Vaño E, Gonzalez L, Fernandez J M, Alfonso F, Macaya C
Department of Radiology, Complutense University Medical School 28040 Madrid, Spain.
Br J Radiol. 2006 May;79(941):383-8. doi: 10.1259/bjr/26829723.
This report describes occupational radiation doses of interventional cardiologists over 15 years and assesses action undertaken to optimize radiation protection. Personal dosimetry records of nine staff cardiologists and eight interventional cardiology fellows were recorded using personal dosemeters worn over and under their lead aprons. The hospital in which this study was conducted currently performs 5000 cardiology procedures per year. The hospital has improved its facilities since 1989, when it had two old-fashioned theatres, to include four rooms with more advanced and safer equipment. Intensive radiation protection training was also implemented since 1989. Initially, some individual dose values in the range of 100-300 mSv month(-1), which risked exceeding some regulatory dose limits, were measured over the lead apron. Several doses in the range of 5-11 mSv month(-1) were recorded under the apron (mean = 10.2 mSv year(-1)). During the last 5 years of the study, after the implementation of the radiation protection actions and a programme of patient-dose optimization, the mean dose under the apron was reduced to 1.2 mSv year(-1). Current mean occupational doses recorded under the lead apron are 14% of those recorded during 1989-1992 and those recorded over the apron are 14-fold less than those recorded during 1989-1992. The regulatory dose limits and the threshold for lens injuries might have been exceeded if radiation protection facilities had not been used systematically. The most effective actions involved in reducing the radiation risk were training in radiation protection, a programme of patient-dose reduction and the systematic use of radiation protection facilities, specifically ceiling-suspended protective screens.
本报告描述了介入心脏病专家15年来的职业辐射剂量，并评估了为优化辐射防护所采取的行动。使用佩戴在铅围裙内外的个人剂量计记录了9名心内科 staff 医生和8名介入心脏病学进修医生的个人剂量记录。本研究开展所在的医院目前每年进行5000例心脏病学手术。自1989年以来，该医院已对其设施进行了改善，当时它有两个老式手术室，现在则有四个配备了更先进、更安全设备的房间。自1989年以来还实施了强化辐射防护培训。最初，在铅围裙上方测得一些个体剂量值在100 - 300 mSv·月⁻¹范围内，有超过某些监管剂量限值的风险。在铅围裙下方记录到几个剂量值在5 - 11 mSv·月⁻¹范围内（平均 = 10.2 mSv·年⁻¹）。在研究的最后5年，在实施了辐射防护行动和患者剂量优化计划后，铅围裙下方的平均剂量降至1.2 mSv·年⁻¹。目前在铅围裙下方记录的平均职业剂量是1989 - 1992年期间记录值的14%，而在铅围裙上方记录的值比1989 - 1992年期间记录的值少14倍。如果没有系统地使用辐射防护设施，监管剂量限值和晶状体损伤阈值可能已被超过。降低辐射风险最有效的行动包括辐射防护培训、患者剂量降低计划以及系统使用辐射防护设施，特别是天花板悬挂式防护屏。
