internal Medicine, Research Institute for Brain and Blood Vessels, Akita, Japan
| | - Toshibumi Kinoshita
- Department of Radiology and Nuclear Medicine, Research Institute for Brain & Blood Vessels, Akita, Japan
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Kato M, Chida K, Ishida T, Toyoshima H, Yoshida Y, Yoshioka S, Moroi J, Kinoshita T. OCCUPATIONAL RADIATION EXPOSURE OF THE EYE IN NEUROVASCULAR INTERVENTIONAL PHYSICIAN. RADIATION PROTECTION DOSIMETRY 2019; 185:151-156. [PMID: 30624732 DOI: 10.1093/rpd/ncy285] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 11/22/2018] [Accepted: 12/12/2018] [Indexed: 06/09/2023]
Abstract
Neurovascular interventional radiology (neuro-IR) procedures tend to require an extended fluoroscopic exposure time and repeated digital subtraction angiography. To evaluate the actual measurement of eye lens dose using a direct eye dosemeter in neuro-IR physicians is important. Direct dosimetry using the DOSIRIS™ (IRSN, France) [3 mm dose equivalent, Hp(3)] was performed on 86 cases. Additionally, a neck personal dosemeter (glass badge) [0.07 mm dose equivalent, Hp(0.07)] was worn outside the protective apron to the left of the neck. The average doses per case of neuro-IR physicians were 0.04 mSv/case and 0.02 mSv/case, outside and inside the radiation protection glasses, respectively. The protective effect of radiation protection glasses was approximately 60%. The physician eye lens dose tended to be overestimated by the neck glass badge measurements. A correct evaluation of the lens dose [Hp(3)] using an eye dosemeter such as DOSIRIS™ is needed for neuro-IR physicians.
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Affiliation(s)
- Mamoru Kato
- Department of Radiology and Nuclear Medicine, Research Institute for Brain & Blood Vessels-Akita
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University
| | - Takato Ishida
- Department of Radiology and Nuclear Medicine, Research Institute for Brain & Blood Vessels-Akita
| | - Hideto Toyoshima
- Department of Radiology and Nuclear Medicine, Research Institute for Brain & Blood Vessels-Akita
| | - Yasuyuki Yoshida
- Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-Akita
| | - Shotaro Yoshioka
- Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-Akita
| | - Junta Moroi
- Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-Akita
| | - Toshibumi Kinoshita
- Department of Radiology and Nuclear Medicine, Research Institute for Brain & Blood Vessels-Akita
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Wong JHD, Anem LEA, Tan S, Tan SK, Ng KH. Eye lens dose of medical personnel involved in fluoroscopy and interventional procedures at a Malaysian Hospital. Phys Med 2019; 68:47-51. [DOI: 10.1016/j.ejmp.2019.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 10/17/2019] [Accepted: 11/05/2019] [Indexed: 10/25/2022] Open
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Mattar E, Alsafi K, Sulieman A, Suliman II. Occupational exposure of the operator eye lens in digital coronary angiography and interventions. Radiat Phys Chem Oxf Engl 1993 2019. [DOI: 10.1016/j.radphyschem.2019.108400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Masterson M, Cournane S, McWilliams N, Maguire D, McCavana J, Lucey J. Relative response of dosimeters to variations in scattered X-ray energy spectra encountered in interventional radiology. Phys Med 2019; 67:141-147. [DOI: 10.1016/j.ejmp.2019.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/10/2019] [Accepted: 11/01/2019] [Indexed: 11/30/2022] Open
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Ishii H, Haga Y, Sota M, Inaba Y, Chida K. Performance of the DOSIRIS™ eye lens dosimeter. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2019; 39:N19-N26. [PMID: 31167175 DOI: 10.1088/1361-6498/ab2729] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Monitoring and protecting of occupational eye doses in interventional radiology (IR) are very important matters. DOSIRIS™ is the useful solution to estimate the 3 mm dose-equivalent (Hp(3)), and it can be worn behind lead glasses. And DOSIRIS™, adjustable according to 3 axes, it is ideally placed as close to the eye and in contact with the skin. So, DOSIRIS™ will be suitable eye lens dosimeter. However, the fundamental characteristics of the DOSIRIS™ in the diagnostic x-ray energy domain (including that of IR x-ray systems) remain unclear. Here, we evaluated the performance of the dosimeter in that energy range. As a result, the DOSIRIS™ has good fundamental characteristics (batch uniformity, dose linearity, energy dependence, and angular dependence) in the diagnostic x-ray energy domain. We conclude that the DOSIRIS™ has satisfactory basic performance for occupational eye dosimetry in diagnostic x-ray energy settings (including IR x-ray systems).
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Affiliation(s)
- Hiroki Ishii
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
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Martin CJ, Temperton DH, Jupp T, Hughes A. IPEM topical report: personal dose monitoring requirements in healthcare. ACTA ACUST UNITED AC 2019; 64:035008. [DOI: 10.1088/1361-6560/aafa3f] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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38
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Dalah EZ, Mahdi O, Elshami W, Abuzaid MM, David LR, Mira OA, Obaideen A, Elmahdi HM, Bradley D. Occupational doses to cardiologists performing fluoroscopically-guided procedures. Radiat Phys Chem Oxf Engl 1993 2018. [DOI: 10.1016/j.radphyschem.2018.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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39
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Jupp T, Kamali-Zonouzi P. EYE LENS DOSIMETRY WITHIN THE CARDIAC CATHETERISATION LABORATORY-ARE ANCILLARY STAFF BEING FORGOTTEN? RADIATION PROTECTION DOSIMETRY 2018; 178:185-192. [PMID: 28985396 DOI: 10.1093/rpd/ncx088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 06/22/2017] [Indexed: 06/07/2023]
Abstract
Eye lens doses have been widely explored for interventional clinicians, however, data for ancillary staff is limited. Eye doses have been measured using a headband technique for clinicians, specialist registrars, nurses and radiographers working in a cardiac catheterisation laboratory in a UK hospital. Workload was found to be significantly higher for ancillary staff, and consequently, despite the absolute monthly collar doses and other indicators such as eye dose/KAP and eye dose/procedure being highest for clinicians, our study found there was no significant difference in the monthly eye dose readings between the clinicians and nurses (p = 0.82), and clinicians and radiographers (p = 0.72). The average eye dose/collar dose ratios were 0.71 and 0.61 for cardiologists and SPRs, but ratios above one were found for nurses and radiographers. This work expands on the eye dose data available for ancillary staff and demonstrates that eye dosimetry for these workers should not be overlooked.
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Affiliation(s)
- Tom Jupp
- Medical Physics Department, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, GU2 7XX, UK
| | - Pedrum Kamali-Zonouzi
- Medical Physics Department, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, GU2 7XX, UK
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Haga Y, Chida K, Kaga Y, Sota M, Meguro T, Zuguchi M. Occupational eye dose in interventional cardiology procedures. Sci Rep 2017; 7:569. [PMID: 28373715 PMCID: PMC5428664 DOI: 10.1038/s41598-017-00556-3] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 03/03/2017] [Indexed: 01/19/2023] Open
Abstract
It is important to measure the radiation dose [3-mm dose equivalent, Hp(3)] in the eye. This study was to determine the current occupational radiation eye dose of staff conducting interventional cardiology procedures, using a novel direct eye dosimeter. We measured the occupational eye dose [Hp(3)] in physicians and nurses in a catheterization laboratory for 6-months. The eye doses [Hp(3)] of 12 physicians (9 with Pb glasses, 3 without), and 11 nurses were recorded using a novel direct eye dosimeter, the DOSIRISTM. We placed dosimeters above and under the glasses. We also estimated the eye dose [0.07-mm dose equivalent] using a neck personal dosimeter. The eye doses among interventional staff ranked in the following order: physicians without Pb glasses > physicians with Pb glasses > nurses. The shielding effect of the glasses (0.07-mm Pb) in a clinical setting was approximately 60%. In physicians who do not wear Pb glasses, the eye dose may exceed the new regulatory limit for IR staff. We found good correlations between the neck dosimeter dose and eye dosimeter dose (inside or outside glasses, R2 = 0.93 and R2 = 0.86, respectively) in physicians. We recommend that interventional physicians use an eye dosimeter for correct evaluation of the lens dose.
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Affiliation(s)
- Yoshihiro Haga
- Department of Radiological Technology, Faculty of Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, 980-8575, Japan
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai, 980-0873, Japan
| | - Koichi Chida
- Department of Radiological Technology, Faculty of Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, 980-8575, Japan.
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, Aramaki Aza-Aoba 468-1, Aoba-ku, Sendai, 980-0845, Japan.
| | - Yuji Kaga
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai, 980-0873, Japan
| | - Masahiro Sota
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai, 980-0873, Japan
| | - Taiichiro Meguro
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai, 980-0873, Japan
| | - Masayuki Zuguchi
- Department of Radiological Technology, Faculty of Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, 980-8575, Japan
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41
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Ionizing Radiation Doses Detected at the Eye Level of the Primary Surgeon During Orthopaedic Procedures. J Orthop Trauma 2016; 30:e230-5. [PMID: 27010182 DOI: 10.1097/bot.0000000000000578] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To evaluate the ionizing radiation dose received by the eyes of orthopaedic surgeons during various orthopaedic procedures. Secondary objective was to compare the ionizing radiation dose received between differing experience level. DESIGN Prospective comparative study between January 2013 and May 2014. SETTING Westmead Hospital, a Level 1 Trauma Centre for Greater Western Sydney. PARTICIPANTS A total of 26 surgeons volunteered to participate within the study. INTERVENTION Experience level, procedure performed, fluoroscopy time, dose area product, total air kerma, and eye dose received was recorded. Participants were evaluated on procedure and experience level. MAIN OUTCOME MEASUREMENTS Radiation dose received at eye level by the primary surgeon during an orthopaedic procedure. RESULTS Data from a total of 131 cases was recorded and included for analysis. The mean radiation dose detected at the eye level of the primary surgeon was 0.02 mSv (SD = 0.05 mSv) per procedure. Radiation at eye level was only detected in 31 of the 131 cases. The highest registered dose for a single procedure was 0.31 mSv. Femoral nails and pelvic fixation procedures had a significantly higher mean dose received than other procedure groups (0.04 mSv (SD = 0.07 mSv) and 0.04 mSv (SD = 0.06 mSv), respectively). Comparing the eye doses received by orthopaedic consultants and trainees, there was no significant difference between the 2 groups. CONCLUSIONS The risk of harmful levels of radiation exposure at eye level to orthopaedic surgeons is low. This risk is greatest during insertion of femoral intramedullary nails and pelvic fixation, and it is recommended that in these situations, surgeons take all reasonable precautions to minimize radiation dose. The orthopaedic trainees in this study were not subjected to higher doses of radiation than their consultant trainers. On the basis of these results, most of the orthopaedic surgeons remain well below the yearly radiation dose of 20 mSv as recommended by the International Commission on Radiological Protection.
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42
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Martin CJ. EYE LENS DOSIMETRY FOR FLUOROSCOPICALLY GUIDED CLINICAL PROCEDURES: PRACTICAL APPROACHES TO PROTECTION AND DOSE MONITORING. RADIATION PROTECTION DOSIMETRY 2016; 169:286-291. [PMID: 26454269 DOI: 10.1093/rpd/ncv431] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Doses to the eye lenses of clinicians undertaking fluoroscopically guided procedures can exceed the dose annual limit of 20 mSv, so optimisation of radiation protection is essential. Ceiling-suspended shields and disposable radiation absorbing pads can reduce eye dose by factors of 2-7. Lead glasses that shield against exposures from the side can lower doses by 2.5-4.5 times. Training in effective use of protective devices is an essential element in achieving good protection and acceptable eye doses. Effective methods for dose monitoring are required to identify protection issues. Dosemeters worn adjacent to the eye provide the better option for interventional clinicians, but an unprotected dosemeter worn at the neck will give an indication of eye dose that is adequate for most interventional staff. Potential requirements for protective devices and dose monitoring can be determined from risk assessments using generic values for dose linked to examination workload.
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Affiliation(s)
- Colin J Martin
- Department of Clinical Physics and Bio-engineering, University of Glasgow, Glasgow, UK
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43
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Bertolini M, Benecchi G, Amici M, Piola A, Piccagli V, Giordano C, Nocetti L. Attenuation assessment of medical protective eyewear: the AVEN experience. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2016; 36:279-289. [PMID: 27122122 DOI: 10.1088/0952-4746/36/2/279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The goal of this paper is to test the attenuation capability of seven models of protective eyewear used in routine clinical practice. Scattered radiation from a standard patient was simulated by using a water tank located over the treatment couch of a GE Innova 3100 x-ray angiography system. Seven protective eyewear models were tested using an anthropomorphic phantom mimicking the first operator. At each test, 4 thermoluminiscent dosimeters were placed on the phantom (respectively in front of the protective eyewear, under the eyewear, on the left earpiece and at chest level) in order to have an eyewear-independent reference. A test session without glasses was also acquired. Each model was tested with standard posterior-anterior (PA) projections and the two most common protective eyewear were tested using LAO90° and LAO45°CRA30° projections. A worst-case scenario was created to be sure of having an upper limit for the assessment of eyewear attenuation in routine clinical practice. In PA projections, the absolute attenuation value ranged between 71% and 81%, while relative attenuation between dose measured at eye lens and that measured at eyewear earpiece ranged from 67% to 85%. The slightly wider range was probably due to scatter radiation variability; anyway, differences are still included in the variable uncertainty of experimental measurements. It is worth noting that #3 eyewear model (the one without lateral protection) allows an attenuation similar to that of #5 eyewear model (with 0.5 mm lead lateral protection) in LAO90° and LAO45°CRA30° projections. Despite the experimental limitations, a description of the radiation properties of protective eyewear concerning radiation attenuation can be useful to rely on protection devices which can be used in routine clinical practice.
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Affiliation(s)
- M Bertolini
- Medical Physics Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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44
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Domienik J, Brodecki M. The effectiveness of lead glasses in reducing the doses to eye lenses during cardiac implantation procedures performed using x-ray tubes above the patient table. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2016; 36:N19-N25. [PMID: 27021615 DOI: 10.1088/0952-4746/36/2/n19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The dose reduction factors (DRF) for different types of lead glasses and C-arm units with x-ray tubes placed above the patient table were calculated from the results of measurements by loose thermoluminescent dosimeters (TLDs) and EYE-D dosimeters using a Rando phantom. The DRF values were analysed for different positions of routine dosimeters worn outside lead eyewear and confronted with DRFs calculated as the ratio of the dose equivalent to the eye measured with and without the eyewear. Moreover, for eye lens dosimeters designed to be worn behind lead glasses, multiplicative factors for various positions of dosimeter were derived in order to account for the differences between the doses measured on the inner side of the glasses and the dose equivalent to the eye lens. The DRFs calculated for the position of a routine dosimeter worn outside lead glasses on the band near the left eye lens are 5.6 and 5.7 for goggles and metallic glasses, respectively, while the DRFs calculated as the ratio of doses to the eyes measured with and without the eyewear are 10.2 and 9.9, respectively. Therefore, for dosimeters routinely used outside lead eyewear, the DRF calculated for the position of the dosimeter should be used. Otherwise, we can anticipate an almost two-fold underestimation of the doses. When the dosimeter is worn behind lead glasses, up to two-fold differences between the dose equivalent to the eye lens and the dose measured at the inner side of the glasses were observed depending on the dosimeter position.
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Affiliation(s)
- J Domienik
- Nofer Institute of Occupational Medicine, Radiation Protection Department, Lodz, Poland
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45
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Mairs WDA. Occupational dose constraints for the lens of the eye for interventional radiologists and interventional cardiologists in the UK. Br J Radiol 2016; 89:20150551. [PMID: 27009739 DOI: 10.1259/bjr.20150551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The International Commission on Radiological Protection (ICRP) has recommended a 20 mSv year(-1) dose limit for the lens of the eye, which has been adopted in the European Union Basic Safety Standards. Interventional radiologists (IRs) and interventional cardiologists (ICs) are likely to be affected by this. The effects of radiation in the lens are somewhat uncertain, and the ICRP explicitly recommend optimization. Occupational dose constraints are part of the optimization process and define a level of dose which ought to be achievable in a well-managed practice. This commentary calls on the professional bodies to review a need for national constraints to guide local decisions. Consideration is given to developing such constraints using maximum expected doses in high-workload facilities with good radiation protection practices and application of a factor allowing for attenuation by lead glasses (LG). Doses are based on a Public Health England survey of eye dose in the UK. Maximum expected doses for ICs are approximately 21 mSv year(-1), neglecting LG. However, the extent of IR exposure is not yet fully known, and further evidence is required before conclusions are drawn. A Health and Safety Laboratory review of LG established a conservative dose reduction factor of 3 for models available in 2012. Application of this factor provides a dose constraint of 7 mSv year(-1) to the eye for ICs. To achieve this constraint, those employers with the most exposed ICs will have to provide and ensure the correct use of a ceiling-suspended eye shield and LG.
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Affiliation(s)
- William DA Mairs
- Christie Medical Physics and Engineering (CMPE), The Christie Hospital NHS Foundation Trust, Manchester, UK
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46
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Higgins A. Measurement of occupational doses of ionising radiation to the lens of the eyes of interventional radiologists. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2016; 36:74-92. [PMID: 26643204 DOI: 10.1088/0952-4746/36/1/74] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Currently, there exists no standardised method for monitoring radiation doses to the eye lens. This investigation aimed to determine the optimum method for monitoring the eye doses for interventional radiologists. Three interventional radiologists were issued with a series of dosimeters to wear during their routine work. These dosimeters were worn at defined positions on the body and the absorbed dose to each position was measured. It was confirmed that the dose received to the thyroid collar followed an apparently well-defined relationship to the dose recorded on the forehead, which is representative of the dose to the lens of the eye. It was also confirmed that, as hypothesised, the dose to the left eye was universally greater than to the right, although by varying factors. It was concluded that the use of dosimeters attached to the inside arms of protective eyewear is the optimum solution for eye lens dosimetry. It was also concluded that, when used with a dose conversion factor which corroborates existing literature, dosimeters attached to the outside of a thyroid collar yield sufficiently accurate results for use in routine dosimetry programmes.
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Affiliation(s)
- Anthony Higgins
- Department of Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Leeds LS1 3EX, UK. Department of Medical Physics and Clinical Engineering, King's College London, Faraday Building, 124-126 Denmark Hill, London SE5 8RX, UK
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47
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Andreoli S, Moretti R, Lorini FL, Lagrotta M. Radiation exposure of an anaesthesiologist in catheterisation and electrophysiological cardiac procedures. RADIATION PROTECTION DOSIMETRY 2016; 168:76-82. [PMID: 25752757 DOI: 10.1093/rpd/ncv009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 01/23/2015] [Indexed: 06/04/2023]
Abstract
Sometimes, cardiac catheterisation and electrophysiological procedures, diagnostic and interventional, require an anaesthesiological support. The anaesthesiologist receives radiation doses depending on various factors, such as type of procedure and exposure modality, anaesthesiological technique, individual protective devices and operator experience. The aim of this study was to investigate the dose per procedure, the exposure inhomogeneity and the effective dose, E, of a senior anaesthesiologist in the haemodynamic laboratory of Ospedali Riuniti, Bergamo. The dose monitoring was routinely performed with sets of several thermoluminescent dosemeters and an electronic personal dosemeter. The study covered 300 consecutive procedures over 1 y. The anaesthesiologist wore a protective apron, a thyroid collar and glasses (0.5 mm lead-equivalent).
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Affiliation(s)
- Stefano Andreoli
- USC Fisica Sanitaria, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Renzo Moretti
- USC Fisica Sanitaria, Papa Giovanni XXIII Hospital, Bergamo, Italy
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48
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Zagorska A, Romanova K, Hristova-Popova J, Vassileva J, Katzarov K. Eye lens exposure to medical staff during endoscopic retrograde cholangiopancreatography. Phys Med 2015; 31:781-4. [DOI: 10.1016/j.ejmp.2015.03.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/18/2015] [Accepted: 03/20/2015] [Indexed: 11/16/2022] Open
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Carinou E, Ferrari P, Bjelac OC, Gingaume M, Merce MS, O'Connor U. Eye lens monitoring for interventional radiology personnel: dosemeters, calibration and practical aspects of H p (3) monitoring. A 2015 review. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2015; 35:R17-R34. [PMID: 26343787 DOI: 10.1088/0952-4746/35/3/r17] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A thorough literature review about the current situation on the implementation of eye lens monitoring has been performed in order to provide recommendations regarding dosemeter types, calibration procedures and practical aspects of eye lens monitoring for interventional radiology personnel. Most relevant data and recommendations from about 100 papers have been analysed and classified in the following topics: challenges of today in eye lens monitoring; conversion coefficients, phantoms and calibration procedures for eye lens dose evaluation; correction factors and dosemeters for eye lens dose measurements; dosemeter position and influence of protective devices. The major findings of the review can be summarised as follows: the recommended operational quantity for the eye lens monitoring is H p (3). At present, several dosemeters are available for eye lens monitoring and calibration procedures are being developed. However, in practice, very often, alternative methods are used to assess the dose to the eye lens. A summary of correction factors found in the literature for the assessment of the eye lens dose is provided. These factors can give an estimation of the eye lens dose when alternative methods, such as the use of a whole body dosemeter, are used. A wide range of values is found, thus indicating the large uncertainty associated with these simplified methods. Reduction factors from most common protective devices obtained experimentally and using Monte Carlo calculations are presented. The paper concludes that the use of a dosemeter placed at collar level outside the lead apron can provide a useful first estimate of the eye lens exposure. However, for workplaces with estimated annual equivalent dose to the eye lens close to the dose limit, specific eye lens monitoring should be performed. Finally, training of the involved medical staff on the risks of ionising radiation for the eye lens and on the correct use of protective systems is strongly recommended.
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50
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Martin CJ, Magee JS, Sandblom V, Almén A, Lundh C. Eye dosimetry and protective eyewear for interventional clinicians. RADIATION PROTECTION DOSIMETRY 2015; 165:284-288. [PMID: 25848118 DOI: 10.1093/rpd/ncv050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Doses to the eyes of interventional clinicians can exceed 20 mSv. Various protective devices can afford protection to the eyes with the final barrier being protective eyewear. The protection provided by lead glasses is difficult to quantify, and the majority of dosimeters are not designed to be worn under lead glasses. This study has measured dose reduction factors (DRFs) equal to the ratio of the dose with no protection, divided by that when lead glasses are worn. Glasses have been tested in X-ray fields using anthropomorphic phantoms to simulate the patient and clinician. DRFs for X-rays incident from the front vary from 5.2 to 7.6, while values for orientations reminiscent of clinical practice are between 1.4 and 5.2. Results suggest that a DRF of two is a conservative factor that could be applied to personal dosimeter measurements to account for the dose reduction provided by most types of lead glasses.
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Affiliation(s)
- C J Martin
- Department of Clinical Physics and Bio-engineering, University of Glasgow, Glasgow, UK
| | - J S Magee
- Health Physics, Gartnavel Royal Hospital, Glasgow G12 0XH, UK
| | - V Sandblom
- Department of Radiation Physics, University of Gothenburg, SE-413 45 Gothenburg, Sweden Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - A Almén
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - C Lundh
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
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