7034 Radiation monitoring and protection during endoscopic retrograde choliangiopancreatograpy (ercp): an ontario survey.

Abstract

Little is reported regarding radiation exposure to endoscopists performing ERCP. In addition, the use of radiation monitoring and protective devices is at the discretion of the endoscopist. Therefore, the purpose of this study is to describe current clinical practices and training regarding radiation safety amongst physicians in Ontario performing ERCPs. METHOD: Physicians practicing ERCP in Ontario were identified from an exisiting data base. Then the endoscopist and chief radiologist at their hospital were sent different surveys regarding radiation monitoring, protective devices, as well as radiation awareness and training.A second mailing was sent out approximately six weeks later to non-respondents. RESULTS: Of 98 surveys mailed to endoscopists 68 responded with 63 choosing to participate (n=63); of the 57 radiologists sent surveys 21 responded with 15 choosing to participate (n=15). 57% of respondents reported that endoscopists controlled the fluoroscopic unit during ERCP with the next highest group being the radiation technicians at 19%. 49% of endoscopists reported to never wearing a TLD (X-ray badge) and only 20% reoported to wearing one all the time, despite recommendations that all personnel performing fluoroscopy should be wearing TLDs. Moreover 27% of endoscopists responded that they did not know, or did not respond at all to a question asking the average amount of fluoroscopic time per procedure. Only one endoscopist reported a possible radiation related problem, siting the development of papillary cancer of the thyroid, fluoroscopy during ERCP accounted for 90% of his radiation exposure. 50% of endoscopists did not know if they had ever been in excess of their yearly radiation limit. 51% of endoscopists were very to moderately concerned about radiation exposure during ERCP with 76% feeling somewhat or not at all comfortable with their training in radiation safety. 77% of endoscopists felt that they would like more training in radiation safety. Of the radiologists that responded 64% felt that ERCP practitioners at their hospitals would benefit from further training in radiology and radiation safety. Of the 36% who did not agree with the need for further training, 50% were from hospitals where the endoscopists were not involved in operating the fluoroscopic unit and 25% already offered radiation training. CONCLUSIONS: ERCP practitioners are interested in and would benefit from, more training and information on radiation protection standards and safety issues.