Radiation Safety Is Not a No-Brainer

摘要

In our first days of training as fellows in the cardiac catheterization laboratory, we were taught the fundamentals of radiation safety. Unfortunately, for many of us, this was woefully inadequate in providing an understanding of radiation physics and how to protect ourselves. Many of us came away with the notion we just needed to cover ourselves in lead and remember to wear a badge. Therefore, it should be no surprise that use of the RADPAD No Brainer surgical cap (Worldwide Innovation and Technologies, Overland Park, Kansas) to protect the brain seemed like the right thing to do. The idea that we should shield our heads in some way arose after the reporting of a tragic series of interventional physicians who developed brain cancer (1). Thirty-one cases, including 17 cases of glioblastoma multiforme, were reported in 23 interventional cardiologists, 2 electrophysiologists, and 6 interventional radiologists who had worked for 12 to 32 years. The idea that these cases were from exposure in the laboratory was supported by the finding that 85% of the brain tumors were left-sided, as physicians mostly worked from the right side of the table with their left side facing the patient. It is well known that the material in the RADPAD No Brainer product does effectively attenuate radiation incident upon the skin under the cap. In a study of vascular surgeons by Kirkwood et al. (2), detectors placed outside and inside the cap showed a dose reduction at the left temporal region of 60% for the attending physician and 33% for the fellow.