Ergonomics in Interventional Radiology: Awareness Is Mandatory

Cornelis, F.; Razakamanantsoa, Léo; Ammar, Mohamed; Lehrer, Raphael; Haffaf, Idriss; El-Mouhadi, Sanaa; Gardavaud, François; Najdawi, Milan; Barral, Matthias

doi:10.3390/medicina57050500

Cited by 14 publications

(9 citation statements)

References 67 publications

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“…It is crucial to evaluate exposure of patients and healthcare workers to radiation during radiological examinations, especially IVR [ 47 , 48 , 49 , 50 , 51 , 52 ]. Despite the importance of protecting IVR physicians from occupational radiation exposure, no ideal radiation shield exists [ 53 , 54 , 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

Development of a New Radiation Shield for the Face and Neck of IVR Physicians

et al. 2022

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Interventional radiology (IVR) procedures are associated with increased radiation exposure and injury risk. Furthermore, radiation eye injury (i.e., cataract) in IVR staff have also been reported. It is crucial to protect the eyes of IVR physicians from X-ray radiation exposure. Many IVR physicians use protective Pb eyeglasses to reduce occupational eye exposure. However, the shielding effects of Pb eyeglasses are inadequate. We developed a novel shield for the face (including eyes) of IVR physicians. The novel shield consists of a neck and face guard (0.25 mm Pb-equivalent rubber sheet, nonlead protective sheet). The face shield is positioned on the left side of the IVR physician. We assessed the shielding effects of the novel shield using a phantom in the IVR X-ray system; a radiophotoluminescence dosimeter was used to measure the radiation exposure. In this phantom study, the effectiveness of the novel device for protecting against radiation was greater than 80% in almost all measurement situations, including in terms of eye lens exposure. A large amount of scattered radiation reaches the left side of IVR physicians. The novel radiation shield effectively protects the left side of the physician from this scattered radiation. Thus, the device can be used to protect the face and eyes of IVR physicians from occupational radiation exposure. The novel device will be useful for protecting the face (including eyes) of IVR physicians from radiation, and thus could reduce the rate of radiation injury. Based on the positive results of this phantom study, we plan to perform a clinical experiment to further test the utility of this novel radiation shield for IVR physicians.

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Section: Discussionmentioning

confidence: 99%

Development of a New Radiation Shield for the Face and Neck of IVR Physicians

et al. 2022

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“…The protective aprons increase the risk of musculoskeletal disorders. Careful selection of a personal protective apron is thus important [ 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…Possible ergonomic improvements include the use of a two-part protective apron (that separately protects the chest and waist). This would distribute the protective apron weight more equally across the shoulders and waist, possibly reducing the risk of musculoskeletal pain [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

Non-Lead Protective Aprons for the Protection of Interventional Radiology Physicians from Radiation Exposure in Clinical Settings: An Initial Study

et al. 2021

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Radiation protection/evaluation during interventional radiology (IVR) poses a very important problem. Although IVR physicians should wear protective aprons, the IVR physician may not tolerate wearing one for long procedures because protective aprons are generally heavy. In fact, orthopedic problems are increasingly reported in IVR physicians due to the strain of wearing heavy protective aprons during IVR. In recent years, non-Pb protective aprons (lighter weight, composite materials) have been developed. Although non-Pb protective aprons are more expensive than Pb protective aprons, the former aprons weigh less. However, whether the protective performance of non-Pb aprons is sufficient in the IVR clinical setting is unclear. This study compared the ability of non-Pb and Pb protective aprons (0.25- and 0.35-mm Pb-equivalents) to protect physicians from scatter radiation in a clinical setting (IVR, cardiac catheterizations, including percutaneous coronary intervention) using an electric personal dosimeter (EPD). For radiation measurements, physicians wore EPDs: One inside a personal protective apron at the chest, and one outside a personal protective apron at the chest. Physician comfort levels in each apron during procedures were also evaluated. As a result, performance (both the shielding effect (98.5%) and comfort (good)) of the non-Pb 0.35-mm-Pb-equivalent protective apron was good in the clinical setting. The radiation-shielding effects of the non-Pb 0.35-mm and Pb 0.35-mm-Pb-equivalent protective aprons were very similar. Therefore, non-Pb 0.35-mm Pb-equivalent protective aprons may be more suitable for providing radiation protection for IVR physicians because the shielding effect and comfort are both good in the clinical IVR setting. As non-Pb protective aprons are nontoxic and weigh less than Pb protective aprons, non-Pb protective aprons will be the preferred type for radiation protection of IVR staff, especially physicians.

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“…The mean KAP 34.6 ± 23.1 Gy.cm 2 (20.2–42.5), mean AK 358.3 ± 240.6 mGy (218.5–422.5) and mean FT of 15.6 ± 7.9 min (11–19.8) calculated in this study were lower to the reference strandards required by the European Directive 2013/59/Euratom in interventional radiology for a vertebroplasty in 1 level (KAP: 60 Gy.cm 2 , AK: 610 mGy and FT: 9 min) or 3 or more levels (110 Gy.cm 2 , 1160 mGy and 14 min) [ 16 , 17 ]. While further studies are needed to validate these results, the use of such intravertebral implants may further help to standardize the procedures without increasing dosage [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Image-Guided Vertebral Fixation in Cancer-Related Vertebral Compression Fractures: A Case Series Study

et al. 2021

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Background and objectives: Cancer-related vertebral compression fractures (VCF) may cause debilitating back pain and instability, affecting the quality of life of cancer patients. To further drive cement deposition during vertebroplasty, the aims of this restrospective case series study were to report the feasibility, safety and short term efficacy (≤6 months) of percutaneous vertebral fixation in cancer-related vertebral compression fractures using various intravertebral implants. Methods: All consecutive cancer patients treated with percutaneous vertebral fixation for VCF were retrospectively included. Various devices were inserted percutaneously under image guidance and filled by cement. Descriptive statistics were used and a matched paired analysis of pain scores was performed to assess for changes following interventions. Results: A total of 18 consecutive patients (12 women (66.6%) and 6 men (33.3%); mean age 59.7 ± 15.5 years) were included. A total of 42 devices were inserted in 8 thoracic and 16 lumbar vertebrae. Visual analogue scale measurement significantly improved from 5.6 ± 1.8 preoperatively to 1.5 ± 1.7 at 1 week (p < 0.01) and to 1.5 ± 1.3 at 6 months (p < 0.01). No severe adverse events were observed, but three adjacent fractures occurred between 1 week and 5 months after implantation. Conclusions: Percutaneous vertebral fixation of cancer-related VCF is feasible and safe and allows pain relief.

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Ergonomics in Interventional Radiology: Awareness Is Mandatory

Cited by 14 publications

References 67 publications

Development of a New Radiation Shield for the Face and Neck of IVR Physicians

Development of a New Radiation Shield for the Face and Neck of IVR Physicians

Non-Lead Protective Aprons for the Protection of Interventional Radiology Physicians from Radiation Exposure in Clinical Settings: An Initial Study

Percutaneous Image-Guided Vertebral Fixation in Cancer-Related Vertebral Compression Fractures: A Case Series Study

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