Anti-X Apron Wearing and Musculoskeletal Problems Among Healthcare Workers: A Systematic Scoping Review

Monaco, Maria Grazia Lourdes; Carta, Angela; Tamhid, Tishad; Porru, Stefano

doi:10.3390/ijerph17165877

Cited by 24 publications

(18 citation statements)

References 21 publications

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“…As interventional radiologists have been reported to suffer from work-related musculoskeletal symptoms [ 12 , 13 , 14 ], an interventional workflow without the need for lead aprons appears to be beneficial and welcome. Nevertheless, especially for tricky interventional procedures (e.g., the biopsy of small lung nodules) with close patient contact, the possibility of direct patient interaction (for instance, breathing instructions), and a fast operation without leaving the CT room, can improve procedural comfort and success.…”

Section: Discussionmentioning

confidence: 99%

Cutting Staff Radiation Exposure and Improving Freedom of Motion during CT Interventions: Comparison of a Novel Workflow Utilizing a Radiation Protection Cabin versus Two Conventional Workflows

et al. 2021

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This study aimed to evaluate the radiation exposure to the radiologist and the procedure time of prospectively matched CT interventions implementing three different workflows—the radiologist—(I) leaving the CT room during scanning; (II) wearing a lead apron and staying in the CT room; (III) staying in the CT room in a prototype radiation protection cabin without lead apron while utilizing a wireless remote control and a tablet. We prospectively evaluated the radiologist’s radiation exposure utilizing an electronic personal dosimeter, the intervention time, and success in CT interventions matched to the three different workflows. We compared the interventional success, the patient’s dose of the interventional scans in each workflow (total mAs and total DLP), the radiologist’s personal dose (in µSV), and interventional time. To perform workflow III, a prototype of a radiation protection cabin, with 3 mm lead equivalent walls and a foot switch to operate the doors, was built in the CT examination room. Radiation exposure during the maximum tube output at 120 kV was measured by the local admission officials inside the cabin at the same level as in the technician’s control room (below 0.5 μSv/h and 1 mSv/y). Further, to utilize the full potential of this novel workflow, a sterile packed remote control (to move the CT table and to trigger the radiation) and a sterile packed tablet anchored on the CT table (to plan and navigate during the CT intervention) were operated by the radiologist. There were 18 interventions performed in workflow I, 16 in workflow II, and 27 in workflow III. There were no significant differences in the intervention time (workflow I: 23 min ± 12, workflow II: 20 min ± 8, and workflow III: 21 min ± 10, p = 0.71) and the patient’s dose (total DLP, p = 0.14). However, the personal dosimeter registered 0.17 ± 0.22 µSv for workflow II, while I and III both documented 0 µSv, displaying significant difference (p < 0.001). All workflows were performed completely and successfully in all cases. The new workflow has the potential to reduce interventional CT radiologists’ radiation dose to zero while relieving them from working in a lead apron all day.

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Section: Discussionmentioning

confidence: 99%

Cutting Staff Radiation Exposure and Improving Freedom of Motion during CT Interventions: Comparison of a Novel Workflow Utilizing a Radiation Protection Cabin versus Two Conventional Workflows

et al. 2021

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“…In interventional radiology, the use of anti-X aprons, in association with awkward postures and non-ergonomic working conditions, might cause the onset of MSDs [ 19 ]. The prevalence of neck and back pain at least once a week ranges from 50% to 60% for those who use lead aprons frequently [ 8 , 20 ].…”

Section: Work-related Musculoskeletal Disordersmentioning

confidence: 99%

“…However, it can increase pressure in the lumbar or cervical discs [ 8 , 39 ]. The impact of anti-X aprons on fitness for work assessment has not been investigated, particularly in subjects with MSDs [ 19 ]. The correlation between anti-X apron-wearing and the occurrence of MSDs remains unclear, although the possible discomfort of workers using anti-X aprons appears more evident.…”

Section: Situations Encountered In Interventional Radiology and Existing Solutionsmentioning

confidence: 99%

Ergonomics in Interventional Radiology: Awareness Is Mandatory

et al. 2021

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Ergonomics in interventional radiology has not been thoroughly evaluated. Like any operators, interventional radiologists are exposed to the risk of work-related musculoskeletal disorders. The use of lead shielding to radiation exposure and the lack of ergonomic principles developed so far contribute to these disorders, which may potentially affect their livelihoods, quality of life, and productivity. The objectives of this review were to describe the different situations encountered in interventional radiology and to compile the strategies both available to date and in development to improve ergonomics.

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“…Shielding sheets for medical radiation are primarily used as apron materials, and generally feature a shielding performance of 0.25 and 0.50 mmPb, lead-equivalent [17]. The thickness of the shielding sheet is around 3 mm, and is primarily determined by the amount of polymer and shielding materials.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Shielding Performance of Radiation-Shielding Materials According to Particle Size and Clustering Effects

Kim

2021

Applied Sciences

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In the field of medical radiation shielding, there is an extensive body of research on process technologies for ecofriendly shielding materials that could replace lead. In particular, the particle size and arrangement of the shielding material when blended with a polymer material affect shielding performance. In this study, we observed how the particle size of the shielding material affects shielding performance. Performance and particle structure were observed for every shielding sheet, which were fabricated by mixing microparticles and nanoparticles with a polymer material using the same process. We observed that the smaller the particle size was, the higher both the clustering and shielding effects in the high-energy region. Thus, shielding performance can be improved. In the low-dose region, the effect of particle size on shielding performance was insignificant. Moreover, the shielding sheet in which nanoparticles and microsized particles were mixed showed similar performance to that of the shielding sheet containing only microsized particles. Findings indicate that, when fabricating a shielding sheet using a polymer material, the smaller the particles in the high-energy region are, the better the shielding performance is. However, in the low-energy region, the effect of the particles is insignificant.

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Anti-X Apron Wearing and Musculoskeletal Problems Among Healthcare Workers: A Systematic Scoping Review

Cited by 24 publications

References 21 publications

Cutting Staff Radiation Exposure and Improving Freedom of Motion during CT Interventions: Comparison of a Novel Workflow Utilizing a Radiation Protection Cabin versus Two Conventional Workflows

Cutting Staff Radiation Exposure and Improving Freedom of Motion during CT Interventions: Comparison of a Novel Workflow Utilizing a Radiation Protection Cabin versus Two Conventional Workflows

Ergonomics in Interventional Radiology: Awareness Is Mandatory

Analysis of Shielding Performance of Radiation-Shielding Materials According to Particle Size and Clustering Effects

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