Recommendations to reduce hand exposure for standard nuclear medicine procedures

Sans-Mercé, M.; Ruiz, Natalia Minguillón; Barth, I.; Carnicer, A.; Donadille, L.; Ferrari, P.; Fülöp, M.; Ginjaume, M.; Gualdrini, G.; Krim, Selim R.; Mariotti, Francesca; Ortega, X.; Rimpler, A.; Vanhavere, F.; Baechler, Sébastien

doi:10.1016/j.radmeas.2011.07.011

Cited by 20 publications

(18 citation statements)

References 9 publications

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“…Bei Kontakt mit einer unabgeschirmten Spritze werden die Positronen nicht vollständig von der Spritzenwand (ca. 1 mm) absorbiert und tragen mit etwa 50 % zur Hautdosis bei, wie MonteCarlo-Simulationen zeigten [ 17 ] .…”

Section: Strahlenexposition Und Strahlenschutz Des Personals In Der Nunclassified

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Strahlenexposition und Strahlenschutz des Personals in der Nuklearmedizin – Ergebnisse des EU-Projekts ORAMED

Rimpler

Barth

2014

Nuklearmediziner

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▼ Staff performing the preparation and administration of radiopharmaceuticals in nuclear medicine runs the risks of receiving skin exposures to the hands, which may exceed the annual limit of 500 mSv. Within the EU project ORAMED ( O ptimization of Ra diation Protection in Med icine) a comprehensive investigation of skin exposures in diagnostics using Tc-99 m and F-18 and during radionuclide therapies by means of Y-90 labelled pharmaceuticals were performed. The survey measurements, involving 124 staff members in 32 nuclear medicine departments from 7 countries, provided numerous data on individual skin doses. The mean of the maximum skin dose, normalised to the activity, H P (0.07) max / A, covered a wide range, from 0.23 mSv/GBq during Tc-99 m administration up to 11 mSv/GBq for technicians during the preparing of Y-90/Zevalin ® . Generally, the radiation exposure of staff when preparing radiopharmaceuticals and syringes was found to be higher than during its administration to the patients. Various parameters that characterise the exposure conditions at workplaces were analysed. Appropriate shielding and the use of tools to increase the distance are the most eff ective protective means. Investigations of the pattern of skin exposure across the hands give reason to revise common practice of wearing extremity dosemeters for routine monitoring. The base of the index fi nger of the non-dominant hand is most suitable to fi x a ring dosemeter, with the detector in palmar direction. But even if a dosemeter is worn in such a manner, the skin dose maximum is underestimated by a factor of 5 on average. The study made clear that there is suffi cient potential to further optimise the radiation protection standard and to decrease exposure of staff . Zusammenfassung ▼Bei der Vorbereitung und der Applikation von Radiopharmaka in der Nuklearmedizin sind vor allem an den Händen des betreff enden Personals Über-schreitungen des Grenzwertes für die Organdosis der Haut von 500 mSv/a nicht auszuschließen. Im Rahmen des EU-Projekts ORAMED ( O ptimization of Ra diation Protection in Med icine) erfolgten Untersuchungen zur Hautexposition bei der Diagnostik mit Tc-99 m und F-18 sowie bei Radionuklidtherapien mittels Y-90-markierter Radiopharmaka. In 7 europäischen Ländern und 32 Einrichtungen wurden Erhebungsmessungen zur Hautdosis an 124 Mitarbeitern durchgeführt. Ziel war die Ermittlung der individuellen maximalen lokalen Hautdosis, H P (0,07) max . Die gefundenen Mittelwerte der aktivitätsnormierten Dosiswerte, H P (0,07) max / A, umfassten erwartungsgemäß einen großen Bereich, von 0,23 mSv/GBq bei der Administration von Tc-99 m bis zu 11 mSv/GBq bei der Markierung von Y-90/Zevalin ® . Dabei war die Strahlenbelastung bei der Markierung der radioaktiven Substanzen und der Vorbereitung der Spritzen grundsätzlich höher als bei deren Administration am Patienten. Die individuelle Dosis hängt entscheidend davon ab, ob adäquate Abschirmungen für Spritzen und Vorratsfl äschchen (Vials) sowie abstandsvergrö-ßernde Hilfsmittel verwendet werde...

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Section: Strahlenexposition Und Strahlenschutz Des Personals In Der Nunclassified

“…. 3 Medianwerte des Quotienten der maximalen Hautdosis H P (0,07) max zur Dosis H P (0,07) m an ausgewählten Messpositionen und Mittelwerte für alle Nuklide und Verfahren nach[ 17 ] . HG: Handgelenk, ZF: Zeigefi nger, RF: Ringfi nger GG: Grundglied; palmar.…”

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Strahlenexposition und Strahlenschutz des Personals in der Nuklearmedizin – Ergebnisse des EU-Projekts ORAMED

Rimpler

Barth

2014

Nuklearmediziner

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“…Based on the results of measurements under the project ORAMED (124 workers monitored at 32 nuclear medicine departments in 7 European countries), several recommendations aimed at reducing exposure of the hands have been proposed (1,9):…”

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Possibilities of the exposure reduction of hands during the preparation and application of radiopharmaceuticals

Hudzietzová¹,

Fülöp²,

Sabol³

2016

BLL

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BACKGROUND: The current routinely used methods of estimating the skin equivalent dose relies on the fi nger dosimetry which usually largely underestimates the real maximum exposure and thus appropriate correction factors have to be used. METHODS: The group under the investigation consisted of 10 workers preparing and 5 workers administering radiopharmaceuticals labelled with 18 F. The monitoring was carried out using 12 pairs of thermoluminiscent dosimeters (TLDs) placed on each hand of the worker. A total of 46 measurements were completed. The maximum exposure of the skin of hands, defi ned in terms of the quantity of the personal dose equivalent H p (0.07), was related to the unit activity of radiopharmaceutical with which the worker came into the contact during the measurement. RESULTS: The exposure of the hands of workers handling 18 F-labelled radiopharmaceuticals showed significant inhomogeneity. Out of 15 workers, in 53 % of cases, the maximum skin exposure was observed on the tip of their index fi nger. It was estimated that in about 60 % of the cases (during the preparation and administration of radiopharmaceuticals), the exposure may exceed the 3/10 of the annual dose limit. Moreover, in 40 % of all cases, the exposure may even be higher than this dose limit. The established relevant correction factors reached the values up to 8 (as for preparations) and 13 (as for administrations). CONCLUSIONS: The study resulted in the establishment of the appropriate correction factors and in the recommendations of procedures aimed at the further reduction of the exposure of extremities (Tab. 3, Fig. 2, Ref. 17). Text in PDF www.elis.sk.

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“…Ein wesentlicher Bestandteil des Projekts war die Durchführung einer Mess-kampagne zur Ermittlung repräsentativer Werte der Hautdosis an den Händen des Personals. Die Resultate wurden bereits in verschiedenen Originalarbeiten publiziert [1,16,17]. In der vorliegenden Übersichtsarbeit werden die im Rahmen des ORA-MED-Projekts gewonnenen Daten zur Hautexposition bei diagnostischen Standardverfahren mit den Nukliden Tc-99 m und F-18 als auch bei Radionuklidtherapien mit Y-90 zusammengefasst und Schlussfolgerungen für den praktischen Strahlenschutz abgeleitet.…”

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“…Auch konventionelle Abschirmungen für Vials aus Blei oder Spritzenabschirmungen aus Wolfram absorbieren die Betastrahlung vollständig und schwächen zudem die entstehende Bremsstrahlung ausreichend. Monte-Carlo-Simulationen haben gezeigt, dass eine Spritzenabschirmung mit 5 mm Wolfram ausreichende Schwächung für F-18 liefert[17]. Eine solche Abschirmung bietet auch bei Radiotherapien mit Y-90 mindestens den gleichen Schutz wie das hier übliche mehr als 10 mm dicke Plexiglas.…”

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Strahlenexposition und Strahlenschutz des Personals in der Nuklearmedizin – Ergebnisse des EU-Projekts ORAMED

Rimpler¹,

Barth²

2014

TumorDiagn u Ther

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Staff performing the preparation and administration of radiopharmaceuticals in nuclear medicine runs the risks of receiving skin exposures to the hands, which may exceed the annual limit of 500 mSv. Within the EU project ORAMED (Optimization of Radiation Protection in Medicine) a comprehensive investigation of skin exposures in diagnostics using Tc-99 m and F-18 and during radionuclide therapies by means of Y-90 labelled pharmaceuticals were performed. The survey measurements, involving 124 staff members in 32 nuclear medicine departments from 7 countries, provided numerous data on individual skin doses. The mean of the maximum skin dose, normalised to the activity, H P (0.07) max /A, covered a wide range, from 0.23 mSv/GBq during Tc-99 m administration up to 11 mSv/GBq for technicians during the preparing of Y-90/Zevalin ® . Generally, the radiation exposure of staff when preparing radiopharmaceuticals and syringes was found to be higher than during its administration to the patients. Various parameters that characterise the exposure conditions at workplaces were analysed. Appropriate shielding and the use of tools to increase the distance are the most effective protective means. Investigations of the pattern of skin exposure across the hands give reason to revise common practice of wearing extremity dosemeters for routine monitoring. The base of the index finger of the non-dominant hand is most suitable to fix a ring dosemeter, with the detector in palmar direction. But even if a dosemeter is worn in such a manner, the skin dose maximum is underestimated by a factor of 5 on average. The study made clear that there is sufficient potential to further optimise the radiation protection standard and to decrease exposure of staff.Heruntergeladen von: University of British Columbia. Urheberrechtlich geschützt.

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Recommendations to reduce hand exposure for standard nuclear medicine procedures

Cited by 20 publications

References 9 publications

Strahlenexposition und Strahlenschutz des Personals in der Nuklearmedizin – Ergebnisse des EU-Projekts ORAMED

Strahlenexposition und Strahlenschutz des Personals in der Nuklearmedizin – Ergebnisse des EU-Projekts ORAMED

Possibilities of the exposure reduction of hands during the preparation and application of radiopharmaceuticals

Strahlenexposition und Strahlenschutz des Personals in der Nuklearmedizin – Ergebnisse des EU-Projekts ORAMED

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