Material Analysis of Lead Aprons Using Radiography Non-Destructive Testing

Lead Apron is a Personal Protective Equipment (PPE) against the effect of Ionizing Radiation such as X-ray. It is essential for the radiation worker to wear Radiation Protection Equipment during commissions involving ionizing radiation. In Pekanbaru, Indonesia the most common radiation worker is Radiographer which help in hospital for diagnose. In this study the Lead Apron analyzed were 6 apron which suspected to have fault due to its inappropriate tend using NDT radiography methods. Radiography methods have advantage of graphic presentation of object unlike any NDT-methods. The image produce from radiography were analyzed using Computed Radiography (CR) and measured the defection of the material. There was only 3 of 6 Lead Apron appropriate for radiation protection.

ESTIMATED EXPOSURE OF SPINE SURGEONS TO RADIATION

ABSTRACT Objective To estimate the amount of radiation received and accumulated in the bodies of two surgeons, one being the responsible surgeon and the other the assistant, performing spine surgery procedures over a period of 25 years. Methods Seventy-two spinal surgeries were performed during a seven-month period and the radiation loads were measured in both surgeons. The measurement of radiation was captured in fluoroscopy in anteroposterior and lateral incidences. The surgeon and the assistant used two dosimeters, one in the cervical region protecting the thyroid and the other on the lead apron in the genital region. The radioactive loads were measured in millisieverts and the accumulated charges were recorded monthly in both regions of the body in the two surgeons for seven months and the means for the work periods (1, 5, 10, 15, 20 and 25 years) were estimated. Results It was observed that in the surgeon the average accumulated radiation loads were 131.9% and 176.92% higher than those of the assistant in the cervical and genital regions, respectively. Conclusion While the use of X-rays is indispensable in routine orthopedic surgery, we have to consider the development of techniques of protection, rigor and discipline in the use of safety materials for surgeons. Preventive exposure reduction measures such as using thyroid protection equipment and turning the head away from the patient during fluoroscopy, among others, should be mandatory to promote less radiation exposure. Level of evidence II; Comparative prospective study.

AWARENESS OF RADIATION HAZARD IN ORTHOPAEDIC RESIDENTS SURGEON IN A CENTRAL INDIA

One of the effective techniques which has evolved in contemporary orthopaedic practice is C-arm fluoroscopy in intra-operative orthopaedic procedures. Such techniques improve the competence of the surgeon while reducing the jejuneness and duration of the patients stay at hospital. Although having awareness about reported benefits of the device, there is increasing worry over the surgical teams elevated radiation exposure. The current research was undertaken on orthopaedic surgeons working in the region of Central India to assess the amount of radiation exposure if they follow the normal precautionary steps as well as to raise awareness and encouraging them to use the image intensifier safety in daily practice. In addition, to raise concerns of radiation safety and the befitting use of radiation in the operating room.Materials and Method: This is an observational review of data gathered by residents performing common orthopedic surgical operations in emergency and routine OT during one-year residency at a medical college hospital. We calculated the mean radiation exposure on each resident (orthopedic resident postgraduate-3yr) with and without lead apron protection, and compared it with the ICRP limit for radiation to body per year between 1st January 2020 and 31st December 2021.Result: Total radiation levels accumulated by one resident without lead apron over 1 year was calculated (35.88 milliSv). which was greater to ICRP limit for radiation to body per year (20milliSv).Total radiation levels accumulated by one resident with lead apron over 1 year was calculated (2.04 mSv).which was less than ICRP limit for radiation to body per year (20mSv).Conclusion: Orthopedic resident surgeons are not listed as Radiation personnel. Radiation toxicity, in addition to the risks of other surgical industries, is therefore an additional occupational danger. As a result, orthopedic resident surgeons should be concerned. During surgeries, junior orthopaedic residents vastly underestimate their level of radiation. They should adhere to the guidelines outlined above. The conventional assertion that radiation exposures during c arm use are negligible and should be disregarded, as the long-term adverse biological effects of continuous low-dose radiation exposure are uncertain at this time. Theres a chance of cancer, as well as genetic variations and fertility complications.

RADIOLOGICAL EVALUATION OF LEAD APRON INTEGRITY IN FIVE SELECTED HOSPITALS IN ABUJA, NIGERIA

Background: The general consensus is that any exposure to ionising radiation carries a risk. Diagnostic radiology is the largest (87%) contributor to man-made ionising radiation, therefore any economical and socially acceptable means of reducing dose without compromising the diagnostic value of the procedure must be worth implementing. Aim: This study is aimed at evaluating lead apron integrity in five selected Hospitals in Abuja, Nigeria. Methodology: The methodology approach includes the application of a large area beam for transmission measurement with the placement of OSLD before and behind the ten (10) lead aprons to determine the entrance and exit dose as well as the transmission factor. In this study, a lead apron consisting of 0.25mm and 0.35mm thickness were examined. Results: The result shows that the transmittance factor of the entrance and exit dose through the lead equivalent aprons is directly proportional to the age of the apron with NHA1 having the highest transmission factor (0.83) and oldest age (16 years). WGH2 has the lowest transfer factor (0.12) and the least age (1 year). Conclusion: Lead aprons loses their attenuation capability over time and should be replaced after 15 years at most for effective protection against ionizing radiation.

Cutting Staff Radiation Exposure and Improving Freedom of Motion during CT Interventions: Comparison of a Novel Workflow Utilizing a Radiation Protection Cabin versus Two Conventional Workflows

This study aimed to evaluate the radiation exposure to the radiologist and the procedure time of prospectively matched CT interventions implementing three different workflows—the radiologist—(I) leaving the CT room during scanning; (II) wearing a lead apron and staying in the CT room; (III) staying in the CT room in a prototype radiation protection cabin without lead apron while utilizing a wireless remote control and a tablet. We prospectively evaluated the radiologist’s radiation exposure utilizing an electronic personal dosimeter, the intervention time, and success in CT interventions matched to the three different workflows. We compared the interventional success, the patient’s dose of the interventional scans in each workflow (total mAs and total DLP), the radiologist’s personal dose (in µSV), and interventional time. To perform workflow III, a prototype of a radiation protection cabin, with 3 mm lead equivalent walls and a foot switch to operate the doors, was built in the CT examination room. Radiation exposure during the maximum tube output at 120 kV was measured by the local admission officials inside the cabin at the same level as in the technician’s control room (below 0.5 μSv/h and 1 mSv/y). Further, to utilize the full potential of this novel workflow, a sterile packed remote control (to move the CT table and to trigger the radiation) and a sterile packed tablet anchored on the CT table (to plan and navigate during the CT intervention) were operated by the radiologist. There were 18 interventions performed in workflow I, 16 in workflow II, and 27 in workflow III. There were no significant differences in the intervention time (workflow I: 23 min ± 12, workflow II: 20 min ± 8, and workflow III: 21 min ± 10, p = 0.71) and the patient’s dose (total DLP, p = 0.14). However, the personal dosimeter registered 0.17 ± 0.22 µSv for workflow II, while I and III both documented 0 µSv, displaying significant difference (p < 0.001). All workflows were performed completely and successfully in all cases. The new workflow has the potential to reduce interventional CT radiologists’ radiation dose to zero while relieving them from working in a lead apron all day.

Knowledge And Awareness of Radiation Safety Among Orthopaedic Surgeon: A Survey Analysis

Purpose: Orthopaedic surgeons are at potential risk to suffer from radiation exposure. The radiation exposure has increased due to minimal invasive and complex orthopaedic procedures. This study evaluates the level of knowledge of orthopaedic surgeons regarding radiation safety and prevention.Methods: A survey consisting of 17 questions was conducted among the 519 orthopaedic surgeons. The orthopaedic surgeons were contacted via mobile or email and the data was analysed.Results: Total of 542 responses were received and 23 were excluded due to incomplete responses. The result depicted, only 5% of the orthopaedic surgeons were aware of the ALARA/ALARP principles. Only 45% of the surgeons were right about the collimated image acquisition. None of the surgeon used dosimeter in the study. Most of the surgeons (40%) were not aware of the influence of C-Arm orientation on the scattered radiation. The protective gears were used by 75% of the orthopaedic surgeons and 5% used it occasionally. A lead apron is used by all the orthopaedic surgeons using the protective gear whereas only 15% used thyroid shield additionally. Only 5% of orthopaedic surgeons had some training in radiation safety and protection.Conclusion: The study demonstrates the level of knowledge regarding radiation safety and consequences among orthopaedic surgeons. The study depicts the need for proper and appropriate training required by the orthopaedic surgeons. Further extensive and elaborate studies are required to ascertain the radiation safety as a part of the training programme of the orthopaedic surgeons.

Collimation Reduces Radiation Exposure to the Surgeon in Endoscopic Spine Surgery: A Prospective Study

Background and Study Aims There are no previous studies in the literature comparing the radiation dose to which surgeons are exposed while using a standard fluoroscopy versus collimation during transforaminal percutaneous endoscopic lumbar diskectomy (PELD). The aim of this study is to compare this and to evaluate the effectiveness of collimation in reducing radiation exposure. Methods In this study, the operating surgeon (single surgeon) placed a gamma radiation dosimeter on his chest outside of the lead apron during transforaminal PELD surgeries and measured the radiation exposure immediately after each surgery. As foraminoplasty using free-hand reamers is a longer procedure and requires more fluoroscopy shots, we divided the patients into two groups. The first group consisted of 24 patients (nonforaminoplasty group). The second group consisted of 13 patients (foraminoplasty group). We compared the radiation exposure to the operating surgeon using a standard fluoroscopy versus collimation for each group individually and overall. We randomized the patients within each group based on the order in which they had their respective procedures. Results We analyzed 39 patients who underwent transforaminal PELD between May and December 2019. In both groups, as well as overall, the recorded radiation exposure to the surgeon was significantly lower in surgeries in which collimation was used. In the first group, the radiation dose was 0.083 versus 0.039 mSv per surgery (p = 0.019), whereas in the second group, it was 0.153 versus 0.041 mSv per surgery (p = 0.001), and overall it was 0.108 versus 0.039 mSv per surgery (p < 0.001). Conclusion The use of collimation during transforaminal PELD significantly reduces spine the surgeon's exposure to radiation. Therefore, spine surgeons should consider using collimation during transforaminal PELD.

RADIATION EXPOSURE TO THE BACK WITH DIFFERENT TYPES OF APRONS

Physicians and nurses stand with their back towards the C-arm fluoroscope when using the computer, taking things out of closets and preparing drugs for injection or instruments for intervention. This study was conducted to investigate the relationship between the type of lead apron and radiation exposure to the backs of physicians and nurses while using C-arm fluoroscopy. We compared radiation exposure to the back in the three groups: no lead apron (group C), front coverage type (group F) and wrap-around type (group W). The other wrap-around type apron was put on the bed instead of on a patient. We ran C-arm fluoroscopy 40 times for each measurement. We collected the air kerma (AK), exposure time (ET) and effective dose (ED) of the bedside table, upper part and lower part of apron. We measured these variables 30 times for each location. In group F, ED of the upper part was the highest (p &lt; 0.001). ED of the lower part in group C and F was higher than that in group W (p = 0.012). The radiation exposure with a front coverage type apron is higher than that of the wrap-around type and even no apron at the neck or thyroid. For reducing radiation exposure to the back of physician or nurse, the wrap-around type apron is recommended. This type of apron can reduce radiation to the back when the physician turns away from the patient or C-arm fluoroscopy.

Assessment Of Whole Body, Skin and Eye Lens Doses of the Interventional Radiologists At Selected Hospitals in Iran

High radiation doses to the body may lead to the stochastic/deterministic effects of ionizing radiation on the critical organs as well as causing the cataract in eye lens of the clinical staff in interventional radiology. In this study, the received doses of the eyes, skin and whole body of 38 clinical staff including physicians, residents, nurses and radiotechnologists in cardiac angiography departments in three selected hospitals were assessed using personal dosemeters during two bimonthly dosimetry periods. Moreover, the correlation coefficients among the measured dose components including eye lens dose, skin dose and whole body dose equivalent in both area of under and over their lead-apron were calculated for all these occupational groups. The results show that the occupational annual dose values of the clinical staff are below the annual dose limits recommended by International Commission on Radiation Protection. Furthermore, among the measured dose components, the highest correlation coefficient value was obtained between the eye lens dose and personal dose equivalent measured over the lead apron for all the occupational groups.