Does Radiological Protection Training or a Real-Time Staff Dosemeter Display Reduce Staff Doses During X-Ray-Guided Pulmonary Bronchoscopy?

Abstract

X-ray-guided interventions have increased in number and complexity. Mandatory radiological protection training includes both theoretical and practical training sessions. A recent additional training tool is real-time display dosemeters that give direct feedback to staff on their individual dose rates. Ten staff members who regularly perform pulmonary bronchoscopy wore an extra dosemeter during four 2-month periods. We controlled for the patient air kerma area product and the number of procedures in each period. Between periods 1 and 2, radiological training sessions were held and during period 3 the staff used the real-time display system. Focus-group interviews with the staff were held to obtain their opinion about learning radiological protection. We hypothesised that neither training nor the additional real-time dose rate display alters the personal dose equivalent, Hp(d); d = 0.07 and 10 mm. Useful experiences from radiological protection training were obtained, and median staff doses did decrease, however not significantly.

Occupational doses in interventional angiography after radiological protection training and use of a real-time direct display dosimeter

“…In that setting, the staff mainly had fixed positioning during RI, which affected the possibilities to take steps away from the radiation. The occupational doses were also low [11]. In the present study, the doses to the operators (physicians) were higher than in Lundvall and Sandborg [11] due to more complex procedures and a thicker patient body part.…”

“…Lasting effects of practical training and usage of a real-time display system were evaluated in a setting with experienced staff and mainly fixed positions during RI. The study reported lower median occupational doses [11]. The same method was used in the present work, but in a different clinical setting with more complex procedures and with higher patient doses.…”

“…Such measures include taking a step back, when possible, positioning the ceiling-mounted lead glass shield correctly, and collimating the x-ray beam. For the most part, a non-significant reduction in staff doses was found by Lundvall and Sandborg [11] in x-ray guided bronchoscopy using similar methods. In that setting, the staff mainly had fixed positioning during RI, which affected the possibilities to take steps away from the radiation.…”

“…If theoretical education is combined with practical training, preferably with the equipment that the staff will use in practice, the acquired knowledge results in lower patient doses and higher compliance to as low as reasonably achievable (ALARA) principles [6,7]. The immediate effect on occupational doses when using a real-time display system during RI has been evaluated [8][9][10][11]. The radiation dose to staff working close to the patient decreased significantly when using a real-time display system [8][9][10].…”

“…Earlier studies indicate that combining theoretical and practical education are advantageous when learning radiation safety [11]. Practical training with the imaging equipment used by staff led to a higher degree of compliance with ALARA-principles [7].…”