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Radiation exposure in emergency physicians working in an urban ED: a prospective cohort study

Published:March 10, 2010DOI:https://doi.org/10.1016/j.ajem.2009.06.008

      Abstract

      Objective

      The National Council on Radiation Protection (NCRP) limits health care–associated occupational exposures to radiation to 5000 mrem/y. Previous studies suggested that emergency physicians were not exposed over this limit. Their relevance to contemporary practice is unknown. We hypothesized that emergency physicians are currently exposed to radiation levels above the NCRP limits.

      Methods

      This prospective cohort study was conducted at an urban, academic, level I trauma center emergency department (ED). Thermoluminescent dosimeter radiation badges were placed on the torso and ring finger of all physicians staffing the ED during May 2008. Thermoluminescent dosimeter badges were affixed to 8 portable phones that are carried by physicians in the ED 24 hours a day. At the end of the study period, exposure dose for each subject was estimated.

      Results

      Seventy-five physicians enrolled in the study; 41 residents worked a median of 94 hours and 34 attendings worked a median of 54 hours. Compliance for physician badge wearing was 99%, ring wearing was 98%, and phone wearing was 100%. Two subjects had detectable levels of radiation on their torso thermoluminescent dosimeters of 4 and 1 mrem, respectively. One phone badge had a detectable level of 1 mrem. The annual extrapolated exposure for the subject with the highest radiation level would have been 50 mrem, below the 5000 mrem exposure limit for health care workers.

      Conclusion

      Emergency physicians working in an urban, academic, level I trauma center ED do not appear to be at risk of exceeding the NCRP dose limits for ionizing radiation exposure to their torso or extremities.
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      References

        • Limacher M.C.
        • Douglas P.S.
        • Germano G.
        • Laskey W.K.
        • Lindsay B.D.
        • McKetty M.H.
        • et al.
        ACC expert consensus document. Radiation safety in the practice of cardiology. American College of Cardiology.
        J Am Coll Cardiol. 1998; 31: 892-913
      1. U. S. Department of Health and Human Services, Public Health Service: National Institute for Occupational Safety and Health, Division of Standards Development and Technology Transfer. Guidelines for Protecting the Safety and Health of Health Care Workers. CDC.gov 1988, 5.2.3.6.

      2. NCRP (1993). Limitation of Exposure to Ionizing Radiation, NCRP Report No. 116 (National Council on Radiation Protection and Measurements, Bethesda, Maryland).

      3. NCRP (2004) Recent Applications of the NCRP Public Dose Limit Recommendation for Ionizing Radiation. NCRP Statement No. 10, December 2004(National Council on Radiation Protection and Measurements, Bethesda, Maryland).

        • Ciraulo D.L.
        • Marini C.P.
        • Lloyd G.T.
        • Fisher J.
        Do surgical residents, emergency medicine physicians, and nurses experience significant radiation exposure during the resuscitation of trauma patients?.
        J Trauma. 1994; 36: 703-705
        • Tan G.A.
        • Van Every B.
        Staff exposure to ionizing radiation in a major trauma centre.
        ANZ Journal of Surgery. 2005; 75: 136-137
        • Singer C.M.
        • Baraff L.J.
        • Benedict S.H.
        • Weiss E.L.
        • Singer B.D.
        Exposure of emergency medicine personnel to ionizing radiation during cervical spine radiography.
        Ann Emerg Med. 1989; 18: 822-825
        • Weiss E.L.
        • Singer C.M.
        • Benedict S.H.
        • Baraff L.J.
        Physician exposure to ionizing radiation during trauma resuscitation: a prospective clinical study.
        Ann Emerg Med. 1990; 19: 134
        • Braun B.J.
        • Skiendzielewski J.J.
        Radiation exposure of emergency physicians.
        Ann Emerg Med. 1982; 11: 535-540
        • Brenner D.J.
        • Hall E.J.
        Computed tomography—an increasing source of radiation exposure.
        N Engl J Med. 2007; 357: 2277-2284
      4. Device Specifications: http://ldrsolutions.landauerinc.com/PRODUCTCATALOG/content/documents/25_LuxelSpecifications.en-US.pdf.

      5. Device Specifications: http://ldrsolutions.landauerinc.com/PRODUCTCATALOG/content/documents/43_RingSpecifications.en-US.pd.

        • Grazer R.E.
        • Meislin H.W.
        • Westerman B.R.
        • Criss E.A.
        A nine-year evaluation of emergency department personnel exposure to ionizing radiation.
        Ann Emerg Med. 1987; 16: 340-342
        • Ingegno M.
        • Nahabedian M.
        • Tominaga G.T.
        • Scannell G.
        • Waxman K.
        Radiation exposure from cervical spine radiographs.
        Am J Emerg Med. 1994; 12: 15-16