The impact of various protective tools on the dose reduction in the eye lens in an interventional cardiology-clinical study

The aim of the study was to check, in clinical practice, the potential for the dose reduction of lead eyewear and a ceiling-suspended shield used to protect the eye lens of physicians working in interventional cardiology. To this end, for the lead eyewear, the dose reduction factors were derived to correct the readings from a dosimeter used routinely outside the glasses. Four types of lead eyewear with attached loose thermoluminescent dosimeters and EYE-D dosimeters were worn by physicians in two clinical centres, for two-month periods, during coronary angiography (CA), percutaneous coronary intervention (PCI), and pacemaker procedures. In order to analyse, separately, how a ceiling-suspended lead screen absorbs the scattered radiation, a series of measurements was carried out during single CA/PCI procedures performed with and without the protection. The lead eyewear may reduce the doses to the eye closest to the x-ray tube by a factor between 1.1 and 3.4, depending on its model and the physician's position. The effectiveness of the eyewear may, however, vary-even for the same model and physician-almost twofold between different working periods. The ceiling-suspended shield decreases the doses in clinical practice by a factor of 2.3. The annual eye lens doses without the eyewear estimated from routine measurements are high-above or close to the new eye lens dose limit established by the recent EU Basic Safety Standards, even though the ceiling-suspended shield was used. Therefore, to comply with the new dose limit that is set in the Directive, protection of the eyes of physicians with high workloads might require the use of both the eyewear and the ceiling-suspended shield.

The impact of x-ray tube configuration on the eye lens and extremity doses received by cardiologists in electrophysiology room

The aim of the study was to analyse the influence of the x-ray tube configuration on the radiation doses to eye lens and extremities of cardiologists performing pacemaker implantation procedures in electrophysiology laboratory. The measurements were performed on one, widely used, portable C-arm system, first with x-ray tube mounted above the patient table and image intensifier below it and then on a reinstalled (but essentially the same) system with under-table x-ray tube configuration. Thermoluminescent dosimeters, placed in various positions near the eye lens, on the hands and ankle, were used during every procedure. The comparison of doses received by cardiologists after changing the x-ray tube configuration from over- to under-table shows statistically significant dose reduction (p < 0.009) for the eye lens closest to the x-ray tube, left finger, left wrist, while for the ankle a dose increase is observed. The corresponding over- to under-table x-ray tube median dose ratios are 4.1 for the right eye, 4.8 for the left finger, 3.0 for left wrist and, finally, 0.13 for the right ankle. Systems with under-table x-ray tube are preferable from a radiation protection point of view. The observed significant increase in doses to the legs should be partially compensated by the use of a protective lead curtain.