title: Eye lens dosimetry in anesthesiology: a prospective study.
abstract: The eye lens is one of the most sensitive organs for radiation injury and exposure might lead to radiation induced cataract. Eye lens dosimetry in anesthesiology has been published in few clinical trials and an active debate about the causality of radiation induced cataract is still ongoing. Recently, the International Commission on Radiological Protection (ICRP) recommended a reduction in the annual dose limit for occupational exposure for the lens of the eye from 150 to 20 mSv, averaged over a period of 5 years, with the dose in a single year not exceeding 50 mSv. This prospective study investigated eye lens dosimetry in anesthesiology practice during a routine year of professional activity. The radiation exposure measured represented the exposure in a normal working schedule of a random anesthesiologist during 1 month and this cumulative eye lens dose was extrapolated to 1 year. Next, eye lens doses were measured in anesthesiology during neuro-embolisation procedures, radiofrequency ablations or vertebroplasty/kyphoplasty procedures. The eye lens doses are measured in terms of the dose equivalent Hp(3) with the Eye-D dosimeter (Radcard, Poland) close to the right eye (on the temple). In 16 anesthesiologists, the estimated annual eye lens doses range from a minimum of 0.4 mSv to a maximum of 3.5 mSv with an average dose of 1.33 mSv. Next, eye lens doses were measured for nine neuro-embolisation procedures, ten radiofrequency ablations and six vertebroplasty/kyphoplasty procedures. Average eye lens doses of 77 ± 76 µSv for neuro-embolisations, 38 ± 34 µSv for cardiac ablations and 40 ± 44 µSv for vertebro-/kyphoplasty procedures were recorded. The maximum doses were respectively 264, 97 and 122 µSv. This study demonstrated that the estimated annual eye lens dose is well below the revised ICRP's limit of 20 mSv/year. However, we demonstrated high maximum and average doses during neuro-embolisation, cardiac ablation and vertebro-/kyphoplasty procedures. With radiation induced cataract being explained as a possible stochastic effect, without a threshold dose, anesthesiologists who regularly work in a radiological environment should remain vigilant and maintain radiation safety standards at all times. This includes adequately protective equipment (protection shields, apron, thyroid shield and leaded eye wear), keeping distance, routine monitoring and appropriate education.
authors.affiliation: Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium. bart_vaes@hotmail.com.
authors.forename: Bart
authors.identifier: http://orcid.org/0000-0001-5061-1254
authors.initials: B
authors.lastname: Vaes
authors.affiliation: Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Karel
authors.initials: K
authors.lastname: Van Keer
authors.affiliation: Radiation Protection Dosimetry and Calibration, Belgian Nuclear Research Centre (SCK·CEN), Mol, Belgium.
authors.forename: Lara
authors.initials: L
authors.lastname: Struelens
authors.affiliation: Radiation Protection Dosimetry and Calibration, Belgian Nuclear Research Centre (SCK·CEN), Mol, Belgium.
authors.forename: Werner
authors.initials: W
authors.lastname: Schoonjans
authors.affiliation: Department of Ophthalmology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Ivo
authors.initials: I
authors.lastname: Nijs
authors.affiliation: Department of Radiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Vandevenne
authors.affiliation: Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Sven
authors.initials: S
authors.lastname: Van Poucke
mesh_terms: D000072080:Anesthesiologists; D000776:Anesthesiology; D002387:Cataract Extraction; D017115:Catheter Ablation; D004621:Embolization, Therapeutic; D006801:Humans; D058498:Kyphoplasty; D007908:Lens, Crystalline / Q000528:radiation effects*; D016273:Occupational Exposure / Q000517:prevention & control*; D011446:Prospective Studies; D011835:Radiation Protection / Q000295:instrumentation / Q000379:methods*; D011846:Radio Waves; D011874:Radiometry / Q000295:instrumentation* / Q000379:methods; D054854:Vertebroplasty; D000078329:Workforce
keywords: Anesthesiology; Cataract; Eye lens; Radiation