Time to take the gloves off: the use of radiation reduction gloves can greatly increase patient dose

Abstract

Sterile radiation reduction gloves have been widely used over the past several decades in an effort to reduce hand doses during fluoroscopically guided procedures. While multiple studies have quantified the potential dose reduction to the fluoroscope operator from the use of such gloves, possible effects on the patient have not yet been quantified. The aim of this study was to examine the impact on patient dose when radiation reduction gloves are used. The impact on patient dose when using radiation reduction gloves in the field of view (FOV) was evaluated by measuring patient entrance surface dose rates (ESDR) using three C‐arm fluoroscopes for a range of patient sizes and different operating and magnification modes. Multiple measuring fields were used in combination with both peripheral and central glove placement. ESDR were measured with no glove in the FOV, with one radiation reduction glove, and with double gloves in the FOV, to replicate the actions of some fluoroscope operators. Compared to an ungloved hand, the use of a single radiation reduction glove in the measuring field resulted in up to a 2.8‐fold increase in ESDR. The use of double radiation reduction gloves resulted in up to a 4.9‐fold increase in ESDR. In both cases, the increase in ESDR was dependent on the size of the patient and on the operating and magnification modes used, and ranged from no increase up to the aforementioned maximum. When used in the FOV, and particularly within the measuring field, radiation reduction gloves can substantially increase ESDR. This increase in dose, when considered against the relatively small published reduction in dose to the operator's hands, may mean that the increased risks from the use of radiation reduction gloves outweigh the benefits. In any case, hands should not be placed in the FOV if not required by the goals of the procedure.PACS number: 87.59.C‐

Perceptions on radioprotective garment usage and underlying reasons for non-adherence among medical radiation workers from public hospitals in a middle-income Asian setting: A qualitative exploration

“…As stated in the latest local guidelines, it is best to keep MRWs' hands away from the primary beam rather than using radioprotective gloves. Placing gloves in the primary beam will increase the scatter radiation in the area [5, 34, 35]. A laboratory finding showed that, in some cases, using RPGs increases the energy of the photons; thus, the MRWs may be unconsciously exposed to a larger dose of radiation than generally believed [30, 32, 35].…”

“…Placing gloves in the primary beam will increase the scatter radiation in the area [5, 34, 35]. A laboratory finding showed that, in some cases, using RPGs increases the energy of the photons; thus, the MRWs may be unconsciously exposed to a larger dose of radiation than generally believed [30, 32, 35]. It is recognised that the updated guidelines are not well communicated among MRWs, and therefore there is an urgent need to do so.…”

Protecting Surgeons' Fingers from Radiation Exposure during Lumbosacral Selective Nerve Root Block

“…Although the attenuation rate of the 0.25-mmPb glove is considered excellent, the glove is difficult to use because of its heavy fabric, which hampers the needle manipulation. In fact, the use of radiation reduction gloves is associated with a substantial increase in the radiation dose due to the automatic exposure control system 6,14,15) . Pasciak et al reported the increase in the patients' exposure to the needle penetration to range between 0% to approximately 500%, depending on factors such as the patients' body mass and the fluoroscopic technique.…”

“…Pasciak et al reported the increase in the patients' exposure to the needle penetration to range between 0% to approximately 500%, depending on factors such as the patients' body mass and the fluoroscopic technique. Based on their findings, Pasciak et al concluded that the use of radiation reduction gloves might be contraindicated 14,15) . In light of these findings, the use of radiation-attenuating gloves outside the FOV, such as in our forceps group, would be most appropriate.…”

Reduction of Fluoroscopy Time and Radiation Dosage During Catheter Ablation for Atrial Fibrillation

“…Other small protectors, such as leaded glasses and leaded gloves, are less effective and efforts to lower radiation exposure need to be balanced against the discomfort of wearing them. [90][91][92] Some centres use radiation-protection units, such as radioprotection cabins (Cathpax ® , Lemer Pax), which protect from almost all scattered radiation without the need to wear lead aprons during the procedure. 93 Another protector is a suspended lead apron mounted on the ceiling or on a floor unit (Zero Gravity™, Biotronik) 94 .…”