Journal of Musculoskeletal Trauma

The Efficiency of Radiation Shielding Sheet to Reduce Radiation Exposure during C-arm Fluoroscopy: Hosang Jeon, Won Chul Shin, Hee Yun Seol, Yongkan Ki, Kyeong Baek Kim, Ki Seok Choo, Sang Don Lee, Suk-Woong Kang; J Korean Fract Soc 2023;36(4):111-117. Published online October 31, 2023; DOI: https://doi.org/10.12671/jkfs.2023.36.4.111

Abstract PDF: Purpose
This study evaluates the radiation shielding performance of a new lead-free tungsten-based sheet to reduce the radiation exposure of operators and patients under C-arm fluoroscopy.
Materials and Methods
A non-lead radiation shielding sheet (ROO201128; Pentas, Korea) was fabri-cated using tungsten and bismuth. The dose measurements were conducted using a C-arm fluoroscopy machine at 64 kVp and 1.5 mA, assuming two possible scenarios according to the position of the sheet. In each scenario, measurements were conducted at three distances (30, 60, and 90 cm) away from the beam center and in three directions (cephal, caudal, and operator’s direction).
Results
In the area within a radius of 60 cm from the beam center, the measured doses were reduced by 66.3% on mean, and the doses measured at distances more than 60 cm were less than 0.1 mSv/h in both scenarios. The most beneficial utilization of the lead-free shielding sheet was verified during C-arm fluoroscopy by placing the sheet on the X-ray tube. The operator’s radiation exposure was reduced by 56.6% when the sheet was placed under the phantom, and by 81.0% when the sheet was placed on the X-ray tube.
Conclusion
The use of lead-free radiation shielding sheets under C-arm fluoroscopy was effective in reducing radiation exposure, and the most beneficial scenario in which the sheet can be utilized was verified when the sheet was placed on the X-ray tube.

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Radiation Exposure Over the Course of a Year from an Image Intensifier in the Orthopaedic Operating Room: Gu Hee Jung, Jae Ho Jang, Jae Do Kim, Chung Kyu Kim; J Korean Fract Soc 2012;25(1):58-63. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.58

PURPOSE
To measure the annual radiation exposure of staff in the orthopaedic surgical room.
MATERIALS AND METHODS
From January 2010 to December 2010, we measured the radiation exposure of a tumor surgeon, spine surgeon, trauma surgeon, six residents, and six scrub nurses. Radiation was monitored with the use of thermoluminescent dosimeters placed on the chest under the lead apron. The annual dose of radiation exposure was compared to the maximum yearly permissible dose (20 mSv). During the study period, the trauma surgeon made a deliberate effort to minimize the radiation time and maintain a distance of 1 m from the image intensifier.
RESULTS
The annual exposure levels were 0.04 mSv (radiation time, 34 min 50 s), 0.08 mSv (151 min 46 s), and 0.12 mSv (135 min 27 s) for the tumor surgeon, trauma surgeon, and spine surgeon, respectively. The mean exposure was 0.0146 mSv (range, 0.4~0.39 mSv) for the residents and 0.06 mSv (range, 0.04~0.13 mSv) for the scrub nurses. Overall, the annual radiation exposure was 0.2~1.95% of the maximal yearly permissible dose. Despite the longer period of radiation exposure, the trauma surgeon was exposed to a lower dose of radiation than the spine surgeon.
CONCLUSION
The annual radiation exposure of a trauma surgeon can be reduced by a deliberate effort to decrease exposure time and maintain a distance of at least 1 m from the image intensifier.

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Current status of occupational radiation exposure and protection among medical interns and residents
Seungwon Cho, Hangyeol Lee, Minku Kang, Won Jin Lee, Seulki Ko
Journal of the Korean Medical Association.2024; 67(2): 134. CrossRef
Radiation exposure and fluoroscopically-guided interventional procedures among orthopedic surgeons in South Korea
Seonghoon Kang, Eun Shil Cha, Ye Jin Bang, Teresa W. Na, Dalnim Lee, Sang Youn Song, Won Jin Lee
Journal of Occupational Medicine and Toxicology.2020;[Epub] CrossRef

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Radiation Exposure from Fluoroscopy during Orthopaedic Surgical Procedures: Su Young Bae, Jong Oh Kim, Jae Doo Yoo, Seong Yong Yoon, Jin Won Jang; J Korean Soc Fract 2001;14(4):792-798. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.792

Abstract PDF

PURPOSE
The aim of this study was to evaluate the radiation dose administered in orthopedic operative procedures and to determine whether all operation room personnel must use the lead protector.
MATERIALS AND METHODS
From March 2001 to May 2001, sixty six orthopedic operations were done with fluoroscopic intensifier(Series 9600TM, OEC Medical Systems Inc.). The accumulative exposure doses of operator, 1st assist, scrub nurse, circulating nurse and anesthesiologist were assessed by TLD(Thermo luminescence dosimeter) and compared with the dose limit set by the KINS(Korea Institute of Nuclear Safety). The exposure times and doses were evaluated in each cases and analyzed according to the each procedure. The exposure doses were assessed by the distance (Om, 0.5m, 1m, 2m) from the fluoroscopic generator.
RESULTS
Accumulative exposure doses(3 months) were checked 1.37mSv in operator, 1.73mSv in 1st assist, 0.17mSv in scrub nurse, 1.01mSv in circulating nurse, 0.01mSv in anesthesiologists and all doses were lower than dose limit set by the KINS(12.5mSv). Low exposure was checked in procedure of hand, ankle, cervical spine but high exposure was checked in IM nailing of femur(one way Anova with postHoc test, p<0.05). The exposure doses were decreased with the distance and exposure dose out of 1m was minimal.
CONCLUSION
Radiation is higher in IM nailing procedure but the total accumulative doses were safe especially in personnel who can fall apart from the operation field more than lm. So, we conclude that the lead protector is not essential to the all operation room personnel.

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Citations to this article as recorded by

Radiation exposure and fluoroscopically-guided interventional procedures among orthopedic surgeons in South Korea
Seonghoon Kang, Eun Shil Cha, Ye Jin Bang, Teresa W. Na, Dalnim Lee, Sang Youn Song, Won Jin Lee
Journal of Occupational Medicine and Toxicology.2020;[Epub] CrossRef

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