title: Ocular Radiation Threshold Projection Based off of Fluoroscopy Time During ERCP.
abstract: Current international guidelines for ocular radiation exposure suggest a threshold of 20 millisieverts (mSv)/year. Although endoscopists wear lead aprons, use of protective eye wear is optional. This study was conducted to analyze the lens radiation exposure during endoscopic retrograde cholangiopancreatography (ERCP) for endoscopists to determine the time of fluoroscopy needed to warrant using lens protection during ERCP.
  
  
  
  ERCP patients were prospectively enrolled. Indications, interventions, fluoroscopy time, dose, and attending ± fellow involvement were recorded. Radiation exposure was collected from body dosimeters and dosimeters placed between the eyes. Cumulative radiation doses were obtained at study completion and averaged over the total fluoroscopy time to determine the mSv/hour exposure.
  
  
  
  A total of 187 cases were included. Attendings and fellows wore lens dosimeters in 178 and 126 cases, respectively, and body dosimeters in 174 and 128 cases, respectively. Attendings and fellows wore lens dosimeters throughout 15.89 and 11.24 h of fluoroscopy, respectively. The cumulative radiation dose absorbed per lens dosimeters was 5.35 mSv for attendings and 2.55 mSv for fellows. The projected lens absorption by the body dosimeters was 19.03 mSv for attendings and 5.21 mSv for fellows. The hourly fluoroscopy lens exposure was 0.34 mSv/hour for attendings and 0.23 mSv/hour for fellows.
  
  
  
  The amount of fluoroscopy hours needed to reach the currently suggested lens threshold limit (20 mSv/year) was 59.41 h for attendings and 88.17 h for fellows. Radioprotective eye wear should be worn by physicians with yearly fluoroscopy times in similarly structured practices that meet or exceed these thresholds.
authors.affiliation: Division of Gastroenterology, Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: Mrinal S
authors.initials: MS
authors.lastname: Garg
authors.affiliation: Division of Gastroenterology, Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: Pikul
authors.initials: P
authors.lastname: Patel
authors.affiliation: Allegheny Health Network, Division of Radiation Safety, Pittsburgh, PA, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Blackwood
authors.affiliation: Washington University, Department of Internal Medicine, St Louis, MO, USA.
authors.forename: Satish
authors.initials: S
authors.lastname: Munigala
authors.affiliation: Allegheny Health Network, Allegheny Singer Research Institute, Pittsburgh, PA, USA.
authors.forename: Payal
authors.initials: P
authors.lastname: Thakkar
authors.affiliation: Division of Gastroenterology, Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: James
authors.initials: J
authors.lastname: Field
authors.affiliation: Division of Gastroenterology, Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: Dustin
authors.initials: D
authors.lastname: Wallace
authors.affiliation: Division of Gastroenterology, Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: Satty
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Division of Gastroenterology, Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: Elie
authors.initials: E
authors.lastname: Aoun
authors.affiliation: Division of Gastroenterology, Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Kulkarni
authors.affiliation: Division of Gastroenterology, Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: Manish
authors.initials: M
authors.lastname: Dhawan
authors.affiliation: Division of Gastroenterology, Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: Katie
authors.initials: K
authors.lastname: Farah
authors.affiliation: Division of Gastroenterology, Allegheny Health Network, Pittsburgh, PA, USA.
authors.forename: Shyam
authors.initials: S
authors.lastname: Thakkar
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005135:Eye Protective Devices; D005257:Fellowships and Scholarships; D005260:Female; D005471:Fluoroscopy; D005762:Gastroenterology; D006801:Humans; D007908:Lens, Crystalline; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000517:prevention & control; D011446:Prospective Studies; D011829:Radiation Dosage; D011834:Radiation Monitoring; D020711:Threshold Limit Values; D013997:Time Factors