Radiation exposure and fluoroscopically-guided interventional procedures among orthopedic surgeons in South Korea

Abstract

Background The use of fluoroscopically-guided interventional (FGI) procedures by orthopedic surgeons has been increasing. This study aimed to investigate the occupational radiation exposure among orthopedic surgeons in South Korea. Methods A nationwide survey of orthopedic surgeons was conducted in South Korea in October 2017. The dosimetry data of the participants were obtained from the National Dosimetry Registry. The orthopedic surgeons were categorized by job specialty [spine or trauma specialists, other orthopedic specialists, and residents], and descriptive statistics for the demographics and work-related characteristics were presented. Multivariable logistic regression analysis was used to evaluate the risk factors for the orthopedic surgeons who were not linked with the dosimetry data. Results Among the total participants ( n = 513), 40.5% of the orthopedic surgeons spent more than 50% of their time working with the FGI procedures when compared with their overall work. The average frequency of the FGI procedures among the orthopedic surgeons was 12.3 days per month. Less than 30% of the participants were regularly provided with radiation monitoring badges. The proportion of subjects who always wore lead aprons and thyroid shields were 52 and 29%, respectively. The residents group experienced more unfavorable working conditions of radiation exposure than the other specialists. The dosimetry data were not significantly linked among the residents (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.11–3.95) and orthopedic surgeons working at small hospitals (OR 4.76, 95% CI 1.05–21.51). Conclusions Although orthopedic surgeons often performed FGI procedures, they wore protective gear less frequently, and a large proportion of orthopedic surgeons were not monitored by the national radiation dosimetry system. As the number of radiation procedures performed by the orthopedic surgeons increases, more intensive approaches are needed to reduce radiation exposure, especially for spine and trauma surgeons.

Knowledge Regarding Ionizing Radiation Exposure Safety Among Orthopedic Surgeons at Hospitals in Al-Madinah

“…With the advancement in medical technology, the use of imaging modalities that utilize ionizing radiation has increased significantly; this could be attributed to the benefits they offer in terms of rapid and accurate diagnosing methods [2,3,[5][6][7][8][9][10]. However, it is not without its adverse effects on the human body.…”

“…The increased use of imaging techniques in orthopedic surgical operations leads to increased exposure to radiation among orthopedic surgeons, and hence orthopedic surgeons may be classified as a high-risk group for occupational radiation exposure [3,[5][6][7]. Despite being exposed to such radiation on a regular basis, the overall knowledge and awareness about radiation and safety protocols among orthopedic surgeons are lacking [2,7,8].…”

“…Many research papers have shown that there is a link between exposure to ionizing radiation and many forms of cancers such as breast, thyroid, and lung [ 1 , 4 , 8 ], with the thyroid gland being particularly vulnerable to radiation exposure [ 9 ]. The harmful effects of regular exposure to ionizing radiation are not confined to cancerous growths, and cases of infertility, cataract, and skin changes have also been reported [ 2 , 4 , 7 ].…”

Occupational radiation exposure among orthopaedic and a need for heath promotional approach

“…Similar responses of commonly using lead aprons, as a protective measure is reported in almost all other studies found. [3][4][5][6][7] The respondents in our study reported, most common reason for not using protective measures was the feeling of being uncomfortable (70%), followed by not having adequate protective gears in operation theatres (57%). Similar results showing reasons indicated for not using certain radiation protection devices included discomfort and impracticality in a study by Van Papendorp et al 4 In a study by Tuncer et al 41% surgeons complained about only headache, had both headache and fatigue, 36% had no complaints after fluoroscopy use.…”

Underestimation of Radiation Doses by Compliance of Wearing Dosimeters among Fluoroscopically-Guided Interventional Medical Workers in Korea

“…Radiologists have received more training and more knowledge on radiation exposure compared with doctors of other medical specialties in Spain [ 18 ] and the US [ 19 ], and radiologists reported a higher accuracy of radiation doses associated with a standard chest x-ray exposure than non-radiologists in Hong Kong [ 20 ]. However, orthopedic surgeons less frequently wore a dosimeter (29.2%) compared with doctors with other specialties and did not apply the standard rules for radiation safety in South Korea [ 21 ]. Orthopedic surgeons in Ireland (15%) [ 22 ] and worldwide (approximately 25%) [ 23 ], pathologists in Australia (36%) [ 24 ], and urologists in the US (35%) [ 25 ] have lower compliance with badge wearing compared with that reported in our study, therefore, the level of radiation dose underestimation would be higher in these populations than that reported in this study.…”