Article
Risk of radiation induced glaucoma: investigation on radiation exposure to the eye during endourologic procedures
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Authors
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Florian Distler
- PMU Nürnberg
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Josefine Hartmann
- PMU Nürnberg
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Martin Baumüller
- PMU Nürnberg
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Ewald Guni
- PMU Nürnberg
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Sascha Pahernik
- PMU Nürnberg
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Michael Wucherer
- PMU Nürnberg
| Published: | May 17, 2018 |
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Outline
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Background: Due to new radiobiological data, the International Commission on Radiological Protection (ICRP) recommends a dose limit of 20 mSv per year to the lens of the eye. Therefore, the council directive 2013/59/EURATOM requires a reduction of the annual dose limit from currently 150 mSv to 20 mSv starting from 2018. Urologists are exposed to an elevated radiation exposure in the head region during urological interventions, due to the commonly used overtable X-ray tubes in urology. Also, technical or personal radiation protection for the head is rarely used by urologists. Aim of the study was to analyze real radiation exposure to the eye during various urologic interventions.
Material and methods: The partial body doses (forehead, apron collar, forearm) of the urologists, surgery staff and anesthetists were measured over a period of two months. All 119 interventions were performed on two separate fluoroscopic workplaces Uroskop Omnia Max (Siemens Healthineers, Erlangen, Germany). The urological interventions were differentiated in three groups regarding supposed radiation exposure dose. Three different types of dosimeter were applied: calibrated electronic personal dosimeter EPD Mk2 (Thermo Fisher Scientific, Waltham, MA, USA), thermoluminescent dosimeter (TLD-100H, copper-doped lithium fluoride, Thermo Fisher Scientific, Waltham, MA, USA) and RaySafe i2 dosimeter (RaySafe, Billdal, Sweden). The radiation exposure parameters of the patient were documented using the dose area product and the fluoroscopy time.
Results: The mean dose value of the eye lenses per intervention was ascertained to 20 µSv. The radiation exposure dose of the surgery staff corresponded approximately to half of the exposure of the interventionist.
Conclusions: The study setup allows a differentiated and time-resolved measurement of the radiation exposure dose during urological interventions. In this setting, approximately 1000 interventions can be performed until the annual eye lens dose limit is achieved.
