1
|
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.
Collapse
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
| |
Collapse
|
2
|
Wilson-Stewart KS, Fontanarosa D, Malacova E, Trapp JV. Fluoroscopically guided vascular and cardiac transcatheter procedures: a comparison of occupational and patient dose by anatomical region. Phys Eng Sci Med 2023; 46:353-365. [PMID: 36877360 PMCID: PMC10030543 DOI: 10.1007/s13246-023-01226-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/27/2023] [Indexed: 03/07/2023]
Abstract
X-ray guided procedures are being performed by an increasing variety of medical specialties. Due to improvements in vascular transcatheter therapies, there is an increasing overlap of imaged anatomy between medical specialties. There is concern that non-radiology fluoroscopic operators may not have sufficient training to be well informed of the potential implications of radiation exposure and mitigation strategies to reduce dose. This was a prospective, observational, single center study to compare occupational and patient dose levels when imaging different anatomical regions during fluoroscopically guided cardiac and endovascular procedures. Occupational radiation dose was measured at the level of the temple of 24 cardiologists and 3 vascular surgeons (n = 1369), 32 scrub nurses (n = 1307) and 35 circulating nurses (n = 885). The patient dose was recorded for procedures (n = 1792) performed in three angiography suites. Abdominal imaging during endovascular aneurysm repair (EVAR) procedures was associated with a comparatively high average patient, operator and scrub nurse dose despite additional table-mounted lead shields. Air kerma was relatively high for procedures performed in the chest, and chest + pelvis. Higher dose area product and staff eye dose were recorded during procedures of the chest + pelvis due to the use of digital subtraction angiography to evaluate access route prior to/during transaortic valve implantation. Scrub nurses were exposed to higher average radiation levels than the operator during some procedures. Staff should be cognizant of the potentially higher radiation burden to patients and exposed personnel during EVAR procedures and cardiac procedures using digital subtraction angiography.
Collapse
Affiliation(s)
- Kelly S Wilson-Stewart
- School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia.
- Cardiovascular Suites, Greenslopes Private Hospital, Ramsay Health Care, Newdegate Street, Greenslopes, Brisbane, QLD, 4120, Australia.
- Centre for Biomedical Technologies (CBT), Queensland University of Technology, 149 Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia.
| | - Davide Fontanarosa
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies (CBT), Queensland University of Technology, 149 Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Eva Malacova
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, 4006, Australia
| | - Jamie V Trapp
- School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
- Centre for Biomedical Technologies (CBT), Queensland University of Technology, 149 Victoria Park Road, Kelvin Grove, Brisbane, QLD, 4059, Australia
| |
Collapse
|
3
|
Otomo K, Inaba Y, Abe K, Onodera M, Suzuki T, Sota M, Haga Y, Suzuki M, Zuguchi M, Chida K. Spatial Scattering Radiation to the Radiological Technologist during Medical Mobile Radiography. Bioengineering (Basel) 2023; 10:bioengineering10020259. [PMID: 36829753 PMCID: PMC9952711 DOI: 10.3390/bioengineering10020259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Mobile radiography allows for the diagnostic imaging of patients who cannot move to the X-ray examination room. Therefore, mobile X-ray equipment is useful for patients who have difficulty with movement. However, staff are exposed to scattered radiation from the patient, and they can receive potentially harmful radiation doses during radiography. We estimated occupational exposure during mobile radiography using phantom measurements. Scattered radiation distribution during mobile radiography was investigated using a radiation survey meter. The efficacy of radiation-reducing methods for mobile radiography was also evaluated. The dose decreased as the distance from the X-ray center increased. When the distance was more than 150 cm, the dose decreased to less than 1 μSv. It is extremely important for radiological technologists (RTs) to maintain a sufficient distance from the patient to reduce radiation exposure. The spatial dose at eye-lens height increases when the bed height is high, and when the RT is short in stature and abdominal imaging is performed. Maintaining sufficient distance from the patient is also particularly effective in limiting radiation exposure of the eye lens. Our results suggest that the doses of radiation received by staff during mobile radiography are not significant when appropriate radiation protection is used. To reduce exposure, it is important to maintain a sufficient distance from the patient. Therefore, RTs should bear this is mind during mobile radiography.
Collapse
Affiliation(s)
- Kazuki Otomo
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 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
| | - Keisuke Abe
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Mana Onodera
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Tomohiro Suzuki
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Masahiro Sota
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 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
| | - Yoshihiro Haga
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 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, Tohoku University Graduate School of Medicine, 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, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 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
- Correspondence: ; Tel.: +81-22-717-7943
| |
Collapse
|
4
|
Wilson-Stewart KS, Fontanarosa D, Malacova E, Trapp JV. A comparison of patient dose and occupational eye dose to the operator and nursing staff during transcatheter cardiac and endovascular procedures. Sci Rep 2023; 13:2391. [PMID: 36765105 PMCID: PMC9918729 DOI: 10.1038/s41598-023-28704-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 01/23/2023] [Indexed: 02/12/2023] Open
Abstract
The number and complexity of transcatheter procedures continue to increase, raising concerns regarding radiation exposure to patients and staff. Procedures such as transaortic valve implantations (TAVI) have led to cardiologists adopting higher dose techniques, such as digital subtraction angiography (DSA). This study compared the estimated patient and occupational eye dose during coronary angiography (CA), percutaneous coronary intervention (PCI), TAVI workups (TWU), TAVI, endovascular aneurysm repairs (EVAR), and other peripheral diagnostic (VD) and interventional (VI) vascular procedures. A quantitative analysis was performed on patient dose during 299 endovascular and 1498 cardiac procedures. Occupational dose was measured for the cardiologists (n = 24), vascular surgeons (n = 3), scrub (n = 32) and circulator nurses (n = 35). TAVI and EVAR were associated with the highest average dose for all staff, and significantly higher patient dose area product, probably attributable to the use of DSA. Scrub nurses were exposed to higher average doses than the operator and scout nurse during CA, VD and VI. Circulating nurses had the highest average levels of exposure during TAVI. This study has demonstrated that EVAR and TAVI have similar levels of occupational and patient dose, with a notable increase in circulator dose during TAVI. The use of DSA during cardiac procedures is associated with an increase in patient and staff dose, and cardiologists should evaluate whether DSA is necessary. Scrub nurses may be exposed to higher levels of occupational dose than the operator.
Collapse
Affiliation(s)
- Kelly S Wilson-Stewart
- School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia. .,Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, 4059, Australia. .,Cardiovascular Suites, Greenslopes Private Hospital, Greenslopes, Brisbane, QLD, 4120, Australia.
| | - Davide Fontanarosa
- Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, 4059, Australia.,School of Clinical Sciences, Faculty of Health, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
| | - Eva Malacova
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia.,QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Brisbane, QLD, 2006, Australia
| | - Jamie V Trapp
- School of Chemistry and Physics, Faculty of Science, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia.,Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove, Brisbane, QLD, 4059, Australia
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Meijer EJ, van Zandvoort DWH, Loos MJA, Tseng CMESN, van Pul C. The eye lens dose of the interventionalist: Measurement in practice. Phys Med 2022; 100:1-5. [PMID: 35690020 DOI: 10.1016/j.ejmp.2022.05.012] [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: 02/17/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Early 2018, the new eye lens dose limit of 20 mSv per year for occupational exposure to ionising radiation was implemented in the European Union. Dutch guidelines state that monitoring is compulsory above an expected eye lens dose of 15 mSv/year. In this study we propose a method to investigate whether the eye lens dose of interventionalists would exceed 15 mSv/year and to determine if the eye lens dose can be derived from the regular personal dosimeter measurements. METHODS The eye lens dose, Hp(3), of interventional radiologists (n = 2), cardiologists (n = 2) and vascular surgeons (n = 3) in the Máxima Medical Centre, The Netherlands, was measured during six months, using thermoluminescence dosimeters on the forehead. Simultaneously, the surface dose, Hp(0,07), and whole body dose, Hp(10), were measured using regular dosimeters outside the lead skirt at chest level. The dosimeters were simultaneously refreshed every four weeks. The eye lens dose was compared to both the body-worn dosimeter values. Measurements were performed in the angiography suite, Cath lab and hybrid OR. RESULTS A clear relation was observed between the two dosimeters: Hp(3) ≈ 0,25 Hp(0,07). The extrapolated year dose for the eye lens did not exceed 15 mSv for any of the interventionalists (average 3 to 10 studies/month). CONCLUSIONS The eye lens dose can be monitored indirectly through the regular dosimeter at chest level. Additionally, based on the measurements we conclude that all monitored interventionalists remain below the dose limit and compulsory monitoring limit for the eye lens dose.
Collapse
Affiliation(s)
- E J Meijer
- Department of Clinical Physics, Máxima Medical Centre, Veldhoven, The Netherlands.
| | - D W H van Zandvoort
- Department of Radiology and Nuclear Medicine, Máxima Medical Centre, Veldhoven, The Netherlands; Fontys Paramedische Hogeschool Eindhoven, The Netherlands
| | - M J A Loos
- Department of General Surgery, Máxima Medical Centre, Veldhoven, The Netherlands
| | - C M E S N Tseng
- Department of Radiology and Nuclear Medicine, Máxima Medical Centre, Veldhoven, The Netherlands
| | - C van Pul
- Department of Clinical Physics, Máxima Medical Centre, Veldhoven, The Netherlands; Department of Applied Physics, Eindhoven University of Technology, Eindhoven, The Netherlands
| |
Collapse
|
7
|
Quaresma A, Brodschneider R, Gratzer K, Gray A, Keller A, Kilpinen O, Rufino J, van der Steen J, Vejsnæs F, Pinto MA. Preservation methods of honey bee-collected pollen are not a source of bias in ITS2 metabarcoding. ENVIRONMENTAL MONITORING AND ASSESSMENT 2021; 193:785. [PMID: 34755261 DOI: 10.1007/s10661-021-09563-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/26/2021] [Indexed: 06/13/2023]
Abstract
Pollen metabarcoding is emerging as a powerful tool for ecological research and offers unprecedented scale in citizen science projects for environmental monitoring via honey bees. Biases in metabarcoding can be introduced at any stage of sample processing and preservation is at the forefront of the pipeline. While in metabarcoding studies pollen has been preserved at - 20 °C (FRZ), this is not the best method for citizen scientists. Herein, we compared this method with ethanol (EtOH), silica gel (SG) and room temperature (RT) for preservation of pollen collected from hives in Austria and Denmark. After ~ 4 months of storage, DNAs were extracted with a food kit, and their quality and concentration measured. Most DNA extracts exhibited 260/280 absorbance ratios close to the optimal 1.8, with RT samples from Austria performing slightly worse than FRZ and SG samples (P < 0.027). Statistical differences were also detected for DNA concentration, with EtOH samples producing lower yields than RT and FRZ samples in both countries and SG in Austria (P < 0.042). Yet, qualitative and quantitative assessments of floral composition obtained using high-throughput sequencing with the ITS2 barcode gave non-significant effects of preservation methods on richness, relative abundance and Shannon diversity, in both countries. While freezing and ethanol are commonly employed for archiving tissue for molecular applications, desiccation is cheaper and easier to use regarding both storage and transportation. Since SG is less dependent on ambient humidity and less prone to contamination than RT, we recommend SG for preserving pollen for metabarcoding. SG is straightforward for laymen to use and hence robust for widespread application in citizen science studies.
Collapse
Affiliation(s)
- Andreia Quaresma
- Centro de Investigação de Montanha, Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253, Bragança, Portugal
| | - Robert Brodschneider
- Institute of Biology, University of Graz, Universitätsplatz 2, 8010, Graz, Austria
| | - Kristina Gratzer
- Institute of Biology, University of Graz, Universitätsplatz 2, 8010, Graz, Austria
| | - Alison Gray
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
| | - Alexander Keller
- Center for Computational and Theoretical Biology, Hubland Nord, Würzburg, Germany
- Department of Bioinformatics, University of Würzburg, Am Hubland, BiocenterWürzburg, Germany
| | | | - José Rufino
- Research Centre in Digitalization and Intelligent Robotics (CeDRI), Instituto Politécnico de Bragança, Bragança, Portugal
| | | | | | - M Alice Pinto
- Centro de Investigação de Montanha, Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253, Bragança, Portugal.
| |
Collapse
|
8
|
Cewe P, Vorbau R, Omar A, Elmi-Terander A, Edström E. Radiation distribution in a hybrid operating room, utilizing different X-ray imaging systems: investigations to minimize occupational exposure. J Neurointerv Surg 2021; 14:1139-1144. [PMID: 34750111 PMCID: PMC9606514 DOI: 10.1136/neurintsurg-2021-018220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/31/2021] [Indexed: 01/10/2023]
Abstract
Objectives To reduce occupational radiation exposure in a hybrid operating room (OR) used for three-dimensional (3D) image guided spine procedures. The effects of staff positioning, different X-ray imaging systems, and freestanding radiation protection shields (RPSs) were considered. Methods An anthropomorphic phantom was imaged with a robotic ceiling mounted hybrid OR C-arm cone beam CT (hCBCT), a mobile O-arm CBCT (oCBCT), and a mobile two-dimensional C-arm fluoroscopy system. The resulting scatter doses were measured at different positions in the hybrid OR using active personal dosimeters and an ionization chamber. Two types of RPSs were evaluated. Results Using the hCBCT system instead of the oCBCT system reduced the occupational radiation dose on average by 22%. At 200 cm from the phantom, scatter doses from the hCBCT were 27% lower compared with the oCBCT. One rotational acquisition with hCBCT or oCBCT corresponded to 12 or 16 min of fluoroscopy with the C-arm, respectively. The scatter dose decreased by more than 90% behind an RPS. However, the protection was slightly less effective at 60 cm behind the RPS, due to tertiary scatter from the surroundings. Conclusions For 3D image guided spine procedures in the hybrid OR, occupational radiation exposure is lowered by using hCBCT rather than oCBCT. Radiation exposure can also be decreased by optimal staff positioning in the OR, considering distance to the source and positioning relative to the walls, ceiling, and RPS. In this setting and workflow, staff can use RPSs instead of heavy aprons during intraoperative CBCT imaging, to achieve effective whole body dose reduction with improved comfort.
Collapse
Affiliation(s)
- Paulina Cewe
- Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden .,Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Robert Vorbau
- Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Artur Omar
- Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Adrian Elmi-Terander
- Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
| | - Erik Edström
- Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
9
|
Wilson-Stewart KS, Fontanarosa D, Malacova E, Trapp JV. Radiation dose to nurses, cardiologists, and patients during coronary angiography: a comparison of femoral and radial access. Eur J Cardiovasc Nurs 2021; 21:325-331. [PMID: 34718509 DOI: 10.1093/eurjcn/zvab096] [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: 05/20/2021] [Revised: 08/26/2021] [Accepted: 10/03/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Exposure to radiation during fluoroscopically guided cardiac procedures is a cause for concern for both the patient and staff. AIMS This study sought to compare the occupational and patient radiation dose during femoral and radially accessed invasive coronary angiography (CA). METHODS AND RESULTS Occupational dose (µSv) was measured at the left temple of the cardiologist (n = 17), scrub (n = 27), and circulator nurse (n = 27) during 761 femoral and 671 radially accessed diagnostic coronary angiograms and percutaneous coronary intervention (PCI) procedures. Patient dose parameters of dose area product (DAP) (Gy.cm2) and air kerma (AK) (Gy) were also measured. Coronary angiography performed via the radial artery is associated with greater mean dose to the cardiologist, with the exception of procedures including only PCI. Results demonstrated that scrub nurses are exposed to higher mean doses than the cardiologist when using femoral access and similar doses during radial cases. Both AK and DAP were associated with a higher average dose for femoral PCI than radial, with DAP being significantly higher. CONCLUSIONS Awareness of factors that increase the dose to staff and patients is vital to inform and improve practice. This study has demonstrated that access route during diagnostic CA and PCI influences both patient and staff dose. Radiation dose to in-room staff other than the fluoroscopic operator should be a focus of future research. In addition, all staff present during X-ray guided procedures should be provided with radiation education and adopt dose minimization strategies to reduce occupational exposures.
Collapse
Affiliation(s)
- Kelly S Wilson-Stewart
- School of Chemistry and Physics, Faulty of Science and Engineering, Queensland University of Technology, 2 George Street, Brisbane, QLD 4000 Australia.,Greenslopes Private Hospital, Ramsay Health Care, Newdegate Street, Greenslopes, Brisbane, QLD 4120 Australia
| | - Davide Fontanarosa
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, 2 George Street, Brisbane, QLD 4000 Australia.,Centre for Biomedical Technologies (CBT), Queensland University of Technology, 2 George Street, Brisbane, QLD 4000 Australia
| | - Eva Malacova
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, 2 George Street, Brisbane, QLD 4000 Australia.,QMIR Berghofer Medical Research Institute, 200 Herston Road, Herston, QLD 4006 Australia
| | - Jamie V Trapp
- School of Chemistry and Physics, Faulty of Science and Engineering, Queensland University of Technology, 2 George Street, Brisbane, QLD 4000 Australia
| |
Collapse
|
10
|
Almén A, Andersson M, O’Connor U, Abdelrahman M, Camp A, García V, Duch MA, Ginjaume M, Vanhavere F. PERSONAL DOSIMETRY USING MONTE-CARLO SIMULATIONS FOR OCCUPATIONAL DOSE MONITORING IN INTERVENTIONAL RADIOLOGY: THE RESULTS OF A PROOF OF CONCEPT IN A CLINICAL SETTING. RADIATION PROTECTION DOSIMETRY 2021; 195:391-398. [PMID: 33823548 PMCID: PMC8507461 DOI: 10.1093/rpd/ncab045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/09/2021] [Accepted: 03/05/2021] [Indexed: 06/12/2023]
Abstract
Exposure levels to staff in interventional radiology (IR) may be significant and appropriate assessment of radiation doses is needed. Issues regarding measurements using physical dosemeters in the clinical environment still exist. The objective of this work was to explore the prerequisites for assessing staff radiation dose, based on simulations only. Personal dose equivalent, Hp(10), was assessed using simulations based on Monte Carlo methods. The position of the operator was defined using a 3D motion tracking system. X-ray system exposure parameters were extracted from the x-ray equipment. The methodology was investigated and the simulations compared to measurements during IR procedures. The results indicate that the differences between simulated and measured staff radiation doses, in terms of the personal dose equivalent quantity Hp(10), are in the order of 30-70 %. The results are promising but some issues remain to be solved, e.g. an automated tracking of movable parts such as the ceiling-mounted protection shield.
Collapse
Affiliation(s)
- A Almén
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Radiation Protection, Swedish Radiation Safety Authority, Stockholm, Sweden
| | - M Andersson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - U O’Connor
- Department of Medical Physics and Bioengineering, St James’s Hospital, Dublin, Ireland
| | - M Abdelrahman
- The Belgian Nuclear Research Center, Boeretang, Belgium
| | - A Camp
- Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - V García
- Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - M A Duch
- Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - M Ginjaume
- Institut de Tècniques Energètiques, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - F Vanhavere
- The Belgian Nuclear Research Center, Boeretang, Belgium
| |
Collapse
|
11
|
Moriarty HK, Clements W, Phan T, Wang S, Goh GS. Occupational radiation exposure to the lens of the eye in interventional radiology. J Med Imaging Radiat Oncol 2021; 66:34-40. [PMID: 34342393 DOI: 10.1111/1754-9485.13307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/15/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Cataract formation is a tissue reaction effected by radiation exposure. The purpose of this study was to evaluate the occupational exposure to the lens of the eye of interventional radiologists (IR's) and interventional radiology staff, with and without lead glasses. METHODS Ethical approval was provided by the hospital research and ethics committee. A prospective cohort study was performed over 1 year, doses recorded, lifetime dose (estimated at working 5 days in angiography, for 30 years) was estimated and dose compared to current guidelines. Thermoluminescent dosimeters (TLDs; Landauer, Glenwood, USA) Hp(3) were placed on both the exterior and interior side of the personal lead glasses worn by three interventional radiologists and two radiographers. They were monitored during all procedures performed within 1 year. Lead glasses (AttenuTech® Microlite® , Florida, USA) with specifications were 0.75 mm lead equivalent front shield, and Side shield 0.3 mm Pb equivalent. A control TLD was placed in the storage location of the lead glasses when not in use. Yearly dose was measured and lifetime dose was calculated from the data obtained. Calculation of dose received per day(s) spent performing procedures for both annual and lifetime exposure was performed. In addition a record of occurrence of splashes on glasses was made after each case. RESULTS Eye doses without protection were double the recommended limits for both annual and lifetime dose. For interventional radiologists working between 3 and 4 or more days in the lab per week, annual dose thresholds would be exceeded (20 mSv/year averaged over 5 years, no more than 50 mSv in 1 year). If interventional radiologists worked between 3 and 4 or more days in the lab, lifetime dose thresholds would be exceeded (500 mSv lifetime dose). Lead glasses reduced radiation exposure by an average of 79%. If lead glasses were worn no interventional radiologists would exceed annual or lifetime dose thresholds to the eyes even if working 5 days per week as the primary operator. Radiographers would not exceed annual or lifetime dose thresholds even without lead glasses. Splash incidents occurred for all interventional radiologists and one radiographer. CONCLUSION The use of lead glasses even in this small study resulted in a decreased dose of radiation to the lens of the eye. Regular use of radiation protection eyewear will reduce eye dose for primary proceduralists to well below yearly and lifetime thresholds.
Collapse
Affiliation(s)
- Heather K Moriarty
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
| | - Warren Clements
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
| | - Tuan Phan
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Sherry Wang
- University of Utah, Salt Lake City, Utah, USA
| | - Gerard S Goh
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
12
|
Kaartinen S, Husso M, Matikka H. Operator's eye lens dose in computed tomography-guided interventions. Eur Radiol 2021; 31:4377-4385. [PMID: 33349894 PMCID: PMC8128838 DOI: 10.1007/s00330-020-07576-0] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 10/30/2020] [Accepted: 11/30/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To survey (1) operator's eye lens doses in typical computed tomography (CT)-guided interventions, (2) correlation between dose length product (DLP) and the operator's dose, and (3) different ways for estimating the eye lens dose in clinical settings. METHODS Doses of 16 radiologists in 164 CT-guided interventional procedures were prospectively measured during a 6-month time period upon radioprotective garments and descriptive statistical outcomes were calculated. The correlations between DLP and measured doses were surveyed. RESULTS On average, the operator's dose at the eye level (DEL, Hp(0.07)) was 22 μSv per procedure and the personal equivalent dose Hp(10) at the collar level was 21 μSv per procedure. The mean DLP of a procedure was 320 mGy cm, where 54% resulted from the fluoroscopy, the mean exposure time being 18 s. Based on the results, the operator's DEL could be estimated from DLP using the equation DEL (μSv) = 0.10 μSv/mGy cm × patient fluoro DLP (mGycm) (p < 0.001), and the dose at the collar level (DCL) using the equation DCL (μSv) = 0.12 μSv/mGy cm × patient fluoro DLP (mGy cm) (p < 0.001). In addition, DEL (μSv) = 0.7 × DCL (μSv). CONCLUSIONS The eye lens doses in CT-guided interventions are generally low even without protective equipment, and it is unlikely that the recommended annual equivalent dose limit of 20 mSv for the lens of the eye will be exceeded by conducting CT-guided interventions solely. Eye lens dose can be roughly estimated based on either DLP of the procedure or dose measured at the operator's collar level. KEY POINTS • Eye lens doses in CT-guided operations are generally low. • It is unlikely that the ICRP recommendation of the yearly equivalent dose limit of 20 mSv will be exceeded by conducting CT-guided interventions solely. • Magnitude of eye lens dose can be estimated based on either DLP of the procedure or dose measured at the operator's collar level.
Collapse
Affiliation(s)
- Siru Kaartinen
- Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland.
| | - Minna Husso
- Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland
| | - Hanna Matikka
- Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland
| |
Collapse
|
13
|
Morcillo AB, Alejo L, Huerga C, Bayón J, Marín A, Corredoira E, Novo JR, Hernández T, Ponce MD, Garzón G, Vañó E, Guibelalde E. Occupational doses to the eye lens in pediatric and adult noncardiac interventional radiology procedures. Med Phys 2021; 48:1956-1966. [PMID: 33544901 DOI: 10.1002/mp.14753] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/04/2020] [Accepted: 01/21/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To assess occupational lens exposure in a mixed interventional radiology department, comparing pediatric and adult procedures. To analyze the correlation between the lens dose and the doses measured at the chest and collar level and the kerma-area product (PKA ). METHODS For 17 months, three radiologists performing both pediatric and adult interventions were monitored by means of 14 dosimeters per worker: 12 single-point optically stimulated luminescent (OSL) dosimeters calibrated in terms of Hp (0.07) were placed on the inside and outside of two pairs of lead glasses, one for pediatric procedures and one for adult interventions; another whole-body OSL dosimeter calibrated in terms of Hp (10) was placed over the thyroid shield; finally, an additional active solid-state dosimeter, also calibrated for Hp (10), was worn on the chest, over the apron. Furthermore, a database was created to register the demographic and dosimetric data of the procedures, as well as the name of the radiologist acting as first operator. RESULTS For the three radiologists, who performed 276-338 procedures/year (20% pediatric), cumulative annual doses to the left bare eye exceeded 20 mSv (21-61 mSv). Considering the glasses' protection, annual doses exceeded 6 mSv (13-48 mSv) for both eyes. No important differences were observed in lens dose per procedure between pediatric and adult interventions (0.16 vs 0.18, 0.12 vs 0.09, and 0.07 vs 0.07 mSv), although lens dose per PKA was 4.1-4.5 times higher in pediatrics (5.8 vs 1.3, 3.3 vs 0.8, and 2.6 vs 0.6 µSv/Gy·cm2 ) despite a similar use of the ceiling-suspended screen. Lens doses were highly correlated with collar readings (with Pearson coefficients [r] ranging from 0.86 to 0.98) and with chest readings (with r ranging from 0.75 to 0.93). However, slopes of the linear regressions varied greatly among radiologists. CONCLUSIONS There is real risk of exceeding the occupational dose limit to the eye lens in mixed interventional radiology rooms if radiation protection tools are not used properly. Regular monitoring of the lens dose is recommended, given lens exposure might easily exceed 6 mSv/yr. Using a collar dosimeter for this purpose might be suitable if it is preceded by an individualized regression analysis. The same radiation protection measures should be applied to interventional radiologists regardless of whether they are treating pediatric or adult patients.
Collapse
Affiliation(s)
- Ana Belén Morcillo
- Medical Physics Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - Luis Alejo
- Medical Physics Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - Carlos Huerga
- Medical Physics Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - José Bayón
- Medical Physics Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - Alberto Marín
- Medical Physics Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - Eva Corredoira
- Medical Physics Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - Joan Ricardo Novo
- Vascular and Interventional Radiology Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - Teresa Hernández
- Vascular and Interventional Radiology Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - María Dolores Ponce
- Vascular and Interventional Radiology Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - Gonzalo Garzón
- Vascular and Interventional Radiology Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain
| | - Eliseo Vañó
- Radiology Department, Complutense University, Plaza de Ramón y Cajal, Madrid, 28040, Spain
| | - Eduardo Guibelalde
- Radiology Department, Complutense University, Plaza de Ramón y Cajal, Madrid, 28040, Spain
| |
Collapse
|
14
|
Bohari A, Hashim S, Ahmad NE, Ghoshal SK, Mohd Mustafa SN. Fluoroscopy-guided intervention procedure norms for occupational eye radiation dose: An overall evaluation. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2020.108909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
Wilson-Stewart KS, Fontanarosa D, Li D, Drovandi CC, Anderson RK, Trapp JV. Taller staff occupationally exposed to less radiation to the temple in cardiac procedures, but risk higher doses during vascular cases. Sci Rep 2020; 10:16103. [PMID: 32999372 PMCID: PMC7528059 DOI: 10.1038/s41598-020-73101-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/11/2020] [Indexed: 01/05/2023] Open
Abstract
This study aimed to evaluate the effect of nurse and doctor height on occupational dose to the temple during fluoroscopically guided cardiovascular procedures. Additionally, an evaluation of the relationship between doctor height and table height was performed. Staff exposed during fluoroscopic procedures may be at elevated risk of cardiovascular damage or oncogenesis and have demonstrated a higher incidence of subscapular cataracts. The heads of taller staff may be exposed to reduced levels of radiation due to the increased distance from the area of highest intensity X-ray scatter. Limited research has been performed investigating height as a predictor of head dose to nursing staff. The level of radiation dose at the level of the temple to the doctor (n = 25), scrub (n = 28), and scout nurse (n = 29) was measured in a prospective single-center, observational study using Philips DoseAware badges. Procedural characteristics were recorded for vascular and cardiac cases performed in three dedicated angiography suites. Data were also collected to investigate relationships between doctor height and table height. Data were collected for 1585 cardiac and 294 vascular procedures. Staff height was a statistically significant predictor of temple dose for doctors, scrub, and scout nurses when considering the full data sample. The log temple dose demonstrated an inverse relationship to staff height during cardiac procedures, but a positive relationship for scrub and scout nurses during vascular studies. This observational study has demonstrated that taller staff are exposed to less cranial exposure dose during fluoroscopically guided cardiac examinations but has revealed a positive correlation between height and temple dose during vascular procedures. It was also determined that doctor height was correlated with average procedural table height and that vascular access point influences the choice of table elevation.
Collapse
Affiliation(s)
- Kelly S Wilson-Stewart
- School of Chemistry and Physics, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia. .,Cardiovascular Suites, Greenslopes Private Hospital, Newdegate Street, Greenslopes, Brisbane, QLD, 4120, Australia.
| | - Davide Fontanarosa
- School of Clinical Sciences, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Q Block, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Australia
| | - Dan Li
- School of Mathematical Sciences, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia.,Centre for Data Science, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia.,ARC Centre of Excellence for Mathematical and Statistical Frontiers, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Chris C Drovandi
- School of Mathematical Sciences, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia.,Centre for Data Science, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia.,ARC Centre of Excellence for Mathematical and Statistical Frontiers, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Rebecca K Anderson
- Cardiovascular Suites, Greenslopes Private Hospital, Newdegate Street, Greenslopes, Brisbane, QLD, 4120, Australia
| | - Jamie V Trapp
- School of Chemistry and Physics, Queensland University of Technology, 2 George Street, Brisbane, QLD, 4000, Australia
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Szumska A, Budzanowski M, Milcewicz-Mika I, Kopeć R. Implementation of eye-lens dosimetry in Poland. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2019.108676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
18
|
|
19
|
Shafiee M, Rashidfar R, Abdolmohammadi J, Borzoueisileh S, Salehi Z, Dashtian K. A study to assess the knowledge and practice of medical professionals on radiation protection in interventional radiology. Indian J Radiol Imaging 2020; 30:64-69. [PMID: 32476752 PMCID: PMC7240898 DOI: 10.4103/ijri.ijri_333_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/31/2019] [Accepted: 01/28/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Ionizing radiation has been extensively used in medical procedures throughout the world. Such interventional radiological procedures could result in occupational exposure that needs urgent control. Therefore, MPs (medical professionals) should receive education and appropriate training on occupational radiation protection. In this context, the present study is aimed to investigate the MPs' knowledge and practice regarding radiation protection principles during interventional radiological procedures. MATERIAL AND METHODS A descriptive questionnaire-based study was carried out among 215 MPs involved in interventional fluoroscopy procedures. The practice of 31 MPs was studied using a checklist based on ALARA principles and ICRP guidelines. RESULTS A total of 43.3% and 45.1% answered correctly for knowledge and practice. However, the difference between radiation protection knowledge and practice between the physicians and nurses was statistically significant. The knowledge and practice survey of MPs demonstrated that nurses rarely adhered to radiation-protection measures. CONCLUSION The present study reflects the lack of knowledge and practice concerning radiation protection concepts among the nurses. This deficiency needs to be resolved by periodic practical radiation protection courses in the curriculum of medicine.
Collapse
Affiliation(s)
- Mohsen Shafiee
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasouj, Iran
| | - Razieh Rashidfar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Radiology, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamil Abdolmohammadi
- Department of Radiology, Faculty of Paramedical, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sajad Borzoueisileh
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasouj, Iran
| | - Zaker Salehi
- Department of Radiation Sciences, School of Paramedical Sciences, Yasuj University of Medical Sciences, Shiraz, Iran
| | | |
Collapse
|
20
|
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
|
21
|
Dorey S, Gray L, Tootell A, Higgins R, Al-Islam S, Baxter H, Dixon P, Hogg P. Radiation protection value to the operator from augmented reality smart glasses in interventional fluoroscopy procedures using phantoms. Radiography (Lond) 2019; 25:301-307. [DOI: 10.1016/j.radi.2019.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 02/09/2019] [Accepted: 02/11/2019] [Indexed: 10/27/2022]
|
22
|
Wilson-Stewart K, Hartel G, Fontanarosa D. Occupational radiation exposure to the head is higher for scrub nurses than cardiologists during cardiac angiography. J Adv Nurs 2019; 75:2692-2700. [PMID: 31144368 DOI: 10.1111/jan.14085] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/07/2019] [Accepted: 03/12/2019] [Indexed: 10/26/2022]
Abstract
AIMS This study aimed to compare the head dose of a cardiologist to scrub and scout nurses during cardiac angiography. DESIGN A correlational longitudinal quantitative design was used to examine the relationship between the variable of occupational dose to the medical operator when compared with the dose to the scrub and scout nurses. METHODS A quantitative analysis was performed on data collected during coronary angiograms (N = 612) for one cardiologist and 22 nurses performing either the scrub or scout role between May 2015 and February 2017. Analysis was based on log-transformed dose levels and reported as geometric means and associated 95% confidence intervals. RESULTS It was found that scrub nurses received on average 41% more head dose than the cardiologist during diagnostic procedures and 52% higher doses during interventional cases. CONCLUSION Nurses working in fluoroscopic cardiovascular procedures should be provided with appropriate training and protective equipment, notably lead skull caps, to minimize their occupational radiation exposure. IMPACT There is a notable lack of research evaluating the occupational head and eye exposure to nurses involved in fluoroscopic procedures. This study found that during diagnostic coronary angiograms, the scrub nurses received 41% more occupational head dose than the cardiologist and 52% higher head doses during interventional cases. Radial access resulted in higher doses to scrub nurses than femoral artery access. It is advisable that staff wear protective lead glasses and skull caps and use appropriately positioned ceiling mounted lead shields to minimize the risk of adverse effects of occupational exposure to ionizing radiation.
Collapse
Affiliation(s)
- Kelly Wilson-Stewart
- Cardiovascular Suites, Greenslopes Private Hospital, Brisbane, Qld, Australia.,School of Clinical Sciences, Queensland University of Technology, Brisbane, Qld, Australia
| | - Gunter Hartel
- QIMR Berghofer Medical Research Institute, Herston, Qld, Australia
| | - Davide Fontanarosa
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Qld, Australia.,Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
| |
Collapse
|
23
|
Mao L, Liu T, Caracappa PF, Lin H, Gao Y, Dauer LT, Xu XG. Influences of operator head posture and protective eyewear on eye lens doses in interventional radiology: A Monte Carlo Study. Med Phys 2019; 46:2744-2751. [PMID: 30955211 DOI: 10.1002/mp.13528] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To quantify the effects of operator head posture and different types of protective eyewear on the eye lens dose to operators in interventional radiology (IR). METHODS A deformable computational human phantom, Rensselaer Polytechnic Institute (RPI) Adult Male, consisting of a high-resolution eye model, was used to simulate a radiologist who is performing an interventional radiology procedure. The radiologist phantom was deformed to a set of different head postures. Three different protective eyewear models were incorporated into the posture-deformed radiologist phantom. The eye lens dose of the radiologist was calculated using the Monte Carlo code, MCNP. Effects of the radiologist's head posture and different types of protective eyewear on eye lens doses were studied. The relationship between efficacy of protective eyewear and the radiologist's head posture was investigated. Effects of other parameters on efficacy of protective eyewear were also studied, including the angular position of the radiologist, the gap between the eyewear and the face of the radiologist, and the lead equivalent thickness. RESULTS The dose to both lenses decreased by 80% as the head posture moved from looking downward to looking upward. Sports wrap glasses were found to reduce doses further than the other two studied models. The efficacy of eyewear was found to be related to radiologist's head posture as well. When the radiologist was looking up, the protective eyewear almost provided no protection to both lenses. Other factors such as the face-to-eyewear distance and the lead equivalent thickness were also found to have an impact on the efficacy of protective eyewear. The dose reduction factor (DRF), defined as the ratio of the dose to the lens without protection to that with protection, decreased from 4.25 to 1.07 as the face-to-eyewear distance increased. The DRF almost doubled when the lead equivalent thickness increased from 0.07 to 0.35 mm. However, further increase in lead equivalent thickness showed little improvement in dose reduction. CONCLUSION The radiologist's head posture has a significant influence on the eye lens dose in IR. Sports wrap protective eyewear which conforms to the curve of the face is essential for the radiation protection of the eye lens. However, the radiologist's head posture and other exposure parameters should be considered when evaluating the protection of the radiologist's eyes.
Collapse
Affiliation(s)
- Li Mao
- Nuclear Engineering Program, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA
| | - Tianyu Liu
- Nuclear Engineering Program, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA
| | - Peter F Caracappa
- Nuclear Engineering Program, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA.,Department of Applied Physics and Applied Mathematics, Columbia University, New York, NY, 10032, USA
| | - Hui Lin
- Nuclear Engineering Program, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA.,Department of Radiation Oncology School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Yiming Gao
- Radiology & Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Lawrence T Dauer
- Radiology & Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - X George Xu
- Nuclear Engineering Program, Rensselaer Polytechnic Institute, Troy, NY, 12180, USA
| |
Collapse
|
24
|
Cornacchia S, Errico R, La Tegola L, Maldera A, Simeone G, Fusco V, Niccoli-Asabella A, Rubini G, Guglielmi G. The new lens dose limit: implication for occupational radiation protection. LA RADIOLOGIA MEDICA 2019; 124:728-735. [PMID: 30919221 DOI: 10.1007/s11547-019-01027-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/11/2019] [Indexed: 10/27/2022]
Abstract
AIM AND OBJECTIVES The aim of this article was to explore the implications of the new Euratom dose limit for occupational radiation protection in the context of medical occupational radiation exposures. The European Directive 2013/59/Euratom takes into account the new recommendations on reduction in the dose limit for the lens of the eye for planned occupational exposures released in 2012 by the International Commission on Radiological Protection (ICRP 118). MATERIALS AND METHODS Different dose-monitoring procedures and devices were considered. Occupational eye lens doses reported by previous studies were analyzed, mainly considering workers involved in interventional procedures with X-rays. The current status of eye lens radiation protection and the main methods for dose reduction were investigated. RESULTS The analysis showed that the workers, potentially exceeding the new limit, are clinical staff performing interventional procedures with a relatively high X-ray dose. Regarding radiological protection issues, the considered literature reports that the proper use of personal protective equipment may reduce the eye lens absorbed dose. CONCLUSION The evaluation of the occupational eye lens dose is essential to establish which method of personal dose monitoring should be preferred. Furthermore, education and training about the right use of personal protective equipment are important for medical staff working with ionizing radiation.
Collapse
Affiliation(s)
| | | | | | | | | | - Vincenzo Fusco
- IRCCS-CROB, Radiation Oncology, Rionero in Vulture, Italy
| | | | - Giuseppe Rubini
- Nuclear Medicine Unit, University of Bari Aldo Moro, Bari, Italy
| | | |
Collapse
|
25
|
Wilson‐Stewart K, Shanahan M, Fontanarosa D, Davidson R. Occupational radiation exposure to nursing staff during cardiovascular fluoroscopic procedures: A review of the literature. J Appl Clin Med Phys 2018; 19:282-297. [PMID: 30294978 PMCID: PMC6236819 DOI: 10.1002/acm2.12461] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/19/2018] [Accepted: 07/14/2018] [Indexed: 11/16/2022] Open
Abstract
Fluoroscopy is a method used to provide real time x-ray imaging of the body during medical procedures to assist with medical diagnosis and treatment. Recent technological advances have seen an increase in the number of fluoroscopic examinations being performed. Nurses are an integral part of the team conducting fluoroscopic investigations and are often located close to the patient resulting in an occupational exposure to radiation. The purpose of this review was to examine recent literature which investigates occupational exposure received by nursing staff during cardiovascular fluoroscopic procedures. Articles published between 2011 and 2017 have been searched and comprehensively reviewed on the referenced medical search engines. Twenty-four relevant studies were identified among which seventeen investigated nursing dose comparative to operator dose. Seven researched the effectiveness of interventions in reducing occupational exposure to nursing staff. While doctors remain at the highest risk of exposure during procedures, evidence suggests that nursing staff may be at risk of exceeding recommended dose limits in some circumstances. There is also evidence of inconsistent use of personal protection such as lead glasses and skull caps by nursing staff to minimize radiation exposure. Conclusions: The review has highlighted a lack of published literature focussing on dose to nurses. There is a need for future research in this area to inform nursing staff of factors which may contribute to high occupational doses and of methods for minimizing the risk of exposure, particularly regarding the importance of utilizing radiation protective equipment.
Collapse
Affiliation(s)
- Kelly Wilson‐Stewart
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQldAustralia
- Cardiovascular SuitesGreenslopes Private HospitalBrisbaneQldAustralia
- Faculty of HealthUniversity of CanberraCanberraACTAustralia
| | | | - Davide Fontanarosa
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQldAustralia
- Institute of Health and Biomedical InnovationQueensland University of TechnologyBrisbaneQldAustralia
| | - Rob Davidson
- Faculty of HealthUniversity of CanberraCanberraACTAustralia
| |
Collapse
|