Medical University of Lodz, Łódź, Poland (Department of Interventional Cardiology and Cardiac Arrythmias).
Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Radiation Protection).
Int J Occup Med Environ Health. 2022 Oct 3;35(5):549-560. doi: 10.13075/ijomeh.1896.01958. Epub 2022 Mar 29.
The study aim was to analyse the influence of the lead free cap on doses received by interventional cardiologists. The impact of lead free cap on doses to the head were evaluated in number of studies. As different methods used to assess the attenuation properties of protective cap can lead to ambiguous results, a detailed study was performed.
The effectiveness of a lead free cap in reducing the doses to the skin was assessed in clinic by performing measurements with thermoluminescent dosimeters attached inside and outside the cap first during individual coronary angiography (CA) or CA/percutaneous transluminal coronary angioplasty (CA/PTCA) procedures and then cumulated during few procedures of the same type. In order to investigate the effect of the cap on reducing the doses to the brain additional measurements were performed with a male Alderson Rando and polymethyl methacrylate (PMMA) phantoms representing the physician and the patient, respectively for different projections. The brain dose per procedure, annual and cumulated during entire working practice were estimated for both cases working with and without the cap.
The dose reduction factor (RF) for the skin (the quotient of doses outside and inside the cap) vary from 1.1 up to 4.0 in clinical conditions; on average 2.3-fold reduction is observed in the most exposed left temple. The RFs determined for the part of the head covered by the cap range from 1.4 to 1.8 while for the brain from 1.0 to 1.1 depending on the projection. The estimated annual brain dose for interventional cardiologist performing yearly 550 CA/PTCA procedures without any protective shields is 7.2 mGy and it is reduced with the lead free cap by an average factor of 1.1.
The study results proved the considerable effectiveness of lead free cap to protect the skin but very limited to protect the brain. Int J Occup Med Environ Health. 2022;35(5):549-60.
本研究旨在分析无铅帽对介入心脏病学家所受剂量的影响。已有多项研究评估了无铅帽对头部剂量的影响。由于评估防护帽衰减特性所使用的方法可能导致结果不明确,因此我们进行了详细的研究。
通过在个体冠状动脉造影(CA)或 CA/经皮腔内冠状动脉成形术(CA/PTCA)过程中,首先在帽内和帽外使用热释光剂量计进行测量,然后在同一类型的若干程序中累积测量,在临床环境中评估无铅帽对降低皮肤剂量的有效性。为了研究帽子对降低大脑剂量的影响,我们还使用代表医生和患者的男性 Alderson Rando 和聚甲基丙烯酸甲酯(PMMA)体模,针对不同的投影进行了额外的测量。对于两种情况下(戴帽和不戴帽),我们分别估计了每个程序、每年和整个工作期间的脑剂量。
在临床条件下,皮肤剂量的降低系数(RF)(帽外与帽内剂量的商)从 1.1 到 4.0 不等;在最暴露的左太阳穴观察到平均 2.3 倍的降低。对于帽覆盖的头部部分,RF 值范围为 1.4 到 1.8,而对于大脑,RF 值范围为 1.0 到 1.1,具体取决于投影。对于每年进行 550 次 CA/PTCA 程序而没有任何防护屏蔽的介入心脏病学家,估计的年脑剂量为 7.2 mGy,使用无铅帽可平均降低 1.1 倍。
研究结果证明了无铅帽在保护皮肤方面的相当有效性,但在保护大脑方面的效果非常有限。国际职业医学与环境卫生杂志。2022;35(5):549-60。