Evaluation of tungsten and lead surgical gloves for radiation protection

Occupational radiation dose on the hand of assisting medical staff in diagnostic CT scans

Chronic radiation exposure increases the risk of skin damage of medical personnel engaged in radiology. However, hand dose measurements in computed tomography (CT) for diagnostic purposes have not been evaluated. The occupational radiation dose to the hands of CT assistants was herein investigated to evaluate its compliance with the equivalent dose limit for the hand (500 mSv/year). The occupational doses of nine CT assistants were measured in 89 cases (April 2017-May 2018) by installing radio-photoluminescence glass dosemeters (GD-302 M) (70-μm dose-equivalent conversion coefficient = 0.37) on the dorsal aspect of both hands. The occupational dose to the hand was the highest with head holding (right: 1.14 mSv/CT scan, left: 1.07 mSv/CT scan). Considering the results for annual work, even for head holding, the hand dose of the CT-assisting personnel was insignificant. However, CT assistants should be mindful of the possibility of locally higher doses to hands.

Endovascular Intervention with a Mobile C-Arm in the Operating Room

Mobile C-arm fluoroscopic X-ray systems are used for various diagnostic imaging and minimally invasive endovascular procedures. One of the greatest advantages of a mobile C-arm is its ability to move around the patient. The purpose of this study was to address the optimal setting of the mobile C-arm and the operating table, as well as the proper position of the operator and assistants for each procedure. In addition, methods to minimize radiation exposure to the operator and medical staff are described. Both the optimal setting and the proper position were classified by 5 types. These include the setting for aortic and inferior vena caval procedures (type I); left lower extremity (LE) intervention with an up-and-over technique (type II); right LE intervention with up-and-over technique, or bilateral LE vascular intervention with antegrade access (type III); arteriovenous fistula/graft intervention (type IV); and central vein catheterization (type V).

Evaluation of Single-Use Radio Attenuating Gloves: From Technical Data to Clinical Practice

Single-use radio-attenuating gloves are devices protecting the operator's hand by reducing the exposition to scattered radiations during radiological-guided intervention. Expensive, these devices are important, as they contribute to lessen the annual dose to which personals are exposed to. However, inconsistencies in their protection value have been reported between theoretical and clinical practice. In this study, we aim to highlight the normative bias existing in standard norms for radioprotective assessments. Using thermoluminescent captors positioned inside and outside the glove, we designed an EN1331-1 norm-inspired bench test with five brands of radio-attenuating gloves. At 100 keV and 56 cm away from the source, we measured indirect beam and attenuated doses in a clinical setting. From the attenuation index measured, we deduced attenuation rates. We then compared our results to their commercial technical data sheets. The assessed attenuating rates of the tested references were 20%, 30%, 32%, 15%, and 25%. Theoretical rates are, respectively, 38%, 43%, 30%, 26%, and 35%. Only one reference showed no difference between commercial and technical attenuating values (p = 0.12). The inconsistencies between observed and theoretical attenuation value show the importance of the conditions in which protection is assessed. Without complete information, the choice of a protective device as simple as a glove is biased, and this may lead to inappropriate protection of the operator, which should raise concern, as interventional radiology is now widespread in routine practice.

Medical health physics: a review

Medical health physics is the profession dedicated to the protection of healthcare providers, members of the public, and patients from unwarranted radiation exposure. Medical health physicists must be knowledgeable in the principles of health physics and in the applications of radiation in medicine. Advances in medical health physics require the definition of problems, testing of hypotheses, and gathering of evidence to defend changes in health physics practice and to assist medical practitioners in making changes in their practices as appropriate. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples included in this review include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This review summarizes evidence that supports changes in consensus recommendations, regulations, and health physics practices associated with recent advances in radiology, nuclear medicine, and radiation oncology. Medical health physicists must continue to gather evidence to support intelligent but practical methods for protection of personnel, the public, and patients as modalities and applications evolve in the practice of medicine.

Medical health physics: a review

Medical health physics is the profession dedicated to the protection of healthcare providers, members of the public, and patients from unwarranted radiation exposure. Medical health physicists must be knowledgeable in the principles of health physics and in the applications of radiation in medicine. Advances in medical health physics require the definition of problems, testing of hypotheses, and gathering of evidence to defend changes in health physics practice and to assist medical practitioners in making changes in their practices as appropriate. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples included in this review include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This review summarizes evidence that supports changes in consensus recommendations, regulations, and health physics practices associated with recent advances in radiology, nuclear medicine, and radiation oncology. Medical health physicists must continue to gather evidence to support intelligent but practical methods for protection of personnel, the public, and patients as modalities and applications evolve in the practice of medicine.

Radiation safety in the cardiac catheterization laboratory: operational radiation safety

The goal of the catheterization laboratory radiation safety program is to facilitate invasive cardiology while simultaneously reducing staff risks to an acceptable level. Achieving this goal requires a balance between the value of catheterization to the patient and the associated radiation risk to the staff. This article introduces the principles of radiation protection as applied in the catheterization laboratory. Prudent conformance to these principles will appropriately reduce radiation risk. Cathet. Cardiovasc. Intervent. 47:347-353, 1999.