Health Risk Level of Health Workers Exposed to Ionizing Radiation in Cardiac Catheterization Laboratory

Authors

  • Piyapong Sirinapakul Department of Community Medicine, Khon Kaen University, Khon Kaen, Thailand, 40002
  • Naesinee Chaiear Department of Community Medicine, Khon Kaen University, Khon Kaen, Thailand, 40002
  • Pattapong Makarawate Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand, 40002
  • Chariya Bamrungsiri Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand, 40002
  • Chamnian Pattanajak Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand, 40002
  • Nikom Namkoch Queen Sirikit Heart Center of the Northeast, Khon Kaen University, Khon Kaen, Thailand, 40002

Keywords:

ionizing radiation; fluoroscopy; catheterization laboratory; risk assessment

Abstract

Background and Objectives: Ionizing radiation (IR) from fluoroscopy in cardiac catheterization laboratory (cath lab) has  health effect on health workers. The health workers in cath lab have  higher risk for cataracts than other health works 2-4 times.  The as low as reasonably achievable (ALARA) principle is applied among cath lab workers exposed to IR from fluoroscopy; however, an evaluation of the IR risk is needed. The purpose of the current study was to determine the risk of IR from fluoroscopy among cath lab workers.

Methods:  A descriptive study was conducted. A walk-through survey was performed during operation of the catheterization laboratory. Sixteen workers participated in the study; they were observed by the researcher using a Semi-Quantitative 3x3 Matrix (SQM).  The workers were asked to perform a Radio-Protection Questionnaire (RPQ). All data from the SQM, RPQ, and personal radiation dosimeter were analyzed to determine the health risk level.

Results: The health risk level of workers assessed vis-à-vis severity and chances of exposure to IR was high. The SQM revealed that the chances of exposure of the 16 workers was moderate. Chance of exposure comprised frequency of exposure, use of lead glasses, optically stimulated luminescence (OSL), and occupational safety training. The RPQ to which 14 of the 16 workers responded revealed that 3 workers wore lead glasses, and 6 OSL, and 1 was aware of the equivalent radiation dose of the eye's lens.

Conclusion: Cath lab workers had a high health risk despite moderate exposure. They thus had a high severity of IR. The chance of exposure was moderate because the workers did not wear lead glasses and/or OSL during the procedure. Additionally, the knowledge and practice of radiation safety were lacking.

References

1. Tipayamongkholgul M, Luksamijarulkul P, Mawn B, Kongtip P, Woskie S. Occupational Hazards in the Thai Healthcare Sector. New Solut 2016; 26: 83–102.
2. Muirhead CR, Goodill AA, Haylock RG, Vokes J, Little MP, Jackson DA, et al. Occupational radiation exposure and mortality: second analysis of the National Registry for Radiation Workers. J Radiol Prot 1999; 19: 3–26.
3. Vaiserman A, Koliada A, Zabuga O, Socol Y. Health impacts of low-dose ionizing radiation: current scientific debates and regulatory issues. Dose Response [serial online] 2018 Sep 19 [cited Feb 4, 2020];16(3):[27 screens]. Available from: https://kku.world/jxip3
4. อภิเดช ชีวะประเสริฐ, วิโรจน์ เจียมจรัสรังษี. ความรู้และการปฏิบัติตนด้านความปลอดภัยจากรังสีในบุคลากรห้องปฏิบัติการสวนหัวใจของโรงพยาบาลรัฐในประเทศไทย. วารสารพยาบาลโรคหัวใจและทรวงอก 2562; 30: 32–45.
5. Awosan KJ, Ibrahim M, Saidu SA, Ma’aji SM, Danfulani M, Yunusa EU, et al. Knowledge of radiation hazards, radiation protection practices and clinical profile of health workers in a teaching hospital in Northern Nigeria. J Clin Diagn Res 2016; 10: LC07-12.
6. Soye JA, Paterson A. A survey of awareness of radiation dose among health professionals in Northern Ireland. Br J Radiol 2008; 81: 725–729.
7. Stewart FA, Akleyev AV, Hauer-Jensen M, Hendry JH, Kleiman NJ, Macvittie TJ, et al. ICRP publication 118: ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs--threshold doses for tissue reactions in a radiation protection context. Ann ICRP 2012; 41: 1–322.
8. Cousins C, Miller DL, Bernardi G, Rehani MM, Schofield P, Vañó E, et al. ICRP publication 120: Radiological protection in cardiology. Ann ICRP 2013; 42: 1–125.
9. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP 2007; 37: 1–332.
10. กฎกระทรวง กำหนดมาตรฐานในการบริหารและการจัดการด้านความปลอดภัย อาชีวอนามัย และสภาพแวดล้อมในการทำงานเกี่ยวกับรังสีชนิดก่อไอออน พ.ศ. 2547. ราชกิจจานุเบกษา 20 ส.ค. 2547; 121(ตอนที่ 52 ก): 16–25.
11. กฎกระทรวง ความปลอดภัยทางรังสี ความปลอดภัยทางรังสี พ.ศ. 2561. ราชกิจจานุเบกษา 5 ต.ค. 2561; 135(ตอนที่ 79 ก): 9–16.
12. Mahesh M. Fluoroscopy: patient radiation exposure issues. Radiographics 2001; 21: 1033–45.
13. Cornacchia S, Errico R, La Tegola L, Maldera A, Simeone G, Fusco V, et al. The new lens dose limit: implication for occupational radiation protection. Radiol Med 2019; 124: 728–35.
14. Elmaraezy A, Ebraheem Morra M, Tarek Mohammed A, Al-Habaa A, Elgebaly A, Abdelmotaleb Ghazy A, et al. Risk of cataract among interventional cardiologists and catheterization lab staff: a systematic review and meta-analysis. Catheter Cardiovasc Interv 2017; 90: 1–9.
15. Bitarafan Rajabi A, Noohi F, Hashemi H, Haghjoo M, Miraftab M, Yaghoobi N, et al. Ionizing radiation-induced cataract in interventional cardiology staff. Res Cardiovasc Med 2015; 4: e25148.
16. ศูนย์หัวใจสิริกิติ์ ภาคตะวันออกเฉียงเหนือ [ออนไลน์]. 2563 [อ้างเมื่อ 5 กุมภาพันธ์ 2563]. จาก: https://kku.world/m5lme
17. Erkan I, Yarenoglu A, Yukseloglu EH, Ulutin HC. The investigation of radiation safety awareness among healthcare workers in an education and research hospital. Int J Radiat Res 2019; 17: 455–61.
18. Rahman N, Dhakam S, Shafqut A, Qadir S, Tipoo FA. Knowledge and practice of radiation safety among invasive cardiologists. J Pak Med Assoc 2008; 58: 119–22.
19. Friedman AA, Ghani KR, Peabody JO, Jackson A, Trinh Q-D, Elder JS. Radiation safety knowledge and practices among urology residents and fellows: results of a nationwide survey. J Surg Educ 2013; 70: 224–31.
20. Padovani R, Le Heron J, Cruz-Suarez R, Duran A, Lefaure C, Miller DL, et al. International project on individual monitoring and radiation exposure levels in interventional cardiology. Radiat Prot Dosimetry 2011; 144: 437–41.

Published

2021-08-20

How to Cite

1.
Sirinapakul P, Chaiear N, Makarawate P, Bamrungsiri C, Pattanajak C, Namkoch N. Health Risk Level of Health Workers Exposed to Ionizing Radiation in Cardiac Catheterization Laboratory. SRIMEDJ [Internet]. 2021 Aug. 20 [cited 2024 Apr. 26];36(4):426-30. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/251815

Issue

Section

Original Articles