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Mothersill C, Seymour C, Cocchetto A, Williams D. Factors Influencing Effects of Low-dose Radiation Exposure. HEALTH PHYSICS 2024; 126:296-308. [PMID: 38526248 DOI: 10.1097/hp.0000000000001816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
ABSTRACT It is now well accepted that the mechanisms induced by low-dose exposures to ionizing radiation (LDR) are different from those occurring after high-dose exposures. However, the downstream effects of these mechanisms are unclear as are the quantitative relationships between exposure, effect, harm, and risk. In this paper, we will discuss the mechanisms known to be important with an overall emphasis on how so-called "non-targeted effects" (NTE) communicate and coordinate responses to LDR. Targeted deposition of ionizing radiation energy in cells causing DNA damage is still regarded as the dominant trigger leading to all downstream events whether targeted or non-targeted. We regard this as an over-simplification dating back to formal target theory. It ignores that last 100 y of biological research into stress responses and signaling mechanisms in organisms exposed to toxic substances, including ionizing radiation. We will provide evidence for situations where energy deposition in cellular targets alone cannot be plausible as a mechanism for LDR effects. An example is where the energy deposition takes place in an organism not receiving the radiation dose. We will also discuss how effects after LDR depend more on dose rate and radiation quality rather than actual dose, which appears rather irrelevant. Finally, we will use recent evidence from studies of cataract and melanoma induction to suggest that after LDR, post-translational effects, such as protein misfolding or defects in energy metabolism or mitochondrial function, may dominate the etiology and progression of the disease. A focus on such novel pathways may open the way to successful prophylaxis and development of new biomarkers for better risk assessment after low dose exposures.
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Affiliation(s)
- Carmel Mothersill
- Department of Biology, McMaster University, 1280 Main St., Hamilton, ON, Canada L8S 4L8
| | - Colin Seymour
- Department of Biology, McMaster University, 1280 Main St., Hamilton, ON, Canada L8S 4L8
| | - Alan Cocchetto
- The National CFIDS Foundation, 285 Beach Ave., Hull, MA 02045
| | - David Williams
- Cambridge University, The Old Schools, Trinity Lane, Cambridge CB2 1TN, United Kingdom
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Alvandi M, Javid RN, Shaghaghi Z, Farzipour S, Nosrati S. An In-depth Analysis of the Adverse Effects of Ionizing Radiation Exposure on Cardiac Catheterization Staffs. Curr Radiopharm 2024; 17:219-228. [PMID: 38314600 DOI: 10.2174/0118744710283181231229112417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 02/06/2024]
Abstract
Diagnostic and interventional angiograms are instrumental in the multidisciplinary approach to CAD management, enabling accurate diagnosis and effective targeted treatments that significantly enhance patient care and cardiovascular outcomes. However, cath lab staff, including interventional cardiologists, is consistently exposed to ionizing radiation, which poses inherent health risks. Radiation exposure in the cath lab primarily results from the use of fluoroscopy and cineangiography during diagnostic and interventional procedures. Understanding these risks and implementing effective radiation protection measurements are imperative to ensure the well-being of healthcare professionals while delivering high-quality cardiac care. Prolonged and repeated exposure can lead to both deterministic and stochastic effects. Deterministic effects, such as skin erythema and tissue damage, are more likely to occur at high radiation doses. Interventional cardiologists and staff may experience these effects when safety measures are not rigorously followed. In fact, while ionizing radiation is essential in the practice of radiation cardiology ward, cath lab staff faces inherent risks from radiation exposure. Stochastic effects, on the other hand, are characterized by a probabilistic relationship between radiation exposure and the likelihood of harm. These effects include the increased risk of cancer, particularly for those with long-term exposure. Interventional cardiologists, due to their frequent presence in the cath lab, face a higher lifetime cumulative radiation dose, potentially elevating their cancer risk. Protective measures, including the use of lead aprons, thyroid shields, and radiation monitoring devices, play a crucial role in reducing radiation exposure for cath lab personnel. Adherence to strict dose optimization protocols, such as minimizing fluoroscopy time and maximizing distance from the radiation source, is also essential in mitigating these risks. Ongoing research and advancements in radiation safety technology are essential in further for minimizing the adverse effects of ionizing radiation in the cath lab.
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Affiliation(s)
- Maryam Alvandi
- Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Zahra Shaghaghi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soghra Farzipour
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Sahar Nosrati
- Institute of Nuclear Chemistry and Technology, Dorodna 16 Str, 03-195, Warsaw, Poland
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Rose A, Rae WI, Sweetlove MA, Ngetu L, Benadjaoud MA, Marais W. Radiation induced cataracts in interventionalists occupationally exposed to ionising radiation. SA J Radiol 2022; 26:2495. [PMID: 36262829 PMCID: PMC9575381 DOI: 10.4102/sajr.v26i1.2495] [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: 06/07/2022] [Accepted: 07/06/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Occupational exposure to ionising radiation may have detrimental health effects. Longer and more complex fluoroscopic procedures have placed interventionalists at increased occupational health risks especially for developing cataracts in the radiosensitive lenses of the eyes. OBJECTIVES This study aimed to determine the prevalence of occupational related cataracts and describe the risk factors for cataracts in occupationally exposed interventionalists compared with unexposed doctors. METHOD A cross-sectional study using multiple methods. A survey was conducted. The radiation workload was determined based on a self-administered questionnaire and dose area product values determined in previous studies. Both groups had slit lamp examinations. The data were analysed analytically using R software version 9.3. RESULTS The study included 98 interventionalists. The combined prevalence of posterior sub-capsular (PSC) and cortical cataracts was 18.8% in the exposed and 13.9% in the unexposed group. The prevalence of PSC cataracts in the exposed group was 5.9% and 2.8% in the unexposed group, with an odds ratio (OR) of 2.2 (95% confidence interval [CI]: 0.58; 8.61). Posterior sub-capsular cataracts were more common in the left eye. The increase in cataracts was not statistically significant in the exposed group but is of clinical significance. CONCLUSION The findings are important as they highlight the need for greater vigilance for protecting the radiation healthcare workforce in a developing country setting. CONTRIBUTION The research is the first of its kind in South Africa and Africa and contributes to determining the prevalence in this highly skilled and occupationally vulnerable group.
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Affiliation(s)
- André Rose
- Center for Health Systems Research and Development, Faculty of Humanities, University of the Free State, Bloemfontein, South Africa
| | - William I.D. Rae
- Prince of Wales Hospital, Faculty of Medical Imaging, University of Sydney, Sydney, Australia
| | - Margaret A. Sweetlove
- Department of Medical Physics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Lumko Ngetu
- Department of Ophthalmology, Faculty of Health, University of the Free State, Bloemfontein, South Africa
| | - Mohamed A. Benadjaoud
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France,Department of Radiobiology and Regenerative Medicine (SERAMED), Fontenay-aux-Roses, France
| | - Wayne Marais
- Department of Ophthalmology, Faculty of Health, University of the Free State, Bloemfontein, South Africa
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Park S, Kim M, Kim JH. Radiation safety for pain physicians: principles and recommendations. Korean J Pain 2022; 35:129-139. [PMID: 35354676 PMCID: PMC8977205 DOI: 10.3344/kjp.2022.35.2.129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/12/2022] [Accepted: 02/13/2022] [Indexed: 11/05/2022] Open
Abstract
C-arm fluoroscopy is a useful tool for interventional pain management. However, with the increasing use of C-arm fluoroscopy, the risk of accumulated radiation exposure is a significant concern for pain physicians. Therefore, efforts are needed to reduce radiation exposure. There are three types of radiation exposure sources: (1) the primary X-ray beam, (2) scattered radiation, and (3) leakage from the X-ray tube. The major radiation exposure risk for most medical staff members is scattered radiation, the amount of which is affected by many factors. Pain physicians can reduce their radiation exposure by use of several effective methods, which utilize the following main principles: reducing the exposure time, increasing the distance from the radiation source, and radiation shielding. Some methods reduce not only the pain physician's but also the patient's radiation exposure. Taking images with collimation and minimal use of magnification are ways to reduce the intensity of the primary X-ray beam and the amount of scattered radiation. It is also important to carefully select the C-arm fluoroscopy mode, such as pulsed mode or low-dose mode, for ensuring the physician's and patient's radiation safety. Pain physicians should practice these principles and also be aware of the annual permissible radiation dose as well as checking their radiation exposure. This article aimed to review the literature on radiation safety in relation to C-arm fluoroscopy and provide recommendations to pain physicians during C-arm fluoroscopy-guided interventional pain management.
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Affiliation(s)
- Sewon Park
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Minjung Kim
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jae Hun Kim
- Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
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Wang G, Xu C, Li S, Zhang D, Chen Y, Liu J, Liu N. THE INFLUENCE OF LOW-DOSE OCCUPATIONAL RADIATION EXPOSURE ON PERIPHERAL BLOOD CELLS IN A COHORT OF CHINESE MEDICAL RADIATION WORKERS. RADIATION PROTECTION DOSIMETRY 2022; 198:246-256. [PMID: 35325251 DOI: 10.1093/rpd/ncac033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The study aims to assess the change of peripheral blood cell numbers following protracted low-dose radiation exposure among medical radiation workers. METHODS A cohort of 375 Chinese medical workers were followed for 5 years (2015-19) and recorded the changes in blood cells and cumulative doses. T-test, least significant difference-T test, variance analysis and correlation analysis were utilized in this study. RESULTS Compared with the control group, the white blood cells, hemoglobin counts and the ratio of eosinophils in the study group showed a downward trend. The differences in blood cells between groups were mainly found in the number of red blood cells. In a short cumulative time, such as 1 or 3 years, a correlation between the cumulative dose and the quantity of blood cells was detected, but not at 5 years. CONCLUSIONS There is no significant difference in the blood cell counts between different types of work, and the long-term cumulative dose has not been statistically correlated with the number of blood cells. So that the number of peripheral blood cells can no longer be used as a good indicator of radiation damage.
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Affiliation(s)
- Gui Wang
- Department of Disease Prevention, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin' s Clinical Research Center for Cancer, Tianjin, China
| | - Chang Xu
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin' s Clinical Research Center for Cancer, Tianjin, China
| | - Shixia Li
- Department of Disease Prevention, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin' s Clinical Research Center for Cancer, Tianjin, China
| | - Daguang Zhang
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin' s Clinical Research Center for Cancer, Tianjin, China
| | - Yue Chen
- Department of Medical Service, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin' s Clinical Research Center for Cancer, Tianjin, China
| | - Juntian Liu
- Department of Disease Prevention, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin' s Clinical Research Center for Cancer, Tianjin, China
| | - Ningbo Liu
- Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin' s Clinical Research Center for Cancer, Tianjin, China
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Little MP, Azizova TV, Hamada N. Low- and moderate-dose non-cancer effects of ionizing radiation in directly exposed individuals, especially circulatory and ocular diseases: a review of the epidemiology. Int J Radiat Biol 2021; 97:782-803. [PMID: 33471563 PMCID: PMC10656152 DOI: 10.1080/09553002.2021.1876955] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/24/2020] [Accepted: 01/09/2021] [Indexed: 01/29/2023]
Abstract
PURPOSE There are well-known correlations between high and moderate doses (>0.5 Gy) of ionizing radiation exposure and circulatory system damage, also between radiation and posterior subcapsular cataract. At lower dose correlations with circulatory disease are emerging in the Japanese atomic bomb survivors and in some occupationally exposed groups, and are still to some extent controversial. Heterogeneity in excess relative risks per unit dose in epidemiological studies at low (<0.1 Gy) and at low-moderate (>0.1 Gy, <0.5 Gy) doses may result from confounding and other types of bias, and effect modification by established risk factors. There is also accumulating evidence of excess cataract risks at lower dose and low dose rate in various cohorts. Other ocular endpoints, specifically glaucoma and macular degeneration have been little studied. In this paper, we review recent epidemiological findings, and also discuss some of the underlying radiobiology of these conditions. We briefly review some other types of mainly neurological nonmalignant disease in relation to radiation exposure. CONCLUSIONS We document statistically significant excess risk of the major types of circulatory disease, specifically ischemic heart disease and stroke, in moderate- or low-dose exposed groups, with some not altogether consistent evidence suggesting dose-response non-linearity, particularly for stroke. However, the patterns of risk reported are not straightforward. We also document evidence of excess risks at lower doses/dose-rates of posterior subcapsular and cortical cataract in the Chernobyl liquidators, US Radiologic Technologists and Russian Mayak nuclear workers, with fundamentally linear dose-response. Nuclear cataracts are less radiogenic. For other ocular endpoints, specifically glaucoma and macular degeneration there is very little evidence of effects at low doses; radiation-associated glaucoma has been documented only for doses >5 Gy, and so has the characteristics of a tissue reaction. There is some evidence of neurological detriment following low-moderate dose (∼0.1-0.2 Gy) radiation exposure in utero or in early childhood.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Tamara V Azizova
- Clinical Department, Southern Urals Biophysics Institute, Ozyorsk, Ozyorsk Chelyabinsk Region, Russia
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Komae, Tokyo, Japan
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Warnakulasuriya T, Williams S, Weerakkody T, Dabarera M, Rodrigo K, Waduge VA, Ediriweera D, Siriwardena N, Wickremasinghe R. BACKGROUND RADIATION LEVELS NEAR A MINERAL SAND MINING FACTORY IN SRI LANKA: CORRELATION OF RADIATION MEASUREMENTS WITH MICRONUCLEI FREQUENCY. RADIATION PROTECTION DOSIMETRY 2020; 189:114-126. [PMID: 32090241 DOI: 10.1093/rpd/ncaa022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 01/11/2020] [Accepted: 01/31/2020] [Indexed: 06/10/2023]
Abstract
Lanka Mineral Sands Ltd (LMS) is a company operating in Pulmoddai, Sri Lanka, mining for rare earth minerals along with monazite which contains thorium that emits ionizing gamma and alpha radiation on decay. The objective of the study was to determine the background radiation levels and selected radionuclides and then to correlate these levels with the frequency of micronuclei (MN) among persons residing in the vicinity of LMS. A cross-sectional study was conducted among persons of both sexes between 35 and 45 years of age residing in the vicinity of LMS. Background radiation measurements were obtained by a survey metre, and gamma spectrometry was done on soil samples. Five millilitres of venous blood was drawn for cytokinesis-blocked MN assay. Background radiation levels measured by the survey metre; 232Th, 226Ra and 210Pb mass activities in soil were highest in the samples collected from the LMS. The background radiation measurements positively correlated with MN frequency although the magnitude of the correlation was small (r = 0.176, p = 0.04). This implies that chronic long-term exposure to low-dose radiation may result in genotoxicity. Prospective large-scale studies are recommended to evaluate the long-term effect of exposure to low-dose radiation at Pulmoddai.
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Affiliation(s)
- Tania Warnakulasuriya
- Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Senani Williams
- Department of Pathology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Thiwanka Weerakkody
- Department of Pathology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Mangala Dabarera
- Department of Pathology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Kusum Rodrigo
- Department of Pathology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | | | - Dileepa Ediriweera
- Faculty of Medicine, Centre for Health Informatics, Biostatistics and Epidemiology, University of Kelaniya, Ragama, Sri Lanka
| | | | - Rajitha Wickremasinghe
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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Laskowski L, Williams D, Seymour C, Mothersill C. Environmental and industrial developments in radiation cataractogenesis. Int J Radiat Biol 2020; 98:1074-1082. [PMID: 32396040 DOI: 10.1080/09553002.2020.1767820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: This review discusses recent developments in our understanding of biological and physiological mechanisms underlying radiation cataractogenesis. The areas discussed include effects of low-dose exposures to the lens including potential relevance of non-targeted effects, the development of new personal-protective equipment (PPE) and standards in clinical and nuclear settings motivated by the updated ICRP recommendations to mitigate exposures to the lens of the eye. The review also looks at evidence from the field linking cataracts in birds and mammals to low dose exposures.Conclusions: The review suggests that there is evidence that cataractogenesis is not a tissue reaction (deterministic effect) but rather is a low dose effect which shows a saturable dose response relationship similar to that seen for non-targeted effects in general. The review concludes that new research is needed to determine the dose response relationship in environmental studies where field data are contradictory and lab studies confined to rodent models for human exposure studies.
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Affiliation(s)
- Lukasz Laskowski
- Department of Physics and Astronomy, McMaster University, Hamilton, Canada
| | - David Williams
- Department of Veterinary Medicine, University of Cambridge, Cambrige, UK
| | - Colin Seymour
- Department of Biology, McMaster University, Hamilton, Canada
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9
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Effective dose to patient measurements for flat-detector computed tomography protocols in acute stroke care. Eur Radiol 2020; 30:5082-5088. [PMID: 32346793 DOI: 10.1007/s00330-020-06891-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/04/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim was to measure the effective dose of flat-detector CT (FDCT) whole-brain imaging, biphasic FDCT angiography (FDCT-A), and FDCT perfusion (FDCT-P) protocols and compare it to previously reported effective dose values of multidetector CT (MDCT) applications. MATERIALS We measured effective dose according to the IRCP 103 using an anthropomorphic phantom equipped with thermoluminescent dosimeters (TLDs). Placement was according to anatomical positions of each organ. In total, 60 TLDs (≥ 4 TLDs/organ) were placed into and onto the phantom to account for all relevant organs. Organs within the primary beam were covered with more TLDs. Additionally, we measured dose to the eye lens with two TLDs per eye. Protocols which we routinely use in clinical practice were measured on a biplane angiography system. RESULTS The effective dose of the 20-s protocol/7-s protocol for whole-brain imaging was 2.6 mSv/2.4 mSv. The radiation dose to the eye lens was 24/23 mGy. For the biphasic high-/low-dose FDCT-A protocol, the effective dose was 8.9/2.8 mSv respectively. The eye lens dose was 60/14 mGy. The contribution of bolus tracking to the effective dose was 0.66 mSv (assuming average duration of 14 s). The multisweep FDCT-P protocol had an effective dose of 5.9 mSv and an eye lens dose of 46 mGy. CONCLUSION Except for the high-dose biphasic FDCT-A protocol, FDCT applications used in neuroradiology have effective doses, which do not deviate more than 1 mSv from previously reported values for MDCT applications. However, the effective dose to the eye lens in commonly used stroke paradigms exceeds the recommended annual dose twofold. KEY POINTS • Flat-detector computed tomography (FDCT) can be used for acute and periinterventional imaging of acute stroke patients and in neurointerventions. • Except for the high-dose FDCT angiography protocol, the effective doses do not deviate more than 1 mSv from previously reported values for multidetector CT applications. • Strategies to decrease the effective lens dose especially in younger patients should be evaluated in the future.
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Pederson SL, Li Puma MC, Hayes JM, Okuda K, Reilly CM, Beasley JC, Li Puma LC, Hinton TG, Johnson TE, Freeman KS. Effects of chronic low-dose radiation on cataract prevalence and characterization in wild boar (Sus scrofa) from Fukushima, Japan. Sci Rep 2020; 10:4055. [PMID: 32132563 PMCID: PMC7055243 DOI: 10.1038/s41598-020-59734-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 01/21/2020] [Indexed: 12/03/2022] Open
Abstract
This study evaluated cataracts in wild boar exposed to chronic low-dose radiation. We examined wild boar from within and outside the Fukushima Exclusion Zone for nuclear, cortical, and posterior subcapsular (PSC) cataracts in vivo and photographically. Plausible upper-bound, lifetime radiation dose for each boar was estimated from radioactivity levels in each animal's home range combined with tissue concentrations of 134+137Cesium. Fifteen exposed and twenty control boar were evaluated. There were no significant differences in overall prevalence or score for cortical or PSC cataracts between exposed and control animals. Nuclear (centrally located) cataracts were significantly more prevalent in exposed boar (p < 0.05) and had statistically higher median scores. Plausible upper-bound, lifetime radiation dose ranged from 1 to 1,600 mGy in exposed animals, with no correlation between dose and cortical or PSC score. While radiation dose and nuclear score were positively associated, the impact of age could not be completely separated from the relationship. Additionally, the clinical significance of even the highest scoring nuclear cataract was negligible. Based on the population sampled, wild boar in the Fukushima Exclusion Zone do not have a significantly higher prevalence or risk of cortical or PSC cataracts compared to control animals.
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Affiliation(s)
- Samantha L Pederson
- Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Margaret C Li Puma
- Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Joshua M Hayes
- Environmental Radiological and Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Kei Okuda
- Institute of Environmental Radioactivity, Fukushima University, Fukushima, Japan
| | | | - James C Beasley
- Savannah River Ecology Laboratory and Warnell School of Forestry and Natural Resources, University of Georgia, Aiken, South Carolina, United States
| | - Lance C Li Puma
- Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Thomas G Hinton
- Institute of Environmental Radioactivity, Fukushima University, Fukushima, Japan
| | - Thomas E Johnson
- Environmental Radiological and Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Kate S Freeman
- Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States.
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Suzuki A, Matsubara K, Chusin T, Sasa Y. EYE LENS DOSES OF RADIOLOGY TECHNOLOGISTS WHO ASSIST PATIENTS DURING RADIOGRAPHY. RADIATION PROTECTION DOSIMETRY 2019; 185:275-281. [PMID: 30753707 DOI: 10.1093/rpd/ncz007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/12/2019] [Accepted: 01/19/2019] [Indexed: 06/09/2023]
Abstract
The International Commission on Radiological Protection (ICRP) revised a drastic decrease of the annual eye equivalent dose limit. The present study aimed to evaluate the amounts of radiation to which the eye lenses of radiological technologists (RT) become exposed and the effects of wearing lead glasses on dose reduction while assisting patients during radiographic assessments. Lens equivalent doses (Hp(3)) were measured at the neck using personal dosemeter. In addition, Hp(3) was estimated by converting air kerma determined using small optically stimulated luminescence (OSL) dosemeters at six positions on lead glasses near the eyes and at the neck. The estimated mean Hp(3) from personal dosemeter at the neck varied from 3.92 to 18.6 mSv/y. Compare to OSL for which the dose varies from 8.95 to 54.75 mSv/y, personal dosimeter underestimate Hp(3).Therefore, Hp(3) for RT might exceed the revised eye equivalent dose limit 20 mSv/y recommended by the ICRP.
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Affiliation(s)
- Akira Suzuki
- Department of Radiology, Japanese Red Cross Sendai Hospital, 2-43-3 Yagiyama Honcho, Sendai, Miyagi 982-8501, Japan
| | - Kosuke Matsubara
- Department of Quantum Medical Technology, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
| | - Thunyarat Chusin
- Department of Quantum Medical Technology, Graduate Course of Medical Science and Technology, Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-0942, Japan
- Department of Radiological Technology, Faculty of Allied Health Sciences, Naresuan University, Muang, Phitsanulok 65000, Thailand
| | - Yuko Sasa
- Department of Radiology, Japanese Red Cross Sendai Hospital, 2-43-3 Yagiyama Honcho, Sendai, Miyagi 982-8501, Japan
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Yi L, Hu N, Mu H, Sun J, Yin J, Dai K, Xu F, Yang N, Ding D. Identification of Cofilin-1 and Destrin as Potential Early-warning Biomarkers for Gamma Radiation in Mouse Liver Tissues. HEALTH PHYSICS 2019; 116:749-759. [PMID: 30913056 DOI: 10.1097/hp.0000000000001012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Gamma radiation causes cell injury and leads to an increased risk of cancer, so it is of practical significance to identify biomarkers for gamma radiation. We used proteomic analysis to identify differentially expressed proteins in liver tissues of C57BL/6J mice treated with gamma radiation from Cs for 360 d. We confirmed obvious pathological changes in mouse liver tissues after irradiation. Compared with the control group, 74 proteins showed a fold change of ≥1.5 in the irradiated groups. We selected 24 proteins for bioinformatics analysis and peptide mass fingerprinting and found that 20 of the identified proteins were meaningful. These proteins were associated with tumorigenesis, tumor suppression, catalysis, cell apoptosis, cytoskeleton, metabolism, gene transcription, T-cell response, and other pathways. We confirmed that both cofilin-1 and destrin were up regulated in the irradiated groups by western blot and real-time polymerase chain reaction. Our findings indicate that cofilin-1 and destrin are sensitive to gamma radiation and may be potential biomarkers for gamma radiation. Whether these proteins are involved in radiation-induced tumorigenesis requires further investigation.
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Affiliation(s)
- Lan Yi
- Key Discipline Laboratory for National Defense for Biotechnology in Uranium Mining and Hydrometallurgy, University of South China
- Institute of Cytology and Genetics, College of Pharmaceutical and Biological Science, University of South China
| | - Nan Hu
- Key Discipline Laboratory for National Defense for Biotechnology in Uranium Mining and Hydrometallurgy, University of South China
| | - Hongxiang Mu
- Institute of Cytology and Genetics, College of Pharmaceutical and Biological Science, University of South China
| | - Jing Sun
- Institute of Cytology and Genetics, College of Pharmaceutical and Biological Science, University of South China
| | - Jie Yin
- Key Discipline Laboratory for National Defense for Biotechnology in Uranium Mining and Hydrometallurgy, University of South China
- Institute of Cytology and Genetics, College of Pharmaceutical and Biological Science, University of South China
| | - Keren Dai
- Institute of Cytology and Genetics, College of Pharmaceutical and Biological Science, University of South China
| | - Fanghui Xu
- Institute of Cytology and Genetics, College of Pharmaceutical and Biological Science, University of South China
| | - Nanyang Yang
- Institute of Cytology and Genetics, College of Pharmaceutical and Biological Science, University of South China
| | - Dexin Ding
- Key Discipline Laboratory for National Defense for Biotechnology in Uranium Mining and Hydrometallurgy, University of South China
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Differential expression of NPM, GSTA3, and GNMT in mouse liver following long-term in vivo irradiation by means of uranium tailings. Biosci Rep 2018; 38:BSR20180536. [PMID: 30061177 PMCID: PMC6200700 DOI: 10.1042/bsr20180536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 07/21/2018] [Accepted: 07/26/2018] [Indexed: 12/19/2022] Open
Abstract
Uranium tailings (UT) are formed as a byproduct of uranium mining and are of potential risk to living organisms. In the present study, we sought to identify potential biomarkers associated with chronic exposure to low dose rate γ radiation originating from UT. We exposed C57BL/6J mice to 30, 100, or 250 μGy/h of gamma radiation originating from UT samples. Nine animals were included in each treatment group. We observed that the liver central vein was significantly enlarged in mice exposed to dose rates of 100 and 250 μGy/h, when compared with nonirradiated controls. Using proteomic techniques, we identified 18 proteins that were differentially expressed (by a factor of at least 2.5-fold) in exposed animals, when compared with controls. We chose glycine N-methyltransferase (GNMT), glutathione S-transferase A3 (GSTA3), and nucleophosmin (NPM) for further investigations. Our data showed that GNMT (at 100 and 250 μGy/h) and NPM (at 250 μGy/h) were up-regulated, and GSTA3 was down-regulated in all of the irradiated groups, indicating that their expression is modulated by chronic gamma radiation exposure. GNMT, GSTA3, and NPM may therefore prove useful as biomarkers of gamma radiation exposure associated with UT. The mechanisms underlying those changes need to be further studied.
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Cataract risk of neuro-interventional procedures: a nationwide population-based matched-cohort study. Clin Radiol 2018; 73:836.e17-836.e22. [PMID: 29945717 DOI: 10.1016/j.crad.2018.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 05/04/2018] [Indexed: 10/28/2022]
Abstract
AIM To demonstrate the risk of cataract associated with radiation exposure from neuro-interventional procedures. MATERIALS AND METHODS This was a nationwide population-based, matched-cohort study. The exposed group (group E) comprised patients diagnosed with an aneurysm, cerebrovascular system anomaly, or subarachnoid haemorrhage who underwent a neuro-interventional procedure, such as brain digital subtraction angiography or endovascular embolisation. The comparison group (group C) included subjects who were never exposed to radiation from neuro-interventional procedures and were propensity score-matched by the date of enrolment, age, sex, and associated comorbidities. Multiple Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) of cataract risk due to radiation exposure while adjusting for potential confounding factors. RESULTS There were 838 patients and 3,352 matched subjects in groups E and C, respectively. The incidence of cataracts was significantly greater among subjects in group E (adjusted HR [aHR] = 1.88; 95% confidence interval [CI] = 1.08-3.26), especially those aged >40 years (aHR = 2.14; 95% CI = 1.16-3.94). The number of computed tomography examinations was positively correlated, but not statistically significant, with an increased risk of cataract occurrence. CONCLUSIONS Neuro-interventional procedures might be significantly associated with an increased risk of cataract occurrence.
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Thome C, Chambers DB, Hooker AM, Thompson JW, Boreham DR. Deterministic Effects to the Lens of the Eye Following Ionizing Radiation Exposure: is There Evidence to Support a Reduction in Threshold Dose? HEALTH PHYSICS 2018; 114:328-343. [PMID: 29360710 DOI: 10.1097/hp.0000000000000810] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Ionizing radiation exposure to the lens of the eye is a known cause of cataractogenesis. Historically, it was believed that the acute threshold dose for cataract formation was 5 Sv, and annual dose limits to the lens were set at 150 mSv. Recently, however, the International Commission on Radiological Protection has reduced their threshold dose estimate for deterministic effects to 0.5 Gy and is now recommending an occupational limit of 20 mSv per year on average. A number of organizations have questioned whether this new threshold and dose limit are justified based on the limited reliable data concerning radiation-induced cataracts. This review summarizes all of the published human epidemiological data on ionizing radiation exposure to the lens of the eye in order to evaluate the proposed threshold. Data from a variety of exposure cohorts are reviewed, including atomic bomb survivors, Chernobyl liquidators, medical workers, and radiotherapy patients. Overall, there is not conclusive evidence that the threshold dose for cataract formation should be reduced to 0.5 Gy. Many of the studies reviewed here are challenging to incorporate into an overall risk model due to inconsistencies with dosimetry, sample size, and scoring metrics. Additionally, risk levels in the studied cohorts may not relate to occupational scenarios due to differences in dose rate, radiation quality, age at exposure and latency period. New studies should be designed specifically focused on occupational exposures, with reliable dosimetry and grading methods for lens opacities, to determine an appropriate level for dose threshold and exposure limit.
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Kim MJ, Kim JH. Radiation exposure and protection for eyes in pain management. Anesth Pain Med (Seoul) 2017. [DOI: 10.17085/apm.2017.12.4.297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Min Jung Kim
- Department Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jae Hun Kim
- Department Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
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Yi L, Hu N, Yin J, Sun J, Mu H, Dai K, Ding D. Up-regulation of calreticulin in mouse liver tissues after long-term irradiation with low-dose-rate gamma rays. PLoS One 2017; 12:e0182671. [PMID: 28931006 PMCID: PMC5607120 DOI: 10.1371/journal.pone.0182671] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/21/2017] [Indexed: 02/06/2023] Open
Abstract
The biological effects of low-dose or low-dose-rate ionizing radiation on normal tissues has attracted attention. Based on previous research, we observed the morphology of liver tissues of C57BL/6J mice that received <50, 50–500, and 500–1000 μGy/h of 137Cs radiation for 180 d. We found that the pathological changes in liver tissues were more obvious as the irradiation dose rates increased. Additionally, differential protein expression in liver tissues was analyzed using a proteomics approach. Compared with the matched group in the 2D gel analysis of the irradiated groups, 69 proteins had ≥ 1.5-fold changes in expression. Twenty-three proteins were selected based on ≥2.5-fold change in expression, and 22 of them were meaningful for bioinformatics and protein fingerprinting analysis. These molecules were relevant to cytoskeleton processes, cell metabolism, biological defense, mitochondrial damage, detoxification and tumorigenesis. The results from real-time PCR and western blot (WB) analyses showed that calreticulin (CRT) was up-regulated in the irradiated groups, which indicates that CRT may be relevant to stress reactions when mouse livers are exposed to low-dose irradiation and that low-dose-rate ionizing radiation may pose a cancer risk. The CRT protein can be a potential candidate for low-dose or low-dose-rate ionizing radiation early-warning biomarkers. However, the underlying mechanism requires further investigation.
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Affiliation(s)
- Lan Yi
- Key Discipline Laboratory for National Defense for Biotechnology in Uranium Mining and Hydrometallurgy, University of South China, Hengyang, Hunan, P.R. China
- College of Pharmacy and Biological Sciences, University of South China, Hengyang, Hunan, P.R. China
| | - Nan Hu
- Key Discipline Laboratory for National Defense for Biotechnology in Uranium Mining and Hydrometallurgy, University of South China, Hengyang, Hunan, P.R. China
| | - Jie Yin
- Key Discipline Laboratory for National Defense for Biotechnology in Uranium Mining and Hydrometallurgy, University of South China, Hengyang, Hunan, P.R. China
- College of Pharmacy and Biological Sciences, University of South China, Hengyang, Hunan, P.R. China
| | - Jing Sun
- College of Pharmacy and Biological Sciences, University of South China, Hengyang, Hunan, P.R. China
| | - Hongxiang Mu
- College of Pharmacy and Biological Sciences, University of South China, Hengyang, Hunan, P.R. China
| | - Keren Dai
- College of Pharmacy and Biological Sciences, University of South China, Hengyang, Hunan, P.R. China
| | - Dexin Ding
- Key Discipline Laboratory for National Defense for Biotechnology in Uranium Mining and Hydrometallurgy, University of South China, Hengyang, Hunan, P.R. China
- * E-mail:
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Abstract
OBJECTIVE Recent articles discussing cases of brain cancer in interventionalists have raised concerns regarding the hazards of occupational exposure to ionizing radiation. We review the basics of radiation dose and the potential radiation effects, particularly as they pertain to the operator. Then we present the data regarding the risk of each type of radiation effect to the fluoroscopy operator and staff, with special attention on cancer induction, radiation-induced cataracts, and the pregnant operator. CONCLUSION Although the evidence overwhelmingly shows that exposure to higher doses of radiation carries a risk of cancer and tissue reactions, the risks of chronic exposure to low-level radiation are less clear. Many studies examining occupational exposure to radiation fail to show an increased risk of stochastic effects of radiation, but the positive results raise concern that the studies are underpowered to consistently detect the small risk. The lack of information in these studies about radiation doses and adherence to radiation protection further confound their interpretation. Large prospective studies of populations with occupational exposure to low-level radiation might clarify this issue. More clearly established are the risks of radiation to the fetus and the risk of cataracts in interventional cardiologists and interventional radiologists. Interventionalists can mitigate these risks by following established radiation safety practices.
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Rose A, Rae WID, Chikobvu P, Marais W. A multiple methods approach: radiation associated cataracts and occupational radiation safety practices in interventionalists in South Africa. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2017; 37:329-339. [PMID: 28253201 DOI: 10.1088/1361-6498/aa5eee] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Ionising radiation is a modality used in diagnostic and therapeutic medicine. The technology has improved and resulted in lower dose exposure but there has been an escalation in the quantity of procedures, their duration and complexity. These factors have meant increased occupational radiation exposure for interventionalists. Ionising radiation exposure can have detrimental health effects and includes radiation skin burns, various carcinomas, genetic and chromosomal aberrations and cataractogenesis of the lenses of the eye. The lenses of the eye are of the most radiosensitive organs and the risk of cataracts is high despite low radiation dose exposures. The use of personal protective equipment (PPE) is a method that can be used to mitigate the risk for developing lens opacifications. The consistent and effective utilisation of PPE is marred by availability, proper fit and ease of use when performing procedures. Radiation safety training is imperative to enforce a culture of radiation safety among interventionalists. The aim of this study was to quantify and describe cataracts among South African interventionalists and to understand their radiation safety practices. For this purpose, a cross sectional study was designed using multiple methods. A survey was conducted to determine the demographics and the risk factors of doctors exposed to radiation to doctors not exposed. The radiation workload and radiation safety practices of interventionalists were explored. Both groups had slit lamp examinations. The data were analysed analytically and a regression model developed looking at the outcomes and the risk factors. Qualitative in-depth interviews and group interviews were conducted to explore the perceptions of interventionalists regarding radiation safety. Deductive and inductive thematic analysis was done. Interdisciplinary research is challenging but offers tremendous opportunity for exploring and tackling complex issues related to securing a safe radiation work environment.
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Affiliation(s)
- A Rose
- Department of Community Health, University of the Free State, South Africa
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Shore RE. Radiation and cataract risk: Impact of recent epidemiologic studies on ICRP judgments. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2016; 770:231-237. [DOI: 10.1016/j.mrrev.2016.06.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 06/20/2016] [Accepted: 06/22/2016] [Indexed: 02/04/2023]
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Ainsbury EA, Barnard S, Bright S, Dalke C, Jarrin M, Kunze S, Tanner R, Dynlacht JR, Quinlan RA, Graw J, Kadhim M, Hamada N. Ionizing radiation induced cataracts: Recent biological and mechanistic developments and perspectives for future research. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2016; 770:238-261. [DOI: 10.1016/j.mrrev.2016.07.010] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 02/06/2023]
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Abstract
OBJECTIVE The purposes of this article are to review available data regarding the range of protection devices and garments with a focus on eye protection and to summarize techniques for reducing scatter radiation exposure. CONCLUSION Fluoroscopy operators and staff can greatly reduce their radiation exposure by wearing properly fitted protective garments, positioning protective devices to block scatter radiation, and adhering to good radiation practices. By understanding the essentials of radiation physics, protective equipment, and the features of each imaging system, operators and staff can capitalize on opportunities for radiation protection while minimizing ergonomic strain. Practicing and promoting a culture of radiation safety can help fluoroscopy operators and staff enjoy long, productive careers helping patients.
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Effect of Changing Work Stressors and Coping Resources on Psychological Distress. J Occup Environ Med 2016; 58:e256-63. [DOI: 10.1097/jom.0000000000000777] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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