Society of Interventional Radiology: Occupational Back and Neck Pain and the Interventional Radiologist

Dixon, Robert G.; Khiatani, Vishal; Statler, John D.; Walser, Eric; Midia, Mehran; Miller, Donald L.; Bartal, Gabriel; Collins, Jeremy D.; Gross, Kathleen A.; Stecker, Michael S.; Nikolic, Boris

doi:10.1016/j.jvir.2016.10.017

Cited by 52 publications

(44 citation statements)

References 63 publications

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“…The long-term use of heavy radiation-protective garments is associated with musculoskeletal problems and fatigue in interventional physicians [ 37 38 ]. Surveys of interventional cardiologists and radiologists indicate evidence of a relationship between the use of lead aprons and spine problems [ 39 40 ]. A standard lead apron weighs approximately 7 kg, which could cause the development of back problems [ 41 ].…”

Section: Main Bodymentioning

confidence: 99%

Radiation safety: a focus on lead aprons and thyroid shields in interventional pain management

Cheon

Kim

et al. 2018

Korean J Pain

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C-arm fluoroscopy is useful equipment in interventional pain management because it helps to guide correct needle targeting for the accurate injection and drug delivery. However, due to increased use of C-arm fluoroscopy in various pain procedures, the risk of radiation exposure is a significant concern for pain physicians. The harmful biological effects of ionizing radiation on the human body are well known. It is therefore necessary to strive to reduce radiation exposure. Lead aprons with thyroid shields are the most fundamental radiation protective devices for interventional procedures, and are very effective. However, the operator's radiation safety cannot be guaranteed because pain physicians seem to lack sufficient interest, knowledge, and awareness about radiation safety. Also, inappropriate care and use of radiation protective devices may result in a higher risk of radiation exposure. The purpose of this article was to review the literature on radiation safety with a focus on lead aprons and thyroid shields and present recommendations related to those devices during C-arm fluoroscopic-guided interventions by pain physicians.

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Section: Main Bodymentioning

confidence: 99%

Radiation safety: a focus on lead aprons and thyroid shields in interventional pain management

Cheon

Kim

et al. 2018

Korean J Pain

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“…Many studies included in this review suggested that overuse of anti-X aprons is associated with possible occupational health risks, especially with a high prevalence of musculoskeletal problems (particularly those related to the spine). They also suggested that the use of aprons is not the only cause: The combination of axial load (i.e., prolonged standing or sitting in non-ergonomic positions while carrying the load), awkward or poor posture (as necessitated by leaning or bending to accomplish procedures), and repetitive injury accumulated over years of practice could participate in the onset of MSDs [ 2 , 6 ]. These contributing factors for back and neck injuries may be aggravated by age-related changes in the muscles, vertebrae, and intervertebral discs, as well as by common pre-existing causes of mechanical neck and back pain.…”

Section: Discussionmentioning

confidence: 99%

“…Historically, radiation-shielding materials have been made of lead due to its great attenuating qualities. The radiation protection of garments is indicated by lead equivalence, with 0.5 mm lead aprons considered the standard, which attenuates more than 95% of incident radiation [ 1 , 2 ]. A lighter, thinner, lead-equivalent garment made of materials differing from lead may provide adequate protection, as a 0.3 mm lead-equivalent apron will result in only a modest increase in the effective dose (7–15%) compared with a 0.5 mm lead-equivalent garment.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, other materials such as barium, bismuth, and antimony are used, which are available in mixtures with low lead content or as lead-free. More significant lead equivalence increases protection but does so at the cost of increased weight [ 2 ]. Recent innovations have aimed at methods for decreasing the weight burden, considering the related skeleton injuries associated with load-bearing procedures.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, an essential aspect is to guarantee an appropriate balance between comfort and protection in order to reduce the strain without compromising safety [ 1 ]; however, this aspect is not always achievable. Generally, lead aprons do not attain the dual goals of excellent radiation protection and musculoskeletal preservation and, when made lighter to help aching spines, fall below acceptable protection standards [ 2 ]. Lightweight aprons may be satisfactory for some ancillary personnel who frequently stay behind a barrier or wall, but not for first operators [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Anti-X Apron Wearing and Musculoskeletal Problems Among Healthcare Workers: A Systematic Scoping Review

Monaco

Carta

Tamhid

et al. 2020

IJERPH

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Interventional radiology activities and other medical practices using ionising radiation have become increasingly prevalent. In this context, the use of anti-X aprons, in association with awkward postures and non-ergonomic working conditions, might cause the onset of musculoskeletal disorders (MSDs). This research aims to evaluate the evidence about the correlation between wearing anti-X aprons and work-related MSDs. A systematic scoping review of articles published between 1990 and 2020 was conducted by searching the PubMed, Scopus, Embase, and Web of Science databases. Twelve cross-sectional studies, conducted among interventional physicians, nurses, and technicians, were finally included. Five studies primarily investigated the association between use of anti-X aprons and MSDs, showing that a higher prevalence of disorders was not always associated with the use of protective aprons. No studies investigated the impact of anti-X aprons on fitness for work assessment, particularly in subjects with MSDs. There is no complete agreement about the correlation between anti-X apron-wearing and the occurrence of MSDs, although the possible discomfort of workers using anti-X aprons appears more evident. Further studies are needed to objectify the role of these protective devices in the genesis of MSDs and to offer specific ergonomic solutions for healthcare workers.

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Performance of elastic x‐ray shield made by embedding Bi₂O₃ particles in porous polyurethane

Maeda,

Hayashi,

Ando

et al. 2023

Medical Physics

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BackgroundMany healthcare institutions have guidelines concerning the usage of protective procedures, and various x‐ray shields have been used to reduce unwanted radiation exposure to medical staff and patients when using x‐rays. Most x‐ray shields are in the form of sheets and lack elasticity, which limits their effectiveness in shielding areas with movement, such as the thyroid. To overcome this limitation, we have developed an innovative elastic x‐ray shield.PurposeThe purpose of this study is to explain the methodology for developing and evaluating a novel elastic x‐ray shield with sufficient x‐ray shielding ability. Furthermore, valuable knowledge and evaluation indices are derived to assess our shield's performance.MethodsOur x‐ray shield was developed through a process of embedding Bi2O3 particles into porous polyurethane. Porous polyurethane with a thickness of 10 mm was dipped into a solution of water, metal particles, and chemical agents. Then, it was air‐dried to fix the metal particles in the porous polyurethane. Thirteen investigational x‐ray shields were fabricated, in which Bi2O3 particles at various mass thicknesses (ranging from 585 to 2493 g/m2) were embedded. To determine the performance of the shielding material, three criteria were evaluated: (1) Dose Reduction Factor (), measured using inverse broad beam geometry; (2) uniformity, evaluated from the standard deviation () of the x‐ray image obtained using a clinical x‐ray imaging detector; and (3) elasticity, evaluated by a compression test.ResultsThe elastic shield with small pores, containing 1200 g/m2 of the metal element (Bi), exhibited a well‐balanced performance. The was approximately 80% for 70 kV diagnostic x‐rays. This shield's elasticity was −0.62 N/mm, a loss of only 30% when compared to porous polyurethane without metal. Although the non‐uniformity of the x‐ray shield leads to poor shielding ability, it was found that the decrease in the shielding ability can be limited to a maximum of 6% when the shield is manufactured so that the of the x‐ray image of the shield is less than 10%.ConclusionsIt was verified that an elastic x‐ray shield that offers an appropriate reduction in radiation exposure can be produced by embedding Bi2O3 particles into porous polyurethane. Our findings can lead to the development of novel x‐ray shielding products that can reduce the physical and mental stress on users.

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Society of Interventional Radiology: Occupational Back and Neck Pain and the Interventional Radiologist

Cited by 52 publications

References 63 publications

Radiation safety: a focus on lead aprons and thyroid shields in interventional pain management

Radiation safety: a focus on lead aprons and thyroid shields in interventional pain management

Anti-X Apron Wearing and Musculoskeletal Problems Among Healthcare Workers: A Systematic Scoping Review

Performance of elastic x‐ray shield made by embedding Bi₂O₃ particles in porous polyurethane

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Society of Interventional Radiology: Occupational Back and Neck Pain and the Interventional Radiologist

Cited by 52 publications

References 63 publications

Radiation safety: a focus on lead aprons and thyroid shields in interventional pain management

Radiation safety: a focus on lead aprons and thyroid shields in interventional pain management

Anti-X Apron Wearing and Musculoskeletal Problems Among Healthcare Workers: A Systematic Scoping Review

Performance of elastic x‐ray shield made by embedding Bi2O3 particles in porous polyurethane

Contact Info

Product

Resources

About

Performance of elastic x‐ray shield made by embedding Bi₂O₃ particles in porous polyurethane