title: THE EFFECT OF RADIATION SHIELDS ON OPERATOR EXPOSURE DURING CONGENITAL CARDIAC CATHETERISATION.
abstract: 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·m2) 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-1m-2and 124 vs. 14 nSv mGy-1with 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-1m-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 m2kg-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.
authors.affiliation: Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|The University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.|Division of Cardiology, Blair E. Batson Hospital for Children, Jackson, MS, USA.|School of Medicine, The University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Sarosh P
authors.initials: SP
authors.lastname: Batlivala
authors.affiliation: Environmental Health and Radiation Safety, The University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Dennise
authors.initials: D
authors.lastname: Magill
authors.affiliation: Environmental Health and Radiation Safety, The University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Felice
authors.affiliation: Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Virginia
authors.initials: V
authors.lastname: Jones
authors.affiliation: Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|The University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Dori
authors.affiliation: Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|The University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Gillespie
authors.affiliation: Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.|The University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Rome
authors.affiliation: Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA glatz@email.chop.edu.|The University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Glatz
mesh_terms: D000388:Air; D006328:Cardiac Catheterization / Q000379:methods*; D005471:Fluoroscopy; D006801:Humans; D016273:Occupational Exposure / Q000517:prevention & control; D011482:Protective Devices; D058996:Quality Improvement; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000517:prevention & control; D011834:Radiation Monitoring / Q000379:methods*; D011835:Radiation Protection / Q000295:instrumentation*; D012189:Retrospective Studies; D012306:Risk; D012542:Scattering, Radiation; D014965:X-Rays