Radiation dose reduction among sub-speciality cardiologists and the importance of tibial protection

摘要

Occupational radiation exposure in fluoroscopy-guided procedures is highest among medical staff, particularly cardiologists involved in interventional procedures. The danger of radiation-induced cataracts in operators, and the suggestion of a higher incidence of malignancy among interventional cardiologists, have led to a significant focus on radiation safety in the cardiac catheterisation laboratory. We examined our mean eye and tibia dosimeter reading trends between 1993 and 2011 (among different sub-specialised cardiologists), and the impact of shin tibia lead protectors. During the period 1993 to 2011 there was a steady decline in radiation doses. The dosimeter readings level fell from a peak of 34 to 6.0 mSv per year and 29 to 1.0 mSv per year at the eye and at the tibia, respectively. Interventional and electrophysiology/pacing cardiologists tend to have a trend of higher radiation doses at the tibia level as compared with non-interventional cardiologists. The introduction of shin leg protectors further reduced radiation exposure from a peak of 6.0 mSv per annum in 2008 to <1.0 mSv per annum. Radiation safety awareness and policies have led to a significant fall in operator radiation exposure. The shins, not protected by conventional lead aprons, receive a significant exposure. We have demonstrated that the routine wearing of shin protectors reduces radiation exposure to a minimal level.