Thyroid Shield Research Articles

RADIATION PROTECTION WHEN USING SOURCES OF IONIZING RADIATION IN MEDICINE

Problem statement. The use of sources of ionizing radiation (SIR) in medicine is necessary for establishing diagnoses and treating patients, as well as measures for visualization and localization of various formations when using radiopharmaceuticals to study the functions and structure of organs. But when using sources of ionizing radiation, risks from radiation exposure to patients and staff are possible. Such risks are safety concerns in nuclear medicine procedures. The application of SIR requires proper radiation protection in accordance with the norms and rules of nuclear and radiation safety. Purpose of the article is to develop recommendations for improving radiation safety measures in medical institutions of Ukraine on the basis of an analytical review of regulatory and scientific and technical literature on radiation safety when using ionizing radiation in nuclear medicine in the countries of the world. Conclusions. During medical research using sources of ionizing radiation, risks from radiation exposure to patients and staff are possible. Radiation safety should consider: duration of exposure, distance of patients and staff from the source of radiation and use of appropriate protection. Dosimeters for measuring the total radiation dose must be worn by all personnel of the radiology department of the hospital. For interventional radiologists, lead aprons and thyroid shields are the primary means of radiation protection that must be worn at all times during the procedure. It is recommended that criteria for clinical audits be included in standards and accreditation and certification programs related to medical practice using ionizing radiation. It is advisable to introduce the teaching of clinical audit into the initial and continuing education and curricula of the professional training of medical workers, including administrative and managerial profiles. In the radiological laboratories of Ukraine, it is expedient to implement the recommendations of the EU Atomic Energy Commission in accordance with Council Directive 2013/59/Euratom. Clinical audit of medical radiological procedures will provide an opportunity to improve the quality and safety of medical services, as well as patient health care.

Assessment of Practice of Radiation Protection Devices in Fluoroscopy in SKIMS SOURA Hospital Srinagar J&K

This study evaluated radiation protection practices in fluoroscopy at Sher-i-Kashmir Institute of Medical Sciences (SKIMS) in Soura, Jammu and Kashmir. A descriptive cross-sectional design involved observing 47 patients and medical professionals during radiological procedures in the gastroenterology and radiology departments. Data were collected using a chart table, focusing on the use of radiation protection apparel and devices. Results showed that 50% of patients were aged 26-35, with an equal gender ratio. Thyroid shields were used by 56.7% and gonad shields by 36.7% of patients. Among radiation technologists, 75% were aged 30-40 and all used lead aprons and thyroid shields. Radiologists were evenly split by age and gender, with all using lead gloves, thyroid shields, collimators, and filters. The findings indicate that SKIMS staff exhibit strong knowledge and adherence to radiation protection guidelines, providing adequate safety measures for patients and themselves.

Knowledge and practices of interventional radiology staff regarding radiation protection

Interventional radiology (IR) has become a widespread medical imaging technique, offering minimally invasive treatment options. However, IR procedures can expose patients and staff to substantial radiation risks, necessitating enhanced radiation protection practices. This study aimed to survey the knowledge and practices of interventional radiology staff regarding radiation protection. A cross-sectional study with a descriptive aim, based on a questionnaire was done. The study subjects were all healthcare personnel of all specialties having practiced in interventional radiology between 2019 and 2022 at the University Hospital Center of Rabat. The statistical processing was carried out using Microsoft Excel 2013® and the IBM SPSS Statistical program version 20 (IBM Inc. NY, USA). The results indicated that 59.4% of participants had not received any specific training in radiation protection, and 45% were unaware of the radiation-induced risks associated with interventional radiology procedures. Regarding safety practices, 75% of participants maintained a distance of at least 1 meter from the x-ray source, while only 6% used the lowest possible exposure settings. Concerning the use of radiation protection devices, 87.5% of participants wore a lead apron, 75% used a thyroid shield, 6.3% wore lead glasses, and 37.5% utilized suspended mobile screens, whereas 12.5% did not use any radiation protection devices. Additionally, 84% of participants wore their personal dosimeter, though not consistently. The knowledge and practices of most interventional radiology personnel are inadequate for effective radiation protection. Regular, ongoing training in radiation safety is essential to improve adherence to protection standards and enhance overall safety in clinical practice.

Monte Carlo simulation study of the effect of thyroid shielding on radiation dose in dental cone beam CT in an adult male phantom.

In this paper, the effect of thyroid collars on radiation dose during dental cone-beam computed tomography (CBCT) was evaluated using Monte Carlo simulations and to calculate the effective dose underestimated for the actual CBCT examination due to accounting only for the head and neck. Three thyroid collar models that covered the surface of the phantom were established according to the International Commission on Radiological Protection (ICRP) adult-male mesh-type reference computational phantoms, and a Particle and Heavy Ion Transport code System was used to calculate the equivalent and effective doses of ICRP phantom when different thyroid shielding protocols were used in NewTom VGi evo CBCT, considering one medium (12×8cm) and one small (8×5cm) fields of view (FOVs), and two centre positions were used for each FOV. In four CBCT scanning scenarios, thyroid shielding reduced the equivalent dose for many tissues. The results indicate that the portion of the thyroid collar that wraps around the neck has the main role in reducing the effective dose during dental CBCT examinations, and the higher the axial level of the top of the shielding, the better the effectiveness of the shielding. In this study, the underestimation of the effective dose due to considering only the head and neck was 3.1%-8.1%, and the underestimation was more pronounced in larger FOVs.

Radiation protection in dental imaging: Evaluating the impact of the SABA thyroid shield during panoramic and cone beam computed tomography

BackgroundDental panoramic radiography (DPR) and cone beam computed tomography (CBCT) are an imaging modalities in dentistry. However, these procedures involve exposure to ionising radiation, raising concerns about radiation-induced thyroid damage. To mitigate these risks, thyroid shields have been introduced. This study aimed to evaluate the effectiveness of the SABA thyroid shield in reducing thyroid radiation exposure during DPR and CBCT scans. MethodAn experimental study to measure surface dose in the thyroid region during (DPR) and (CBCT) scans using an Anthropomorphic Phantom and a Solid-State Detector. The attenuation percentage was calculated between radiation surface doses with and without shielding. The significance of the Saba thyroid shield was calculated using a t-test. ResultsFor DPR scans, the average surface doses in the thyroid reduced significantly from 301.1 μGy (at 85 kVp) and 170.3 μGy (at 60 kVp) to 64.43 μGy and 12.94 μGy, respectively, when the Saba thyroid shield was used. For CBCT scans, the average surface doses in the thyroid decreased significantly from 814.43 μGy (for 11 × 13 cm2 field size) and 32.40 μGy (for 5 × 5 cm2 field size) to 62.91 μGy and 12.07 μGy, respectively, with the application of the Saba thyroid shield. The maximum attenuation percentages in the thyroid for the DPR and CBCT scans were 92.40% and 92.27%, respectively. Statistically significant differences between the surface dose reduction with the Saba shield and without it was observed in both DPR scans (p < 0.0000) and CBCT scans (p < 0.0003). ConclusionThe study demonstrates that Saba thyroid shields effectively reduce doses in the thyroid region during dental DPR and CBCT scans. The dose reduction depends on tube voltage for DPR scans, field size, and its position for CBCT scans. Findings highlight the importance of using Saba thyroid shields to minimise radiation exposure and protect the thyroid gland during dental scans.

An In-depth Analysis of the Adverse Effects of Ionizing Radiation Exposure on Cardiac Catheterization Staffs.

Diagnostic and interventional angiograms are instrumental in the multidisciplinary approach to CAD management, enabling accurate diagnosis and effective targeted treatments that significantly enhance patient care and cardiovascular outcomes. However, cath lab staff, including interventional cardiologists, is consistently exposed to ionizing radiation, which poses inherent health risks. Radiation exposure in the cath lab primarily results from the use of fluoroscopy and cineangiography during diagnostic and interventional procedures. Understanding these risks and implementing effective radiation protection measurements are imperative to ensure the well-being of healthcare professionals while delivering high-quality cardiac care. Prolonged and repeated exposure can lead to both deterministic and stochastic effects. Deterministic effects, such as skin erythema and tissue damage, are more likely to occur at high radiation doses. Interventional cardiologists and staff may experience these effects when safety measures are not rigorously followed. In fact, while ionizing radiation is essential in the practice of radiation cardiology ward, cath lab staff faces inherent risks from radiation exposure. Stochastic effects, on the other hand, are characterized by a probabilistic relationship between radiation exposure and the likelihood of harm. These effects include the increased risk of cancer, particularly for those with long-term exposure. Interventional cardiologists, due to their frequent presence in the cath lab, face a higher lifetime cumulative radiation dose, potentially elevating their cancer risk. Protective measures, including the use of lead aprons, thyroid shields, and radiation monitoring devices, play a crucial role in reducing radiation exposure for cath lab personnel. Adherence to strict dose optimization protocols, such as minimizing fluoroscopy time and maximizing distance from the radiation source, is also essential in mitigating these risks. Ongoing research and advancements in radiation safety technology are essential in further for minimizing the adverse effects of ionizing radiation in the cath lab.

Fabrication and Evaluation of Thyroid Shield from Silicone Rubber-Cooper and its Comparison to Tube Current Modulation in CT Examination

This study aimed to fabricate thyroid shields made from Silicone Rubber (SR)-Cooper (Cu) material, analyze the effectiveness of SR-Cu shields in reducing radiation dose, and compare them with tube current modulation (TCM) in computed tomography (CT) examination. Thyroid shields were made from SR-Cu with Cu percentages of 0, 5, 10, 15, and 20%. The thyroid shields were positioned over the neck of the anthropomorphic phantom. Scanning was performed using a GE 128-slice CT scanner with fixed tube current of 150 mA and tube current modulation (TCM). The elatiscity of thyroid shields was tested using an universal testing machine (UTM). The ability of thyroid shields for dose reduction was measured using a 10X6-3CT Radcal detector, and quality of the resulted images was characterized with metric of signal-to-noise ratio (SNR) at the anterior, posterior, and lateral areas of the neck area of anthropomorphic phantom. It is found that the elasticity of the thyroid shields increased from 0.09 to 0.12 N/mm2 for Cu percentages from 0 to 20%. The measured dose decreased as the percentage of Cu increased. 20% of SR-Cu was able to reduce the dose by 32.4% for the fix tube current. In comparison, the TCM technique reduced the dose by 44.5%. Therefore, dose reduction using the developed shields is lower than using TCM approach. It is also found that implementation of the thyroid shields did not reduce image quality significantly. It is found that there were no apparent artifacts in the images. The highest SNR was found in the image with 20% SR-Cu, which was 3.84. In comparison, the SNR using the TCM approach was 3.59. In conclusion SR-Cu shields were successfully developed and they reduced dose with relatively consistent of image quality.

Knowledge and Utilization of Sex-Specific Lead Aprons Among Pediatric Orthopaedic Surgeons.

Orthopaedic surgeons routinely face exposure to ionizing radiation during intraoperative use of fluoroscopy. Lead personal protective equipment reduces occupational radiation exposure. Female-specific lead aprons are designed with expanded lateral coverage to improve protection of breast tissue against radiation beams. The purpose of this study was to identify current trends in knowledge and utilization of female-specific lead aprons as well as any barriers to utilization. An anonymous electronic survey including 20 multiple choice and multiple selection responses was distributed to all members of the Pediatric Orthopaedic Society of North America (POSNA). Respondents who reported the use of intraoperative fluoroscopy in their practice were included in the study. Most respondents were attending surgeons (91%) and practiced in an academic setting (85%) in an urban environment (75%). Most respondents reported using a lead apron for every case (76%) and a thyroid shield for every case (75%), while most respondents reported they do not wear lead glasses (73%). Fifty-one percent of respondents were aware of female-specific lead aprons. The majority of respondents reported female-specific lead is unavailable (45%) or available in insufficient quantities (5.5%) at their institution. Ninety percent of females reported they do not wear female-specific lead with the common reasons being lack of availability and discomfort. Knowledge of female-specific lead is low with lack of availability as a common barrier to utilization. As female presence in the field of orthopaedic surgery expands, efforts should be made to improve education and availability of sex-specific lead aprons.

Study on the Effectiveness of Radiological Technologist’s Thyroid Shielding in Pediatric Paranasal Sinus X-ray Examination

Study on the Effectiveness of Radiological Technologist’s Thyroid Shielding in Pediatric Paranasal Sinus X-ray Examination

The use of thyroid shielding and lead apron in dentistry. Position Statement from the Costa Rican Academy of Oral and Maxillofacial Radiology

The use of thyroid shielding and lead apron in dentistry. Position Statement from the Costa Rican Academy of Oral and Maxillofacial Radiology

Intraoperative Ionizing Radiation Exposure Awareness and Associated Morbidity in Neurosurgery: A Nationwide Survey

Neurosurgeons often use radiation to visualize blood vessels and implants intraoperatively. However, high exposure to radiation increases one's cancer risk. This study aims to investigate intraoperative ionizing radiation exposure awareness and associated morbidity among neurosurgeons. An anonymized 30-question survey about their intraoperative radiation exposure, protective measures, radiation knowledge, and any conditions that can arise from protracted radiation exposure was disseminated to 3344 American Association of Neurological Surgeons members. A total of 227 (6.8%) neurosurgeons completed the survey. Most neurosurgeons (61, 27%) performed 2-4 surgeries per week necessitating radiation (61, 27%), did not use a dosimeter (134, 59%), and wore a lead apron (89%) and a thyroid shield (75%). Only 7 (3%) of respondents could correctly identify the safety limit for occupational radiation. One hundred and thirty-four (59%) respondents correctly identified the relationship between distance and radiation dose reduction. Two hundred and thirteen (94%) neurosurgeons reported concern about occupational radiation exposure. No significant association was found between occupational radiation exposure and the rate of cataracts, combined cancer, and skin cancer. Multivariate logistic regression adjusting for age and cancer history found that the likelihood of developing leukemia (P= 0.02) and nonmalignant thyroid nodular disease (P= 0.01) is positively associated with increased total occupational radiation exposure. There is a need for improved radiation safety awareness among neurosurgeons, especially in the context of rising usage of minimally invasive surgery. This can allow for a greater understanding of radiation-associated risks among neurosurgeons and guide the implementation of safer practices.

In-depth exploration of the radiation exposure to staff performing endoscopic retrograde cholangiopancreatography procedures (ERCP) through RANDO phantom and TLDs.

This study provides a comprehensive evaluation of the occupational radiation exposure faced by healthcare professionals during Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures. Utilizing an anthropomorphic RANDO phantom equipped with Thermoluminescent Dosimeters (TLDs), we replicated ERCP scenarios to measure radiation doses received by medical staff. The study meticulously assessed radiation exposure in various corresponding body regions typically occupied by medical staff during ERCP, with a focus on eyes, thyroid, hands, and reproductive corresponding organ regions. The findings revealed significant variations in radiation doses across different body parts, highlighting areas of higher exposure and underscoring the need for improved protective measures and procedural adjustments. The effective radiation doses were calculated using standard protocols, considering the varying levels of protection offered by lead aprons and thyroid shields. The results demonstrate the substantial radiation exposure experienced by healthcare staff, particularly in regions not adequately shielded. This study emphasizes the necessity for enhanced radiation safety protocols in clinical settings, advocating for advanced protective equipment, training in radiation safety, and the exploration of alternative imaging modalities. The findings have crucial implications for both patient and staff safety, ensuring the continued efficacy and safety of ERCP and similar interventional procedures. This research contributes significantly to the field of occupational health and safety in interventional radiology, providing vital data for the development of safer medical practices.

Protecting Our Own: A Method for Reducing Breast Radiation Exposure in Healthcare Workers.

Standard lead aprons do not protect the female breast adequately from radiation exposure, which has been associated with breast cancer in healthcare workers. A novel lead shield was designed to reduce radiation to the breast, axilla, and thyroid (BAT). A procedure room was simulated with an anthropomorphic phantom representing the operator. Dosimeters were positioned on the outer quadrant of each breast, the chest, the thyroid, and deep inside of a phantom acrylic female torso with neck and head. Standard lead vest plus a thyroid shield was used as control and compared to standard lead vest plus BAT shield. Three operator and two image receptor positions were tested. The reductions in radiation exposure were calculated. The standard vest plus BAT shield provided significant reductions in radiation exposure for all anatomic locations compared to control. When averaging all operator positions, the BAT provided reductions of 91% (p < 0.0001) for near breast. Reductions for far breast, chest, thyroid, and deep tissues were 76% (p = 0.016), 94% (p < 0.0001), 52% (p = 0.026), and 60% (p = 0.004). With operator 90° to the table using a cross-table lateral beam, the BAT provided a 97.7% reduction in radiation to the near breast and significant reduction in radiation to the chest, thyroid, and deep tissues. The BAT shield reduces radiation exposure to the breast, chest, thyroid and deep hematopoietic tissues. Such shields could benefit healthcare workers to reduce the risk of breast cancer and other radiation-associated cancers.

Nilai Entrance Skin Dose Tiroid antara menggunakan Thyroid Shield dan tanpa Thyroid Shield pada Pemeriksaan CT Scan Kepala

Background: CT scans have a much greater dose than conventional radiographic examinations. The thyroid organ is an organ that is sensitive to radiation which is located near the head, precisely in the inferior part of the head so that when a CT scan of the head is carried out, the thyroid organ will be exposed to radiation. The aim of this study was to determine the difference in thyroid skin dose entry value between using a thyroid shield and without a thyroid shield on a head CT scan.Methods: This study is a type of quantitative research with a pre-experimental design. The object of research is Entrance Skin Dose (ESE) of ThyroidOrgan on non-contrast head CT Scan examination. The research location is at the Radiology Department at the Regional General Hospital Prof. Dr. Margono Soekarjo Purwokerto. Sample data number is 50 people (25 samples of non-contrast head CT scans without thyroid shield, and 25 samples of non-contrast head CT scans with thyroid shield. Data was obtained by measuring the radiation dose using a dosimeter placed over the thyroid area during a non-contrast CT scan between using a thyroid shield and without using a thyroid shield. Data analysis was performed using statistical tests Results: The results of measuring the radiation dose to the samples showed that the average radiation dose to the skin surface of the thyroid organ on a non-contrast CT scan without using a thoracic shield was 884.96 µSv and using a thyroid shield was 428.64 µSv. This shows that the average radiation dose from the skin surface of the thyroid organ decreased by 456.32 µSv (51.56%).Conclusions: There is a significant difference in the amount of radiation dose to the surface of the skin of the thyroid organ in non-contrast head CT scans between using a thyroid shield and without using a shield with a dose reduction of 51.6% of the radiation dose without using a thyroid shield.

Current status of occupational radiation exposure and protection among medical interns and residents

Background: While individuals exposed to radiation in hospitals are typically registered as radiation workers, with regulated exposure levels, many interns and residents who are not registered as radiation workers are occupationally exposed to radiation. This study aimed to assess the current status and awareness of radiation exposure and related protective practices among interns and residents.Methods: An online survey was conducted nationwide from June 3 to June 16, 2023, engaging 262 interns and 799 residents. Descriptive analyses were conducted to summarize the status of occupational radiation exposure and radiation protection practices.Results: Approximately 6% of interns and 18% of residents reported receiving personal dosimeters, and 6% and 20%, respectively, were registered as radiation workers. In contrast, compliance with personal radiation protection equipment, such as lead aprons and thyroid shields, exceeded 85% during tasks involving radiation exposure. On average, interns spent 7 months (standard deviation [SD], 2.1) and residents 8.1 months (SD, 4.8) in main departments with potential radiation exposure. While overall safety performance showed improvement, the provision of personal dosimeters and radiation worker registration remained low (14.7%, 16.6%).Conclusion: Despite improvements in radiation protection education and the provision of personal protective equipment, the registration rate for radiation workers among interns and residents remains low. Ensuring these medical professionals are registered and managed as radiation workers is crucial for prioritizing their safety and well-being.

Dose reduction using Saba thyroid shield during diagnostic X-ray energy range: a phantom study

The Saba thyroid shield is a new X-ray dose reduction tool for radiosensitive organs that can reduce the X-ray dose without degrading the image quality. This study investigated its effectiveness in reducing the X-ray dose on the thyroid surface during diagnostic X-ray. This study was conducted in the lab of the Medical Physics Department at Umm-Alqura University. The experiments were performed in the year 2022. A mixed fission product phantom and a solid-state detector were used to measure the radiation dose on the thyroid surface during diagnostic X-ray using a tube voltage within 40–120 kVp. The effectiveness of the Saba thyroid shield was examined in two settings: in-field and out-of-field. Measurements were conducted for these two settings without and with the Saba thyroid shield, and the attenuation percentages were computed. Analysis of covariance was used to test the tool’s effectiveness in X-ray dose reduction. The average in- and out-of-field dose attenuation percentages using the Saba thyroid shield were 80.12 ± 0.12% and 81.13 ± 0.18%, respectively. A significant difference was shown between the measurements done without and with the Saba thyroid shield (p = 0.000) for both the in-field and out-of-field doses. The in-field and out-of-field dose reduction levels using the shield were approximately the same. This study demonstrated that the newly developed Saba thyroid shield made of copper and bismuth effectively reduces both the in-field and out-of-field radiation doses.

Radiation dose to multidisciplinary staff members during complex interventional procedures

IntroductionComplex interventional radiology procedures involve extensive fluoroscopy and image acquisition while staff are in-room. Monitoring occupational radiation dose is crucial in optimization. The purpose was to determine radiation doses received by staff involved in complex interventional procedures performed in a dedicated vascular or neuro intervention room. MethodsIndividual real-time radiation dose for all staff involved in vascular and neuro-interventional procedures in adult patients was recorded over a one-year period using wireless electronic dosimeters attached to the apron thyroid shield. A reference dosimeter was attached to the C-arm near the tube housing to measure scattered, unshielded radiation. Radiology staff carried shoulder thermo-luminescent dosimeters with monthly read-out to monitor dose over time. ResultsOccupational radiation dose was measured in 99 interventional procedures. In many cases prostate artery embolization procedures exposed radiologists to high radiation doses with a median of 15.0 μSv and a very large spread, i.e. 0.2–152.5 μSv. In all procedures except uterine fibroid embolization radiographers were exposed to lower doses than those of radiologists, with endovascular aortic repair being the procedure with highest median exposure to assisting radiographers, i.e. 2.2 μSv ranging from 0.1 to 36.1 μSv. Median radiation dose for the reference dosimeter was 670 μGy while median staff dose for all procedures combined was 3.2 μGy. ConclusionRadiation doses for multiple staff were determined and the ratio between staff dose and reference dosimeter indicated proper use of shielding in general. Some high-dose procedures may need further optimization for certain staff members, especially those not primarily employed in radiology. Implications for practiceThe study provides benchmark doses that may be used widely in audits and in the ongoing effort to optimize radiation protection for staff in interventional radiology.

Time to Look for Ergonomically Viable Designs of Radiation Protection Aprons and Thyroid Shields in Orthopedic Surgery: A Survey of 416 Orthopedic Surgeons

Time to Look for Ergonomically Viable Designs of Radiation Protection Aprons and Thyroid Shields in Orthopedic Surgery: A Survey of 416 Orthopedic Surgeons

Radiation doses in extraoral bitewing radiography compared with intraoral bitewing and panoramic radiography

We compared the effective dose (E) and thyroid equivalent dose of 2 extraoral bitewing (EOBW) units and compared E with their respective panoramic (PAN) modes and with intraoral bitewing radiography (IOBW). Child and adult anthropomorphic phantoms with dosimeters were used to evaluate Orthophos SL, Rayscan α+, and 1 intraoral unit using rectangular and circular collimation. Extraoral bitewing thyroid equivalent dose was assessed without and with thyroid shielding. Child and adult E values of EOBW were lower with Orthophos (3.6 and 8.6 μSv) than with Rayscan (28.1 and 30.2 μSv). For IOBW, E was lower with rectangular vs circular collimation for child (7.0 vs 11.8 μSv) and adult (4.6 vs 14.2 μSv). E values of EOBW were lower than PAN for Orthophos. The IOBW E was lower than Rayscan EOBW for child (≤11.8 vs 28.1 μSv) and adult (≤14.2 vs 30.2 μSv). Adult E for rectangular IOBW (4.6 μSv) was lower than EOBW with Orthophos (8.6 μSv) and Rayscan (30.2 μSv). Thyroid shielding reduced EOBW thyroid equivalent dose with Rayscan in the adult from 190.7 to 89.0 μSv. Orthophos provides significantly lower EOBW E than Rayscan, thus EOBW recommendations must be unit specific. For children, Orthophos EOBW could be an alternative to IOBW, for which rectangular collimation is recommended. Thyroid shielding reduced adult Rayscan equivalent dose but added imaging artifacts.

Radiation exposure in fluoroscopy guided spinal interventions: A prospective observational study of standard practice in a physiatry academic center

ContextFluoroscopy is the recommended image guidance modality for most spinal pain interventions. However, it exposes interventional pain physicians to chronic ionizing radiation, with known risks to the eye, skin, and hand. The use of protective glasses and gloves is variable among pain physicians. ObjectivesTo document the total radiation exposure (mSv) by pain physicians to their eyes, hands and chest in an academic setting including various spinal interventions. MethodsFour pain physicians wore a finger, head/collar (equivalent to eye exposure) and chest dosimeter over and under their lead apron during a three-month period where they performed their usual fluoroscopy-guided interventions, including close supervision of trainees. We calculated an average exposure per intervention and extrapolated the recorded exposure to a maximum, worst-case scenario of a caseload of 13 procedures per day, 5 days a week and 52 weeks per year. ResultsFour pain physicians of variable experience performed 15 different types of procedures on 607 patients throughout the study period. The yearly maximum exposure scenarios for each pain physician were all below the Canadian Nuclear Safety Commission thresholds for nuclear energy workers: for the hands (31.56 mSv, 25.67 mSv, 20.59 mSv, 21.51 mSv; threshold = 500 mSv), eyes (16.01 mSv, 18.64 mSv, 24.08 mSv, 18.68 mSv; threshold = 50 mSv) and chest over the lead apron (28.27 mSv, 46.91 mSv, 30.00 mSv, 40,03 mSv; whole body threshold = 50 mSv), with some doses even below general population thresholds. The exposure under the lead apron was 0 mSv for each pain physician. ConclusionThe standard practice of an interventional pain physician using fluoroscopy in this academic setting is below radiation exposure regulations, even in a theoretical, worst-case, maximum exposure scenario. Standard radiation protection practices such as the use of lead aprons and thyroid shields should still be used. However, this data is reassuring for pain physicians with a practice in fluoroscopy-guided interventions who wish to not use protective glasses or gloves.