A study of the dose distribution in the region of the eye lens and extremities for staff working in interventional cardiology

Abstract

Abstract The dose distributions at the region of eye lens and extremities of staff working in interventional cardiology were analyzed. The doses to physicians and nurses from three hospitals in Poland were measured with TL dosimeters (MCP-N) located on various places near eyebrows, on both fingers, wrists, knees and on the ankle. The procedures under investigation were coronary angiography (CA) and percutaneous coronary intervention (PCI), peacemaker and defibrillator implantations (PM/ICDs), cardiac resynchronization therapy with or without defibrillator implantations (CRT-D or CRT) and radiofrequency ablations (RFA). The study aimed at analyzing the distribution of radiation in selected anatomic regions, determining the typical locations of highest doses and estimating the dose ranges for selected types of procedures. The maximum registered doses per procedure to eye lens and ankle were 1.21 mSv and 1.46 mSv for CA PCI procedures, 0.02 mSv and 0.05 mSv for RFA and 0.13 mSv and 0.51 mSv for PM/ICDs, respectively. The maximum doses to fingers, wrists and knees were, accordingly, 2.11 mSv, 1.07 mSv and 0.77 mSv for CA PCI procedures, 0.38 mSv, 0.20 mSv and 0.04 mSv for RFA ones, 0.50 mSv, 0.25 mSv and 0.01 mSv for PM/ICDs procedures and 2.25 mSv, 1.12 mSv and 0.58 mSv for CRT and CRT-D ones. The factors which might influence the dose like utilized radiation, availability of additional protective equipment and position of the staff with respect to X-ray source were also analyzed. The annual doses for eye lens and extremities were estimated on the basis of individual annual workloads of the physicians participating in the study. The highest annual doses were revealed for physicians performing CA PCI procedures. Annual eye lens doses range up to 247 mSv indicating that the occupational limit for eye lens 150 mSv has been surpassed. In case of extremities the maximal estimated annual doses were 355 mSv, 136 mSv, 55 mSv and 328 mSv, for fingers, wrists, knees and for ankle, respectively. Moreover, in the light of ICRP new Statement on Tissue Reactions raising the possibility of lowering the annual limit for the lens of the eye the annual doses estimated in our paper indicate that for some procedures the monitoring of eye lens doses should be considered. On the other hand, it is important to note that most of high occupational doses can be easily avoided if radiation protection tools are used and, moreover, used properly. The present survey is a part of ORAMED project concerning the determination of doses to extremities (fingers, wrists and knees) and eye lens during interventional procedures and includes the detailed analyses of results of Polish partner. They are, however, presented in wider context. The study is additionally extended by the investigation of the dose distribution at the eyebrows and ankle level.