Department of Orthopaedic Surgery, Alfred Health, Melbourne, Victoria, Australia.
Department of Orthopaedic Surgery, Peninsula Health, Frankston, Victoria, Australia.
ANZ J Surg. 2022 Jan;92(1-2):51-56. doi: 10.1111/ans.17160. Epub 2021 Aug 25.
The widespread adoption of minimally invasive surgery and increased use of intra-operative fluoroscopy places surgeons and trainees at risk of cumulative occupational radiation exposure. Unfortunately, there is limited published data specific to surgeons on the potential health implications. This study aims to review current literature regarding the hazards of cumulative radiation exposure among operating theatre staff.
A systematic review was conducted of four databases for studies reporting on cumulative intra-operative radiation exposure for operating theatre staff and the hazards associated with prolonged and frequent use. References from relevant studies were screened for additional texts. English language studies, controlled trials and cross-sectional studies were included. Abstracts and full-text studies were assessed for relevance and eligibility independently by two authors using Covidence.
Six studies were included, with cancer being the most commonly reported long-term health hazard possibly associated with cumulative radiation exposure. A 1.85 fold greater prevalence of all cancers and 2.9 fold greater prevalence of breast cancer was reported amongst female orthopaedic surgeons compared to a sex- and age-adjusted population, but the results were not replicated amongst other surgical specialties. Multiple limitations of quantifying health risks of intra-operative radiation exposure were identified, including identifying a dose-effect relationship and confounders such as nulliparity and maternal age.
This article highlights the lack of robust evidence regarding the potential hazards of cumulative occupational intra-operative radiation exposure. This study demonstrates the importance of developing standardised national radiation safety protocols for surgical colleges and subspecialties to minimise risks to operating theatre staff.
微创外科的广泛采用和术中透视的增加使外科医生和受训者面临累积职业辐射暴露的风险。不幸的是，关于外科医生潜在健康影响的具体数据有限。本研究旨在回顾目前关于手术室工作人员累积辐射暴露危害的文献。
对四个数据库进行了系统回顾，以检索报告手术室工作人员术中累积辐射暴露情况以及与长时间和频繁使用相关的危害的研究。从相关研究的参考文献中筛选出其他文本。纳入了英语语言研究、对照试验和横断面研究。使用 Covidence 由两位作者独立评估摘要和全文研究的相关性和合格性。
纳入了 6 项研究，癌症是最常报道的与累积辐射暴露相关的长期健康危害。与性别和年龄调整后的人群相比，女性骨科医生的所有癌症患病率高出 1.85 倍，乳腺癌患病率高出 2.9 倍，但在其他外科专业中未复制到这些结果。确定术中辐射暴露健康风险的多个局限性被确定，包括确定剂量-效应关系和混杂因素，如未婚和母亲年龄。
本文强调了缺乏关于累积职业术中辐射暴露潜在危害的可靠证据。本研究表明，为了降低手术室工作人员的风险，有必要为外科医学院和专科制定标准化的国家辐射安全协议。
