ARE YOU AT RISK ?
  >>> “…unprotected individuals working twenty-four inches (70cm) or less from a fluoroscopic beam receive significant amounts of radiation…”
L. Orthopedic Trauma, Vol. 11, N° 6, 1997.		  

  >>> “…operators can approach the dose limit to hands in high workload. It is important that protection measures are taken to reduce hand dose, especially for those with high workloads and those involved with complex procedures.”
European Journal of radiology 21 (1995) 72-75.		  

  >>> “…under no circumstances should the surgeon allow her hands to enter the fluoroscopic beam because such direct contact is associated with exposure rates of approximately 4,000 mrem/min (40 mSv/min) and established hand limits would be met or exceeded after only 12.5 minutes of such direct exposure."
J. Orthop Trauma, Vol. 11, N° 6, 1997.		  

  >>> DOSE THRESHOLD - “The highest operator doses for the left arm and left hand were 1.99 and 3.55 mSv, respectively. A similar calculation indicates that an operator performing 140 (500/3.55) or more endovascular surgeries in a year has a potential risk of exceeding the dose limit for the skin. Even in the highest dose for the hand (3.55 mSv) was overestimated in our study, the operator dose for the arm exceeded 1 mSv in three procedures in this study, indicating that skin exposure should not be overlooked by operators who perform hundreds of endovascular surgeries in a year.”
AJNR Am J. Neuroradiol 15:1801-1808, Nov. 1994.		  

  >>> “The occurence of epilation suggests that certain threshold doses have been exceeded and doses of about twice the threshold or less may result in more serious skin reactions.”
L. Wagner, PhD, et al. SCVIR 1994.		  

  >>> “ Minimizing or eliminating potential skin effects from the interventional radiological procedure is one important goal in ensuring that detrimental deterministic side effects do not compromise the benefits of such procedures.”
L. Wagner, PhD, et al. SCVIR 1994.		  

 

>>>

 DETERMINISTIC EFFECTS
 Deterministic radiation responses:  
    A.
B.
C.
D. 		Increase in severity with increasing dose
Increase in incidence with increasing dose
Occur at all doses
Include genetic mutations
 

 

   Recommended dose limits are below the:  
  A.
B.
C.
D. 		threshold for deterministic responses
threshold for stochastic responses
threshold of the radiation monitor
sensitivity of the radiation monitor
    “Deterministic effects such as erythema or cataract, are those for which a minimum number of cells must be effected before the biological response is observed…If the dose is sufficiently high, there is a 100% certainty that the effect will be induced.”
L. Wagner, Ph.D., et al. SCVIR 1994.		  

  >>> HOW DOES THIS EFFECT YOU? - Fluoroscopic x-rays are attenuated rapidly in tissue:
- Have you noticed hair loss on your forearm and/or shins from ankle to knee?
- Have you noticed a redness of the skin (erythema), similar to a sunburn, on your dominant hand and forearm?
L. Wagner, PhD, et al. SCVIR 1994.		  

  >>> A.L.A.R.A. - The Nuclear Regulatory Commission has suggested that occupational exposure should be:
  
    AS LOW AS REASONABLY ACHIEVABLE
  

 

>>>

 The three principles of radiation protection:  
  1.
2.
3.
 Increase distance from the source.
X-ray beam should be collimated as much as possible.
Reduce exposure time.
    WEAR SHIELDING AND PROTECTIVE PRODUCTS
  
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