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医务人员在透视引导介入程序中执行或协助操作的职业剂量。

Occupational Doses to Medical Staff Performing or Assisting with Fluoroscopically Guided Interventional Procedures.

机构信息

From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Bethesda, MD 20892-9778 (D.B., C.M.K.); Departments of Radiology and Medicine, Columbia University Medical Center, New York, NY (S.B.); and Independent consultant, Weddington, NC (C.Y.).

出版信息

Radiology. 2020 Feb;294(2):353-359. doi: 10.1148/radiol.2019190018. Epub 2019 Nov 26.

Abstract

Background Staff who perform fluoroscopically guided interventional (FGI) procedures are among the most highly radiation-exposed groups in medicine. However, there are limited data on monthly or annual doses (or dose trends over time) for these workers. Purpose To summarize occupational badge doses (lens dose equivalent and effective dose equivalent values) for medical staff performing or assisting with FGI procedures in 3 recent years after accounting for uninformative values and one- versus two-badge monitoring protocol. Materials and Methods Badge dose entries of medical workers believed to have performed or assisted with FGI procedures were retrospectively collected from the largest dosimetry provider in the United States for 49 991, 81 561, and 125 669 medical staff corresponding to years 2009, 2012, and 2015, respectively. Entries judged to be uninformative of occupational doses to FGI procedures staff were excluded. Monthly and annual occupational doses were described using summary statistics. Results After exclusions, 22.2% (153 033 of 687 912) of the two- and 32.9% (450 173 of 1 366 736) of the one-badge entries were judged to be informative. There were 335 225 and 916 563 of the two- and one-badge entries excluded, respectively, with minimal readings in the above-apron badge. Among the two-badge entries, 123 595 were incomplete and 76 059 had readings indicating incorrect wear of the badges. From 2009 to 2015 there was no change in lens dose equivalent values among workers who wore one badge ( = .96) or those who wore two badges ( = .23). Annual lens dose equivalents for workers wearing one badge (median, 6.9 mSv; interquartile range, 3.8213.8 mSv; = 6218) were similar to those of staff wearing two badges (median, 7.1 mSv; interquartile range, 4.6-11.2 mSv; = 1449) ( = .18), suggesting a similar radiation environment. Conclusion These workers are among the highest exposed to elevated levels of ionizing radiation, although their occupational doses are within U.S. regulatory limits. This is a population that requires consistent and accurate dose monitoring; however, failure to return one or both badges, reversal of badges, and improper badge placement are a major hindrance to this goal. © RSNA, 2019 See also the editorial by Karellas in this issue.

摘要

背景 在医学领域,进行透视引导介入(FGI)程序的工作人员属于职业辐射暴露最高的群体之一。然而,目前关于这些工作人员的每月或每年剂量(或随时间推移的剂量趋势)的数据有限。目的 总结近 3 年来美国最大剂量检测服务机构提供的 39991、81561 和 125669 名从事或协助 FGI 程序的医务人员的职业徽章剂量(晶状体剂量当量和有效剂量当量值),同时考虑不相关值和一至两个徽章监测方案。材料和方法 对美国最大剂量检测服务机构提供的 39991、81561 和 125669 名从事或协助 FGI 程序的医务人员的职业徽章剂量记录进行回顾性收集,这些医务人员分别对应 2009、2012 和 2015 年。排除被认为不能说明 FGI 程序工作人员职业剂量的记录。使用汇总统计数据描述每月和每年的职业剂量。结果 排除不相关记录后,两个徽章记录中有 22.2%(153033 个中有 153033 个)和一个徽章记录中有 32.9%(450173 个中有 450173 个)被认为是有意义的。分别排除了 335225 个和 916563 个两个徽章记录和一个徽章记录,这些记录中在上围裙徽章中有最小读数。在两个徽章记录中,有 123595 个记录不完整,有 76059 个记录表明徽章佩戴不正确。从 2009 年到 2015 年,佩戴一个徽章的工作人员( =.96)或佩戴两个徽章的工作人员( =.23)的晶状体剂量当量值没有变化。佩戴一个徽章的工作人员(中位数,6.9 mSv;四分位间距,3.8213.8 mSv; = 6218)的年晶状体剂量当量与佩戴两个徽章的工作人员(中位数,7.1 mSv;四分位间距,4.6-11.2 mSv; = 1449)相似( =.18),这表明辐射环境相似。结论 这些工作人员是职业辐射暴露最高的人群之一,尽管他们的职业剂量在美 国监管限制范围内。这是一个需要持续、准确剂量监测的人群;然而,未能归还一个或两个徽章、徽章反转和徽章放置不当是实现这一目标的主要障碍。©RSNA,2019 本期杂志还刊登了 Karellas 撰写的社论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f9a/6996708/194eb1079ba5/radiol.2019190018.VA.jpg

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