A Study on the Use of Radiation-Protective Apron among Interventionists in Radiology

Livingstone, Roshan S; Varghese, Anna M.; Keshava, Shyamkumar N.

doi:10.4103/jcis.jcis_34_18

Cited by 28 publications

(21 citation statements)

References 11 publications

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“…Their study showed a greater incidence of cervical, rather than lumbar, problems. It was also noted that interventional cardiologists use aprons for longer periods, which increases the impact on the axial skeleton [12]. However, our study produced results similar to Moore.…”

Section: Discussionsupporting

confidence: 69%

The hidden risk of ionizing radiation in the operating room: a survey among 258 orthopaedic surgeons in Brazil

et al. 2020

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Background: This study aims to assess orthopaedic surgeon knowledge in Brazil about ionizing radiation and its health implications on surgical teams and patients. Methods: A 15-question survey on theoretical and practical concepts of ionizing radiation was administered during the 23rd Brazilian Orthopaedic Trauma Association annual meeting. The survey addressed issues within orthopedic surgery, such as radiation safety concepts, protection, exposure, as well as the participant gender. Participants were either orthopedic surgeons or orthopedic surgery residents working at institutions in Brazil. Results: One thousand surveys were distributed at the moment of the meeting registration, and 258 were answered completely (25.8% response rate). Only 5.8% of participants used basic radiation protection equipment; 47.3% used a dosimeter; 2.7% reached the annual maximum permissible radiation dose; 10.5% knew the period of increased risk to fetal gestation; 5.8% knew the maximum permissible radiation dose during pregnancy; 58.5% knew that the hands, eyes, and thyroid are the most exposed areas and at greater risk of radiation-related lesions; 25.2% knew the safe distance from a radiation-emitting tube is 3 m or more; 44.2% knew the safest positioning of the radiation-emitting tube; 25.2% knew that smaller tubes emit greater radiation at the entrance dose to magnify the image; and 55.4% knew that the surgery team receives more scattered radiation in surgical procedures performed on obese patients. Conclusion: This study revealed inadequate theoretical and practical knowledge about radiation exposure among orthopaedic surgeons in Brazil. Only a minority of orthopaedic surgeons used basic radiation protection equipment. No significant differences in knowledge were found when comparing all orthopedic surgery specialties. Our findings indicate an urgent need for education to increase knowledge among orthopaedic surgeons about the hazards of ionizing radiation. Personal protection and implementation of the ALARA (as low as reasonably achievable) protocol in daily practice are important behaviors to prevent the harmful effects of ionizing radiation.

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Section: Discussionsupporting

confidence: 69%

The hidden risk of ionizing radiation in the operating room: a survey among 258 orthopaedic surgeons in Brazil

et al. 2020

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“…As shown in the flow diagram reported in Figure 1 , a total of 2337 articles were retrieved. Of these, twelve studies [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ] were finally included. All studies had a cross-sectional design.…”

Section: Resultsmentioning

confidence: 99%

“…In this same study, the number of years performing invasive procedures post-fellowship was found to be significantly related to having spine disorders: 26% of physicians with less than five years of experience reported spinal problems, while this percentage increased to 60% in those physicians who had more than 21 years of interventional practice. No specific relationship between the rate of orthopaedic injuries and yearly caseload was identified [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

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Anti-X Apron Wearing and Musculoskeletal Problems Among Healthcare Workers: A Systematic Scoping Review

Monaco

Carta

Tamhid

et al. 2020

IJERPH

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Interventional radiology activities and other medical practices using ionising radiation have become increasingly prevalent. In this context, the use of anti-X aprons, in association with awkward postures and non-ergonomic working conditions, might cause the onset of musculoskeletal disorders (MSDs). This research aims to evaluate the evidence about the correlation between wearing anti-X aprons and work-related MSDs. A systematic scoping review of articles published between 1990 and 2020 was conducted by searching the PubMed, Scopus, Embase, and Web of Science databases. Twelve cross-sectional studies, conducted among interventional physicians, nurses, and technicians, were finally included. Five studies primarily investigated the association between use of anti-X aprons and MSDs, showing that a higher prevalence of disorders was not always associated with the use of protective aprons. No studies investigated the impact of anti-X aprons on fitness for work assessment, particularly in subjects with MSDs. There is no complete agreement about the correlation between anti-X apron-wearing and the occurrence of MSDs, although the possible discomfort of workers using anti-X aprons appears more evident. Further studies are needed to objectify the role of these protective devices in the genesis of MSDs and to offer specific ergonomic solutions for healthcare workers.

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“…Differences in physician preferences can be identified if desired and their use in an interventional x-ray facility having Cine or DSA can be standardized. 9,10 Hanging tableside drapes are shown to reduce the exposure by more than 90% via measurement. It is an important pre-procedure preparation that x-ray technologists attach the hanging drapes as standard room preparation.…”

Section: F | Effectiveness Of Personal Protective Equipmentmentioning

confidence: 99%

Sample content of kinesthetic educational training: Reducing scattered X‐ray exposures to interventional physician operators of fluoroscopy

Pavlicek

Sensakovic

Zhou

et al. 2019

J Applied Clin Med Phys

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Content used by Medical Physicists for fluoroscopy safety training to staff is deliverable via several formats, that is, online content or a live audience slide presentations. Here, we share one example of a kinesthetic (live, hands-on simulation) educational program in use at our facility for some time (~10 years). In this example, the format and content specifically target methods of reducing physician operator exposures from scattered x rays. A kinesthetic format identifies and promotes the adoption of exposure-reducing behaviors. Key kinesthetic elements of this type of training include: physician hands-on measurements of radiation levels at locations specific to their standing positions (e.g., primary arterial access points) in the room using handheld exposure rate meters, measurement of exposure rate reduction to physicians provided by using personal protective equipment, that is, wearable aprons, hanging lead drapes, and pull-down shields. Physician choice of procedurespecific tableside selectable controls affecting exposure rate from optional fluoroscopy, Cine or digital subtraction angiography (DSA), along with comparative measured contribution to physician exposure is demonstrated. The inverse square exposure rate reduction to physicians when stepping back from the table during DSA is a key observation. Kinesthetic simulations in the rooms used by physicians have been found to provide the highest level of understanding giving rise to adoption of practices that are impactful for physicians. Specific training scripts are in place for physician sub-specialization in interventional radiology, cardiology, neurosurgery, vascular surgery, and gastroenterology. This training is used for new physician staff while classroom presentations (whose content mimics in room training) are used with staff who have had previously had in room training.

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A Study on the Use of Radiation-Protective Apron among Interventionists in Radiology

Cited by 28 publications

References 11 publications

The hidden risk of ionizing radiation in the operating room: a survey among 258 orthopaedic surgeons in Brazil

The hidden risk of ionizing radiation in the operating room: a survey among 258 orthopaedic surgeons in Brazil

Anti-X Apron Wearing and Musculoskeletal Problems Among Healthcare Workers: A Systematic Scoping Review

Sample content of kinesthetic educational training: Reducing scattered X‐ray exposures to interventional physician operators of fluoroscopy

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