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International Journal of Environmental... Dec 2021(1) Background: Health professionals' knowledge, beliefs and perceptions concerning radiation protection may affect their behaviour during surgery and consequently...
(1) Background: Health professionals' knowledge, beliefs and perceptions concerning radiation protection may affect their behaviour during surgery and consequently influence the quality of health services. This study highlights the health professionals' average knowledge level and captures the beliefs, perceptions, and behaviours in a large public Greek hospital. (2) Materials and Methods: A cross-sectional study was carried out, including health professionals working in operating rooms. One hundred thirty-two staff members participated by responding to an original questionnaire. The sample consisted of nurses, radiographers and medical doctors of various specialties involved daily in surgical procedures where ionizing radiation is required. The survey was conducted from March to June 2021, and the response rate was 97%. (3) Results: The level of overall knowledge of health professionals regarding radiation protection safety was not satisfactory. Females and employees with a lower level of education had more misconceptions about radiation and radiation protection. Employees of younger ages and with less previous experience were more likely to have negative emotions towards radiation exposure. Finally, employees with fewer children tended to express physical complaints caused by their negative emotions due to radiation exposure. (4) Conclusions: Health professionals' lack of basic and specialized knowledge concerning radiation protection safety had a negative impact on the provision of health services. The continuing training of the staff seemed to be the only solution to reverse this trend. The training should highlight how radiation exposure can be minimized, safeguarding health professionals' trust and sense of security by significantly improving their working environment.
Topics: Attitude of Health Personnel; Child; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Health Personnel; Humans; Radiation Exposure; Radiation Protection
PubMed: 34948989
DOI: 10.3390/ijerph182413380 -
Health Physics Sep 2021Two major sets of exposure limits for radiofrequency (RF) radiation, those of the International Commission on Nonionizing Radiation Protection (ICNIRP 2020) and the... (Review)
Review
Two major sets of exposure limits for radiofrequency (RF) radiation, those of the International Commission on Nonionizing Radiation Protection (ICNIRP 2020) and the Institute of Electrical and Electronics Engineers (IEEE C95.1-2019), have recently been revised and updated with significant changes in limits above 6 GHz through the millimeter wave (mm-wave) band (30-300 GHz). This review compares available data on thermal damage and pain from exposure to RF energy above 6 GHz with corresponding data from infrared energy and other heat sources and estimates safety factors that are incorporated in the IEEE and ICNIRP RF exposure limits. The benchmarks for damage are the same as used in ICNIRP IR limits: minimal epithelial damage to cornea and first-degree burn (erythema in skin observable within 48 h after exposure). The data suggest that limiting thermal hazard to skin is cutaneous pain for exposure durations less than ≈20 min and thermal damage for longer exposures. Limitations on available data and thermal models are noted. However, data on RF and IR thermal damage and pain thresholds show that exposures far above current ICNIRP and IEEE limits would be required to produce thermally hazardous effects. This review focuses exclusively on thermal hazards from RF exposures above 6 GHz to skin and the cornea, which are the most exposed tissues in the considered frequency range.
Topics: Cornea; Radiation Protection; Radio Waves; Temperature
PubMed: 34261892
DOI: 10.1097/HP.0000000000001447 -
The British Journal of Radiology Sep 2021Orthopaedic surgeons have a responsibility to minimise risks of ionising radiation to patients, themselves and staff. This study aims to establish the understanding of...
OBJECTIVES
Orthopaedic surgeons have a responsibility to minimise risks of ionising radiation to patients, themselves and staff. This study aims to establish the understanding of radiation practice, legislation and risk by orthopaedic surgeons.
METHODS
A nationwide online survey of UK-based orthopaedic surgeons was conducted. Participants answered 18 multiple-choice questions assessing level of radiation safety training, basic principles/knowledge of ionising radiation, relevant legislation and operating practice.
RESULTS
A total of 406 surgeons completed the survey. 92% reported using intraoperative ionising radiation at least once per week. 38% received no formal training on radiation safety. Knowledge of basic principles of radiation and legislation was limited. There was variable knowledge when labelling an image intensifier machine and choosing its safest orientation. Poor uptake of radiation protection equipment was noted. Only 19% agreed they had adequate training in ionising radiation safety and 27% reported receiving adequate training in equipment emitting ionising radiation in the operating theatre.
CONCLUSION
Many orthopaedic surgeons in the UK do not believe they are adequately trained in radiation safety. There is a deficiency amongst practicing surgeons in basic knowledge, relevant legislation and practicalities of the use of ionising radiation in the operating room. This could potentially put patients and health-care professionals at additional risk. We recommend that a standardised national training programme on the basic principles and safety of ionising radiation is implemented for all practicing orthopaedic surgeons.
ADVANCES IN KNOWLEDGE
This paper is the first UK national survey amongst orthopaedic surgeons and is one of the largest reported internationally.
Topics: Attitude of Health Personnel; Clinical Competence; Health Care Surveys; Humans; Orthopedic Procedures; Orthopedic Surgeons; Radiation Protection; Radiation, Ionizing; United Kingdom
PubMed: 34235964
DOI: 10.1259/bjr.20210736 -
Cardiovascular and Interventional... Aug 2020Over recent years, an increasing number of fluoroscopically guided interventions (FGIs) have been performed by radiologists and non-radiologists. Also, the number of... (Review)
Review
Over recent years, an increasing number of fluoroscopically guided interventions (FGIs) have been performed by radiologists and non-radiologists. Also, the number of complex interventional procedures has increased. In the late nineties, first reports of skin injuries appeared in the literature. The medical community responded through increased awareness for radiation protection and public authorities by recommendations and legislation, for example, the European Basic Safety Standards (EU-BSS) which were published in 2014, or the international Basic Safety Standards (BSS). Implementation of the EU-BSS requires concerted action from interventionalists, radiographers, medical physics experts and competent national authorities. Interventionalists should play an important role in this project since implementation of the EU-BSS will affect their daily practice. This paper discusses some important issues of the EU-BSS such as unintended and accidental radiation exposures of patients, the meaning of significant dose events and how to deal with patients who were exposed to a substantial radiation dose with the risk of tissue injuries. In addition, this paper provides practical advice on how to implement alert and trigger levels in daily practice of FGIs in order to increase patient safety.
Topics: Humans; Patient Safety; Radiation Dosage; Radiation Exposure; Radiation Injuries; Radiation Protection; Radiology, Interventional
PubMed: 32435834
DOI: 10.1007/s00270-020-02517-2 -
Eye (London, England) Feb 2016Cataract surgery was revolutionised by the introduction of modern intraocular lenses in the late 1940's. By the late 1960's to 1970's evidence had emerged that... (Review)
Review
Cataract surgery was revolutionised by the introduction of modern intraocular lenses in the late 1940's. By the late 1960's to 1970's evidence had emerged that short-wavelength light caused phototoxicity at the retina and retinal pigment epithelium. By the early 1980's ultraviolet filters had been incorporated into intraocular lenses. This caused intense controversy, as there was concern that the UV-filtering chromophore might leach out into the eye causing toxicity. With the arrival of blue-filtering intraocular lenses (BFIOLs) in 1990's, a further debate was ignited as to their safety and potential disadvantages. Selecting the optimal performing intraocular lens to obtain the best visual performance with the fewest potential drawbacks has become complex and challenging for cataract surgeons and their patients with the wide choice of lenses available. Choosing a personalised lens to address astigmatism, presbyopia, spherical aberration, chromatic aberration, and potentially to shield the retina from short-wavelength light is now possible. The potential benefits and possible side effects of these different innovations emphasise the importance of assessing the evidence for their clinical utility, allowing the surgeon and the patient to weigh-up the risk benefit ratio and make an informed decision. The BFIOLs were developed to reduce cyanopsia, address chromatic aberration, and improve contrast sensitivity in different lighting conditions, as well as to prevent short-wavelength light reaching the retina thus potentially reducing the risk of developing age-related macular degeneration. Further design development of the BFIOLs was to mimic the natural crystalline lens absorption and transmittance properties in adulthood. Multiple publications have reported on the potential benefits and pitfalls of implanting a blue-filtering lens. The potential disadvantages raised in the literature over the last 25 years since their introduction, regarding compromise of visual function and disruption of the circadian system, have been largely dispelled. The clear benefits of protecting the retina from short-wavelength light make a BFIOLs a sensible choice. The purpose of this article presented at the Cambridge symposium 2015 is to review the literature on this subject.
Topics: Cataract Extraction; Coated Materials, Biocompatible; Filtration; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Prosthesis Design; Radiation Injuries; Radiation Protection; Ultraviolet Rays; Vision Disorders
PubMed: 26742866
DOI: 10.1038/eye.2015.267 -
JACC. Cardiovascular Interventions Jan 2018
Topics: Cardiac Catheterization; Radiation Exposure; Radiation Protection
PubMed: 29102577
DOI: 10.1016/j.jcin.2017.08.012 -
Dento Maxillo Facial Radiology Feb 2018To investigate dentists' perceptions and attitudes regarding radiation safety in dental practices in Korea.
OBJECTIVES
To investigate dentists' perceptions and attitudes regarding radiation safety in dental practices in Korea.
METHODS
207 dentists participated in this study. An anonymous survey was conducted regarding the following areas: years of practice, characteristics of the radiography equipment, knowledge of diagnostic reference levels, prescription of dental radiographs, use of radiation protection procedures and participation in the radiation safety program. Data were evaluated according to frequency distribution; the χ test; and Fisher's exact test, which was used to investigate statistical significances (p < 0.05) between those with less than 10 years of experience in practice vs those with 10 years of experience or more.
RESULTS
Approximately 83% of the dentists who responded to our survey participated in the radiation safety program, but only 58% were satisfied with it. There were statistically significant differences in the installation of X-ray units, learning pathway of diagnostic reference levels, prescription of dental radiography for new adult patients, use of personnel radiation monitoring systems and participation in the radiation safety program between those with less than 10 years of experience in practice vs those with 10 years of experience or more (p < 0.05).
CONCLUSIONS
Dentists with less than 10 years of experience were less attentive to radiation protection procedures. Therefore, taking both the duration of experience of dentists and the installed X-ray equipment into consideration, continuous and efficient education for both dental workers and patients regarding radiation safety and protection is recommended.
Topics: Attitude of Health Personnel; Attitude to Health; Dentistry; Humans; Occupational Health; Radiation Protection; Radiography, Dental; Republic of Korea; Self Report
PubMed: 29236521
DOI: 10.1259/dmfr.20170228 -
The British Journal of Radiology Aug 2021To evaluate knowledge, routine use and concerns of trainee cardiologists in the Republic of Ireland regarding radiation use in the cardiac catheterization laboratory.
OBJECTIVE
To evaluate knowledge, routine use and concerns of trainee cardiologists in the Republic of Ireland regarding radiation use in the cardiac catheterization laboratory.
METHODS
We handed out a Radiation Questionnaire to cardiology trainees in February 2020 at the Irish Cardiac Society "Spring Meeting". The questionnaire assessed radiation protection use amongst trainees and tested knowledge of X-ray basics.
RESULTS
Many trainees report inadequate access to properly sized lead protection, and infrequent dosimeter usage. Over one-third of trainees report musculoskeletal issues from wearing leads, the majority of whom use correct size lead <60% of the time.33.3% report radiation concerns will affect their decision making regarding subspeciality training, but notably 83.3% of females and only 19% of males surveyed report this, showing this is a bigger issue for females in cardiology. Less than half of trainees feel adequately educated about radiation.
CONCLUSION
Our assessment show deficiencies in the provision and use of personal protective equipment to trainees, highlights extra radiation concerns of female cardiology trainees, and notes gaps in knowledge in radiation use.
ADVANCES IN KNOWLEDGE
Our assessment highlights deficiencies in the education of cardiology trainees regarding ionizing radiation, and suggests this area needs to be improved upon.
Topics: Adult; Cardiac Imaging Techniques; Cardiology; Clinical Competence; Female; Humans; Ireland; Male; Procedures and Techniques Utilization; Radiation Protection; Self Report; Young Adult
PubMed: 33989036
DOI: 10.1259/bjr.20201348 -
Hand (New York, N.Y.) Jul 2021Previous studies have highlighted the particular risk of radiation exposure to the surgeon's hands with intraoperative fluoroscopy. Although evidence exists that...
Previous studies have highlighted the particular risk of radiation exposure to the surgeon's hands with intraoperative fluoroscopy. Although evidence exists that shielding equipment for the hands reduces exposure, the extent of protection is not well understood. Therefore, we set out to determine the degree to which radiation exposure to the surgeon's hands is decreased with hand-shielding products. An anthropomorphic model was positioned to simulate a surgeon sitting at a hand table. Thermoluminescent dosimeters were placed on the proximal phalanx of each index finger. The right index finger dosimeter was covered with a standard polyisoprene surgical glove (control arm), whereas the left index finger dosimeter was covered with commercially available hand-shielding products (study arm): lead-free metal-oxide gloves, leaded gloves, and radiation-attenuating cream. Mini fluoroscope position, configuration, and settings were standardized. The model was scanned for 15 continuous minutes in each test run, and each comparative arm was run 3 times. The mean radiation dose absorbed by the control and variable dosimeters across all tests was 44.8 mrem (range, 30-54) and 18.6 mrem (range, 14-26), respectively. Each hand-shielding product resulted in statistically lower radiation exposure than a single polyisoprene surgical glove. The mean radiation exposure to the hands was significantly decreased when protected by radiation-attenuating options. Each product individually resulted in a statistically significant decrease in hand exposure compared with the control. We recommend that in addition to efforts to decrease radiation exposure, surgeons consider routine use of hand-shielding products when using mini c-arm fluoroscopy.
Topics: Fluoroscopy; Hand; Humans; Occupational Exposure; Radiation Dosage; Radiation Protection
PubMed: 31402748
DOI: 10.1177/1558944719865937 -
Sensors (Basel, Switzerland) Jan 2023In 2011, the International Commission on Radiological Protection (ICRP) recommended a significant reduction in the lens-equivalent radiation dose limit, thus from an...
In 2011, the International Commission on Radiological Protection (ICRP) recommended a significant reduction in the lens-equivalent radiation dose limit, thus from an average of 150 to 20 mSv/year over 5 years. In recent years, the occupational dose has been rising with the increased sophistication of interventional radiology (IVR); management of IVR staff radiation doses has become more important, making real-time radiation monitoring of such staff desirable. Recently, the i3 real-time occupational exposure monitoring system (based on RaySafeTM) has replaced the conventional i2 system. Here, we compared the i2 and i3 systems in terms of sensitivity (batch uniformity), tube-voltage dependency, dose linearity, dose-rate dependency, and angle dependency. The sensitivity difference (batch uniformity) was approximately 5%, and the tube-voltage dependency was <±20% between 50 and 110 kV. Dose linearity was good (R2 = 1.00); a slight dose-rate dependency (~20%) was evident at very high dose rates (250 mGy/h). The i3 dosimeter showed better performance for the lower radiation detection limit compared with the i2 system. The horizontal and vertical angle dependencies of i3 were superior to those of i2. Thus, i3 sensitivity was higher over a wider angle range compared with i2, aiding the measurement of scattered radiation. Unlike the i2 sensor, the influence of backscattered radiation (i.e., radiation from an angle of 180°) was negligible. Therefore, the i3 system may be more appropriate in areas affected by backscatter. In the future, i3 will facilitate real-time dosimetry and dose management during IVR and other applications.
Topics: Humans; Radiation Dosage; Radiology, Interventional; Radiation Dosimeters; Radiometry; Radiation Protection
PubMed: 36617110
DOI: 10.3390/s23010512