Department of Surgery, Division of Trauma/Critical Care, West Virginia University, Morgantown, West Virginia 26506, USA.
J Trauma Acute Care Surg. 2012 Sep;73(3):605-11. doi: 10.1097/TA.0b013e318265c9fa.
Health care workers' potential exposure to ionizing radiation has increased. Annual radiation exposure limit for the general public per US Nuclear Regulatory Commission is 100 mrem (1 mSv). The whole-body annual occupational radiation exposure limit is 5,000 mrem (50 mSv). Studies have been done to evaluate patient radiation exposure. To date, there has been no study to evaluate the radiation exposure of trauma team members or evaluate their behaviors and attitudes.
Forty primary providers (residents, physician assistants) rotating on the trauma service at an American College of Surgeons Level 1 trauma center participated. Dosimeters were worn by participants, and the radiation doses were measured monthly. A survey detailing the frequency of involvement in radiographic studies, use of protective equipment, and knowledge of education programs was completed monthly.
The range of radiation measured was 1 mrem to 56 mrem, with an average effective dose of 10 mrem per month. Thirty-two (80%) of 40 reported daily exposure to x-rays and 28 (70%) of 40 to computed tomographic scans. Thirty-four (85%) of 40 reported that they never or seldom wore lead apron in trauma bay as opposed to 1 (3%) of 40 who failed to wear it during fluoroscopy. Twenty (50%) reported that an apron was not available, while 20 (50%) reported that it was too hot or did not fit. Thirty-nine (97%) of 40 reported that they received training in radiation safety.
Despite inconsistent use of protective equipment by resident staff, the actual radiation exposure remains low. Hospitals should be sure lead aprons and collars are available. Additional education concerning the availability of programs during pregnancy is needed.
Epidemiologic study, level III.
医疗工作者面临的电离辐射暴露风险增加。美国核管理委员会规定，普通公众每年的辐射暴露限值为 100 毫雷姆（1 毫希沃特）。全身职业性辐射暴露限值为 5000 毫雷姆（50 毫希沃特）。已经有研究评估了患者的辐射暴露情况。迄今为止，还没有研究评估创伤团队成员的辐射暴露情况，也没有评估他们的行为和态度。
在一家美国外科医师学会一级创伤中心，有 40 名初级医护人员（住院医师、医师助理）参与了这项研究。参与者佩戴剂量计，每月测量辐射剂量。每月还完成了一份详细调查，内容包括参与放射学研究的频率、使用防护设备的情况以及对教育项目的了解。
测量的辐射范围为 1 毫雷姆至 56 毫雷姆，平均每月有效剂量为 10 毫雷姆。40 名医护人员中有 32 名（80%）报告每天接触 X 射线，28 名（70%）接触计算机断层扫描。40 名医护人员中有 34 名（85%）报告在创伤区从不或很少穿铅围裙，而 40 名医护人员中有 1 名（3%）在透视时未穿铅围裙。20 名（50%）报告说没有铅围裙，20 名（50%）报告说铅围裙太热或不适合。40 名医护人员中有 39 名（97%）报告接受过辐射安全培训。
尽管住院医师未始终如一地使用防护设备，但实际的辐射暴露仍保持在较低水平。医院应确保铅围裙和颈套的可用性。还需要进一步开展关于在怀孕期间可获得的辐射防护计划的教育。
流行病学研究，III 级。
