Radiation dose to urological surgeons during X-ray fluoroscopy for percutaneous stone extraction.

Abstract

Radiation protection of staff using X rays in UK hospitals is generally acknowledged to be satisfactory. This is supported by the fact that relatively few need to be Classified Workers under the Ionizing Radiations Regulations (HMSO, 1985). This view is based on routine measures to protect the main body of the worker, e.g. with a lead apron, and the results of routine dose monitoring, generally with monitors underneath such aprons. There remains the problem of dose to unshielded parts of the body from procedures such as fluoroscopy where protection depends mainly on lead aprons, and where some staff are very close to unshielded X-ray beams. Doses to heads and arms of radiologists were reported earlier (Law, 1985). This paper reports doses received by one surgeon conducting percutaneous nephrolithotomy using an overcouch system. This procedure requires the surgeon's fingers, head and neck to be very close to the X-ray beam, and monitors were therefore worn on two fingers of each hand, as well as over the thyroid. Satisfactory sterile conditions were maintained. Under the Ionizing Radiations Regulations (HMSO, 1985) there is renewed emphasis on monitoring dose to staff, and under the 1988 Regulations (HMSO, 1988) on protection of the patient there is a requirement for adequate training of all staff using X-ray equipment, not only radiologists and radiographers.