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Estimated head, neck radiation dose evaluated for interventional physicians
Researchers have identified a novel assessment model based on personal dosimeter readings as well as the limitations of wearable radiation safety devices to help evaluate the radiation dose to the head and neck tissue of interventional physicians.
The researchers used a single representative geometry and a humanoid phantom to mimic scatter radiation upon a physician performing a left femoral access cardiac interventional procedure. Scatter radiation dose was measured by radiochromic film and normalized by radiation dose received by the left collar of the radioprotective thorax apron.
Average radiation doses to each organ varied. According to the data, for the unprotected brain, carotid arteries and ocular lenses, doses were 8.4%, 17% and 50% of the dose measured at the left collar, respectively.
“Radiation safety remains a concern for interventional cardiologists, radiologists and surgeons. This work provides physicians a method to estimate dose to head and neck organs and tissues from their own personal dosimeter readings and thereby provides a means to assess the potential for associated health risks,” the researchers wrote.
Results showed that wearable radiation safety devices provided limited protection. One type of leaded glasses appeared to reduce radiation dose to the ocular lens on the side of the physician from which the scatter originates by 27%, and a second pair of glasses tested reduced the dose by 62%. However, neither pair offered any protection to the contralateral eye. The researchers also found that the radioabsorbent surgical cap reduced radiation dose to the brain by only 3.3%.
“This work highlights a need for continued development of radiation safety devices that are both effective and practical,” the researchers wrote. “Furthermore, it provides a method by which the potential for radiation safety devices to protect tissues can be directly assessed,” the researchers wrote. – by Melissa Foster
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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This is an important, albeit worrisome, study. When studies suggest that people in the cath lab may not be as well protected from occupational hazards as they think they are, I find it troubling. It further troubles me when these studies come out and people do not discuss their implications.
As to the findings, I was not surprised to find that the lead caps are not as protective as they should be because the material is very thin, but I have always thought the lead glasses, especially the wraparound glasses, were more protective than the study showed. When we have conducted surveys of people in the cath lab, we have detected signals of an increased incidence of cataracts, so this is an area that requires more exploration. Overall, though, the study shows that wearing this kind of lead armor on our head and our eyes is not offering that much protection, which is not a surprise. However, even if it were, it still leads to orthopedic problems.
The take-home message of this study is that we need to start moving to a more operator-friendly environment that is truly protective and does not cause us harm. There are financial barriers to accomplishing this, but the truth is this lack of safety will continue until doctors get together and say they will not work under these conditions anymore. Unfortunately, doctors do not want to do this for two reasons. First, we think we’re invulnerable. Second, we’re always competing against the next person, and we worry that having this attitude toward improving safety for operators in the cath lab will cast us in a negative light when compared with our competition. However, in many other professions, such as mining or construction, there are societies or labor unions that protect their workers. We are coming to a point where we have to think about cardiology that way.