Chida Koichi
Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai, 980-8575, Japan.
Division of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, 980-8572, Japan.
Radiol Phys Technol. 2022 Jun;15(2):101-115. doi: 10.1007/s12194-022-00660-8. Epub 2022 May 24.
Protection against occupational radiation exposure in clinical settings is important. This paper clarifies the present status of medical occupational exposure protection and possible additional safety measures. Radiation injuries, such as cataracts, have been reported in physicians and staff who perform interventional radiology (IVR), thus, it is important that they use shielding devices (e.g., lead glasses and ceiling-suspended shields). Currently, there is no single perfect radiation shield; combinations of radiation shields are required. Radiological medical workers must be appropriately educated in terms of reducing radiation exposure among both patients and staff. They also need to be aware of the various methods available for estimating/reducing patient dose and occupational exposure. When the optimizing the dose to the patient, such as eliminating a patient dose that is higher than necessary, is applied, exposure of radiological medical workers also decreases without any loss of diagnostic benefit. Thus, decreasing the patient dose also reduces occupational exposure. We propose a novel four-point policy for protecting medical staff from radiation: patient dose Optimization, Distance, Shielding, and Time (pdO-DST). Patient dose optimization means that the patient never receives a higher dose than is necessary, which also reduces the dose received by the staff. The patient dose must be optimized: shielding is critical, but it is only one component of protection from radiation used in medical procedures. Here, we review the radiation protection/reduction basics for radiological medical workers, especially for IVR staff.
临床环境中预防职业性辐射暴露至关重要。本文阐明了医疗职业暴露防护的现状以及可能的额外安全措施。已有报道称,从事介入放射学(IVR)的医生和工作人员出现了如白内障等辐射损伤,因此,他们使用屏蔽设备(如铅眼镜和天花板悬挂式屏蔽)很重要。目前,没有一种完美的辐射屏蔽;需要多种辐射屏蔽组合使用。放射医学工作者必须接受适当的教育,以减少患者和工作人员的辐射暴露。他们还需要了解可用于估计/减少患者剂量和职业暴露的各种方法。当应用优化患者剂量的措施,如消除高于必要剂量的患者剂量时,放射医学工作者的暴露也会减少,而不会损失任何诊断益处。因此,降低患者剂量也会减少职业暴露。我们提出了一项保护医务人员免受辐射的新的四点政策:患者剂量优化、距离、屏蔽和时间(pdO - DST)。患者剂量优化意味着患者永远不会接受高于必要的剂量,这也会减少工作人员所接受的剂量。必须优化患者剂量:屏蔽很关键,但它只是医疗程序中用于辐射防护的一个组成部分。在此,我们回顾放射医学工作者,尤其是IVR工作人员的辐射防护/减少基础知识。