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The need to protect the thyroid gland during image intensifier use in orthopaedic procedures.

The image intensifier has become an essential part of the orthopaedic surgeon's armamentarium. Its increasing use, however, may expose medical staff and theatre personnel to high doses of radiation. The aim of this study was to assess the compliance of surgeons and staff with radiation protection protocols, especially the use of the thyroid shield and to calculate the radiation exposure dose during routine orthopaedic procedures. We carried out this prospective study of 44 consecutive cases at the Rochdale Infirmary. The total dose of radiation and the total number of images taken were found to be more during hip surgery such as dynamic hip screw fixation for intertrochanteric fracture (1,715.5 mGy.cm2) and the intramedullary nailing (4,357.5 mGy.cm2). However the total percentage of the theatre personnel wearing thyroid shield was as low as 4% (14 people out of total 345 people present in theatre in 44 procedures) in spite of its availability. The consistent neglect in the use of the thyroid shield by surgeons and nursing staff present in theatre during fluoroscopically assisted procedures is a matter for concern. The data presented in this study will emphasise the need to wear a thyroid collar during orthopaedic procedures and the need for better guidelines to protect theatre personnel as well as patients from radiation exposure hazards.

Adult↗

[A comparative analysis of the impact on biota and man in the 30 km zone of the Chernobyl NPP].

A methodological approach is described for a comparative assessment of ionizing radiation effects on man and biota, based on the use of indices of radiation impact--ratios of actual exposure doses to environmental objects (including humans) and critical ones. As such doses, standards limiting radiation exposure and doses at which phenotypical effects were absent after the Chernobyl accident were employed, respectively for man and biota. For the test site chosen within the 30 km ChNPP zone (region of the Borshchovka settlement), dose burdens to reference biota species and the population (with and without evacuation) and the corresponding radiation impact indices were calculated. For the long term period after the accident radiation safety standards for man are shown to ensure radiation safety for biota as well. At the same time in the early period after the accident the emergency regulations do not guarantee adequate protection of nature, some species of which can be subject to irradiation more than man, even if countermeasures like evacuation are not applied. A conclusion has been made on the necessity of a more detailed and comprehensive analysis of situations when the anthropocentric principle "if radiation standards protect man then biota are also adequately protected" is violated.

Animals↗

[The principles of radiological quality assessment of water resources].

In the paper the main approaches to radiation safety of water objects have been analyzed. It is shown that radiation safety requirements for drinking water, fixed in the Rules and Regulations on radiation safety, do not ensure radiation safety of water objects used for the complex national economy needs. Application of the conservatism principle (choosing of the worst variant) for radiation safety ensuring is considered and proved. On the base of this principle the model is developed comparing the anthropocentric (sanitary--hygienic) with ecological (biota) principles for ensuring safety of water objects. It is proved, that the application of the Water Radiation Safety Rules currently in force, based on the norms of dose quotas, reserved for regulation of nuclear power plants and industry impact, ensures safety of the water ecological systems.

Fresh Water↗

[The use of computer system in the introduction of countermeasures in agriculture after the Chernobyl accident].

In the development of strategies for countermeasures aimed at the rehabilitation of contaminated areas, essential is to identify criteria for assessing their effectiveness and factors influencing the priority of the criteria chosen. A method is suggested for assessing effectiveness of countermeasures in agriculture based on a multicriterium analysis of radiologic, economic, regulatory and socio-psychological indicators characterizing the use of countermeasures. Rating of countermeasures strategies is presented depending on financing of works on the rehabilitation of the Chernobyl affected areas.

Chernobyl Nuclear Accident↗

[Effective radiation doses of the personnel at rentgenosurgical studies].

In the paper versatile study of radiation dose of the medical personnel is carried out at rentgenosurgery with application of tissue-equivalent phantoms. For the first time spectrometric study of dissipated radiation by object is carried out, normalized to unit of exposition dose fields around of the object are constructed.

Humans↗

Technologist radiation exposure in routine clinical practice with 18F-FDG PET.

OBJECTIVE: The use of 18F-FDG for clinical PET studies increases technologist radiation dose exposure because of the higher gamma-radiation energy of this isotope than of other conventional medical gamma-radiation-emitting isotopes. Therefore, 18F-FDG imaging necessitates stronger radiation protection requirements. The aims of this study were to assess technologist whole-body and extremity exposure in our PET department and to evaluate the efficiency of our radiation protection devices (homemade syringe drawing device, semiautomated injector, and video tracking of patients). METHODS: Radiation dose assessment was performed for monodose as well as for multidose 18F-FDG packaging with both LiF thermoluminescence dosimeters (TLD) and electronic personal dosimeters (ED) during 5 successive 18F-FDG PET steps (from syringe filling to patient departure). RESULTS: The mean +/- SD total effective doses received by technologists (n = 50) during all of the working steps were 3.24 +/- 2.1 and 3.01 +/- 1.4 microSv, respectively, as measured with ED and TLD (345 +/- 84 MBq injected). These values were confirmed by daily TLD technologist whole-body dose measurements (2.98 +/- 1.8 microSv; 294 +/- 78 MBq injected; n = 48). Finger irradiation doses during preparation of single 18F-FDG syringes were 204.9 +/- 24 and 198.4 +/- 23 microSv with multidose vials (345 +/- 93 MBq injected) and 127.3 +/- 76 and 55.9 +/- 47 microSv with monodose vials (302 +/- 43 MBq injected) for the right hand and the left hand, respectively. The protection afforded by the semiautomated injector, estimated as the ratio of the doses received by TLD placed on the syringe shield and on the external face of the injector, was near 2,000. CONCLUSION: These results showed that technologist radiation doses in our PET department were lower than those reported in the literature. This finding may be explained by the use of a homemade syringe drawing device, a semiautomated injector, and patient video tracking, allowing a shorter duration of contact between the technologist and the patient. Extrapolation of these results to an annual dose (4 patients per day per technologist) revealed that the annual extrapolated exposure values remained under the authorized limits for workers classified to work in a radioactivity-controlled area.

Allied Health Personnel↗

[Details in relation to emergency planning in case of undesired dispersion of radioactivity].

In the present context of terrorist threat and the multiple uses of radioactive sources for many applications, one cannot exclude the probability of a contamination with radioactive products in the public domain. The most probable scenario is the loss or theft of a source, or a source showing up in some unexpected location (orphan sources). Terrorist actions may lead to a similar problem (radiological dispersion devices, RDD). If the radiological situation is serious, the Belgian emergency plan will be declared, aiming at protecting the population as adequately as possible. However, the emergency plan has mainly been conceived for an accident in a nuclear facility; as exercises are organised frequently and as the technical possibilities can be studied in advance, the experts are better prepared for such accidents. But a radioactive contamination in some other location would lead to modifications to be made, which may result in less effective response. Indeed, the very first stage--an alert--will presumably be missing. Or the contamination may occur in a town not involved in radiological emergency exercises, leading to a local lack of means. The main concern is that this should not lead to a degradation of the response. It is essential that all decision makers at all levels know how to deal with the situation, or at least know whom to call for support (Mayors, emergency workers) A special focus on medical staff who could be involved with potentially strong (yet local) fields of radiation, injured people with contamination, but also (and presumably especially) with the psychological impact of large groups of population feeling concerned about the potential health or societal (and economic) consequences for themselves or their children. Whether the probability of such an event is large in Belgium or not is in that sense less relevant: the probability surely isn't zero, and as such an adapted preparation scheme is absolutely necessary.

Disaster Planning↗

Method of patient dose evaluation in the angiographic and interventional radiology procedures.

PURPOSE: The aim of this study was to evaluate the effective dose in interventional radiology and angiography procedures on the basis of the dose-area product (DAP), either measured or calculated using two different methods. MATERIALS AND METHODS: We studied 2072 examinations carried out on several X-ray systems both in angiography and in interventional radiology. Some of the systems were equipped with an on-board transmission chamber for DAP measurements; for these systems we took direct DAP measurements for each type of examination. For the systems without the dose measurement device, we used a portable transmission chamber, acquiring the data from a set of sampling frames. We then derived the dose values from the systems' dosimetry data and the information about each examination. To this end, the dosimetry of each x-ray system was done by measuring tube output in the different acquisition modes, backscatter factor and field-homogeneity factor. Survey data sheets were filled in after every examination indicating the exposure data (mean Kv, mAs, focus-skin distance and field size). These values combined with the dosimetric data were used to evaluate the DAP for each exam. Where possible, we compared the measured and calculated DAP values by assessing the percentage deviation between each pair of values. A similar comparison was made for the single examinations using a simplified calculation algorithm reported in the literature. For all the examinations for which we had adequate survey data sheets, we estimated the DAP and the entrance dose values and, with the aid of WinODS software, the effective dose. RESULTS: The direct measurements of DAP showed that, in interventional radiology and angiographic procedures, the variability in examination conditions leads to a wide range of possible patient doses even within the same examination type. The comparison between the measured and calculated DAP using our algorithm showed substantial agreement (mean difference 30%, maximum 80%). By contrast, using the algorithm proposed in the literature, we obtained deviations higher than 100%. An estimate of the effective dose for all the recorded examinations (2072) permitted evaluation of both magnitude and variability of patient doses in special radiology procedures such as angiography and interventional radiology. However, it should be noted that evaluations based on calculated DAP values may be as uncertain as those estimated for DAP, and that clearly the evaluations made for the examinations for which direct measurements are available are more accurate. In particularly ''invasive'' examinations in terms of entrance dose, where the threshold limits for deterministic effects might possibly be exceeded, the equivalent doses to critical organs were also assessed. This analysis showed that in a small percentage of patients (5%) 2 Gy to the skin was exceeded in the areas exposed with possible transient erythema, while in fewer than 2% of patients, the 3 Gy limit for temporary epilation was exceeded. CONCLUSIONS: Many interventional radiology, especially haemodynamic, examinations have shown to give significant exposure to patients. The direct dose measurement method has shown to be the only method able to provide reliable information on such exposure.However, the authors believe that since the patient dose cannot be established in advance, even in terms of magnitude and since direct dose measurement cannot be performed on all patients, it is nonetheless interesting to be able to assess, at least semiqualitatively, the amount of the above doses.

Algorithms↗

[System preserving radiation safety for Moscow population].

Radiation safety system functioning on Moscow territory enables to control potential dangerous sources, opportunely reveal and liquidate accidents and pollutions, forecast degree of radiation jeopardy according to its components.

Air Pollutants, Radioactive↗

[Effect of the physiological-biochemical characteristics variability on a radiosensitiveness of the Atriplex patula L. and Artemisia vulgaris L. ecoforms].

On the example of the physiological and the cytology-biochemical characteristics variability of an Atriplex patula L. and Artemisia vulgaris L. sprouts which parental plants were generated in various environmental conditions (South Yakutia, the Central Yakutia, Middle Ural), was shown, that radiostability depends not only on set protective antioxidant, on the DNA-reparation systems and on the vulnerability degree of a functioning genome, but also on the phenotypic diversifications of a population which in turn, in the certain degree, are consequence of previous selection of a population to all set of ecological stresses-factors of the environment.

Adaptation, Physiological↗

[Verification of Polish regulations of maximum permissible intensities in electromagnetic fields by the Commission for Bioelectromagnetic Issues of the Polish Radiation Research Society].

Experts in the field of bioelectromagnetism have reported a growing need to verify Polish regulations on the protection against electromagnetic fields (EMF) in the 0-300 GHz range, especially in their maximal permissible intensities (MPI). There is a general belief that Polish standards do not fully comply with recommendations and directives of the European Union (EU) and that Polish regulations on the border values for environmental and occupational exposure to EMF are not harmonized. To this end, the Commission for Bioelectromagnetic Issues have been set up in the Polish Radiation Research Society. Following a through analysis of standards binding in Poland and EU, the Commission set about working on verified MPI values for EMF. This paper presents some comments of the Commission members, stressing the complexity of this undertaking.

Electromagnetic Fields↗

[Ultrastructure of blood cells in children exposed to radiation in utero and resided in radionuclide contaminated zones].

The electron-microscopic examinations of lymphocytes and neutrophiles in circulating blood of children irradiated during intrauterine development and on posterior stages of ontogenesis were performed in dynamics after accidental period. Some changes in lymphocyte ultrastructure were revealed; namely the increased undulation of nuclear contours with dilated perinuclear space and some reconstructions of their cellular organoids (the increased density of mitochondrial matrix, crist disorganization, dilation of clear space in cisterns of cytoplasmic net, disorders in the structure of electron-dense granules). The peculiarities of neutrophile ultrastructure that are characterized by centre dilated perinuclear space, decrease in glycosomes, disorders in granular structure, vacuole presence, degradation of cytoplasm and nuclear hypersegmentation were determined.

Cesium Radioisotopes↗