Comparison of Occupational Radiation Exposure in Interventional Pain Medicine Physician Wearing Chest versus Hand Dosimeters
Occupational radiation exposure amongst interventional pain medicine physicians is an essential topic in the discussion of workplace safety and career longevity. Many opinions from across all medical specialties exist for the varying types of dosimeters to accurately estimate exposure during radiation producing procedures. Some argue that hand dosimeters worn on the finger are superior due to proximity of the hands to the working field and source of radiation. Others note the variability in physician technique affecting the accuracy of hand dosimeters as well as their perceived effect on dexterity and discomfort while preforming procedures. This study’s aim was to compare radiation exposure recordings between the commonly worn chest dosimeter and hand dosimeters to elucidate any potential discrepancies that may lead to more impactful safety measures. A secondary aim was to examine any differences in broken glove events or breeches of sterility during procedures.
•Ten subjects were randomly divided into two equal numbered cohorts consisting of a control group (n=5) that was assigned to wear the standard chest dosimeter only and an experimental group (n=5) that wore both chest and hand dosimeters. Dosimeter wearing compliance and radiation exposure measurements were collected for each of the subjects’ dosimeter(s).
•Comparison between the chest dosimeters of the control and experimental groups was done to assess baseline radiation exposure of the experimental group.
•Due to the differing OSHA safety thresholds for chest and extremity radiation (2500 mrem vs. 37500 mrem), to compare radiation recordings between the chest and hand dosimeters, absolute radiation exposure recordings were interpreted as a percentage of the allowable six-month maximum.
•There was no significant difference in average six-month radiation exposure per individual between the control and experimental groups detected by chest dosimeters (158.8 mrem vs. 122.8 mrem P = 0.473). This indicates a similar overall exposure within the time period between the two groups.
•The average percentage of six-month maximum radiation exposure was significantly higher on the chest dosimeter compared to the hand dosimeter (4.9% vs. 0.63% P = 0.0069)
•The chest dosimeter recorded nearly nine times the acceptable percentage maximum compared to the hand dosimeter. However, both dosimeter recordings were well within acceptable safe standards.
•Given this data, the chest dosimeters may be the safer, more conservative option for monitoring occupational exposure compared to hand dosimeters.
•This data also indicates that the use of a hand dosimeter alone may underestimate radiation to other parts of the body and physicians must consider their procedural practices when monitoring radiation exposure.
•There were no glove breaks recorded for any subjects in either group. One subject noted discomfort with the hand dosimeter that affected their ability to preform procedures, which emphasizes previously sighted concerns for this method of monitoring.
