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Are X-ray Safety Glasses Alone Enough for Adequate Ocular Protection in Complex Radiological Interventions?
Health Physics ( IF 1.0 ) Pub Date : 2021-4-22 , DOI: 10.1097/hp.0000000000001393
Mathias Grau , Osama Eldergash 1 , Sandeep Sunder Amin 1 , Tobias Kowald 1 , Johannes Schnabel 1 , Anika Wißmann 2 , Sebastian Simka 2 , Ajay Chavan 3 , Christian Mathys , Björn Poppe 4 , Bernhard Schmuck 5 , Rohit Philip Thomas 6
Affiliation  

The maximum annual radiation ocular dose limit for medical staff has been reduced to 20 mSv in the current European directive 2013/59/Euratom. This multi-centric study aims at reporting the protected and unprotected eye lens doses in different fluoroscopically guided interventions and to evaluate any other factors that could influence the ocular dose. From July 2018 to July 2019, ocular radiation doses of six interventionists of four departments during complex interventions were recorded with a thermoluminescent dosimeter in front of and behind radiation protection glasses to measure the protected and unprotected doses. The position of personnel, intervention type, fluoroscopy time, total body dose and use of pre-installed protection devices like lead acrylic shields were also systematically recorded. Linear regression analysis was used to estimate the doses at 2 y and 5 y. The annual unprotected/protected ocular doses of six interventionists were 67/21, 32.7/3.3, 27.4/5.1, 7/0, 21.8/2.2, and 0/0 mSv, respectively. The unprotected dose crossed the 20-mSv annual limits for four interventionists and protected dose for one less experienced interventionist. The estimated 5-y protected ocular dose of this interventionist was 101.318 mSv (95%CI 96.066-106.57), also crossing the 5-y limit. The use of a lead acrylic shield was observed to have a significant effect in reducing ocular doses. The annual unprotected and protected ocular doses for interventionists dealing with complex interventions could cross the present permitted yearly limit. The measurement of significant protected ocular dose behind the radiation protection glasses emphasizes the additional indispensable role of pre-installed radiation protection devices and training in reducing radiation doses for complex procedures.

中文翻译:

在复杂的放射干预中,仅使用 X 射线安全眼镜就足以提供足够的眼部保护吗?

在当前的欧洲指令 2013/59/Euratom 中,医务人员的年度最大辐射眼剂量限值已降至 20 毫希沃特。这项多中心研究旨在报告不同荧光镜引导干预措施中受保护和未受保护的眼晶状体剂量,并评估可能影响眼部剂量的任何其他因素。2018年7月至2019年7月,用热释光剂量计在防辐射眼镜前后记录4个科室的6名干预人员在复杂干预过程中的眼部辐射剂量,测量受保护和未受保护的剂量。人员位置、干预类型、透视时间、全身剂量以及预装防护装置(如铅丙烯酸屏蔽)的使用情况也被系统记录。使用线性回归分析来估计 2 年和 5 年的剂量。六名干预人员的年无保护/受保护眼部剂量分别为 67/21、32.7/3.3、27.4/5.1、7/0、21.8/2.2 和 0/0 mSv。四名干预人员的无保护剂量超过了 20 毫西弗的年度限值,而一名经验不足的干预人员的受保护剂量则超过了 20 毫西弗的年度限值。该干预医生估计的 5 年受保护眼部剂量为 101.318 mSv (95%CI 96.066-106.57),也超过了 5 年限值。据观察,使用丙烯酸铅防护罩对于减少眼部剂量具有显着效果。处理复杂干预措施的干预人员的年度无保护和受保护眼部剂量可能会超过目前允许的年度限值。辐射防护眼镜后面的显着受保护眼部剂量的测量强调了预装辐射防护装置和减少复杂手术辐射剂量培训的额外不可或缺的作用。
更新日期:2021-04-24
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