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不同介入心脏病学操作中医疗人员职业眼部剂量:所有放射工作人员都需要佩戴铅眼镜吗?

Occupational eye dose to medical staff in various interventional cardiologic procedures: is the need for lead goggles the same in all groups of radiation workers?

机构信息

Industrial Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Department of Medical Physics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

Int J Cardiovasc Imaging. 2020 Aug;36(8):1417-1425. doi: 10.1007/s10554-020-01864-y. Epub 2020 Apr 30.

Abstract

Considering the increased use of interventional cardiologic procedures and concern about irradiation to the eyes, it is necessary to measure eye dose in radiation workers. The assessment of eye dose using collar dose is a routine but inaccurate method. Therefore this study was designed to measure eye dose in the radiation workers of various interventional cardiologic procedures. In this study eye dose was measured for left and right eyes in three groups of radiation workers in angiography ward of Afshar hospital in various procedures using TLD. Measurements were done separately for cardiologists, nurses and radio-technologists in 100 procedures. The nurses functioned as surgical assistants and were usually close to the table. The correlation of staff dose to exposure parameters was also investigated. Eye dose in physicians were higher than other staff in all procedures. Also the left eye dose was considerably higher than right one, especially for physicians. The median equivalent dose per procedure of left eye for physicians, nurses and radio-technologists were 7.4, 3.6, 1.4 µSv (PCI) and 3.2, 3.1, 1.3 µSv (Adhoc) and 3.2, 1.7, 1.1 µSv (CA), respectively. The annual left eye equivalent dose with (without) using lead goggles were 2.4 (15.3), 1.4 (2.2), 1.0 (1.1) mSv for physicians, nurses and radio-technologists, respectively. There were also a positive correlation between eye dose and KAP for procedures without lead goggles. The lead goggles showed lower protection effects for radio-technologists than other staff. Only 30% of physicians received a dose higher than 1/3 of the ICRP annual dose limit, therefor only physician eye dose should be monitored in catheterization labs.

摘要

考虑到介入心脏病学程序的使用增加以及对眼睛照射的关注,有必要测量放射工作人员的眼部剂量。使用领剂量评估眼部剂量是一种常规但不准确的方法。因此,本研究旨在测量各种介入心脏病学程序中放射工作人员的眼部剂量。在这项研究中,使用 TLD 在 Afshar 医院的血管造影病房中对三组放射工作人员的左眼和右眼在各种程序中的眼部剂量进行了测量。在 100 次手术中,分别对心脏病专家、护士和放射技师进行了测量。护士作为手术助手,通常靠近手术台。还研究了工作人员剂量与暴露参数的相关性。在所有程序中,医生的眼部剂量均高于其他工作人员。此外,左眼剂量明显高于右眼,尤其是对于医生。左眼中医、护士和放射技师每例程序的等效剂量中位数分别为 7.4、3.6、1.4µSv(PCI)和 3.2、3.1、1.3µSv(Adhoc)和 3.2、1.7、1.1µSv(CA)。使用(不使用)铅眼镜时,医生、护士和放射技师的左眼年当量剂量分别为 2.4(15.3)、1.4(2.2)、1.0(1.1)mSv。对于没有铅眼镜的程序,眼部剂量与 KAP 之间也存在正相关关系。铅眼镜对放射技师的保护效果低于其他工作人员。只有 30%的医生接受的剂量高于 ICRP 年剂量限值的 1/3,因此仅应在导管室监测医生的眼部剂量。

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