Strategies to optimise occupational radiation protection in interventional cardiology using simultaneous registration of patient and staff doses

Abstract

The International Commission on Radiological Protection recommends that occupational protection and patient protection be managed in an integrated approach. This paper describes the experience and the initial results of a system able to register and to process simultaneously staff and patient doses in interventional cardiology and the practical use of this system in the optimisation of occupational exposure. The system used simultaneously collects and manages patient and staff doses for all radiation events. The personal electronic dosimeters worn over the protective apron of health professionals working inside catheterisation laboratories can send (wireless) doses and dose rate values to an X-hub and provide the operators inside the catheterisation rooms with real-time information. Individual and global reports for all the health professionals may be periodically obtained from the system to help with the optimisation. The results for eight cardiologists, one fellow and four nurses for a total of 2468 interventional cardiology procedures and 3207 occupational dose values collected over one year are presented here. Annual doses Hp(10) measured over the apron for cardiologists ranged from 0.3 to 6.3 mSv. For the cardiologist, the ratio between occupational doses (over the apron) and patient doses ranged from 0.05 to 0.23 μSv Gy−1 cm−2, with a mean value of 0.12 μSv Gy−1 cm−2. The system allows defining optimisation strategies by comparing the results between the different operators while considering the workload and complexity of the procedures (based on the total Kerma Area Product managed by the different operators). The registration of the date and time of the occupational radiation doses allows auditing the use of the personal dosimeters worn by the various operators.