title: An investigation of the radiation doses to the lower legs and feet of staff undertaking interventional procedures.
abstract: OBJECTIVE
  Occupational radiation doses from fluoroscopic procedures are some of the highest doses of exposure amongst medical staff using radiography. Protective equipment and dose monitoring are used to minimize and control the risk from these occupational doses. Other studies have considered the effectiveness of this protection, but this study further considers whether protection is adequate for the lower leg and foot and the extent to which these doses can be reduced.
  
  
  METHODS
  Scatter air kerma profiles at toe level were measured with an ionization chamber. Thermoluminescent dosemeters and lower extremity phantoms were used to estimate the dose variation with the height of patient couch. A 7-week period of in situ toe dose monitoring of four radiologists was also undertaken.
  
  
  RESULTS
  The use of protective curtains effectively reduced the exposure to most of the lower extremities. Toe doses were found to be high and increased with increase in couch height. In situ monitoring indicated annual toe doses of 110 mSv for two of the four radiologists monitored.
  
  
  CONCLUSIONS
  Protective curtains should be used, but they might have limitations with respect to toe doses. Annual toe doses approaching the classification threshold of 150 mSv were measured for two radiologists. Caution should be exercised when there is a gap below curtains and, when possible, staff should step back from the couch. Lower legs and toes should be included in local radiation protection programmes.
  
  
  CONCLUSIONS
  Toe doses in interventional radiology may be higher than expected and may have to be included in radiation protection programmes.
authors.affiliation: 1 Department of Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, St James's University Hospital Leeds, Leeds, UK.
authors.forename: R E R
authors.initials: RE
authors.lastname: Artschan
authors.forename: D S
authors.initials: DS
authors.lastname: Brettle
authors.forename: K
authors.initials: K
authors.lastname: Chase
authors.forename: A
authors.initials: A
authors.lastname: Fender
authors.forename: P G
authors.initials: PG
authors.lastname: Howells
authors.forename: S
authors.initials: S
authors.lastname: Buchan
mesh_terms: D005471:Fluoroscopy; D006801:Humans; D035002:Lower Extremity / Q000528:radiation effects*; D016273:Occupational Exposure / Q000517:prevention & control*; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011835:Radiation Protection / Q000295:instrumentation*; D015641:Radiography, Interventional; D013819:Thermoluminescent Dosimetry