title: Surgical Staff Radiation Protection During Fluoroscopy-Guided Urologic Interventions.
abstract: Over the past 20 years, the use of fluoroscopy to guide urologic surgical interventions has been constantly growing. Thus, in their daily practice, urologists and other operating room (OR) staff are exposed to X-radiation increasingly frequently. This raises questions as to the risks they encounter and the actions needed to reduce them.
  
  
  
  Evaluate X-ray dose exposure in the members of the surgical team and determine urologist radioprotection knowledge and practices.
  
  
  
  A prospective bicenter study was conducted within AFUF (French urology resident association) and in association with The French Nuclear Safety Authority/The Institute for Radiological Protection and Nuclear Safety (ASN/IRSN). Radiation exposure was measured on 12 operators using dosimeters (seven per operator), in staff-occupied locations in the OR using ionization chambers, and on anthropomorphic phantoms. A survey was used to gather information on radiation knowledge and safety practices of the AFUF members.
  
  
  
  Annual whole-body radiation doses were low (0.1-0.8 millisieverts [mSv], mostly at around 0.3 mSv), and equivalent doses were low for the fingers (0.7-15 mSv, mostly at around 2.5 mSv), and low for the lens of the eye (0.3-2.3 mSv, mostly at around 0.7 mSv). In percutaneous nephrolithotomy, extremity doses were lower when the patient was placed in dorsal decubitus compared with ventral decubitus. Pulsed fluoroscopy reduced radiation dose exposure by a factor of 3 compared with continuous fluoroscopy with no image quality loss. Radiation safety practices were poor: only 15% of urologists wore dosimeters and only 5% had been trained in the handling of X-ray generators.
  
  
  
  In the present study, radiation exposure for urologists was low, but so was knowledge of radiation safety and optimization practices. This absence of training for radiation safety and reduction, teamed with novel techniques involving long fluoroscopy-guided interventions, could result in unnecessarily high exposure for patients and OR personnel.
authors.affiliation: 1 Department of Urology, Centre Hospitalier Clermont Ferrand , Clermont-Ferrand, France .|2 Department of Urology, Centre Hospitalier Lyon Sud , Lyon, France .
authors.forename: François
authors.initials: F
authors.lastname: Galonnier
authors.affiliation: 3 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .
authors.forename: Olivier
authors.initials: O
authors.lastname: Traxer
authors.affiliation: 4 The Institute for Radiological Protection and Nuclear Safety (IRSN) , Paris, France .
authors.forename: Maeva
authors.initials: M
authors.lastname: Rosec
authors.affiliation: 3 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Terrasa
authors.affiliation: 5 French Nuclear Safety Authority (ASN) , Paris, France .
authors.forename: Pascal
authors.initials: P
authors.lastname: Gouezel
authors.affiliation: 4 The Institute for Radiological Protection and Nuclear Safety (IRSN) , Paris, France .
authors.forename: David
authors.initials: D
authors.lastname: Celier
authors.affiliation: 4 The Institute for Radiological Protection and Nuclear Safety (IRSN) , Paris, France .
authors.forename: Céline
authors.initials: C
authors.lastname: Bassinet
authors.affiliation: 2 Department of Urology, Centre Hospitalier Lyon Sud , Lyon, France .
authors.forename: Alain
authors.initials: A
authors.lastname: Ruffion
authors.affiliation: 2 Department of Urology, Centre Hospitalier Lyon Sud , Lyon, France .
authors.forename: Philipe
authors.initials: P
authors.lastname: Paparel
authors.affiliation: 6 Department of Urology, Grenoble University Hospital , Grenoble, France .
authors.forename: Gaelle
authors.initials: G
authors.lastname: Fiard
authors.affiliation: 2 Department of Urology, Centre Hospitalier Lyon Sud , Lyon, France .
authors.forename: Jean-Etienne
authors.initials: JE
authors.lastname: Terrier
mesh_terms: D000886:Anthropometry; D005471:Fluoroscopy; D006801:Humans; D009403:Nephrostomy, Percutaneous / Q000379:methods; D016273:Occupational Exposure / Q000517:prevention & control*; D060051:Occupational Injuries / Q000517:prevention & control*; D009873:Operating Rooms; D019047:Phantoms, Imaging; D010820:Physicians; D011446:Prospective Studies; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D011874:Radiometry; D013819:Thermoluminescent Dosimetry; D013520:Urologic Surgical Procedures; D014572:Urology; D014916:Whole-Body Irradiation; D000078329:Workforce; D014965:X-Rays