X-rays which injure intestinal epithelium (and presumably other body or tumor cells) travel in straight lines from the target through the living tissues, forming a cone or beam of rays as controlled by impervious screens. It is probable that secondary radiation is formed, especially deep in the body tissues, but such radiation does no injury to intestinal epithelium outside of the cone or path of radiation. Lesions in the stomach and intestine may be confidently predicted from a knowledge of the size and form of the cone or beam of x-rays given over the abdomen. These lesions even more than skin burns do not heal and may in fact go on after many weeks to perforation. Even in the depths of the abdomen the duodenal lesions are as clean-cut as a peptic ulcer, indicating the lack of dispersion or scattering of the primary or secondary rays in passage through the living tissues. Transition from normal to necrotic mucosa rarely occupies more than 2 to 3 mm. and often can be observed in a single low power microscopic field.
A single large dose of x-rays over the abdomen will cause a definite injury of the mucosa of the small intestine and the severity of the clinical intoxication seems to parallel this recognizable epithelial injury. This clinical intoxication lasts 4 to 6 days if the x-ray dose is sublethal. Subsequent doses of radiation given within this period of clinical intoxication give recognizable evidence of summation or a cumulative effect. Small but repeated doses of radiation given within a 5 or 6 day period will cause practically the same cell injury and clinical intoxication as will a single dose representing the sum of the small doses expressed in milliampere minutes. Doses of radiation given at 6 day or longer intervals show no evidence of summation. The reaction of this relatively sensitive intestinal epithelium to radiation may be similar to the reaction of certain deep lying tumor tissues to x-ray therapy and our experiments may give information of value to physicians concerned with x-ray or radium therapy.
Nepal has a long history of medical radiology since1923 but unfortunately, we still do not have any Radiation Protection Infrastructure to control the use of ionizing radiations in the various fields. The objective of this study was an assessment of the radiation protection in medical uses of ionizing radiation. Twenty-eight hospitals with diagnostic radiology facility were chosen for this study according to patient loads, equipment and working staffs. Radiation surveys were also done at five different radiotherapy centers. Questionnaire for radiation workers were used; radiation dose levels were measured and an inventory of availability of radiation equipment made. A corollary objective of the study was to create awareness in among workers on possible radiation health hazard and risk. It was also deemed important to know the level of understanding of the radiation workers in order to initiate steps towards the establishment of Nepalese laws, regulation and code of radiological practice in this field. Altogether, 203 Radiation workers entertained the questionnaire, out of which 41 are from the Radiotherapy and 162 are from diagnostic radiology. The radiation workers who have participated in the questionnaire represent more than 50% of the radiation workers working in this field in Nepal. Almost all X-ray, CT and Mammogram installations were built according to protection criteria and hence found safe. Radiation dose level at the reference points for all the five Radiotherapy centers are within safe limit. Around 65% of the radiation workers have never been monitored for radiation. There is no quality control program in any of the surveyed hospitals except radiotherapy facilities.
Dose limit; personnel monitoring; quality control; workload
Two practical protective tools for occupational exposure for neurointerventional radiologists are presented. The first purpose of this study was to investigate the effectiveness of double focus spectacles for the aged with a highly refracted glass lens (special spectacles for the aged) for radiation protection of the crystalline lens of the eye in comparison with other spectacles on the market, based on the measurement of film density which was obtained by exposure of X-ray through those spectacles. As a result of the film densitometry mentioned above, the effectiveness of special spectacles for the aged in radiation protection was nearly equal to the effectiveness of a goggle type shield which is made with a 0.07 mm lead-equivalent plastic lens.
The second purpose of this study was to investigate the effectiveness of the protective barrier; which we remodeled for cerebral angiography or neuroendovascular therapy, for radiation exposure, based on the measurement in a simulated study with a head phantom, and on the measurement of radiation exposure in operaters during procedures of clinical cases. In the experimental study radiation exposure in supposed position of the crystalline lens was reduced to about one third and radiation exposure in supposed position of the gonadal glands was reduced to about one seventh, compared to radiation exposure without employing the barrier.
The radiation exposure was monitored at the left breast of three radiologists, in 215 cases of cerebral angiography. Employing the barrier in cerebral angiography, average equivalent dose at the left breast measured 1.49µ Sv during 10 min of fluoroscopy. In three kinds of neuroendovascular therapy in 40 cases, radiation exposure in an operator was monitored in the same fashion and the dose was recorded less than the result reported in previous papers in which any protective barrier have not been employed in the procedure1,2.
As a result, the two above mentioned protective tools are considered practical in clinical usage and very effective to reduce radiation exposure in an operator of interventional neuroradiolgy which may sometimes require many hours to complete the therapy under extended fluoroscopic time.
occupational exposure, radiation protection, crystalline lens of eye, barrier against X-ray exposure, cerebral angiography, interventional neuroradiology
These experiments show that the common laboratory animals are about equally sensitive to the x-ray given over the abdomen. The clinical reaction following a M.L.D. is very similar and the intestinal pathology almost identical. The rat and guinea pig are slightly more sensitive to the x-ray than are the dog, cat, and rabbit. By contrast birds, frogs, and reptiles are very resistant to the x-ray and may tolerate two or three doses of radiation lethal for dogs. We can offer no convincing explanation for this fact which is discussed above. These data strengthen our belief in the scattered and incomplete observations on human cases which indicate that the human intestinal tract is likewise sensitive to radiation. This fact must be given careful consideration in conditions where abdominal or pelvic radiation is being used because such injury done to intestinal epithelium is always serious and in some cases irreparable.
Recent improvements in x-ray technology have greatly contributed to the advancement of diagnostic imaging. Fluoroscopically guided neurointerventional procedures with digital subtraction angiography (DSΛ) are being performed with increasing frequency as the treatment of choice for a variety of neurovascular diseases. Radiation-induced skin injuries can occur after extended fluoroscopic exposure times, and the injuries have recently been reported. In this article, measured radiation doses at the surface of Rando Phantom with Skin Dose Monitor, and estimated and measured entrance skin doses in patients underwent neurointerventional procedures are reported as well as means of reducing radiation doses absorbed by patients and personnel to avoid occurrence of radiation-induced injuries.
fluoroscopically guided interventional procedure, digital subtraction angiography, radiation protection
Exposure to large doses of x-rays will cause notable increase in the speed of autolysis of the crypt or secretory epithelium of the dog's small intestine. These changes can be demonstrated readily in material obtained from dogs killed 2, 24, 48, 72, or 96 hours after the initial radiation (Text-figs. 1 and 2). In the radiated dogs the secretory crypt epithelium of the small intestine autolyzes first and the epithelium of the villi last, while the reverse is true in the normal control small intestine. These abnormalities of autolysis associated with lethal Roentgen ray exposures can be demonstrated for the small intestine over the whole 4 day period subsequent to radiation. The colon shows little change and the stomach no demonstrable changes in autolysis under like conditions. The kidney likewise is negative. The spleen, lymph glands, liver, and pancreas show a moderate increase in speed of autolysis in tissues taken from radiated animals within 48 hours of the initial exposure. What the significance of this disturbance of cell ferments in the intestinal mucosa may be, we cannot pretend to say. At least these observations strengthen one's confidence in the profound functional disturbance of this important intestinal epithelium—a disturbance which we believe is responsible for the clinical abnormalities and fatal intoxication.
As a first step in developing a protocol for multidimensional sialography using cone beam CT (CBCT), the objective of this study was to compare the effective radiation doses from sialography of the parotid and submandibular glands using plain radiography and CBCT.
The effective doses were calculated from dose measurements made at 25 selected locations in the head and neck of a radiation analogue dosimeter (RANDO) phantom, using International Commission on Radiological Protection 2007 tissue weighting factors.
The effective dose (E) changed in relationship to changes in CBCT field of view (FOV), peak kilovoltage (kVp) and milliamperage (mA). Specifically, E decreased from a maximum of 932 μSv (30 cm FOV, 120 kVp, 15 mA) to 60 μSv (15 cm FOV, 80 kVp, 10 mA) for a parotid gland study and to 148 μSv (15 cm FOV, 80 kVp, 10 mA) for a submandibular study. The collective series of plain radiographs made during sialography of the parotid and submandibular glands yielded effective doses of 65 μSv and 156 μSv, respectively. The plain parotid gland series included one panoramic, two anterior–posterior skull and four lateral skull radiographs, whereas the submandibular gland series included one panoramic, one standard mandibular occlusal and four lateral skull radiographs.
The effective doses from CBCT examinations centred on the parotid and submandibular glands were similar to those calculated for plain radiograph sialography when a 15 cm FOV was chosen in combination with exposure conditions of 80 kVp and 10 mA.
cone beam computed tomography; sialography; radiation dosimetry
It is well accepted that collimation is a cost-effective dose-reducing tool for X-ray examinations. This phantom-based study investigated the impact of X-ray beam collimation on radiation dose to the lenses of the eyes and thyroid along with the effect on image quality in facial bone radiography.
A three-view series (occipitomental, occipitomental 30 and lateral) was investigated, and radiation doses to the lenses and thyroid were measured using an Unfors dosemeter. Images were assessed by six experienced observers using a visual grading analysis and a total of 5400 observations were made.
Strict collimation significantly (p<0.0001) reduced the radiation dose to the lenses of the eyes and thyroid when using a fixed projection-specific exposure. With a variable exposure technique (fixed exit dose, to simulate the behaviour of an automatic exposure control), while strict collimation was again shown to reduce thyroid dose, higher lens doses were demonstrated when compared with larger fields of exposure. Image quality was found to significantly improve using strict collimation, with observer preference being demonstrated using visual grading characteristic curves.
The complexities of optimising radiographic techniques have been shown and the data presented emphasise the importance of examining dose-reducing strategies in a comprehensive way.
Objectives To provide direct estimates of risk of cancer after protracted low doses of ionising radiation and to strengthen the scientific basis of radiation protection standards for environmental, occupational, and medical diagnostic exposures.
Design Multinational retrospective cohort study of cancer mortality.
Setting Cohorts of workers in the nuclear industry in 15 countries.
Participants 407 391 workers individually monitored for external radiation with a total follow-up of 5.2 million person years.
Main outcome measurements Estimates of excess relative risks per sievert (Sv) of radiation dose for mortality from cancers other than leukaemia and from leukaemia excluding chronic lymphocytic leukaemia, the main causes of death considered by radiation protection authorities.
Results The excess relative risk for cancers other than leukaemia was 0.97 per Sv, 95% confidence interval 0.14 to 1.97. Analyses of causes of death related or unrelated to smoking indicate that, although confounding by smoking may be present, it is unlikely to explain all of this increased risk. The excess relative risk for leukaemia excluding chronic lymphocytic leukaemia was 1.93 per Sv (< 0 to 8.47). On the basis of these estimates, 1-2% of deaths from cancer among workers in this cohort may be attributable to radiation.
Conclusions These estimates, from the largest study of nuclear workers ever conducted, are higher than, but statistically compatible with, the risk estimates used for current radiation protection standards. The results suggest that there is a small excess risk of cancer, even at the low doses and dose rates typically received by nuclear workers in this study.
Optimisation of radiation protection in fluoroscopy is important since the procedure could lead to relatively high absorbed doses both in patients and personnel resulting in acute radiation injury. Optimisation procedures include adjustment of the fluoroscopy equipment such as exposure factors as well as proper use of automatic brightness control and pulsed fluoroscopy. It is also important to gain the benefits of image processing and the higher sensitivity of flat panel detectors as compared to image intensifier-TV systems.
Proper positioning of the patient with respect to detector and X-ray tube is of fundamental importance to image quality and radiation dose to the patient. Both image quality and radiation dose are also affected by the methodology used with parameters such as magnification factor, increased filtration, use of last-image-hold and the use of a grid.
There is a direct relation between patient dose and the absorbed dose to the personnel since this is mostly due to scattered radiation from the patient. If the correct methodology and the correct radiation protection devices are used, the absorbed dose to the personnel could be minimised to acceptable levels even for those working with complex procedures.
In order to have an organised review of all aspects of optimisation, it is recommendable to have an active quality system at the department. This system should define responsibilities and tasks for persons involved.
Radiation protection; fluoroscopy; patient dose; dose reduction
This study was aimed to investigate the methods to reduce operator's radiation dose when taking intraoral radiographs with portable dental X-ray machines.
Materials and Methods
Two kinds of portable dental X-ray machines (DX3000, Dexcowin and Rextar, Posdion) were used. Operator's radiation dose was measured with an 1,800 cc ionization chamber (RadCal Corp.) at the hand level of X-ray tubehead and at the operator's chest and waist levels with and without the backscatter shield. The operator's radiation dose at the hand level was measured with and without lead gloves and with long and short cones.
The backscatter shield reduced operator's radiation dose at the hand level of X-ray tubehead to 23 - 32%, the lead gloves to 26 - 31%, and long cone to 48 - 52%. And the backscatter shield reduced operator's radiation dose at the operator's chest and waist levels to 0.1 - 37%.
When portable dental X-ray systems are used, it is recommended to select X-ray machine attached with a backscatter shield and a long cone and to wear the lead gloves.
Dental digital radiography; Portable dental X-ray; Radiation dosage; Radiation protection
In digital radiography we are now able to electronically collimate images after acquisition. This may seem convenient in paediatric imaging, but we have to be aware that electronic collimation has two major downsides. Electronic collimation implicates that the original field size should have been smaller and the child has been exposed to unnecessary radiation. Also, by use of electronic collimation, potentially important information may be lost. The “silver lining”, denoting the X-ray beam collimation, can serve as a useful radiation protection instrument to check for proper field size and detect unnecessary exposure. Furthermore, the silver lining confirms all exposed anatomy is shown in the final image, and thus may also serve as a quality assurance instrument as the patient has the right to all acquired information.
• The ability to electronically collimate an image after acquisition may serve to enhance contrast in the region of interest.
• The ability to electronically collimate an image after acquisition carries the risk of overexposure.
• The ability to electronically collimate an image after acquisition carries the risk of losing important information.
• The silver lining can serve as a quality control instrument for proper collimation.
• The patient has the right to all information obtained during an X-ray examination.
Paediatrics; Radiation protection; Digital radiography; Radiographic image enhancement; Patient rights
During the last 15 years, developments in X-ray technologies have substantially improved the ability of practitioners to treat patients using fluoroscopically guided interventional techniques. Many of these procedures require a greater use of fluoroscopy and more recording of images. This increases the potential for radiation-induced dermatitis and epilation, as well as severe radiation-induced burns to patients. Many fluoroscope operators are untrained in radiation management and do not realize that these procedures increase the risk of radiation injury and radiation-induced cancer in personnel as well as patients. The hands of long-time fluoroscope operators in some cases exhibit radiation damage—especially when sound radiation protection practices have not been followed. In response, the Center for Devices and Radiological Health of the United States Food and Drug Administration has issued an Advisory calling for proper training of operators. Hospitals and administrators need to support and enforce the need for this training by requiring documentation of credentials in radiation management as a prerequisite for obtaining fluoroscopy privileges. A concerted effort on the part of professional medical organizations and regulatory agencies will be required to train fluoroscopy users to prevent physicians from unwittingly imparting serious radiation injuries to their patients.
Credentialing fluoroscopist; Fluoroscopist radiation dose
The aim of this study was to determine any increase in the incidence of cone cut errors that adversely affected diagnostic yield resulting in more retakes using rectangular collimation with film holders in bitewing radiography. Comparisons were also made with other positioning errors that occurred when bitewings were taken with circular collimation, with and without film holders.
A preliminary questionnaire was used to determine the year that rectangular collimation was adopted by military dental practice. 3 time-framed subsets, each of 1000 bitewing radiographs, were identified: subset 1, films taken with circular collimators without film holders; subset 2, films taken with circular collimators with film holders; and subset 3, films taken with rectangular collimators with film holders. Each subset was assessed for positioning errors of cone cut, horizontal overlap, vertical distortion and film centring. The χ2 test was used to test significant differences amongst the three subsets.
The use of film holders with circular collimation significantly reduced the incidence of cone cut errors from 21.7% to 3.3%. There was an increase in the incidence of cone cut errors from 3.3% to 20.9% when rectangular collimation was used, but the actual number considered “rejects” was very small, only 0.1% (1 in 1000 films) in subset 2 and 0.3% (3 of 1000 films) in subset 3, when assessed for diagnostic yield.
This study provides evidence that rectangular collimation did not significantly affect the diagnostic yield of bitewing radiographs despite the presence of cone cut. Therefore, all practitioners should adopt rectangular collimation.
bitewing radiography; rectangular collimation; circular collimation; cone cut
Roentgen findings in subphrenic abscess, in the order of their specificity and clinical value, are subphrenic air-fluid level, elevation and restriction of motion of the diaphragm, pleural reaction with congestion, segmental atelectasis or pneumonitis at the lung base and upper abdominal mass. Less frequently there may be empyema or bronchopleural fistula.
Suppression of the infection by antibiotics may protract the course and obscure the clinical findings. Serial x-ray and fluoroscopic studies are recommended when a patient who has had rupture of a viscus or previous abdominal operation does not completely recover or has a persistent lowgrade fever.
There are now several independent studies that indicate that the dose-response for the endpoint of radiation-induced neoplastic transformation in vitro is non-linear for low linear energy transfer (LET) radiation. At low doses (<10 cGy) the transformation frequency drops below that seen spontaneously. Importantly, this observation has been made using fluoroscopic energy x-rays, a commonly used modality in diagnostic radiology, the practice of which is responsible for the majority of radiation exposure to the general public. Since the transformation frequency is reduced over a large dose range (0.1 to 10cGy) it is likely that multiple mechanisms are involved and that the relative contribution of these may vary with dose. These include the killing of a subpopulation of cells prone to spontaneous transformation at the lowest doses, and the induction of DNA repair at somewhat higher doses. Protective effects of low doses of low LET radiation on other cancer-relevant endpoints in vitro and in vivo have also been observed by several independent laboratories. These observations strongly suggest that the linear-nonthreshold dose-response model is unlikely to apply to the induction of cancer by low doses of low LET radiation in humans.
Low dose; radiation; neoplastic transformation; adaptive response
Ultrasounds and ionizing radiation are extensively used for diagnostic applications in the cardiology clinical practice. This paper reviewed the available information on occupational risk of the cardiologists who perform, every day, cardiac imaging procedures. At the moment, there are no consistent evidence that exposure to medical ultrasound is capable of inducing genetic effects, and representing a serious health hazard for clinical staff. In contrast, exposure to ionizing radiation may result in adverse health effect on clinical cardiologists. Although the current risk estimates are clouded by approximations and extrapolations, most data from cytogenetic studies have reported a detrimental effect on somatic DNA of professionally exposed personnel to chronic low doses of ionizing radiation. Since interventional cardiologists and electro-physiologists have the highest radiation exposure among health professionals, a major awareness is crucial for improving occupational protection. Furthermore, the use of a biological dosimeter could be a reliable tool for the risk quantification on an individual basis.
Diagnostic reference levels (DRLs) are an important tool in the optimisation of clinical radiography. Although national DRLs are provided for many diagnostic procedures including dental intra-oral radiography, there are currently no national DRLs set for cephalometric radiography. In the absence of formal national DRLs, the Health Protection Agency (HPA) has previously published National Reference Doses (NRDs) covering a wide range of diagnostic X-ray examinations. The aim of this study was to determine provisional NRDs for cephalometric radiography.
Measurements made by the Dental X-ray Protection Service (DXPS) of the HPA, as part of the cephalometric X-ray equipment testing service provided to dentists and dental trade companies throughout the UK, were used to derive provisional NRDs.
Dose–area product measurements were made on 42 X-ray sets. Third quartile dose–area product values for adult and child lateral cephalometric radiography were found to be 41 mGy cm2 and 25 mGy cm2, respectively, with individual measurements ranging from 3 mGy cm2 to 108 mGy cm2.
This report proposes provisional NRDs of 40 mGy cm2 and 25 mGy cm2 for adult and child lateral cephalometric radiographs, respectively; these doses could be considered by employers when establishing their local DRLs.
1. The individual destructive effects of colloidal silver and heavily filtered radiation are still evident when the two are used together. 2. The combined effects are cumulative in that small doses are more destructive than when either is used alone. 3. The leucocytosis resulting from the injection of the colloidal silver affords no protection against the terminal leucopenia following the radiation.
The x-ray has a specific effect upon the epithelium lining the crypts and covering the villi of the small intestine. A suitable dose of x-ray will destroy this epithelium in large measure, leaving empty crypts and naked villi exposed to swarms of bacteria in the intestine. Subsequently one does not observe an overwhelming invasion of the tissues, lymph, and blood by intestinal bacteria. It seems obvious therefore that the intestinal epithelium is not the all important barrier which protects the tissues from invasion by intestinal bacteria.
Virus-induced papillomas (Shope) on domestic rabbits are susceptible to Roentgen rays. The dosage which uniformly brings about their complete and permanent disappearance has been found to be 3600 r (200 kilovolts), whether this dose be administered at one time or fractionally. 60 per cent of the tumors are cured when irradiated with 3000 r.
This study was aimed to examine the association between the effective radiation dose of diagnostic radiation workers in Korea and their risk for cancer. A total of 36,394 diagnostic radiation workers (159,189 person-years) were included in this study; the effective dose and cancer incidence were analyzed between the period 1996 and 2002. Median (range) follow-up time was 5.5 (0.04–7) years in males and 3.75 (0.04–7) years in females. Cancer risk related to the average annual effective dose and exposure to more than 5 mSv of annual radiation dose were calculated by the Cox proportional hazard model adjusted for occupation and age at the last follow-up. The standardized incidence ratio of cancer in radiation workers showed strong healthy worker effects in both male and female workers. The relative risk of all cancers from exposure of the average annual effective dose in the highest quartile (upper 75% or more of radiation dose) was 2.14 in male workers (95% CI: 1.48–3.10, p-trend: <0.0001) and 4.43 in female workers (95% CI: 2.17–9.04, p-trend: <0.0001), compared to those in the lower three quartiles of radiation exposure dose (less than upper 75% of radiation dose). Cancer risks of the brain (HR: 17.38, 95% CI: 1.05–287.8, p-trend: 0.04) and thyroid (HR: 3.88, 95% CI: 1.09–13.75, p-trend: 0.01) in female workers were significantly higher in the highest quartile group of radiation exposure compared to those in the lower three quartiles, and the risk of colon and rectum cancers in male workers showed a significantly increasing trend according to the increase of the average annual radiation dose (HR: 2.37, 95% CI: 0.99–5.67, p-trend: 0.02). The relative risk of leukemia in male workers and that of brain cancer in female workers were significantly higher in the group of people who had been exposed to more than 5 mSv/year than those exposed to less than 5 mSv/year (HR: 11.75, 95% CI: 1.08–128.20; HR: 63.11, 95% CI: 3.70–1,075.00, respectively). Although the present study involved a relatively young population and a short follow-up time, statistically significant increased risks of some cancers in radiation workers were found, which warrants a longer follow-up study and more intensive protective measures in this population.
cancer risk; diagnostic radiation workers; effective dose
Routine diagnostic X-rays (e.g., chest X-rays, mammograms, computed tomography scans) and routine diagnostic nuclear medicine procedures using sparsely ionizing radiation forms (e.g., beta and gamma radiations) stimulate the removal of precancerous neo-plastically transformed and other genomically unstable cells from the body (medical radiation hormesis). The indicated radiation hormesis arises because radiation doses above an individual-specific stochastic threshold activate a system of cooperative protective processes that include high-fidelity DNA repair/apoptosis (presumed p53 related), an auxiliary apoptosis process (PAM process) that is presumed p53-independent, and stimulated immunity. These forms of induced protection are called adapted protection because they are associated with the radiation adaptive response. Diagnostic X-ray sources, other sources of sparsely ionizing radiation used in nuclear medicine diagnostic procedures, as well as radioisotope-labeled immunoglobulins could be used in conjunction with apopto-sis-sensitizing agents (e.g., the natural phenolic compound resveratrol) in curing existing cancer via low-dose fractionated or low-dose, low-dose-rate therapy (therapeutic radiation hormesis). Evidence is provided to support the existence of both therapeutic (curing existing cancer) and medical (cancer prevention) radiation hormesis. Evidence is also provided demonstrating that exposure to environmental sparsely ionizing radiations, such as gamma rays, protect from cancer occurrence and the occurrence of other diseases via inducing adapted protection (environmental radiation hormesis).
radiation hormesis; adaptive response; LNT
The C-arm fluoroscope is known as the most important equipment in pain interventions. This study was conducted to investigate the completion rate of education on radiation safety, the knowledge of radiation exposure, the use of radiation protection, and so on.
Unsigned questionnaires were collected from the 27 pain physicians who applied for the final test to become an expert in pain medicine in 2011. The survey was composed of 12 questions about the position of the hospital, the kind of hospital, the use of C-arm fluoroscopy, radiation safety education, knowledge of annual permissible radiation dose, use of radiation protection, and efforts to reduce radiation exposure.
In this study, although most respondents (93%) had used C-arm fluoroscopy, only 33% of the physicians completed radiation safety education. Even though nine (33%) had received education on radiation safety, none of the physicians knew the annual permissible radiation dose. In comparing the radiation safety education group and the no-education group, the rate of wearing radiation-protective glasses or goggles and the use of radiation badges or dosimeters were significantly higher in the education group. However, in the use of other protective equipment, knowledge of radiation safety, and efforts to reduce radiation exposure, there were no statistical differences between the two groups.
The respondents knew very little about radiation safety and had low interest in their radiation exposure. To make the use of fluoroscopy safer, additional education, as well as attention to and knowledge of practices of radiation safety are required for pain physicians.
education; fluoroscopy; radiation; radiation monitoring; radiation protection