Eye lens dosimetry in anesthesiology: a prospective study

Abstract

The eye lens is one of the most sensitive organs for radiation injury and exposure might lead to radiation induced cataract. Eye lens dosimetry in anesthesiology has been published in few clinical trials and an active debate about the causality of radiation induced cataract is still ongoing. Recently, the International Commission on Radiological Protection (ICRP) recommended a reduction in the annual dose limit for occupational exposure for the lens of the eye from 150 to 20 mSv, averaged over a period of 5 years, with the dose in a single year not exceeding 50 mSv. This prospective study investigated eye lens dosimetry in anesthesiology practice during a routine year of professional activity. The radiation exposure measured represented the exposure in a normal working schedule of a random anesthesiologist during 1 month and this cumulative eye lens dose was extrapolated to 1 year. Next, eye lens doses were measured in anesthesiology during neuro-embolisation procedures, radiofrequency ablations or vertebroplasty/kyphoplasty procedures. The eye lens doses are measured in terms of the dose equivalent H (3) with the Eye-D dosimeter (Radcard, Poland) close to the right eye (on the temple). In 16 anesthesiologists, the estimated annual eye lens doses range from a minimum of 0.4 mSv to a maximum of 3.5 mSv with an average dose of 1.33 mSv. Next, eye lens doses were measured for nine neuro-embolisation procedures, ten radiofrequency ablations and six vertebroplasty/kyphoplasty procedures. Average eye lens doses of 77 ± 76 µSv for neuro-embolisations, 38 ± 34 µSv for cardiac ablations and 40 ± 44 µSv for vertebro-/kyphoplasty procedures were recorded. The maximum doses were respectively 264, 97 and 122 µSv. This study demonstrated that the estimated annual eye lens dose is well below the revised ICRP's limit of 20 mSv/year. However, we demonstrated high maximum and average doses during neuro-embolisation, cardiac ablation and vertebro-/kyphoplasty procedures. With radiation induced cataract being explained as a possible stochastic effect, without a threshold dose, anesthesiologists who regularly work in a radiological environment should remain vigilant and maintain radiation safety standards at all times. This includes adequately protective equipment (protection shields, apron, thyroid shield and leaded eye wear), keeping distance, routine monitoring and appropriate education.

Percutaneous structural cardiology: are anaesthesiologists properly protected from ionising radiation?

“…far enough to keep their occupational doses close to background readings. Some authors have reported average occupational doses of 1-3 mSv yr −1 at the eye lenses or over the protective apron for anaesthesiologists participating in interventional procedures [8,9], which means that it is very likely that under the apron the dose will be under the regulatory limits for the general public (i.e. <1 mSv yr −1 ).…”

New-old methods of reducing and monitoring x-ray exposure in the interventional radiology environment

“…Osłony osobiste -okulary, maski i czapki ołowiowe Autorzy wielu artykułów naukowych podkreślali konieczność ochrony soczewek oczu przed promieniowaniem jonizującym oraz monitorowania dawki na soczewki oczu w ramach dozymetrii indywidualnej (głównie podczas zabiegów interwencyjnych) [12][13][14][15][16][17][18][19][20][21][22][23][24]. Opisywane we wspomnianych artykułach badania dotyczyły pomiaru ekspozycji na soczewki oczu, który wcześniej nie był prowadzony w ramach dozymetrii indywidualnej ze względu na wysoki, nieprzekraczany w miejscach pracy limit dawki (150 mSv/rok).…”

The Impact of Implementing a Radiation-Sparing Protocol for Percutaneous Kyphoplasty—A Prospective Dosemetric Study

“…At the same time, dosemetric data on intraoperative radiation exposure to the surgeon and patient are hardly available. 3 - 5 Often only fluoroscopy times have been reported, 6 - 8 but their extent can be underestimated. For instance, taking into account the current recommendations of the International Commission on Radiological Protection (ICRP) 9 for occupationally exposed persons, a previous report with a fluoroscopy time of 27.7 min and surgeon’s radiation exposure to the eye lens of 0.328 mSv per vertebroplasty 3 implicated that the annual dose limit for the surgeon would already be exceeded after 61 vertebroplasty procedures.…”