The Effect of Radiation Shields on Operator Exposure During Congenital Cardiac Catheterisation.

TitleThe Effect of Radiation Shields on Operator Exposure During Congenital Cardiac Catheterisation.
Publication TypeJournal Article
Year of Publication2016
AuthorsBatlivala SP, Magill D, Felice MA, Jones V, Dori Y, Gillespie MJ, Rome JJ, Glatz AC
JournalRadiat Prot Dosimetry
Volume171
Issue4
Pagination520-526
Date Published2016 Dec
ISSN1742-3406
KeywordsAir, Cardiac Catheterization, Fluoroscopy, Humans, Occupational Exposure, Protective Devices, Quality Improvement, Radiation Dosage, Radiation Injuries, Radiation Monitoring, Radiation Protection, Retrospective Studies, Risk, Scattering, Radiation, X-Rays
Abstract

Cardiac catheterisation personnel are exposed to occupational radiation and its health risks. Little data exist regarding the efficacy of radiation-protective equipment from congenital catheterisation laboratories (CLs). The authors retrospectively reviewed data in which CL operators wore a radiation dosemeter during catheterizations on patients of >20 kg. A leaded under-table skirt was present in all cases. Three additional radiation-protective devices were utilised at operator discretion: a top extension to the under-table skirt, a ceiling-mounted shield and a disposable patient drape. Case details, operator position, fluoroscopy time, incident air KERMA in the patient plane (K, mGy) and dose-area product (DAP, µGy·m(2)) were recorded. A total of 136 catheterizations over 8 months were included. Median operator dose (OpD) was 12 µSv (range 0-930) and indexed to K and DAP to correct for patient factors and case times. Indexed OpD decreased significantly with each additional shield used (14.8 vs. 1.3 nSv µGy(-1) m(-2) and 124 vs. 14 nSv mGy(-1) with one and four shields, respectively, p < 0.001). This trend was not significant with operator at head-of-bed. Combinations that included the ceiling shield had the lowest indexed OpD. The patient drape did not further reduce OpD when all other shields were used (1.3 vs. 2.2 nSv µGy(-1) m(-2), p = 0.5; 14 vs. 17 nSv mGy(-1), p = 0.4) and was associated with higher patient exposure indexed to weight and fluoroscopy time (4.5 vs. 3.1 µGy m(2) kg-min(-1), p = 0.009; and 0.51 vs. 0.38 mGy kg-min(-1), p = 0.01). Supplemental radiation barriers can decrease operator-absorbed radiation. A ceiling-mounted shield may provide greatest benefit. The authors do not recommend routine use of disposable patient drapes.

DOI10.1093/rpd/ncv471
Alternate JournalRadiat Prot Dosimetry
PubMed ID26582175