The Effect of Radiation Shields on Operator Exposure During Congenital Cardiac Catheterisation.
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<p>Cardiac catheterisation personnel are exposed to occupational radiation and its health risks. Little data exist regarding the efficacy of radiation-protective equipment from congenital catheterisation laboratories (CLs). The authors retrospectively reviewed data in which CL operators wore a radiation dosemeter during catheterizations on patients of >20 kg. A leaded under-table skirt was present in all cases. Three additional radiation-protective devices were utilised at operator discretion: a top extension to the under-table skirt, a ceiling-mounted shield and a disposable patient drape. Case details, operator position, fluoroscopy time, incident air KERMA in the patient plane (K, mGy) and dose-area product (DAP, µGy·m(2)) were recorded. A total of 136 catheterizations over 8 months were included. Median operator dose (OpD) was 12 µSv (range 0-930) and indexed to K and DAP to correct for patient factors and case times. Indexed OpD decreased significantly with each additional shield used (14.8 vs. 1.3 nSv µGy(-1) m(-2) and 124 vs. 14 nSv mGy(-1) with one and four shields, respectively, p < 0.001). This trend was not significant with operator at head-of-bed. Combinations that included the ceiling shield had the lowest indexed OpD. The patient drape did not further reduce OpD when all other shields were used (1.3 vs. 2.2 nSv µGy(-1) m(-2), p = 0.5; 14 vs. 17 nSv mGy(-1), p = 0.4) and was associated with higher patient exposure indexed to weight and fluoroscopy time (4.5 vs. 3.1 µGy m(2) kg-min(-1), p = 0.009; and 0.51 vs. 0.38 mGy kg-min(-1), p = 0.01). Supplemental radiation barriers can decrease operator-absorbed radiation. A ceiling-mounted shield may provide greatest benefit. The authors do not recommend routine use of disposable patient drapes.</p>
Radiat Prot Dosimetry