Pires Robinson Esteves, Reis Igor Guedes Nogueira, de Faria Ângelo Ribeiro Vaz, Giordano Vincenzo, Labronici Pedro José, Belangero William Dias
1Departamento do Aparelho Locomotor, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Santa Efegênia, Belo Horizonte, MG Brazil.
Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rio de Janeiro, RJ Brazil.
Patient Saf Surg. 2020 Apr 22;14:16. doi: 10.1186/s13037-020-00238-6. eCollection 2020.
This study aims to assess orthopaedic surgeon knowledge in Brazil about ionizing radiation and its health implications on surgical teams and patients.
A 15-question survey on theoretical and practical concepts of ionizing radiation was administered during the 23rd Brazilian Orthopaedic Trauma Association annual meeting. The survey addressed issues within orthopedic surgery, such as radiation safety concepts, protection, exposure, as well as the participant gender. Participants were either orthopedic surgeons or orthopedic surgery residents working at institutions in Brazil.
One thousand surveys were distributed at the moment of the meeting registration, and 258 were answered completely (25.8% response rate). Only 5.8% of participants used basic radiation protection equipment; 47.3% used a dosimeter; 2.7% reached the annual maximum permissible radiation dose; 10.5% knew the period of increased risk to fetal gestation; 5.8% knew the maximum permissible radiation dose during pregnancy; 58.5% knew that the hands, eyes, and thyroid are the most exposed areas and at greater risk of radiation-related lesions; 25.2% knew the safe distance from a radiation-emitting tube is 3 m or more; 44.2% knew the safest positioning of the radiation-emitting tube; 25.2% knew that smaller tubes emit greater radiation at the entrance dose to magnify the image; and 55.4% knew that the surgery team receives more scattered radiation in surgical procedures performed on obese patients.
This study revealed inadequate theoretical and practical knowledge about radiation exposure among orthopaedic surgeons in Brazil. Only a minority of orthopaedic surgeons used basic radiation protection equipment. No significant differences in knowledge were found when comparing all orthopedic surgery specialties. Our findings indicate an urgent need for education to increase knowledge among orthopaedic surgeons about the hazards of ionizing radiation. Personal protection and implementation of the ALARA (as low as reasonably achievable) protocol in daily practice are important behaviors to prevent the harmful effects of ionizing radiation.
本研究旨在评估巴西骨科医生关于电离辐射及其对手术团队和患者健康影响的知识水平。
在第23届巴西骨科创伤协会年会上,进行了一项关于电离辐射理论和实践概念的15道题的调查。该调查涉及骨科手术中的问题,如辐射安全概念、防护、暴露以及参与者的性别。参与者为在巴西各机构工作的骨科医生或骨科手术住院医师。
在会议注册时发放了1000份调查问卷,258份被完整回答(回复率为25.8%)。只有5.8%的参与者使用基本的辐射防护设备;47.3%的人使用剂量计;2.7%的人达到了年度最大允许辐射剂量;10.5%的人知道胎儿妊娠期风险增加的时期;5.8%的人知道怀孕期间的最大允许辐射剂量;58.5%的人知道手、眼睛和甲状腺是最易暴露且辐射相关损伤风险更高的部位;25.2%的人知道距辐射发射管的安全距离为3米或更远;44.2%的人知道辐射发射管的最安全位置;25.2%的人知道较小的管子在放大图像的入射剂量时会发射更强的辐射;55.4%的人知道手术团队在对肥胖患者进行的手术过程中会受到更多散射辐射。
本研究揭示了巴西骨科医生在辐射暴露方面理论和实践知识的不足。只有少数骨科医生使用基本的辐射防护设备。在比较所有骨科手术专业时,未发现知识上的显著差异。我们的研究结果表明迫切需要开展教育,以增加骨科医生关于电离辐射危害的知识。在日常实践中进行个人防护和实施“尽可能合理低水平”(ALARA)原则是预防电离辐射有害影响的重要行为。