title: A 5-Year Retrospective Analysis of Exposure to Ionizing Radiation by Neurosurgery Residents in the Modern Era.
abstract: BACKGROUND
  The potential for radiation exposure during neurosurgical training has increased dramatically in the last decade. Incorporation of instrumented and minimally invasive spinal surgery and neuroendovascular procedures into the curriculum has led to increased potential for exposure to ionizing radiation. Contemporary neurosurgery residents' exposure to radiation has not been previously reported.
  
  
  OBJECTIVE
  To determine neurosurgery residents' exposure to radiation over the course of 7 years of training.
  
  
  METHODS
  Retrospective analysis of a prospectively maintained radiation database from July 2009 to July 2014 for all neurosurgery residents based on radiation dosimetry data. Standard radiation safety precautions were used (e.g., lead gowns or aprons), although compliance was not specifically monitored.
  
  
  RESULTS
  Thirty-eight neurosurgery residents were monitored from 2009 to 2014. Radiation exposure data were available for 34 residents for the final analysis. A total of 20,541 days of radiation monitoring data were available. The mean deep dose equivalent over this period was 0.67 ± 0.75 mrem per resident/day. The calculated maximum cumulative exposure during the course of residency training was 12.15 ± 13.50 mSv, approximately equivalent to 6 computed tomography head scans.
  
  
  CONCLUSIONS
  To our knowledge, this study is the first to quantify radiation exposure for neurosurgery residents in the current era of training. From this work, efforts may be initiated to increase awareness and safety with regard to radiation exposure. Although the total dose is not high, a better understanding of the impact of radiation exposure on practitioners may help to drive institutional policies to reduce occupational exposure.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Hasan A
authors.initials: HA
authors.lastname: Zaidi
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Andrew
authors.initials: A
authors.lastname: Montoure
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Peter
authors.initials: P
authors.lastname: Nakaji
authors.affiliation: Regulatory Compliance/Radiation, Safety Office, Corporate Compliance Department, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
authors.forename: Alden
authors.initials: A
authors.lastname: Bice
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona. Electronic address: neuropub@dignityhealth.org.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Tumialán
mesh_terms: D016208:Databases, Factual; D006801:Humans; D007396:Internship and Residency; D000069471:Neurosurgeons / Q000706:statistics & numerical data*; D009493:Neurosurgery / Q000706:statistics & numerical data*; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D016273:Occupational Exposure / Q000517:prevention & control / Q000706:statistics & numerical data*; D011834:Radiation Monitoring / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012449:Safety
keywords: Exposure; Fluoroscopy; Intraoperative; Radiation; Residency