This article expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about radiation protection for endoscopic procedures, in particular endoscopic retrograde cholangiopancreatography (ERCP). Particular cases, including pregnant women and pediatric patients, are also discussed. This Guideline was developed by a group of endoscopists and medical physicists to ensure that all aspects of radiation protection are adequately dealt with. A two-page executive summary of evidence statements and recommendations is provided. The target readership for this Guideline mostly includes endoscopists, anesthesiologists, and endoscopy assistants who may be exposed to X-rays during endoscopic procedures.
Objectives: The aim of this study was to determine occupational dose levels in interventional radiology and cardiology procedures. Methods: The study covered a sample of 25 procedures and monitored occupational dose for all laboratory personnel. Each individual wore eight thermoluminescent dosemeters next to the eyes, wrists, fingers and legs during each procedure. Radiation protection shields used in each procedure were recorded. Results: The highest doses per procedure were recorded for interventionists at the left wrist (average 485 mSv, maximum 5239 mSv) and left finger (average 324 mSv, maximum 2877 mSv), whereas lower doses were recorded for the legs (average 124 mSv, maximum 1959 mSv) and the eyes (average 64 mSv, maximum 1129 mSv). Doses to the assisting nurses during the intervention were considerably lower; the highest doses were recorded at the wrists (average 26 mSv, maximum 41 mSv) and legs (average 18 mSv, maximum 22 mSv), whereas doses to the eyes were minimal (average 4 mSv, maximum 16 mSv). Occupational doses normalised to kerma area product (KAP) ranged from 11.9 to 117.3 mSv/1000 cGy cm 2 and KAP was poorly correlated to the interventionists' extremity doses. Conclusion: Calculation of the dose burden for interventionists considering the actual number of procedures performed annually revealed that dose limits for the extremities and the lenses of the eyes were not exceeded. However, there are cases in which high doses have been recorded and this can lead to exceeding the dose limits when bad practices are followed and the radiation protection tools are not properly used.
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