On the feasibility of utilizing active personal dosimeters worn on the chest to estimate occupational eye lens dose in x-ray angiography

Abstract

The International Commission on Radiological Protection (ICRP) has recommended that the occupational dose limit to the eye lens be substantially reduced. To ensure compliance with these recommendations, monitoring of the occupational eye lens dose is essential in certain hospital work environments. For assessment of the eye lens dose it is recommended to use a supplementary dosimeter placed at a position adjacent to the eye(s). Wearing a dosimeter at eye level can, however, be impractical and distributing and managing additional dosimeters over long periods of time is cumbersome and costly for large clinical sites. An attractive alternative is to utilize active personal dosimeters (APDs), which are routinely used by clinical staff for real-time monitoring of the personal dose equivalent rate (H(p)(10)). In this work, a formalism for the determination of eye lens dose from the response of such APD's worn on the chest is proposed and evaluated. The evaluation is based on both phantom and clinical measurements performed in an x-ray angiography suite for interventional cardiology. The main results show that the eye lens dose to the primary operator and to the assisting clinical staff can be conservatively estimated from the APD response as D(eye)(conductor) = 2.0 APD chest and D(eye)(assisting) = 1.0 APD chest, respectively. However, care should be exercised for particularly short assisting staff and if radiation protection shields are misused. These concerns can be greatly mitigated if the clinical staff are provided with adequate radiation protection training.

Occupational radiation exposure to the head is higher for scrub nurses than cardiologists during cardiac angiography

“…This study did not find a significant correlation between the heights of nursing staff and head dose which reflects the findings by Antic et al, (2013), but contradicts clinical and phantom studies which found that dosimeters worn at chest level detected higher levels of radiation in short staff members than in their taller colleagues (Omar, Marteinsdottir, Kadesjo, & Fransson, 2015;Rigatelli et al, 2016).…”

“…It has been reported that staff height may also influence occupational dose as the taller the staff member is, the further away their head is from the source of scattered radiation (Principi et al, ). This study did not find a significant correlation between the heights of nursing staff and head dose which reflects the findings by Antic et al, (), but contradicts clinical and phantom studies which found that dosimeters worn at chest level detected higher levels of radiation in short staff members than in their taller colleagues (Omar, Marteinsdottir, Kadesjo, & Fransson, ; Rigatelli et al, ).…”

Occupational radiation exposure to nursing staff during cardiovascular fluoroscopic procedures: A review of the literature

“…The importance of careful positioning of the movable ceiling mounted lead shield has been previously reported especially when using biplane equipment, and this was echoed in the reviewed literature . Several authors declared the absence of ceiling and table‐mounted lead shields when no other additional lead protection such as lead glasses or skull caps were worn by staff .…”

“…Some authors investigated dose in relation to proximity to the x‐ray tube . Explanatory diagrammatic representation of the position of staff was provided in several articles which allows comparison by dosimetric location rather than assigned role. Specific articulation of staff distances from the x‐ray tube or table was constructive when comparing occupational doses.…”

“…Dosimeters are also available in H p (10) and H p (0.07) which estimate values for dose of deep organs and skin dose, respectively. Several of the reviewed manuscripts recorded eye dose at the level of the eye and some utilized multiple dosimeters around the face or head (Table ) …”