Mairs William DA
Christie Medical Physics and Engineering (CMPE), The Christie Hospital NHS Foundation Trust, Manchester, UK.
Br J Radiol. 2016 Jun;89(1062):20150551. doi: 10.1259/bjr.20150551. Epub 2016 Mar 24.
The International Commission on Radiological Protection (ICRP) has recommended a 20 mSv year(-1) dose limit for the lens of the eye, which has been adopted in the European Union Basic Safety Standards. Interventional radiologists (IRs) and interventional cardiologists (ICs) are likely to be affected by this. The effects of radiation in the lens are somewhat uncertain, and the ICRP explicitly recommend optimization. Occupational dose constraints are part of the optimization process and define a level of dose which ought to be achievable in a well-managed practice. This commentary calls on the professional bodies to review a need for national constraints to guide local decisions. Consideration is given to developing such constraints using maximum expected doses in high-workload facilities with good radiation protection practices and application of a factor allowing for attenuation by lead glasses (LG). Doses are based on a Public Health England survey of eye dose in the UK. Maximum expected doses for ICs are approximately 21 mSv year(-1), neglecting LG. However, the extent of IR exposure is not yet fully known, and further evidence is required before conclusions are drawn. A Health and Safety Laboratory review of LG established a conservative dose reduction factor of 3 for models available in 2012. Application of this factor provides a dose constraint of 7 mSv year(-1) to the eye for ICs. To achieve this constraint, those employers with the most exposed ICs will have to provide and ensure the correct use of a ceiling-suspended eye shield and LG.
国际放射防护委员会(ICRP)建议眼睛晶状体的年剂量限值为20毫希沃特(mSv),这一建议已被欧盟基本安全标准所采纳。介入放射科医生(IRs)和介入心脏病科医生(ICs)可能会受到这一规定的影响。辐射对晶状体的影响在一定程度上尚不确定,ICRP明确建议进行优化。职业剂量限制是优化过程的一部分,它定义了在良好管理的实践中应该能够达到的剂量水平。本评论呼吁专业机构审查制定国家限制以指导地方决策的必要性。考虑利用高工作量设施中在具备良好辐射防护措施的情况下的最大预期剂量,并应用一个考虑铅玻璃(LG)衰减作用的系数来制定此类限制。剂量数据基于英国公共卫生部门对英国眼部剂量的一项调查。在不考虑铅玻璃的情况下,介入心脏病科医生的最大预期剂量约为每年21毫希沃特。然而,介入放射科医生的受照剂量情况尚未完全明确,在得出结论之前还需要更多证据。健康与安全实验室对铅玻璃的审查为2012年可用型号确定了一个保守的剂量降低系数3。应用这个系数后,介入心脏病科医生眼部的剂量限制为每年7毫希沃特。为达到这一限制,那些拥有受照剂量最高的介入心脏病科医生的雇主将必须提供并确保正确使用天花板悬挂式眼罩和铅玻璃。