Non-Lead Protective Aprons for the Protection of Interventional Radiology Physicians from Radiation Exposure in Clinical Settings: An Initial Study
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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.Keywords:
Lead apron
Personal Protective Equipment
Equivalent dose
Interventional radiology
Interventional radiologists receive significant radiation doses, and it is important to have simple methods for routine monitoring of their exposure.To evaluate the usefulness of a dosimeter worn outside the protective apron for assessments of dose to interventional radiologists.Assessments of effective dose versus dose to dosimeters worn outside the protective apron were achieved by phantom measurements. Doses outside and under the apron were assessed by phantom measurements and measurements on eight radiologists wearing two routine dosimeters for a 2-month period during ordinary working conditions. Finger doses for the same radiologists were recorded using thermoluminescent dosimeters (TLD; DXT-RAD Extremity dosimeters).Typical values for the ratio between effective dose and dosimeter dose were found to be about 0.02 when the radiologist used a thyroid shield and about 0.03 without. The ratio between the dose to the dosimeter under and outside a protective apron was found to be less than 0.04. There was very good correlation between finger dose and dosimeter dose.A personal dosimeter worn outside a protective apron is a good screening device for dose to the eyes and fingers as well as for effective dose, even though the effective dose is grossly overestimated. Relatively high dose to the fingers and eyes remains undetected by a dosimeter worn under the apron.
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After a short recall of the Belgian legislation in the field of radiation protection, the practical organization of individual dosimetry is described. The workers occupationally exposed to radiation shall always wear an individual dosimeter at the level of the chest. When a high irradiation of the hands is suspected, it is necessary to wear a second dosimeter at the level of the wrist or the fingers. When a lead apron is used, due to the important resulting dose heterogeneity, two dosimeters have to be worn, the first one permanently at the level of the chest (behind the lead apron), the second one at the level of the non-protected parts of the body (e.g. neck, shoulders). The effective dose is then calculated by adding the dose received by the first dosimeter and the dose received by the second dosimeter (not shielded by the lead apron) divided by a weighting factor of 10. This evaluation of the effective dose is fully conservative.
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Evaluation of radiation protective devices in radiology departments is one of the practices that ensure radiation protection and staff and patients safety in hospitals. A research work to evaluate 1.5mm lead shield used for radiological protection was carried out in Radiological Unit of Sharda Hospital, of Sharda University, India, using 300mA fixed x-ray machine room. The evaluation was done in the x-ray energy (kVp) range between 52- 81 and by using calculative procedure and by direct measurement of the radiation dose rates. The two results were compared. The resultsshows that, in the absence of the shield, only 11.82% of the radiation exposure was attenuated by the air space before reaching the radiographer’s stand, while in the presence of the shield, 96.50% was attenuated, whereas, for the measured result only 10.17% was attenuated in the absence of the shield and 89.83% was attenuated in the presence of the shield before reaching the radiographer’s stand. The unit of radiation exposure was converted to that of equivalent dose and that of effective dose in order to assess the radiographer’s safety level behind the shield. It was found that, the equivalent/effective dose is as low as to be accepted according to the policy of ALARA (As Low As Reasonably Achievable), and within the NCRP recommended limit. This guaranteed the effectiveness of the lead shield of 1.5mm thickness in the x-ray energy range used in this study.Keywords: Lead shield, radiological protection, effectiveness of 1.5mm leadshield, presence of shield, absence of shield, radiographer’s safety.
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Objective:To evaluate the value of three-dimensional radiation protective measures for interventional radiology. Methods:Plumbous drapes below the operation table,pensile lead glass screen,exposure suit,lead scarf,lead-impregnated eye-glasses and distance protection were used for radiation protection.RADOS RAD-60 personal alarm dosimeter was used to detect the dose of X-ray radiation.Results:Plumbous drapes,pensile lead glass screen,exposure suit and distance protection can obviously reduce the dose of X-ray radiation exposure.Conclusion:The three-dimensional radiation protective measures for interventional radiology can reduce obviously the dose of radiation exposure to operators and patients.
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Interventional radiology
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Objective: To discuss the methods and evaluate the effectiveness of radiation protection during interventional therapy of orthopedics in c-arm operation room.Methods: The knowledge of radiation protection was popularized and plumbous drapes below the operation table,pensile lead glass screen,exposure suit,lead scarf,lead impregnated eye glasses and distance protection were used for radiation protection.Personal dosimeter was used to detect the dose of X ray radiation.Results: Pensile lead glass screen,exposure suit,lead scarf,lead impregnated eye glasses and distance protection could obviously reduce the dose of X ray radiation exposure.The radiation protection knowledge also improved radiation protection.Conclusion: Many kinds of radiation protective measures for interventional radiology can reduce obviously the dose of radiation exposure to operators.
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Radioprotection for Cardiac Device Implant . Introduction: Pacemaker implants are associated with a high cumulative exposure of the operators to radiation. Standard radiation protection with lead aprons is incomplete and the cause of spine disorders. A radiation protection cabin offers complete protection by surrounding the operator, without requiring a lead apron. Methods: We randomly and evenly assigned 60 patients undergoing implantations of permanent pacemakers or cardioverter defibrillators (ICD) with (a) a radiation protection cabin (cabin group, n = 30) versus (b) standard protection with a 0.5 mm lead‐equivalent apron (control group, n = 30). Radiation exposure was measured using personal electronic dosimeters placed on the thorax, back, and head of the operator. Results: The patient, procedural, and device characteristics of the 2 study groups were similar. All procedures in the cabin group were performed as planned without increase in duration or complication rate compared with the control group. The mean radiation dose to the head, normalized for fluoroscopy duration, was significantly lower in the cabin (0.040 ± 0.032 μSv/min) than in the control (1.138 ± 0.560 μSv/min) group (p < 0.0001). The radiation doses to the thorax (0.043 ± 0.027 vs 0.041 ± 0.040 μSv/min) and back (0.038 ± 0.029 vs 0.033 ± 0.018 μSv/min) in the cabin versus control group (under the apron) were similar. Conclusions: The use of a radiation protection cabin markedly decreased the exposure of the operator to radiation, and eliminated the need to wear a lead apron, without increasing the procedural time or complication rate during implantation of pacemaker and ICD. (J Cardiovasc Electrophysiol, Vol. 21, pp. 428–430, April 2010)
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Background: Assessment of the radiation doses to which workers are exposed can differ depending on the placement of dosimeters on the body. In addition, it is affected by whether the placement is under or over a shielding apron. This study aimed to evaluate the actual positioning of personal dosimeters on the body, with or without shielding aprons, among radiation workers in Korea.Materials and Methods: We analyzed the survey data, which included demographic characteristics, such as sex, age, occupation, work history, and placement of the personal dosimeter being worn, from a cohort study of Korean radiation workers. We assessed the use of personal dosimeters among workers, stratified by sex, age, working period, starting year of work, and occupation.Results and Discussion: Overall, high compliance (89.1% to 99.0%) with the wearing of dosimeters on the chest was observed regardless of workers’ characteristics, such as age, sex, occupation, and work history. However, the placement of dosimeters, either under or over the shielding aprons, was inconsistent. Overall, 40.1% of workers wore dosimeters under their aprons, while the others wore dosimeters over their aprons. This inconsistency indicates that radiation doses are possibly measured differently under the same exposure conditions solely owing to variations in the placement of worn dosimeters.Conclusion: Although a lack of uniformity in dosimeter placement when wearing a shielding apron may not cause serious harm in radiation dose management for workers, the development of detailed guidelines for dosimeter placement may improve the accuracy of dose assessment.
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Secondary Standard Dosimetry Laboratory (SSDL) Department, of Malaysian Nuclear Agency (nuclear Malaysia) is responsible for monitoring radiation worker in Malaysia. All radiation workers in Malaysia is monitor using two kind of personal dosimeter either, film badge or thermo luminescent (TL) dosimeter .In the year 2015, SSDL Nuclear Malaysia plan to terminate all film badge services and switch to Optically Stimulated Luminescene (OSL) dosimeter. This OSL dosimeter is the new kind personal dosimeter in Malaysia. OSL dosimeter is sensitive to low dosage as low as 0.05 miliSievert (mSv) up to 10000 mSv. OSL can detect photon (x-ray and gamma ray), beta and neutron radiation. It can be re-read and very simple to maintain. OSL dosimeter can estimate and detect deep dose or personal dose equivalent in 10 mm tissue (Hp(lO)mSv), shallow dose or skin dose or personal dose equivalent in 0.07 mm tissue (Hp(0.07),mSv) and also can detect lens dose or personal dose equivalent in 3 mm in lens tissue (Hp(3),mSv). Radiation exposure in OSL dosiemeter is measure using Microstar Reader , this happen when by stimulating the detector that is aluminium oxide (A1203:C) crystal, with a green Light Emitting Diode (LED) array causing the luminescent phenomena which proportion to the amount of radiation absorbed. During the stimulation only some trapped electrons are released so the dosimeter can be re-read. Currently SSDL-Nuclear Malaysia already purchases nearly 2000 new OSL dosimeter. As a new dosimeter this OSL dosimeter need to undergo some type testing such as linearity response test, energy response test, angular response test and repeatability response test. This research project will use irradiation facility and OSL MICROSTAR READER situated in SSDL Nuclear Malaysia facility. This research proposal is to study the linearity of OSL dosimeter base on the response of shallow dose or skin dose or personal dose equivalent in
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Objective To investigate the radiation doses in different areas around the operation table during intervention procedure and to study the effect of X-ray protection equipments.Methods A total of 37 procedures(12 diagnostic cardiac angiographies and 25 percutaneous coronary intervention therapy) were investigated.The detection of X-ray was carried out in 2 separate groups.The first group included the operators,assistants and nurses.There were 6 detecting points on each person resulting in a total of 18 detecting points.The second group consisted of 10 detecting points on different areas of the patients and the protecting lead shields around.The measurement of X-ray doses was performed by the specialist from the radiation protection agency.Results The doses of X-ray was directly proportional to the duration of exposure.The X-ray doses varied among the 28 detecting points.The highest amount of radiation were detected on the left arm of the operator and on the left axilla and the back of the patients.Above 90% of radiation could be protected by lead shields and lead clothes.Conclusion Lead protective products available at precent are efficient in protecting radiation exposure during cardiovascular intervention procedures.More attention still need to be paid to certain highly exposed areas.
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Lead (geology)
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The purpose of this study is to evaluate the effectiveness of personal radiation shields currently worn in hospital and other diagnostic environments. This study was performed with four different radioisotopes; 18F, 99mTc, 124I and 131I. 18F results showed a decrease in dose with 0.5-mm Pb shielding but the reduction provided does not warrant its use clinically. 124I testing demonstrated that dose enhancement can occur in greater shield thicknesses. PET isotope 124I can be adequately shielded using 0.25-mm Pb equivalent aprons but any higher thickness increase the wearer's dose. As a result more shielding does not always equal more protection. The 131I test showed that no dose reduction occurred, even when tested with up to 1.25-mm Pb equivalent shielding. Novel radioisotopes being used in the laboratory and clinic should be individually tested as each requires specific shielding testing.
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Shielded cable
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