Radiation protection for surgeons and anesthetists: practices and knowledge before and after training

Abstract

The use of radiological activity in the operating room (OR) and a regulatory decrease of the eye lens dose warrant an assessment of how medical staff are protected from radiation. This study aims to evaluate practices and knowledge in radiation protection (RP) for OR doctors before and after training. A descriptive study of surgeons and anesthetists in a French public hospital center was conducted in 2016. An ad hoc questionnaire concerning occupational practices and knowledge about RP was distributed before and one month after RP training. Among 103 doctors attending the training, 90 answered the questionnaire before the training. Results showed a lack of knowledge and good practice in RP. Most of the participants (86.7%) had never been trained in RP and recognized insufficient knowledge. Most of them (92.2%) wore a lead apron, 50.0% a thyroid-shield, 5.6% lead glasses, 53.3% a passive dosimeter and 17.8% an electronic dosimeter. None of them benefitted from collective protective equipment such as a ceiling suspended screen. The questionnaire following the training was completed by only 35 doctors. A comparison before and after training results showed an improvement in knowledge (scores of correct responses: 5.5/16 before and 9.5/16 after training) but not in RP good practices (scores of correct responses: 3.2/7 before and 3.3/7 after training). One training session appears to be insufficient to improve the application of the safety rules when x-rays are used. Communication needs to be improved regarding RP among anesthetists and surgeons, such as training renewal, workstation analysis in OR related to x-ray use and occupational medical follow-up. Otherwise, radiological risks in OR need to be given better consideration, such as radio-induced cataract risk. It is necessary to encourage the use of dosimeters and protective equipment and to strengthen access to lead glasses and collective protective equipment, such as ceiling suspended screens. All these recommendations ensure the received dose is reduced to as low as is reasonably achievable.

Assessment of Health Professionals’ Attitudes on Radiation Protection Measures

“…G2: the following post hoc analysis showed that statistically significant differences existed only for the pair (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) vs. (31)(32)(33)(34)(35)(36)(37)(38)(39)(40), meaning that, employees with less previous experience had fewer misconceptions about the necessity for radiation protection than those with more experience.…”

“…Most of the participants were males (54.5%). As regards their age, most of them (40.9%) were in the age group of (35)(36)(37)(38)(39)(40)(41)(42)(43)(44), and in terms of education level, most of the employees (62.1%) were university graduates. Additionally, 50% of the participants stated that they have three or more children.…”

Semi-automatic positioning of the protective screen based on integration with C-arm X-ray device

“…The microcomputer, through the software for the assessment of optimal angulation, in order to most effectively protect all occupationally exposed persons [1,3,7,10,11,32,35,36], processes the following input data:…”

“…Serious strides have been made to improve X-ray diagnostic devices to emit less radiation [28][29][30] but, contrarily, the X-ray systems tend to be more complex and sophisticated. Clear guidelines have been written and constantly adapted and improved [31][32][33][34][35][36][37].…”

Radiation protection value to the operator from augmented reality smart glasses in interventional fluoroscopy procedures using phantoms

“…Damage to biological tissue by ionising radiation is dependant partly on the amount of radiation received 9 and its use in medicine is continuously increasing. 10 Fluoroscopy is often the imaging technique of choice for interventional radiology procedures, but it is associated with a higher radiation dose, 11,12 especially in relation to the clinician's eye lens. The lens of the clinician's eye is one of the most radiosensitive structures in the human body and is located within a high intensity region for fluoroscopy radiation dose.…”