Occupational Eye Lens Radiation Dose While Performing Interventional Procedures over 18 Months Using a Face-Shield Equipped Suspended Radiation Protection System

Abstract

Background: Numerous studies have demonstrated increasing evidence for cataractogenesis at lower levels of ionizing radiation than previously believed, with some suggesting possible absence of a threshold. Genetic differences between individuals also result in increased susceptibility in some operators, who might not be aware. European occupational exposure limits have been reduced and operators are seeking protective measures. Objective: To evaluate the protective effect of a face-shield equipped suspended protection system (Zero-Gravity ® , TIDI Products, Neenah, WI) along with adherence to safety practices against radiation dose to the eye lens for an interventional radiologist performing a wide variety of procedures. Materials and Methods: In this institutional review board-approved single-institution study, one interventional radiologist wore a highly sensitive personnel monitoring dosimeter badge on the cap near the left eye while performing 299 procedures (3690 fluoroscopy minutes) over 18 consecutive months while utilizing the suspended protection system along with adherence to other generally recommended safety practices and movement away from the field during angiographic power injections. Dosimetry reports and procedural information were retrospectively reviewed. Results: Total lens dose equivalent to the left eye over 18 months was 0.11 mSv (annualized dose = 0.073 mSv, or 7.3 mRem). The patient-dose-area product standardized dose of 0.00576 μSv/Gy•cm 2 is well below reports of conventional lead aprons, shields, and protective eyewear. Conclusion: Eye exposures were kept to near-background levels using the materials and methods of this study while performing a wide variety of complex procedures from all positions around the patient.

Occupational exposure to physicians working with a Zero-Gravity™ protection system in haemodynamic and electrophysiology labs and the assessment of its performance against a standard ceiling suspended shield

“…In the case of our study, for example, the differences between eye lens doses normalised to DAP for CA/PCI and RFA/CRYA (0.629 µSv/Gycm 2 vs. 0.496 µSv/Gycm 2 ) might be due to few dynamic factors such as the shielding (only ZG vs. ZG and CSS), the access (radial vs. femoral) and projections used [large variety of different types vs. restricted to few (mainly PA)]. Their relatively high values with respect to other studies, 0.017 µSv/Gycm 2 in Savage et al ( 2013 ), 0.006 µSv/Gycm 2 in both Kwarcinski et al 2020 and Ray et al 2013 and 0.123 µSv/Gycm 2 in Haussen et al 2016 , might be also due to relatively low sensitivity of TLDs and estimated LDL used to assess the exposure for RFA/CRYA (all measured eye lens doses were below LDL). Therefore, the value of 0.496 µSv/Gycm 2 is, in fact, the upper limit of left eye lens doses normalised to DAP for ablations.…”