Interventional Radiology Workers Research Articles

Improving Cytogenetic Surveillance in Radiology Workers Exposed to Low-Dose Radiation in Africa: A Call to Action

Radiation exposure is an occupational hazard for diagnostic and interventional radiology workers, potentially leading to chromosomal damage and increased cancer risk. This review explores the status of cytogenetic monitoring of radiation exposure among radiology workers in Africa. Monitoring of Radiation Exposure in Diagnostic and Interventional Radiology Workers in Ghana and Africa provides a crucial examination of radiation safety practices within the Ghanaian and Africa healthcare sector. We recovered existing literature on the cytogenetic surveillance conducted on radiology workers in Ghana and Africa stressing on the impact and/or significance of cytogenetic monitoring programmes. In these studies, mostly mathematical modeling and physical methods were used to estimate and extrapolate risks of exposure to ionizing radiation. Additionally, we discuss the challenges and opportunities for implementing cytogenetic monitoring programmes in Africa particularly Ghana and provide recommendations for future research and occupational health policies. This review attempts to bridge the gap between physical and biological dosimetry in surveillance studies. It addresses the significant gap in cytogenetic monitoring among diagnostic and interventional radiology workers in Africa. It highlights the importance of cytogenetic surveillance for early detection of radiation-induced genetic damage, assesses the current practices, and provides a recommendation and a roadmap for establishing robust monitoring programmes. This work would contribute significantly to the understanding of occupational radiation safety issues in the healthcare sector of Africa. It also offers a comprehensive examination of the challenges and opportunities in implementing cytogenetic monitoring programmes.

Effects of low-dose ionizing radiation on genomic instability in interventional radiology workers

Interventional radiologists are chronically exposed to low-dose ionizing radiation (IR), which may represent a health risk. The aim of the present study was to evaluate genomic instability by analyzing chromosomal aberrations, micronuclei, and 53BP1 DNA repair foci in peripheral blood lymphocytes of radiologists. Based on the IAEA guidelines on biodosimetry using dicentrics, the average protracted whole-body dose in radiologists were estimated. Since preleukemic fusion genes (PFG) are the primary events leading to leukemia, we also studied their presence by RT-qPCR and FISH. No significant difference in 53BP1 foci and incidence of PFG (MLL-AF4, MLL-AF9, AML1-ETO, BCR-ABL p190) was found in cells of interventional radiologists in comparison to controls. However, our results showed an increased frequency of micronuclei and various types of chromosomal aberrations including dicentrics in interventional radiologists. The average protracted whole body estimated dose was defined at 452.63 mGy. We also found a significantly higher amplification of the MLL gene segment and increased RNA expression in cells of interventional radiologists in comparison to controls. In conclusion, our results showed that long-term low-dose IR induces genomic instability in interventional radiologists.

Trend and distribution analysis of occupational radiation exposure among medical practices in Chongqing, China (2008-2020).

The personal dose levels of medical radiation workers in Chongqing from 2008 to 2020 were investigated and analysed. The results showed that a total of 68379 people were monitored from 2008 to 2020. The number of radiation workers increased year by year, and the number of female radiation workers increased rapidly. The monitoring data were analysed by Mann-Whitney test, Mann-Kendall test and Bonferroni method. The annual mean effective dose from 2008 to 2020 showed a decreasing trend (P<0.0001). At the 5% significance level, six occupational categories showed a significant decreasing trend (P<0.0001).The average annual effective dose for medical radiation workers in Chongqing in 2020 was 0.4482mSv and 94.73% of radiation workers received annual doses less than the public dose limit (1mSv). Personal dose monitoring results for most radiation workers were low. The protection of radiation workers in interventional radiology and nuclear medicine should be concerned.

Use of secondary air kerma from dose area product and fluoroscopy time for preventive effective dose estimation in interventional radiology procedures for staff

Introduction: interventional radiology workers are potentially exposed to high levels of ionizing radiation, therefore preventive dose estimation is mandatory for the correct risk classification of staff. Effective dose (ED) is a radiation protection quantity strictly related to the secondary air kerma (K S), using appropriate multiplicative conversion factors (ICRP 106). The aim of this work is to evaluate the accuracy of K S estimated from physically measurable quantities such as dose-area product (DAP) or fluoroscopy time (FT). Methods: radiological units (n = 4) were characterized in terms of primary beam air kerma and DAP-meter response, consequently defining a DAP-meter correction factor (CF) for each unit. K S, scattered from an anthropomorphic phantom and measured by a digital multimeter, was then compared with the value estimated from DAP and FT. Different combinations of tube voltages, field sizes, current and scattering angles were used to simulate the variation of working conditions. Further measurements were performed to estimate the couch transmission factor for different phantom placements on the operational couch, defining a CF as the mean transmission factor. Results: when no CFs were applied, the measured K S showed a median percentage difference of between 33.8% and 115.7% with respect to K S evaluated from DAP, and between −46.3% and 101.8% for K S evaluated from FT. By contrast, when previously defined CFs were applied to the evaluated K S, the median percentage difference between the measured K S and the value evaluated from DAP ranged from between −7.94% and 15.0%, and between −66.2% and 17.2% for that evaluated from FT. Conclusion: when appropriate CF are applied, the preventive ED estimation from the median DAP value seems to be more conservative and easier to obtain with respect to the one obtained from the FT value. Further measurements should be performed with a personal dosimeter during routine activities to assess the proper K S to ED conversion factor.

Psychosocial factors at work and teachers' illness: a systematic review.

The aim of the present study is to analyze scientific evidence about associations between psychosocial factors at work and teachers' illness. A systematic literature review based on the PRISMA statement was conducted. Biblioteca Virtual em Saúde, Medical Literature Analysis and Retrievel System Online, Cumulative Index of Nursing and Allied Health Literature, Scopus, Web of Science, PsycINFO, and Excerpta Medica Database databases were searched. Articles in Portuguese, English and Spanish, published in the past 11 years, were of interest. In total, 861 articles were identified, but only 15 of them met all the eligibility criteria and were included in the review. Eleven articles (73.3%) used validated instruments to assess psychosocial factors, and the Job Content Questionnaire was the most cited one. Low social support, heavy workload, high job demands, and low job control were the most commonly investigated factors and showed statistically significant associations with teachers' illness.

Musculoskeletal disorders in interventional radiology workers: an integrative review.

This integrative review analyzed scientific production on musculoskeletal disorders related to personal protective equipment used by interventional radiology teams. The PubMed, Embase, and SciELO databases were searched using a strategy developed with the help of a librarian. The double-blind selection process involved the Rayyan online tool. A total of 12 articles were included, which were organized according to year of publication, country research subjects, study type, and main outcomes. Five thematic categories emerged from the analysis: "personal protective equipment"; "ergonomics in the interventional radiology environment"; "the composition of personal protective equipment"; "radiation protection for interventional teams" and "the prevalence of musculoskeletal symptoms in interventional teams". Outcomes associated with musculoskeletal disorders among interventional teams predominated in the studies, and advances in radiological protection were reported, especially in shielding technologies, as well as continuing efforts toward more ergonomic protective equipment to reduce the risk of musculoskeletal disorders.

Analysis on individual dosage monitoring of some interventional radiology staffs in Tianjin City from 2016 to 2020

Objective: To investigate the individual external dose level of some interventional radiology staffs from 2016 to 2020 in Tianjin City. Methods: All 2068 interventional radiology staffs who were included in the work of the Radiation Monitoring Project from 2016 to 2020 were selected as study subjects in March 2021. The individual dose monitoring results of interventional radiology staffs of different ages, working years, time and medical institutions were analyzed. Results: Among 2068 interventional radiology workers, 1406 (67.99%) were male and 662 (32.01%) were female. The age was 44.6 (39.2, 50.3) years, and the working years was 10.5 (4.3, 14.6) years. The annual effective doses per capita of 40-49 age group and ≥50 age group were higher than that of 30-39 age group (P<0.05) . The annual effective dose per capita of 5-9 working years was higher than that of <5 working years, and the annual effective dose per capita of 10-29 working years was higher than that of 5-9 working years (P<0.05) . The median per capita annual effective dose of the interventional radiology staffs was 0.164 mSv. There were 1976 interventional radiology staffs with an annual effective dose of <0.50 mSv/a (95.6%) . The collective dose distribution ration SR(0.5) was 41.1%. The difference of effective dose per capita in each year was statistically significant (H=19.23, P<0.05) . The per capita annual effective dose of interventional radiology staffs in tertiary medical institutions was higher than that in secondary medical institutions, and the difference was statistically significant (P<0.05) . Conclusion: The personal dose of interventional radiology staffs in Tianjin City is at a low level. It is necessary to emphasize the radiation hazard protection of interventional radiology staffs in tertiary medical institutions, 40-49 years old, ≥50 years old age groups and 5-9, 10-29 working years groups.

Study of Low-Dose Radiation Workers Ionizing Radiation Sensitivity Index and Radiation Dose-Effect Relationship.

In the present study, we analyzed radiation injuries to Chinese workers exposed to low-dose radiation. We discuss the relationships between dose and injury. This study randomly selected 976 radiation workers who underwent occupational health monitoring. The radiation workers were divided into 5 different types of work: radiation diagnosis, radiation therapy, interventional therapy, nuclear medicine, and industrial inspection. This research was approved by the Bioethics Committee at the Gansu Provincial Center for Disease Control and Prevention. The average annual cumulative dose to interventional radiation workers was the highest, i.e., 0.86 mSv. The detection rate of lens opacity was 37%, but 99.70% of lens opacities occurred in the peripheral cortex. Posterior subcapsular opacification was detected less than 1.00% of the time. The rate of chromosomal aberrations was highest for radiological workers with more than 20 years of service. Annual cumulative dose reached 2.04 mSv, and the monitoring dose for 3 months was as high as 1.62 mSv. Dicentric chromosomes were also detected. The manual packaging and drug delivery nuclear medicine staffs totaled 14 individuals. 131 131 was detected in the thyroids of 4 workers (28.57%). The detection rate of thyroid 131 I was higher in the hand-packed and administered group than in the automatic administration group. Radiation workers exposed to low doses of radiation can sustain injuries. Interventional radiology workers receive the highest doses and sustain the most significant effects. This study suggests that chromosome aberration analysis is an important index in occupational health monitoring of radiological workers. Monitoring of internal radiation exposure cannot be ignored for nuclear medicine staff.

Assessment of Occupational Exposure to Eye Lens Dosimetry for Interventional Radiology Workers in China during 2017-2019.

The eye lens is a sensitive tissue to ionizing radiation and recently has been recognized as more radiosensitive than previously considered. The International Commission on Radiological Protection (ICRP) has recommended a considerable reduction in the equivalent dose limit of eye lens from 150 mSv y -1 to 20 mSv y -1 , averaged over a defined period of 5 y. In this paper, the eye lens dose of interventional radiology workers in China during 2017-2019 is analyzed to understand the current status of eye lens occupational exposure and to provide decision-making suggestions for health supervision departments using data obtained from the National Radiological Health Information Platform in China. A total of 3,026 eye lens dose records of interventional radiology workers were collected. The average annual eye lens dose (AAELD) for interventional radiology workers ranged from 1.07 to 1.51 mSv during 2017-2019 and was 1.44 mSv for all monitored interventional radiology workers, with 2,973 records (98.2%) lower than the public limit of 15 mSv and 33 records (1.1%) exceeding the newly revised occupational eye lens dose limit of 20 mSv y -1 . During the period of 2017-2019, the AAELDs of interventional radiologists (1.61 mSv) and of interventional cardiologists (1.59 mSv) were significantly higher than that of other interventional workers (0.62 mSv); the AAELD of doctors (1.50 mSv) was significantly higher than that of nurses (1.01 mSv); the AAELD of western China (2.00 mSv) was significantly higher than that of eastern (1.11 mSv) and central China (1.27 mSv); and the AAELD of males (1.59 mSv) was significantly higher than that of females (0.84 mSv). The eye lens dose of interventional radiology workers meets the Chinese standard limit of 150 mSv y -1 , while some cases exceed the one recommended by ICRP. The study shows that the interventional radiology workers' eye lens dosimetry data complied with the existing Chinese eye lens dose limits. However, education, training, and supervision of radiation protection also should be strengthened continuously for interventional radiology workers, especially for the interventional radiologists and interventional cardiologists. Significant attention should be paid to the radiation protection of underdeveloped regions in China in future works.

Assessment of Occupational Exposure in Medical Practice in the Region of Hohhot, China, for the Period 2004-2020.

Individual monitoring is of great significance in efforts to protect the health of radiation workers and improve the level of radiation protection and management. This paper presents a retrospective analysis of occupational exposure to ionizing radiation from medical practice in the region of Hohhot, China, from 2004 to 2020. Results show that the average annual effective dose of occupationally exposed workers in medical practice significantly declined from 1.44 mSv in 2005 to 0.29 mSv in 2020 (Z = -5.23, P < 0.05). The number of medical radiation workers increased by 181%, the composition of radiation workers whose average annual effective dose exceeded 1 mSv decreased, and the number of radiation workers whose average annual effective dose was less than or equal to the minimum detection level (MDL) increased yearly over the 17-y study period. It was found that the dose of 1.106 mSv received by workers in interventional radiology is significantly higher than the doses of 0.52 mSv in dental radiology, 0.47 mSv in radiotherapy, and 0.33 mSv in all other medical uses (Z = 3.71, 9.13, 5.93, respectively; P < 0.05). The distribution ratios of workers in nuclear medicine and interventional radiology whose annual individual effective dose exceeded 5 mSv were 0.040 and 0.043, respectively, which are significantly higher than those in other occupational categories (χ2 = 307.11, P < 0.05). It was also shown that the average annual effective dose of 0.67 mSv in interventional radiology is significantly higher than that of 0.17 mSv in radiotherapy (Z = 3.39, P < 0.05) in 2020. According to these observations, the exposure of radiation workers in medical practice in Hohhot meets the requirements of the China standard. This study shows that the status of radiation workers in medical practice has obviously improved during the period 2004-2020. However, it is still necessary to focus on the protection of groups with high occupational exposure risk, and the continuous improvement of protection measures, monitoring means, and radiation workers' training, especially for the workers in the fields of interventional radiology and nuclear medicine.

Radiation Exposure of Crystalline Bodies during Interventional Therapy and Related Research Status.

The aim of this study was to estimate the exposure dose level of ocular corpuscles during the common interventional procedures of interventional radiology workers. This article retrospectively analyzed the general instruments and equipment of interventional therapy, the general methods and steps of interventional therapy, and the influence of X-ray of interventional surgery. The related contents of eye protection for interventional radiology workers were summarized. This study found that there was a significant linear correlation between the equivalent dose of lens and the exposure time. The tube voltage, tube current, and the size of fluoroscopic field of vision also have an impact on the radiation of workers during surgical exposure. Interventional surgery is difficult and easy. The exposure time of difficult surgery is relatively long, so the dose received by interventional staff is large. The intervention staff should improve their professional knowledge, be proficient in the operation technology, and try to reduce the exposure without affecting the diagnosis and treatment effect. During the intervention operation, the eye substance of the operator is exposed to a certain dose of radiation, and the wearing rate of protective lead glasses of the intervention staff is very low. Therefore, we must pay attention to the protection of the eyes, strengthen the protection management, and reduce the exposure dose of the intervention staff as much as possible.

Investigation on influencing factors of blood indexes of interventional radiology workers

Objective: To analyze the influencing factors of blood indicators indexes of interventional radiology workers, and provide a theoretical basis for radiological occupational health monitoring, radiation protection monitoring and risk assessment. Methods: In March 2020, a total of 500 interventional radiology workers (interventional group) and 200 non-interventional radiology workers (control group) who underwent an occupational health examination in Liaoning Center for Disease Control and Prevention from 2018 to 2019 were selected as the subjects. The general information, occupation related information, blood routine, fasting blood glucose and thyroid stimulating hormone test results of the subjects were collected. The differences in the levels and abnormal detection rates of blood indexes between the two groups were compared. And the influencing factors of blood indexes of the intervention riodiology workers were analyzed. Results: The lymphocyte count of interventional group[2.10 (1.70, 2.50) ×10(9)/L] was lower than that of control group[2.20 (1.80, 2.60) ×10(9)/L], the difference was statistically significant (P<0.05) . The white blood cell count and lymphocyte count of interventional workers in the service age≤13 years were higher than those of service age≥28 years group, and fasting blood glucose was lower than those of service age ≥28 years group (P<0.05) . The detection rate of abnormal fasting blood glucose of interventional radiology workers in the service age ≤13 years group was lower than that of the service age 14-27 years and service age ≥28 years (P<0.05) . The lymphocyte count and platelet count of interventional radiology workers in annual effective dose<0.5 mSv group was higher than that of annual effective dose≥1 mSv group (P<0.05) . The results of multi-factor linear regression analysis showed that service age, annual effective dose and female gender were the influencing factors of lymphocyte count of interventional radiology workers (b=-0.008, -0.110, -0.167, P<0.05) . Conclusion: Long-term low-dose radiation exposure had certain influence on the lymphocyte count of interventional radiology workers. Service age, annual effective dose and gender are the influencing factors of lymphocyte count in interventional radiology workers. It should be reinforced to the radiological protection monitoring and risk assessment on interventional radiology workers.

Analysis on monitoring results of individual dose of occupational external radiation among radiation workers in Lanzhou in 2019

Objective: To analyze the individual dose level of occupational external radiation of radiation workers in Lanzhou in 2019, so as to provide reference for radiation protection and occupational health management. Methods: In April 2020, a total of 1460 radiation workers in Gansu Provincial Center for Disease Control and Prevention in 2019 were selected as the research objects. The unit nature, hospital level and occupational category of the monitored workers were collected, and the monitoring results of external radiation personal dose in 2019 were analyzed and compared. Results: In the occupational external radiation monitoring of radiation workers in Lanzhou in 2019, the effective dose of 48 persons was 1.0~<5.0 mSv, the effective dose of 2 persons was 5.0~<10.0 mSv, the annual collective effective dose was 308.21 people·mSv, and the average annual effective dose of monitored persons was 0.21 mSv/a. There was significant difference in the distribution of annual effective dose per capita among different occupational groups (H=34.43, P<0.05) . The annual effective dose per capita of nuclear medicine personnel was higher (0.56 mSv/a) , followed by interventional radiology (0.33 mSv/a) . The ratio of annual collective dose to total annual collective dose with annual individual dose more than 5 mSv (SR(5)) and the ratio of the number of staff with annual individual dose more than 1mSv to the total number of monitored personnel (NR(1)) were higher in nuclear medicine and interventional radiology personnel. The average annual effective dose distribution of diagnostic radiologists in different level hospitals was statistically significant (H=16.46, P<0.05) . The average annual effective dose in private hospitals, community hospitals and health centers was higher (0.32 mSv) , followed by county hospitals (0.23 mSv) . Conclusion: The individual dose of occupational external radiation of radiation workers in Lanzhou is generally low, and the annual effective dose of nuclear medicine and interventional radiology workers is high. The management of radiation protection should be emphasis on this people. And it is suggested to strengthen the supervision of private hospitals and update and maintain the equipment of community health centers.

41A Influence of radiation protection equipment on the operator and patient dosimetry in coronary angiography

Introduction To reduce exposure to the workers in interventional radiology, Collective Protection Equipment (CPE) are used (low lead curtains and their vertical extension, ceiling suspended screen …). For the same purpose, radio-attenuator soft screens (RADPAD®) have been developed. The objective of this study is to evaluate the influence of the CPE and the RADPAD® on the operator’s dosimetry in coronary angiography; we also measured patient’s skin-dose without and with the utilization of the RADPAD®. Methods Firstly, the interventional radiology equipment has been positioned at the tube incidence LAO 0°. The dose at different heights along the operator’s body (50, 75, 100, 125, 150 and 175 cm) was measured without the use of any CPE, and then by adding them successively (low curtains, vertical extension of the low curtains, ceiling suspended screens and then the radio-attenuator screen RADPAD®). Secondly, the skin dose of a phantom placed on the patient’s table was measured at three different distances from the ceiling screen, with and without RADPAD® at a tube voltage of 68 kVp in LAO 0° and then at 125 kVp in LAO 0° and LAO 30°. Results The use of the three CPE shows an attenuation of the radiation dose by 76% at the height of 175 cm along the operator’s body, it increases by 3.8% when using the RADPAD®. At low voltage, the use of the RADPAD® increases patient’s dose by 13% in the region near the ceiling screen. However, it attenuates the dose by 85.5% at 26 cm form this latter. At high voltage, the dose decreases at all of the three measure points; the effect of the RADPAD® varies depending on the distance from the screen and the tube angle. Conclusions Collective Protection Equipment are effective to decrease operator’s exposure in coronary angiography. The RADPAD® allows a significant reduction of the patient’s dose far the ceiling screen.

Analysis of individual dose monitoring results among radiation workers in a first-class hospital at Grade 3 from 2010 to 2017

Objective: To understand the occupational external exposure dose among radiation workers in a first-class hospital at Grade 3 of Suzhou, and to provide reference for radiological protection. Methods: The individual dose of 1156 radiation workers in the hospital from 2010 to 2017 were detected, the annual collective effective dose and per capita annual effective dose were analyzed for different years, different occupations (diagnostic radiology, radiotherapy, nuclear medicine, interventional radiology) , gender, and age. Results: From 2010 to 2017, the total annual collective effective dose was 351.40 person·mSv, the per capita annual dose was 0.30 mSv/a, and radiation workers whose annual effective dose was less than 1 mSv accounted for 94.98%. There were 5 interventional radiology workers and 1 nuclear medicine worker with annual effective dose between 2 and 4 mSv. There was no worker with annual effective dose over 4 mSv. The per capita annual effective dose of nuclear medicine workers was the highest (0.40 mSv/a) . The per capita annual effective dose was not significantly different between radiation workers with different genders and ages (P>0.05) . Conclusion: Most of radiation workers have low individual dose level in the hospital. It is important to focus on nuclear medicine workers and interventional radiology workers.

Personal dose monitoring of radiation workers in medical institutions at the municipal level and below in a city from 2011 to 2014

Objective: To determine the personal dose level of radiation workers in medical institutions at the municipal level and below in a city, and to provide a scientific support for strengthening the radiation protection in the city's medical institutions. Methods: Information of the successful applicants for the "Radiation Worker Permit" from 174 medical institutions at the municipal level and below was collected from October 1, 2011 to December 31, 2014. The annual effective dose was calculated based on the personal dose monitoring report, and indicators including sex, permit application time, hospital level, type of occupational radiation, length of radiation work, blood test, and micronucleated lymphocyte rate were analyzed. Results: Of the 1 143 radiation worker permit applications submitted by medical institutions the municipal level and below in this city from 2011 to 2014, 1 123 provided at least one personal dose monitoring report. The annual effective dose of the radiation workers was 0-4.76 mSv (mean 0.31±0.40 mSv) , and the collective annual effective dose was 351.96 mSv. The annual effective dose was significantly different between radiation workers with different times of permit application, hospital levels, and types of occupational radiation (P<0.05) . Interventional radiology workers had the highest annual effective dose (0.63 mSv) , and annual effective dose was significantly different between interventional radiology workers with different lengths of radiation work (H=10.812, P<0.05) . Conclusion: The personal radiation dose of radiation workers in medical institutions at the municipal level and below in this city is maintained at a relatively low level, suggesting that the occupational environment is relatively safe for these workers. However, more focus should be placed on clinical interventional radiology workers.

ASSESSMENT OF EYE LENS DOSES IN INTERVENTIONAL RADIOLOGY: A SIMULATION IN LABORATORY CONDITIONS.

As workers in interventional radiology belong to one of the most occupationally exposed groups, methods for sufficiently accurate quantification of their external exposure are sought. The objective of the authors' experiment was to investigate the relations between eye lens dose and Hp(10), Hp(3) or Hp(0.07) values measured with a conventional whole-body personal thermoluminescence dosemeter (TLD). Conditions of occupational exposure during common interventional procedures were simulated in laboratory. An anthropomorphic phantom represented a physician. The TLDs were fixed to the phantom in different locations that are common for purposes of personal dosimetry. In order to monitor the dose at the eye lens level during the exposures, a special thermoluminescence eye dosemeter was fixed to the phantom's temple. Correlations between doses measured with the whole-body and the eye dosemeters were found. There are indications that personnel in interventional radiology do not need to be unconditionally equipped with additional eye dosemeters, especially if an appropriate whole-body dosimetry system has been already put into practice.

8:18 AM; Abstract No. 213; Featured Abstract - Radiation exposure in pregnant and non-pregnant female interventional radiology workers

In 2012-13, 27% of Radiology residents and 15% of VIR fellows were women. Survey data from the ACR show that 3.1% of all practicing radiologists who consider IR their primary specialty are women. The percent of current women members in the SIR is 9%. A recent article in Academic Radiology by Blake et al recommended that IR rotations for residents be limited during pregnancy as accumulated exposure from these cases may be unpredictable. This recommendation is based on information regarding institutional policies rather than exposure data.

Double-dosimetry algorithm for workers in interventional radiology

Based on double-dosemeter readings, a conservative effective dose (E) estimation algorithm for lead apron workers in interventional radiology is proposed. Typical radiation conditions for various exposure geometries were simulated using the MCNPX 2.4.0 code. The simulation model consisted of an X-ray source and image intensifier, a patient phantom and a voxelised staff member phantom with lead apron. The effective staff dose and dosemeter readings for several positions of the worker were calculated. The effective dose to a physician, positioned in close proximity to the primary beam, can be estimated within a 10% underestimation margin by E = 1.64 H(p)(10)thorax,under + 0.075 H(p)(10)neck,over. The dose to the eye lens can be estimated by a dosemeter reading at collar level (R2 = 0.98).

Deterministic effects in interventional radiology.

Since the development of interventional radiology, the number and complexity of procedures has increased significantly and continues to grow. Interventional radiology procedures offer substantial health care benefits. However, associated with the increasing complexity as well as a lack of quality control programmes and specific training in radiation protection, there is an increase in the occurrence of deterministic effects in both patients and staff. There is a growing literature of case reports describing deterministic effects. A review of some case reports and the response of various international organisations is presented. It is important that workers in interventional radiology are aware of the potential for deterministic effects and the dose threshold for their onset, so that patients can be followed up appropriately.