Variations of the altitude and changes in the weather conditions may produce significant density corrections, and that effect should be taken into account. This effect is chamber-dependent, indicating that a specific calibration is necessary for each particular chamber. To our knowledge, this correction has not been considered so far for SourceCheck ionization chambers, but its magnitude cannot be neglected in clinical practice. The atmospheric pressure and temperature at which the chamber was calibrated need to be taken into account, and they should be reported in the calibration certificate. In addition, each institution should analyze the particular response of its SourceCheck ionization chamber and compute the adequate correction factors. In the absence of a suitable pressure chamber, a possibility for this assessment is to take measurements at different altitudes, spanning a wide enough air density range.
Monitoring of occupationally exposed persons in Bosnia and Herzegovina started in 1960s and it was interrupted in 1992. Dosimetry service resumed in 1999 when the International Atomic Energy Agency provided Harshaw 4500 TLD-reader and the first set of TLDs for the Radiation Protection Centre (RPC) of the Institute of Public Health of the Federation of Bosnia and Herzegovina. In January 2009, the RPC covered 1279 professionals with personal dosimetry, which is more than 70 % of all radiation workers in the country. Most of the TLD users work in medical institutions. In period 1999-2003 RPC provided 984 workers with dosemeters. In the next 5 y period (2004-2008), the number of persons covered by dosimetry increased by an average of 51 %. The mean and collective effective dose in the period 1999-2003 were 1.55 mSv and 1.54 personSv, respectively. In the period 2004-2008, the mean doses changed by 1 % on average, but the collective effective dose increased by 53 % for all practices. Mean and collective effective dose were 1.57 mSv and 2.34 personSv, respectively. The highest personal doses are associated with industrial radiography, than exposures in nuclear medicine. Radiology plays a significant role in collective dose only, whereas other exposures are low. Results correspond to results found in the literature. New practices in industry and medicine emphasise the need for more personal dosemeters, as well as specialised dosemeters for extremities monitoring, etc.
Monitoring of professionally exposed workers in Bosnia and Herzegovina started in 1960s. Doses received by patients and professionals in interventional cardiology are high in comparison with other practices in medicine. The purpose of this study is to present personal and patient dosimetry data. Results show increase in doses of personnel in interventional cardiology. Total collective dose for four cardiology centres in Bosnia and Herzegovina increased from 15 person mSv in 2007 to 52 person mSv in 2010. This increase mainly corresponds to higher number of personnel and increase in the number of procedures. Average monthly dose has increased from 0.40 to 0.72 mSv in the same period. The results of occupational and patient doses in interventional cardiology are similar to results reported in the literature. It is of great importance for professionals working in this field to be educated in radiation protection and proper use of X-ray equipment.
Many new computed tomography (CT) techniques have been introduced during the recent years, one of them being CT-assisted dynamic perfusion imaging (perfusion CT, PCT). Many concerns were raised when first cases of deterministic radiation effects were reported. This paper shows how radiochromic films can be utilised as passive dosemeters for use in PCT. Radiochromic dosemeters undergo a colour change directly and do not require chemical processing. Prior to their use, they need to be calibrated. Films are placed on top and on the right side of the patient and exposed during the procedure. Readout is performed using a densitometer. Results show that average local skin doses are 0.51±0.07 and 0.42±0.04 Gy on top and on the lateral side of the patient, respectively. Results of the patient dosimetry (local skin doses) are consistent. This is due to the fact that each patient had the same CT protocol used for imaging (120 kV, 60 mA and C(vol) of 247.75 mGy). Radiochromic films designed for interventional radiology can be effectively used for local skin dose measurements in perfusion CT. Dose values obtained are below the threshold needed for deterministic effects (erythema, hair loss, etc.). These effects might happen if inappropriate CT protocol is used; one that is usually used for routine imaging.
Cardiologists at the Cardiac Centre of the Clinical Centre of Sarajevo University performed invasive cardiology procedures in one room equipped with a Siemens Coroskop (Siemens Healthcare, Erlangen, Germany) unit with the possibility of digital cine imaging. The number of procedures performed with this unit is 1126 per year. The number of adults performing only diagnostic procedures is 816, therapeutic procedures 62 and both diagnostic and therapeutic 228. Twenty diagnostic examinations but no therapeutic procedure are performed on children per year. The workload is increasing year by year, with an average increase of 26 % per year. The X-ray system does not have a kerma area product (KAP) meter installed; therefore an external KAP meter was mounted on the X-ray tube. Gafchromic dosimetry films (International Specialty Products, Wayne, USA) were placed under the patient to record the skin dose distribution. The peak skin dose (PSD) was calculated from the maximum optical density of the dosimetry films. Dose measurements were performed on 51 patients undergoing therapeutic procedures (percutaneous transluminal coronary angioplasty and stent placement). Two patients received doses (KAP) larger than 100 Gycm(2). The PSD was higher than 1 Gy in 3 out of 16 evaluations, and one of these patients received a skin dose >2 Gy. No deterministic skin effects were recorded. The dosimetry results are similar to results reported in other countries. Invasive cardiac procedures deliver high doses to the skin that could cause deterministic effects (erythema). Physicians performing these procedures should be aware of these risks. More efforts should be put into the training of cardiologists in radiation protection.
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