Chromosome aberrations in peripheral blood lymphocytes of Croatian hospital staff occupationally exposed to low levels of ionising radiation

Medical personnel occupationally exposed to low-dose ionising radiation in Federation of Bosnia and Herzegovina: A cytogenetic study

Medical radiation exposures have been reduced significantly with modern equipment and protection measures. Biomonitoring of medical personnel can provide information concerning possible effects of radiation exposure. However, chromosome aberration (CA) analysis is now recommended only when the estimated effective dose is 200 mSv or higher. In this retrospective study in Bosnia and Herzegovina, we have measured the cytogenetic status of medical workers and healthy volunteers (controls). Peripheral blood samples from 66 medical workers exposed to low-dose ionising radiation and 89 non-exposed volunteers were collected for chromosome aberrations (CA) analysis and the cytokinesis-block micronucleus (CBMN) assay. Higher rates of chromatid and chromosome breaks, acentric fragments, double minutes, micronuclei, and micronucleated binuclear cells were observed in the control group, while the rate of nucleoplasmic bridges was higher in the medical workers group.

Efficiency of novel shielding curtains combined with pulsed irradiation for reducing radiation exposure in an operating room: Human renal collecting system phantom study

OBJECTIVE

To evaluate the impact of novel shielding curtains combined with pulsed irradiation mode to protect medical radiation workers from radiation exposure during ureteroscopy.

METHODS

0.25 mm Pb equivalent novel shielding curtains were mounted to the caudal and bilateral sides of the operating table in the ureteroscopy setting. C-arm was positioned as per normal in the operating room with the X-ray tube under the patient table. A water-filled anthropomorphic renal collecting system phantom was positioned in the standard position on the operating table that was set at a height of 100 cm. The ionization chambers were also positioned at a height of 100 cm and set in eight positions. We took measurements at distances of 50, 100, 150, and 200 cm from the phantom with the focus directed toward the X-ray tube. We measured the spatial distribution of the scattered radiation dose in four combinations: (1) continuous irradiation mode without novel shielding curtains; (2) pulsed irradiation mode (11 films per second) without novel shielding curtains; (3) continuous irradiation mode with novel shielding curtains; and (4) pulsed irradiation mode with novel shielding curtains. Continuous or pulsed irradiation was activated for 30 s each time.

RESULTS

Pulsed irradiation mode with novel shielding curtains was a significantly more efficient method than other combinations to reduce scattered radiation exposure in this study (P < 0.001). There was approximately a 95% reduction in scattered radiation exposure with the pulsed irradiation mode with novel shielding curtains set up as compared with continuous irradiation mode without novel shielding curtains.

CONCLUSION

Combining a novel shielding curtain and using a low pulse radiation setting can greatly reduce radiation exposure during ureteroscopic procedures.

Biomarkers of Genotoxicity in Medical Workers Exposed to Low-Dose Ionizing Radiation: Systematic Review and Meta-Analyses

Medical staff represent the largest group of workers occupationally exposed to ionizing radiation (IR). Chronic exposure to low-dose IR may result in DNA damage and genotoxicity associated with increased risk of cancer. This review aims to identify the genotoxicity biomarkers that are the most elevated in IR-exposed vs. unexposed health workers. A systematic review of the literature was performed to retrieve relevant studies with various biomarkers of genotoxicity. Subsequent meta-analyses produced a pooled effect size for several endpoints. The search procedure yielded 65 studies. Chromosome aberrations (CA) and micronuclei (MN) frequencies were significantly different between IR-exposed and unexposed workers (θ_pooled = 3.19, 95% CI 1.46–4.93; and θ_pooled = 1.41, 95% CI 0.97–1.86, for total aberrant cells and MN frequencies, respectively), which was not the case for ring chromosomes and nucleoplasmic bridges. Although less frequently used, stable translocations, sister chromatid exchanges (SCE) and comet assay endpoints were also statistically different between IR-exposed and unexposed workers. This review confirms the relevance of CA and MN as genotoxicity biomarkers that are consistently elevated in IR-exposed vs. unexposed workers. Other endpoints are strong candidates but require further studies to validate their usefulness. The integration of the identified biomarkers in future prospective epidemiological studies is encouraged.

Trends in Professional Radiation Exposures of Medical Staff Covered by Personal Dose Monitoring at a Rijeka Clinical Hospital Centre (2000 to 2015)

ABSTRACT

The increase in the number of radiological procedures observed in recent years also means greater exposure to ionizing radiation for the medical staff performing these procedures. This is most pronounced in the teams that perform interventional and invasive radiological procedures. The aim of this study was to examine the impact of increasing numbers of radiological procedures on the effective dose received by medical staff and to determine which professions received the highest exposure to ionizing radiation. Data for effective doses of 326 employees of Rijeka Clinical Hospital Centre covered by personal dosimetry in the period from 2000 to 2015 have been analyzed. Employees were divided by sex, by departments in which they were employed, and according to their professions. The analysis has shown that the exposure level of workers working in the ionizing radiation zone is typically well below the dose limits. During 2015, most employees (over 96.3%) received an annual effective dose of less than 0.1 mSv. Only three persons received an annual dose higher than 0.5 mSv, and one person received an annual dose of 6.9 mSv. Comparison of the radiation exposure doses of medical workers of different professions has shown that the highest dose of radiation is received by cardiologists involved in interventional cardiology procedures. Therefore, the additional need is to take care of their protection, check the manner of their work, and ensure more even workload of cardiologists participating in procedures that involve higher exposure to ionizing radiation.

A New Shielding Curtain for Protection of Intraoperative Radiation During Minimally Invasive Spine Surgery

Objective

Gradually increasing number of minimally invasive spine surgery (MISS), there is an increasing risk of radiation exposure to medical personnel during the surgery. We measured the radiation exposure of the operating room personnel during MISS, tried to find the riskiest person, and checked the effectiveness of a new lead-composite shielding curtain.

Methods

Radiation exposure of medical staffs (operator, first assistant, anesthesiologist, and scrub nurse) involved in MISS procedures of 35 patients without shielding curtain (nonshield group) and 35 patients with shielding curtain (shield group). The shielding curtain had 0.25-mm nominal lead equivalent and was mounted on 2 frame bars fixed on the operating table.

Results

In the nonshield group, radiation exposure was significantly higher in the order of operator > first assistant > scrub nurse > anesthesiologist (p < 0.001) during both anteroposterior (AP) and lateral views. In the shield group, the radiation exposure of the operator and the scrub nurse decreased significantly by 94.1% and 76.4% in AP view (p < 0.001), and by 96.3% and 73.9% in lateral view (p < 0.001), respectively.

Conclusion

Since the radiation dose of the operator was highest in a C-arm-guided MISS, there is a high priority need to protect the operator from the radiation exposure. The shielding curtain could most effectively reduce the radiation exposure of the operator.

Frequency of chromosome aberrations among adult male individuals from high and normal level natural radiation areas of Kerala in the southwest coast of India

Chromosome aberration analysis was carried out in peripheral blood lymphocytes of adult male individuals from normal level natural radiation areas (NLNRA, ≤1.5 mGy/year, N = 27) and high level natural radiation areas (HLNRA, >1.5mGy/year, N = 70) of Kerala coast in southwest India. The mean age of individuals from NLNRA and HLNRA was 40.9 ± 9.4 and 43.7 ± 12.4 years, respectively, with an overall mean of 42.9 ± 11.6 (range: 18-80). Whole-blood cultures were set up and about 260 metaphases were scored per individual. The frequency of chromosome aberrations was calculated per 1000 cells. The overall basal frequency of unstable (dicentrics and rings), stable (translocations and inversions) and other (fragments and breaks) aberrations was 1.54 ± 0.25, 4.1 ± 0.40 and 6.66 ± 0.51, respectively. Individuals of NLNRA and HLNRA had statistically similar frequency of unstable (2.11 ± 0.64 v/s 1.39 ± 0.26; RR = 0.66; 95% CI: 0.33-1.33), stable (4.60 ± 0.94 v/s 3.97 ± 0.44; RR = 0.86; 95% CI: 0.55-1.36) and other (7.85 ± 1.23 v/s 6.36 ± 0.56; RR = 0.81; 95% CI: 0.57-1.15) chromosome aberrations. Frequencies of unstable, stable and other chromosome aberrations did not show any dose response after stratification of HLNRA samples into three dose groups (1.51-5.0 mGy/year, 5.01-10 mGy/year and >10.0 mGy/year). Smokers showed an increase in other chromosome aberrations (P < 0.001), but smoking was not associated with unstable and stable aberrations. Alcohol consumption and tobacco chewing had no significant association with any type of chromosome aberrations. In conclusion, chronic low dose radiation prevailing in Kerala coast did not show any significant effect on the basal frequency of chromosome aberrations among the adult population.

Biological dose assessment after low-dose overexposures in nuclear medicine

This paper focuses on the application of dicentric chromosome assay biodosimetry in cases of low-dose overexposures to professionals working in nuclear medicine and discusses how to present the results and associated uncertainties, to make possible a better understanding of biodosimetric reports. Five examples are presented of low or possibly zero exposure dose that are illustrative of typical problems that arise in occupational settings, in this instance in nuclear medicine departments. This is a scenario of minor concern in terms of health consequences but it is relevant in legal terms. They pose dilemmas for investigators but biological dosimetry can make a valuable contribution to resolving the cases.

Current attitudes of Turkish anesthesiologists to radiation exposure

PURPOSE

The aim of this study was to investigate the attitudes of anesthesiologists to radiation exposure and current safety practice in Turkey.

METHODS

The study enrolled anesthesiologists from all over Turkey, including all levels of academic degrees and all types of different institutions. Questionnaire forms were sent via e-mail to 505 anesthesiologists. The survey collected demographic data such as age, gender, position, and the institution at which the participant worked, and data about the frequency of radiation exposure during procedures and the participant's attitudes concerning radiation safety measures during these procedures.

RESULTS

The questionnaire forms were delivered to 491 anesthesiologists, and 301 (61.3 %) of these were returned. Of these, 9 had not completed the questionnaire because of a lack of exposure to radiation. Among the remaining 292 personnel, the weekly frequencies of radiation exposure were more than five times (36.7 %), one to five times (50.3 %), and less than once (13 %) per week, respectively. Only a few anesthesiologists regularly wore a lead apron (30.11 %) and a thyroid shield (11.3 %) during procedures involving radiation exposure.

CONCLUSIONS

This study demonstrated that nearly all anesthesiologists are regularly exposed to radiation and that few anesthesiologists in Turkey wear protective clothing, which is essential for radiation protection. Therefore, if it is not, increasing awareness about radiation protection should be an integral part of medical training and education.

Radiation exposure--do urologists take it seriously in Turkey?

PURPOSE

A questionnaire was administered to urologists to evaluate attitudes and behaviors about protection from radiation exposure during fluoroscopy guided endourological procedures.

MATERIALS AND METHODS

The questionnaire was e-mailed to 1,482 urologists, including urology residents, specialists and urologists holding all levels of academic degrees, between May and June 2011. The questionnaire administered to study participants was composed of demographic questions, and questions on radiation exposure frequency, and the use of dosimeters and flexible protective clothes. If a respondent reported not using dosimeters or protective clothes, additional questions asked for the reason.

RESULTS

Of the 1,482 questionnaires 394 (26.58%) were returned, of which 363 had completed answers. A total of 307 physicians (84.58%) were exposed to ionizing radiation, of whom 79.61% stated that they perform percutaneous nephrolithotomy at the clinic. Fluoroscopy guidance was the initial choice of 96.19% of urologists during percutaneous nephrolithotomy. Despite the common use of lead aprons (75.24%) most urologists did not use dosimeters (73.94%), eyeglasses (76.95%) or gloves (66.67%) while 46.44% always used thyroid shields during fluoroscopy. When asked why they did not use protective clothing, the most common answers were that protective clothes are not ergonomic and not practical.

CONCLUSIONS

Results clearly highlight the lack of use of ionizing radiation protection devices and dosimeters during commonly performed fluoroscopy guided endourological procedures among urologists in Turkey.