Radiation exposure affecting anesthesia personnel during endoscopic retrograde cholangiopancreatography is a lead apron necessary for x-ray protection?

Abstract

© 2018, Medical Association of Thailand. All rights reserved. Objective: To find out the amount of radiation affecting anesthesia personnel, the appropriate positions that lowers the risk of radiation exposure during endoscopic retrograde cholangiopancreaticography [ERCP], and the necessity to wear lead apron for protection. Materials and Methods: Two hundred twenty-two patients that underwent ERCPs with sedation were allocated to the present study. Four pocket dosimeters [PDSs] were placed at points A and B, 96.5 cm and 204 cm from the fluoroscopy tube, respectively with A being PDSal and PDSa2 on the outside and inside of the lead apron-covered box, and B being PDSbl and PDSb2 on the outer and inner parts of the glass shield of the fluoroscopy control room. Data were expressed as means and standard deviations, analyzed with SPSS version 18.0. Categorical data were compared by using a Chi-square and dependent t-test. A p-value lower than 0.05 was considered statistically significant difference at the 95% confidence interval. Results: The fluoroscopy average time was 13.7±14.11 minutes with a median of 10.1 minutes. The degrees of radiation at the outside and inside of positions A and B, measured at 5.3±7.9 ×10-3 mSv and 0.2±0.6 ×10-3 mSv, and 4.4±5.9 ×10-3 mSv and 0.2±0.7 ×10-3 mSv, respectively, were statistically significant different. Thus, the lead apron and glass shield prevented X-ray exposure by up to 96.2% and 95.5%, respectively, without any statistical significance. The radiation at position A and B were shown to decrease 2,000 to 16,000 and 2,500 to 20,000 times from the origin respectively. Conclusion: The degree of radiation affecting anesthesia personnel during an ERCP was so small that a lead apron was not needed for protection. Yet, one who monitors patient sedation should stay as far as possible from sources of scattered rays since radioactive emission could yield cumulative harmful effects.