Radiation dose to staff from medical X-ray scatter in the orthopaedic theatre.
Fluoroscopy
Nursing
Orthopaedics
Radiation
Radiography
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
18
01
2023
accepted:
21
03
2023
medline:
18
9
2023
pubmed:
3
4
2023
entrez:
2
4
2023
Statut:
ppublish
Résumé
Given the growing demand for intraoperative imaging, there is increased concern for radiation dose for orthopaedic surgical staff. This study sought to determine the distribution of scatter radiation from fluoroscopic imaging in the orthopaedic surgical environment, with particular emphasis on the positions of personnel and the type of orthopaedic surgery performed. A radiation survey detector was deployed at various angles and distances around an anthropomorphic phantom. The scatter dose rate in microsieverts per hour (µSv/h) was recorded using consistent exposure parameters for five common surgical procedures. A C-arm unit produced radiation for the hip arthroscopy, hip replacement and knee simulations, whilst a mini C-arm unit produced fluoroscopy for the foot and hand simulations. Readings were tabulated, and coloured heatmaps were generated from scatter measurements for each of the five procedures. Positions corresponding to the typical location of the surgical staff (surgeon, surgical assistant, anaesthetist, instrument (scrub) nurse, circulation (scout) nurse and anaesthetic nurse) were superimposed on heatmaps. The surgeon's proximity to the radiation source meant this position experienced the greatest amount of radiation in all five surgical procedures. Mini C-arm doses were considered low in all procedures for positions, with and without lead protection. This investigation demonstrated the distribution of scattered radiation dose experienced at different positions within the orthopaedic surgical theatre. It reinforces the importance of staff increasing their distance from the primary beam where possible, reducing exposure time and increasing shielding with lead protection.
Identifiants
pubmed: 37004602
doi: 10.1007/s00590-023-03538-6
pii: 10.1007/s00590-023-03538-6
pmc: PMC10504098
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3059-3065Informations de copyright
© 2023. The Author(s).
Références
Giordano BD, Ryder S, Baumhauer JF, DiGiovanni BF (2007) Exposure to direct and scatter radiation with use of mini-c-arm fluoroscopy. J Bone Joint Surg Am 89(5):948–952. https://doi.org/10.2106/jbjs.F.00733
doi: 10.2106/jbjs.F.00733
pubmed: 17473130
Kaplan DJ, Patel JN, Liporace FA, Yoon RS (2016) Intraoperative radiation safety in orthopaedics: a review of the ALARA (As low as reasonably achievable) principle. Patient Saf Surg 10:27–27. https://doi.org/10.1186/s13037-016-0115-8
doi: 10.1186/s13037-016-0115-8
pubmed: 27999617
pmcid: 5154084
Rehani MM, Ciraj-Bjelac O, Vañó E, Miller DL, Walsh S, Giordano BD, Persliden J (2010) ICRP Publication 117. Radiological protection in fluoroscopically guided procedures performed outside the imaging department. Ann ICRP 40(6):1–102. https://doi.org/10.1016/j.icrp.2012.03.001
doi: 10.1016/j.icrp.2012.03.001
pubmed: 22732420
Chou LB, Chandran S, Harris AH, Tung J, Butler LM (2012) Increased breast cancer prevalence among female orthopaedic surgeons. J Womens Health 21(6):683–689. https://doi.org/10.1089/jwh.2011.3342
doi: 10.1089/jwh.2011.3342
Mastrangelo G, Fedeli U, Fadda E, Giovanazzi A, Scoizzato L, Saia B (2005) Increased cancer risk among surgeons in an orthopaedic hospital. Occup Med (Lond) 55(6):498–500. https://doi.org/10.1093/occmed/kqi048
doi: 10.1093/occmed/kqi048
pubmed: 16140840
Kang S, Cha ES, Bang YJ, Na TW, Lee D, Song SY, Lee WJ (2020) Radiation exposure and fluoroscopically-guided interventional procedures among orthopaedic surgeons in South Korea. J Occup Med Toxicol 15(1):24. https://doi.org/10.1186/s12995-020-00276-x
doi: 10.1186/s12995-020-00276-x
pubmed: 32793295
pmcid: 7418415
Vanzant D, Mukhdomi J (2022) Safety of Fluoroscopy in Patient, Operator, and Technician. In: StatPearls. StatPearls Publishing, Treasure Island (FL), London
Boal TJ, Pinak M (2015) Dose limits to the lens of the eye: international basic safety standards and related guidance. Annals ICRP 44:112–117. https://doi.org/10.1177/0146645314562321
doi: 10.1177/0146645314562321
Serna Santos J, Uusi-Simola J, Kaasalainen T, Aho P, Venermo M (2020) Radiation doses to staff in a hybrid operating room: an anthropomorphic phantom study with active electronic dosimeters. Eur J Vasc Endovasc Surg 59(4):654–660. https://doi.org/10.1016/j.ejvs.2020.01.018
doi: 10.1016/j.ejvs.2020.01.018
pubmed: 32061447
Nowak M, Carbonez P, Krauss M, Verdun FR, Damet J (2020) Characterisation and mapping of scattered radiation fields in interventional radiology theatres. Sci Rep 10(1):18754. https://doi.org/10.1038/s41598-020-75257-5
doi: 10.1038/s41598-020-75257-5
pubmed: 33127938
pmcid: 7599331
Bratschitsch G, Leitner L, Stücklschweiger G, Guss H, Sadoghi P, Puchwein P, Leithner A, Radl R (2019) Radiation exposure of patient and operating room personnel by fluoroscopy and navigation during spinal surgery. Sci Rep 9(1):17652. https://doi.org/10.1038/s41598-019-53472-z
doi: 10.1038/s41598-019-53472-z
pubmed: 31776364
pmcid: 6881318
Archer BR, Thornby JI, Bushong SC (1983) Diagnostic X-ray shielding design based on an empirical model of photon attenuation. Health Phys 44(5):507–517. https://doi.org/10.1097/00004032-198305000-00005
doi: 10.1097/00004032-198305000-00005
pubmed: 6853171