Radiation safety knowledge and practices among urology residents and fellows: results of a nationwide survey.

INTRODUCTION Reliance upon fluoroscopy within urology is increasing, with urologists key in determining radiation exposure to patients, themselves, and other healthcare personnel. However, education in occupational radiation safety is nonstandardized, often lacking. Consequently, residents and practicing urologists risk overexposure. We assessed occupational radiation safety attitudes and practices of training urologists. METHODS A confidential, anonymous, internet-based survey on workplace radiation safety practices was distributed to residents and fellows via program directors identified from the American College of Graduate Medical Education and the American Osteopathic Association. Items explored included sources of education on occupational radiation exposure, knowledge of occupational dose limits, exposure frequency, and protective item utilization. Investigators were blinded to responses. RESULTS Overall, 165 trainees responded, almost all of whom reported at least weekly workplace radiation exposure. Compliance with body and thyroid shields was high at 99% and 73%, respectively. Almost no one used lead-lined glasses and gloves; three-quarters cited lack of availability. The principle of keeping radiation doses As Low As Reasonably Achievable (ALARA) was widely practiced (88%). However, 70% of respondents never used dosimeters, while 56% never had one issued. Only 53% felt adequately trained in radiation safety; this number was 30% among those pregnant during training. Fewer than half (46%) correctly identified the maximum acceptable annual physician exposure. Departmental education in radiation safety improved knowledge, protective practices, monitoring, and satisfaction with education in radiation exposure. CONCLUSIONS Our findings show that protective equipment usage and occupational radiation monitoring for the training urologist are insufficient. Despite frequent exposure, resident education in radiation safety was found lacking. Efforts should be made to address these deficiencies on a local and national level.

[1]  S. Balter,et al.  Review of radiation safety in the cardiac catheterization laboratory. , 1992, Catheterization and cardiovascular diagnosis.

[2]  E. G. Letourneau,et al.  Health outcomes of low-dose ionizing radiation exposure among medical workers: a cohort study of the Canadian national dose registry of radiation workers. , 2009, International journal of occupational medicine and environmental health.

[3]  E. Garshick,et al.  Satisfaction of women urologists with maternity leave and childbirth timing. , 2010, The Journal of urology.

[4]  A. Jacobs,et al.  Task force 3: training in diagnostic and interventional cardiac catheterization endorsed by the Society for Cardiovascular Angiography and Interventions. , 2008, Journal of the American College of Cardiology.

[5]  Donald L. Miller,et al.  Cancer risks associated with external radiation from diagnostic imaging procedures , 2012, CA: a cancer journal for clinicians.

[6]  M. Moran,et al.  Current trends in ureteroscopy. , 2004, The Urologic clinics of North America.

[7]  Heang-Ping Chan,et al.  Evaluation of the transmitted exposure through lead equivalent aprons used in a radiology department, including the contribution from backscatter. , 2003, Medical physics.

[8]  B. Altunoluk,et al.  Radiation exposure--do urologists take it seriously in Turkey? , 2012, The Journal of urology.

[9]  H. Kal,et al.  [Pregnancy and medical irradiation; summary and conclusions from the International Commission on Radiological Protection, Publication 84]. , 2002, Nederlands tijdschrift voor geneeskunde.

[10]  Stephen Balter,et al.  ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures. A report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task , 2004, Journal of the American College of Cardiology.

[11]  L. Dauer,et al.  Abstract No. 134: Featured Abstract: Comparing Strategies for IR Eye Protection , 2009 .

[12]  J. Steel,et al.  X-ray dose training: are we exposed to enough? , 2004, Clinical radiology.

[13]  Shinji Yoshinaga,et al.  Cancer risks among radiologists and radiologic technologists: review of epidemiologic studies. , 2004, Radiology.

[14]  L. Wagner,et al.  Radiation-attenuating surgical gloves: effects of scatter and secondary electron production. , 1996, Radiology.

[15]  L. Brateman The AAPM/RSNA Physics Tutorial for Residents: Radiation Safety Considerations for Diagnostic Radiology Personnel , 1999 .

[16]  J. A. Soye,et al.  A survey of awareness of radiation dose among health professionals in Northern Ireland. , 2008, The British journal of radiology.

[17]  Hyun-Sul Lim Health Disorders Caused by Physical Factors among Health Care Workers - Focusing on Ionizing Radiation - , 2010 .

[18]  F. Mettler,et al.  Radiation injuries after fluoroscopic procedures. , 2002, Seminars in ultrasound, CT, and MR.

[19]  A. D. Quinn,et al.  Radiation protection awareness in non-radiologists. , 1997, The British journal of radiology.

[20]  Madan M Rehani,et al.  Risk for radiation‐induced cataract for staff in interventional cardiology: Is there reason for concern? , 2010, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[21]  F. Mettler,et al.  Skin injuries from fluoroscopically guided procedures: part 1, characteristics of radiation injury. , 2001, AJR. American journal of roentgenology.

[22]  Stephen Balter,et al.  ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task , 2005, Circulation.

[23]  C. Streffer,et al.  Biological effects after prenatal irradiation (embryo and fetus). A report of the International Commission on Radiological Protection. , 2003, Annals of the ICRP.

[24]  I. Maral,et al.  Doctors' and intern doctors' knowledge about patients' ionizing radiation exposure doses during common radiological examinations. , 2007, Diagnostic and interventional radiology.

[25]  M. A. Elkoushy,et al.  Prevalence of orthopedic complaints among endourologists and their compliance with radiation safety measures. , 2011, Journal of endourology.

[26]  R. Galland,et al.  Doctors' knowledge of radiation exposure: questionnaire study , 2003, BMJ : British Medical Journal.