Radiation safety at a glance:
• Respect exposure risks, but don’t worry too much.
• Patients receive much higher radiation doses with no adverse effects.
• Wear proper shielding, including around the eyes.
• Exposure risk is well within guidelines for those who are pregnant or planning to become pregnant.
• Be safe: minimize exposure to yourself and patients as much as possible.
who have radiation-induced cataracts get them in the corners of the eyes where they were vulnerable to scatter.
But be sensible and don’t panic. A lot of people are worried about the radiation exposure to their heads and want to wear skull caps. The head is very radio- resistant, and has the least likelihood of coming up with adverse health effects.
WK: Do skullcaps make exposure worse or are you just wasting your money? JR: You’re just wasting your money. And when people wear them, they get hot and sweaty and it distracts from the procedure. Anything that’s going to cause you to push the pedal longer or make you feel uncomfortable is going to increase exposure to you and the patient.
WK: What about gloves? JR: Gloves are even more insignificant. By wearing gloves, we have the potential to put the gloves in the way of the radiation field. Imaging devices are smart and adjust to what they see in the field. When a glove shows up inadvertently, the system says “Oh, something changed, increase the parameters to maintain image quality,” and everyone gets a much higher dose.
WK: Has it been your experience that women and men have different concerns about radiation? JR: I tend to find that men are less concerned about radiation exposures
26 IRQ | WINTER 2022
than women, and that could be because pregnancy and breast cancer aren’t in the equation for them. But women tend to be more practical in managing their radiations exposures. With many female radiologists, as soon as they find out they are pregnant or are interested in becoming pregnant, their radiation dosemeters practices change dramatically. They’ll become more interested and knowledgeable about risks. However, while their practices change, they don’t necessarily decrease their radiation exposure.
But be sensible and don’t panic. A lot of people are worried about the radiation exposure to their heads and want to wear skull caps. The head is very radio-resistant, and has the least likelihood of coming up with adverse health effects.
WK: Are you aware of any statistical validation or studies that show one gender may be of more risk, or that fetuses are at more risk if certain precautions aren’t taken? JR: We know for certain that fetuses are at more risk because they’re developing faster. However, is it something to really worry about? I wouldn’t say so. When we look at exposures to fetuses, for the most part they are well under the radiation limits for pregnant workers. Even my male clinicians who work in the very highest doses receive exposure to their bellies well under the limits.
WK: That should hopefully be reassuring to a clinician who is or wants to get pregnant, that the data suggests there won’t be long term risk to the fetus. Is that accurate? JR: That’s accurate. The units of exposure are too small for traditional radiation units in medicine so we use
the millirem. Most under-apron belly badges are going to be in the 10 millirem or less per month range, even on highly exposed IRs. The regulations say we should be under 50 millirem per month. When looking at a pregnancy’s potential impact from exposure, we don’t do anything until the exposure is 10,000 millirem. And the guidance from the American College of Radiology and the American College of Obstetrics and Gynecology has no problems allowing CT exposures of a pregnant woman— and that’s when you’re going to get a dose that will be deep enough to bypass shielding. But we see no impacts. That said, you obviously want to manage the exposure and minimize the dose as much as possible.
WK: That’s great to know, especially because we want to make IR more inclusive, and a lot of younger colleagues in medical school have concerns about the risk, both male and female. In your opinion, is that something we can discount when counseling them? JR: I appreciate the concern for radiation exposure and will never minimize someone’s concern for it. But except for the cataract issue, we don’t really consider exposure risks until your body gets up into the tens of rem, or the tens of milli-gray. Even over a lifetime, that’s a lot of exposure, and most of my interventionalists never reach that dose. And in any medical field today, especially surgery, you really can’t get away from exposure. If someone has a passion for IR, they should follow it and not worry about risks as long as they follow good safety practices: minimize the patient dose, wear protective clothing, use the fold on shields as close to the patient as you can and utilize the table skirt to minimize the radiation under the table.
Read more about radiation safety in IRQ at
bit.ly/2Gchfd2
or about the impact of radiation on pregnancy at
bit.ly/2AgHi0f.
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