D.V. VASEEV¹, S.A. RYZHKIN^1, 3, B.M. SHARAFUTDINOV⁴, M.K. MIKHAYLOV¹, R.Sh. KHASANOV¹

¹Kazan State Medical Academy – Branch Campus of  RMACPE MH Russia, Kazan

²Interregional Interregional Clinical Diagnostic Center, Kazan

³Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan

⁴Kazan (Volga) Federal University, Medical Unit, Kazan

 Contact details:

Vaseev D.V. — Ph. D. student of the Department of X-ray Diagnostic, Doctor of the Division of X-ray Diagnostic and Treatment Methods

Address: 11 Mushtari St., Kazan, Russian Federation, 420012, tel.: +7-960-040-60-98, e-mail: dvaseew@mail.ru

The purpose — to study modern condition of the problem of occupational exposure of medical staff performing interventions under control of X-Ray.

Material and methods. Study of specialized domestic and foreign literature.

Results. The basic concepts of occupational exposure in interventional radiology and radiology are discussed in the article, some studies in this area are reviewed, effects of ionizing radiation on health of medical personnel are described, and basic methods of radiation protection and radiation exposure reduction are presented.

Conclusion. The level of radiation exposure for medical personnel depends on many factors: on the choice of vascular access, on the projection and position of the X-ray source in relation to a doctor, on the area of ​​exposure and the type of invasive intervention, on the duration of fluoroscopy, as well as on the use of personal protective equipment and the level of education of an interventional doctor in the field of radiation safety. However, the degree of influence of the above factors on the radiation dose has not been fully studied. Therefore, further studies of mechanisms for reducing radiation doses to medical personnel in interventional radiology and radiology are very relevant.

Key words: medical exposure, radiation burden, radiation safety of medical staff, X-ray, X-ray endovascular interventions.

(For citation: Vaseev D.V., Ryzhkin S.A., Sharafutdinov B.M., Mikhaylov M.K., Khasanov R.Sh. Modern condition of the problem of occupational exposure of medical staff performing interventions under control of X-Ray. Practical Medicine. 2019. Vol. 17, № 7, P. 154-157)

REFERENCES

1. Little M.P., Wakeford R., Tawn E.J. et al. Risks associated with low doses and low dose rates of ionizing radiation: why linearity may be (almost) the best we can do. Radiology, 2009, Apr, vol. 251 (1), pp. 6–12.
2. Kong Y., Gao L., Zhuo W. et al. A survey on radiation exposure of primary operators from interventional X-ray procedures. Radiation Measurements, 2013, vol. 55, pp. 3–45.
3. Kim K.P., Miller D.L., Berrington de Gonzalez A. et al. Occupational radiation doses to operators performing fluoroscopically-guided procedures. Health Phys, 2012, vol. 103 (1), pp. 80–99.
4. Choi J., Kim B., Choi Y. et al. Image Quality of Low-Dose Cerebral Angiography and Effectiveness of Clinical Implementation on Diagnostic and Neurointerventional Procedures for Intracranial Aneurysms. American Journal of Neuroradiology, 2019, Apr, pp. 1–7.
5. Ryzhkin S.A., Slesareva A.N., Galeeva G.Z. et al. Clinical study of the organ of vision and dosimetry of the lens of the eye of personnel performing surgical interventions under the control of x-ray radiation. Radiatsiya i risk, 2017, vol. 26, no. 3, pp. 90–98 (in Russ.).
6. Normy radiatsionnoy bezopasnosti (NRB-99/2009). Sanitarnye pravila i normativy SanPiN 2.6.1.2523-09 [Radiation safety standards (NRB-99/2009). Sanitary rules and regulations SanPiN 2.6.1.2523-09]. Moscow: Federal’nyy tsentr gigieny i epidemiologii Rospotrebnadzora, 2009. 100 p.
7. Hamada N., Fujimichi Y. Classification of radiation effects for dose limitation purposes: history, current situation and future prospects. J Radiat Res, 2014, vol. 55 (4), pp. 629–640.
8. Michael Seymour. Health Impacts of Radiation Exposure During PCI. Cath Lab Digest, 2017, vol. 25, I. 3.
9. Feldman D.N., Swaminathan R.V., Kaltenbach L.A. et al. Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention: An updated report from the National Cardiovascular Data Registry (2007–2012). Circulation, 2013, vol. 1267, pp. 2295–2306.
10. Tarighatnia A., Mohammadalian A., Ghojazade M. et al. Beam projections and radiation exposure in transradial and transfemoral approaches during coronary angiography. Anatol J Cardiol, 2017, vol. 18 (4), pp. 298–303.
11. Plourde G., Pancholy S.B., Nolan J. et al. Radiation exposure in relation to the arterial access site used for diagnostic coronary angiography and percutaneous coronary intervention: a systematic review and meta-analysis. Lancet, 2015, vol. 386, pp. 2192–2203.
12. J Am Coll. Radiation Exposure and Vascular Access in Acute Coronary Syndromes: The RAD-Matrix Trial. Cardiol, 2017, May 23, vol. 69 (20), pp. 2530–2537.
13. Smith I.R., Cameron J., Mengersen K.L., Rixers J.T. Evaluation of coronary angiographic projections to balance the clinical yield with the radiation risk. The British Journal of Radiology, 2012, vol. 85, pp. 722–728.
14. Sukupova L., Hlavacek O., Vedlich D. Impact of the Ceiling-Mounted Radiation Shielding Position on the Physician’s Dose from Scatter Radiation during Interventional Procedures. Radiol Res Pract., 2018. 7 p.
15. Kuon E., Glaser C., Dahm J.B. Effective techniques for reduction of radiation dosage to patients undergoing invasive cardiac procedures. Br J Radiol, 2003, Jun, vol. 76 (906), pp. 406–413.
16. Fish D.E., Kim A., Ornelas C. et al. The risk of radiation exposure to the eyes of the interventional pain physician. Radiol. Res. Pract, 2011, vol. 2011, pp. 1–5.
17. Naryshkin S.A. Metody optimizatsii luchevykh nagruzok na personal pri rentgenoendoskopicheskikh operatsiyakh v urologii: avtoref. dis. … kand. med.nauk [Methods for optimizing radiation loads on personnel during x-ray endoscopic operations in urology. Synopsis of dis. PhD med. sciences]. Moscow, 2009. 24 p.
18. Shams T., Zaidat O., Yavagal D. et al. Society of Vascular and Interventional Neurology (SVIN) Stroke Interventional Laboratory Consensus (SILC) Criteria: A 7M Management Approach to Developing a Stroke Interventional Laboratory in the Era of Stroke Thrombectomy for Large Vessel Occlusions. Interv Neurol, 2016, vol. 5 (1–2), pp. 1–28.
19. Kuon E., Weitmann K., Hoffmann W. et al. Role of Experience, Leadership and Individual Protection in the Cath Lab-A Multicenter Questionnaire and Workshop on Radiation Safety. Rofo, 2015, Oct, vol. 187 (10), pp. 899–905.
20. Durán A., Hian S.K., Miller D.L. et al. Recommendations for occupational radiation protection in interventional cardiology. Catheter Cardiovasc Interv, 2013, vol. 82 (1), pp. 29–42.
21. Jurado-Román A., Sánchez-Pérez I., Lozano Ruíz-Poveda F. et al. Effectiveness of the implementation of a simple radiation reduction protocol in the catheterization laboratory. Cardiovasc Revasc Med, 2016, Jul–Aug., vol. 17 (5), pp. 328–332.