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

Mirowski, Mateusz

doi:10.13075/mp.5893.01022

Cited by 3 publications

(3 citation statements)

References 57 publications

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“…In the angio suite, IRs must comply with recommendations to limit the radiation exposure to themselves [ 37 , 38 ]. A central piece of shielding is the lead apron.…”

Section: Situations Encountered In Interventional Radiology and Existing Solutionsmentioning

confidence: 99%

Ergonomics in Interventional Radiology: Awareness Is Mandatory

et al. 2021

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Ergonomics in interventional radiology has not been thoroughly evaluated. Like any operators, interventional radiologists are exposed to the risk of work-related musculoskeletal disorders. The use of lead shielding to radiation exposure and the lack of ergonomic principles developed so far contribute to these disorders, which may potentially affect their livelihoods, quality of life, and productivity. The objectives of this review were to describe the different situations encountered in interventional radiology and to compile the strategies both available to date and in development to improve ergonomics.

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“…In the angio suite, IRs must comply with recommendations to limit the radiation exposure to themselves [ 37 , 38 ]. A central piece of shielding is the lead apron.…”

Section: Situations Encountered In Interventional Radiology and Existing Solutionsmentioning

confidence: 99%

Ergonomics in Interventional Radiology: Awareness Is Mandatory

et al. 2021

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“…Radiation protection is essential to minimize occupational exposure to ionizing radiation. The use of shielding materials is one of the main radiation protection measures besides maximizing distance and minimizing exposure time (Lopez et al 2018; Mirowski 2020; Vano et al 2020; Sanchez et al 2021). Personal protective equipment (PPE) consists of personal radiation protective equipment; e.g., lead-equivalent aprons and thyroid shields and in-room radiation protective devices, such as ceiling and table mounted lead screens.…”

Section: Introductionmentioning

confidence: 99%

Multicentric Study on the Relation between Perceived Department Radiation Shielding Policies and Staff Radiation Shielding Conscientiousness

et al. 2023

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Personal protective equipment (PPE), including personal garments as well as in-room devices, is crucial to minimize ionizing radiation exposure during fluoroscopy-guided procedures. However, recent studies have highlighted a lack of knowledge and awareness between and within departments about the use and risks of ionizing radiation and radiation safety. Employees differ in their conscientiousness regarding PPE and perceive the program regarding PPE differently. It has been shown that being conscientious about safety precedes safety behavior and can be triggered through increased perception of the present safety policy. This study explores the relation between employees’ perception of the PPE program and their PPE conscientiousness. Employees from interventional cardiology (IC), interventional radiology (IR), and vascular surgery (VS) were invited to complete anonymously a self-administered online survey assessing the perceived PPE program, their own PPE conscientiousness, and demographics. Associations between PPE program and PPE conscientiousness were investigated using forward stepwise regression on a significance level of 5%. Study variables were standardized. Sixty-one out of the 72 (84.7%) participants answered the survey fully. The PPE program was positively associated with PPE conscientiousness [ =0.32 (CI: 0.02 to 0.51)]. This association was found to be department-dependent (p-value < 0.001). Significant mean differences in PPE conscientiousness were found between IC and IR and between IC and VS, respectively [ =1.25 (CI: 0.69 to 1.82)] and [ =0.63 (CI: 0.06 to 1.20)]. This study is the first to investigate the relation between the perceived PPE program and employees’ PPE conscientiousness. The positive association between PPE program and PPE conscientiousness suggests that employees’ perception of the prevailing PPE program in their department might influence their PPE conscientiousness. Therefore, policy makers are recommended to not only improve their PPE program but also enhance employees’ perception of the reigning PPE program in order to foster their radiation shielding behavior.

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“…Due to both high doses from single procedure and a considerable workload, interventional cardiology practices involve relatively high doses for physicians performing the procedures (Vaño 2003 , 2006 ; Kim and Miller 2009 ; Martin 2009 ; Domienik-Andrzejewska et al 2018 ). For this reason, there is fast technological development of methods and tools helping in reducing doses to the medical staff (Mirowski 2021 ). The latest innovations include lead-free aprons and state of the art shields design to protect the prime operator, such as radiation protective cabin or Zero-Gravity system (ZG).…”

Section: Introductionmentioning

confidence: 99%

Occupational exposure to physicians working with a Zero-Gravity™ protection system in haemodynamic and electrophysiology labs and the assessment of its performance against a standard ceiling suspended shield

Domienik-Andrzejewska

Mirowski

Jastrzębski

et al. 2022

Radiat Environ Biophys

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A two centre clinical study was performed to analyse exposure levels of cardiac physicians performing electrophysiology and haemodynamic procedures with the use of state of the art Zero-Gravity™ radiation protective system (ZG). The effectiveness of ZG was compared against the commonly used ceiling suspended lead shield (CSS) in a haemodynamic lab. The operator’s exposure was assessed using thermoluminescent dosimeters (TLDs) during both ablation (radiofrequency ablation (RFA) and cryoablation (CRYA)) and angiography and angioplasty procedures (CA/PCI). The dosimeters were placed in multiple body regions: near the left eye, on the left side of the neck, waist and chest, on both hands and ankles during each measurement performed with the use of ZG. In total 29 measurements were performed during 105 procedures. To compare the effectiveness of ZG against CSS an extra 80 measurements were performed with the standard lead apron, thyroid collar and ceiling suspended lead shield during CA/PCI procedures. For ZG, the upper values for the average eye lens and whole body doses per procedure were 4 µSv and 16 µSv for the left eye lens in electrophysiology lab (with additionally used CSS) and haemodynamic lab (without CSS), respectively, and about 10 µSv for the remaining body parts (neck, chest and waist) in both labs. The skin doses to hands and ankles non-protected by the ZG were 5 µSv for the most exposed left finger and left ankle in electrophysiology lab, while in haemodynamic lab 150 µSv and 17 µSv, respectively. The ZG performance was 3 times (p < 0.05) and at least 15 times (p < 0.05) higher for the eye lenses and thoracic region, respectively, compared to CSS (with dosimeters on the apron/collar). However, when only ZG was used slightly higher normalised doses were observed for the left finger compared to CSS (5.88e − 2 Sv/Gym2 vs. 4.31 e − 2 Sv/Gym2, p = 0.016). The study results indicate that ZG performance is superior to CSS. It can be simultaneously used with the ceiling suspended lead shield to ensure the protection to the hands as long as this is not obstructive for the work.

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

Cited by 3 publications

References 57 publications

Ergonomics in Interventional Radiology: Awareness Is Mandatory

Ergonomics in Interventional Radiology: Awareness Is Mandatory

Multicentric Study on the Relation between Perceived Department Radiation Shielding Policies and Staff Radiation Shielding Conscientiousness

Occupational exposure to physicians working with a Zero-Gravity™ protection system in haemodynamic and electrophysiology labs and the assessment of its performance against a standard ceiling suspended shield

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