Practical radiation safety and protection for the endoscopist during ERCP

Campbell, Nicole; Sparrow, Keith; Fortier, Marielle V.; Ponich, Terry

doi:10.1067/mge.2002.122578

Cited by 72 publications

(82 citation statements)

References 19 publications

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“…Therefore, it is more effective to wear wrapping-type aprons rather than frontal cover types. 9 Our survey results show that, although all practitioners wore lead aprons, the majority wore frontal cover types. Additionally, lead aprons should be kept on dedicated hangers to prevent damage or loss, because creases and puckers on the lead apron can result in cracks where scattering waves can penetrate.…”

Section: Discussionmentioning

confidence: 78%

Lack of Radiation Protection for Endoscopists Performing Endoscopic Retrograde Cholangiopancreatography

Son

Lee

Kim

et al. 2011

Korean J Gastroenterol

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Background/Aims: ERCP using fluoroscopy should be practiced with an adequate radiation protection. However, the awareness of gastrointestinal endoscopists to radiation protection was considered insufficient. In Korea, a country with a rapid increase the number of ERCP procedures, there is no data about radiation protection practices for gastrointestinal endoscopists. The purpose of this study was to investigate current clinical practices and the awareness on radiation protection in ERCP performing physicians in Korea. Methods: An anonymous questionnaire regarding radiation protection practices was mailed to 100 members of Korean Pancreatobiliary Association who was porforming ERCP. The questionnaire included ERCP volume of each endoscopist, use of protection devices such as apron, thyroid shield, lead glasses and any mobile shield for scattered radiation, and whether they monitored their own radiation exposure dosage. Results: All respondents wore lead aprons during ERCP. While 52.5% of endoscopists answered that they always wear thyroid guards, 26.9% rarely or never wore it. Only 14% wore lead glasses during the procedure and 69% never wore it. The preparation rates of mobile shields or lead curtains were only 14% and 24%, respectively. Only 10% of endoscopists attached an X-ray badge and 66.7% never used it. Moreover, 75% of endoscopists responded that they did not monitor their own exposure dose to radiation during ERCP. Conclusions: The lack of radiation protection of ERCP endoscopists in Korea was seemed serious. Awareness of radiation hazard should be more concerned and educated in parallel with the preparation of radiation protection equipments. (Korean J Gastroenterol 2011;58:93-99)

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Section: Discussionmentioning

confidence: 78%

Lack of Radiation Protection for Endoscopists Performing Endoscopic Retrograde Cholangiopancreatography

Son

Lee

Kim

et al. 2011

Korean J Gastroenterol

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“…Radiation exposure of patients and staff during an ERCP procedure is determined by factors related to the fluoroscope itself, which are not under the endoscopist's control, and fluoroscope-unrelated factors, which are more readily modifiable. One of these modifiable factors is fluoroscopy time, which has been shown in several studies to be strongly correlated with radiation exposure [3,10,12,[23][24][25][26]. As expected, a longer fluoroscopy time increases radiation exposure in patients and staff alike.…”

Section: Introductionmentioning

confidence: 64%

“…The absence of a lower dose limit for interpreting the stochastic effects of radiation prompted the ICRP to come up with the ALARA concept, the main components of which included distance, shielding, and time to help keep radiation exposure as low as reasonably achievable, taking into account economic and social considerations [3,5,6]. In our study, the importance of distance and shielding is vindicated by the results obtained for the assistant localization.…”

Section: Discussionmentioning

confidence: 82%

“…Several studies have reported a strong correlation between fluoroscopy time and degree of radiation exposure [3,10,12,[23][24][25]. The difficulties and challenges posed by direct dose measurements have seen recent studies use fluoroscopy time as an indicator of radiation exposure [23,27,28].…”

Section: Discussionmentioning

confidence: 99%

“…Like other fluoroscopic procedures, ERCP puts both patients and staff at risk for radiation exposure [3,4]. Ionizing radiation incurs many negative effects on the human body.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Endoscopic Retrograde Cholangiopancreatography Education on Radiation Exposure to Experienced Endoscopist: “Trainee Effect”

et al. 2012

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Background Endoscopic retrograde cholangiopancreatography (ERCP), as with other fluoroscopic procedures, carries the risk of exposure of staff to radiation. However, over the last two decades, only a few studies have investigated this risk. Objective The aim of this work was to evaluate the dose of radiation exposure to staff participating in ERCP procedures in a busy teaching hospital that performs more than 1,850 procedures annually. Methods The entire ERCP staff consisted of the experienced endoscopist, the assistant, and two nurses who were responsible for monitoring patients as well as keeping their heads in position during the procedure. RAD DOSE NEB.226 dosimeters, which were provided by the Turkish Atomic Energy Authority, were used for this study. Results Data on 110 consecutive therapeutic ERCP procedures was recorded. The mean fluoroscopy time was 5.65 ± 4.71 min. The mean fluoroscopy time of the 61 procedures performed by an experienced endoscopist alone was 5.41 ± 4.65 min, whereas the mean fluoroscopy time for the 49 procedures during which an assistant was involved was 5.94 ± 4.81 min (p = 0.56). In terms of median dose of ionizing radiation exposure to the eyes, the dose measurement per procedure in which the primary endoscopist participated alone was 72 microsievert (lSv), compared to 92 lSv when an assistant took part in the proceedings. Considering that the recommended annual equivalent dose limit to the lens of the eye is 150 mSv, by performing 1,850 procedures annually, the primary endoscopist exceeds this limit. Conclusions Based on our results, taking into consideration the heavy workload in our hospital, it would seem that more experienced endoscopists are required to help provide training in ERCP, and that the use of lead acrylic goggles is required to decrease radiation exposure to the eyes.

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ERCP: Risks, Prevention, and Management

Cotton¹

2005

Advanced Digestive Endoscopy: ERCP

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Practical radiation safety and protection for the endoscopist during ERCP

Cited by 72 publications

References 19 publications

Lack of Radiation Protection for Endoscopists Performing Endoscopic Retrograde Cholangiopancreatography

Lack of Radiation Protection for Endoscopists Performing Endoscopic Retrograde Cholangiopancreatography

The Impact of Endoscopic Retrograde Cholangiopancreatography Education on Radiation Exposure to Experienced Endoscopist: “Trainee Effect”

ERCP: Risks, Prevention, and Management

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