Medical Radiology and Radiation Safety. 2022. Vol. 67. № 1
Dose Assessment to the Lens of the Eye and Skin of the Personnel
in Advanced Medical Technologies
Korenkov I.P.1, Okhrimenko S.E.1,2, Shandala N.K.1,
Semenova M.P.1, Ryzhkin S.A.2, Ermolina E.P.2 , Akopova N.A.2
1A.I. Burnasyan Federal Medical Biophysical Center, Moscow, Russia
2Russian Medical Academy of Continuous Professional Education, Moscow, Russia
Contact person: Okhrimenko Sergey Evgenevich: : Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.
ABSTRACT
Background: The widespread use of radiation technologies in medicine puts some new issues on the agenda in the field of radiation safety and protection of the personnel. This primarily relates to the advanced methods of diagnosis and treatment with the use of X-ray technology and radiopharmaceuticals (RPhP) under conditions of occupational exposure to low-intensity scattered radiation. The applied personal protective equipment reliably assures that the effective dose is not exceeded, but does not ensure compliance with the standards for the lens of the eye and the irradiated areas of the skin.
Purpose: This study is to evaluate, in the advanced medical technologies, the doses to the lens of the eye and skin of the personnel working in a low-intensity radiation field and in direct contact with radioactive sources.
Materials and methods: To evaluate the doses, TLD detectors were used for the purpose of dose assessment to the lens of the eye НР(3) and the skin of the fingers НР(0,07). The data of international studies are involved.
Results: In conditions of a significant reduction in the limits of equivalent doses to the lens of the eye, up to 20 mSv the assessment of the radiationlevels of the latter, based on data on the effective dose, becomes impossible. In addition, there are facts of damage to the lens of the eye at much lower levels of radiation than previously thought. The paper evaluates the existing exposure to the lens of the eye for some medical technologies, both according to the published data and according to the results of our own research. It is shown that the existing radiation levels can significantly exceed 20 mSv per year (up to 0.2 mSv per operation) and it is impossible to exclude the stochastic nature of lens damage. Data on the levels of skin irradiation in X-ray surgical technologies and when using RPhP based on 18F (up to 200 mSv per year for finger biting) are also provided.). New approaches to rationing activities with radiation sources are considered based on the assessment of the workload: the number of manipulations, the activity used.
Conclusion: The research data confirm the relevance of the problem of exposure to the lens of the eye and the skin of the personnel working in the field of scattered radiation of low intensity. Along with the assessment of the equivalent doses to these organs, epidemiological studies should be conducted for the purpose ofassessment and development of adequate radiation protection measures for the lens of the eye and the irradiated parts of the skin (hands)
Keywords: lens of the eye, skin, effective dose, equivalent dose, 18F, X-ray radiation, cataract, personnel
For citation: Okhrimenko SE, Korenkov IP, Shandala NK, Semenova MP, Ryzhkin SA, Ermolina EP, Akopova NA. Dose Assessment to the Lens of the Eye and Skin of the Personnel in Advanced Medical Technologies // Medical Radiology and Radiation Safety. 2022;67(1):39-44.
DOI: 10.12737/1024-6177-2022-67-1-54-59
References
1. Balonov M.I., Golikov V.YU., Vodovatov A.V., CHipiga L.A., Zvonova I.A.., Kalnitskiy S.I., et al. Nauchnyye Osnovy Radiatsionnoy Zashchity v Sovremennoy Meditsine. T.1. Luchevaya Diagnostika = Scientific Bases of Radiation Protection in Modern Medicine. V.1. Radiation Diagnostics. Ed. Balonova M.I. St. Petersburg, NIIRG Im. prof. P. V. Ramzayeva Publ., 2019. 320 p. (In Russ.).
2. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Annals of the ICRP. 2007;37:1–332.
3. Doshchenko V.N., Buldakov L.A. Medical Consequences of Man-Made Radiation Exposure. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Мedical Radiology and Radiation Safety. 2003;48;4:38-44 (In Russ.).
4. Khazagerov S.M., Shayakhmetova A.A., Arefyeva D.V., Ivanova T.A. Justification of the Procedure for Monitoring Individual Equivalent Doses in the Lens of the Eye from Photon Radiation in Production Conditions at Nuclear Shipbuilding and Ship Repair Enterprises. Sovremennyye problemy nauki i obrazovaniya = Modern Problems of Science and Education. Surgery. 2015;2;3. URL: http://science-education.ru/ru/article/view?id=23817 (In Russ.).
5. Azizova T.A., Bragin E.V., Khamada N., Bannikova M.V. Risk Assessment of Senile Cataract Incidence in a Cohort of Nuclear Workers of Mayak Production Association. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Medical Radiology and Radiation Safety. 2018;63;4:15–21. DOI: 10.12737/article_5b83b0430902e8.35861647 (In Russ.).
6. Azizova T.V., Khamada N., Grigoryeva Ye.S., Bragin Ye.V. Risk of Various Types of Cataracts in the Cohort of Workers Exposed to Occupational Chronic Radiation. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Medical Radiology and Radiation Safety. 2020;65;4:48–57. DOI: 10.12737/1024-6177-2020-65-4-48-57 (In Russ.).
7. Mikryukova L.D., Krestinina L.Yu., Yepifanova S.B. A Study of Layered Lens Change in the Process of Cataract Formation in Persons Exposed to Radiation as a Result of Radiation Accidents in the Southern Urals. Radiatsionnaya Gigiyena = Radiation Hygiene. 2018;11;4: 51-63. DOI: 10.21514/1998-426Х-2018-11-4-51-63 (In Russ.).
8. David E.F., Andrew K., Christopher O., Sungchan S., and Sanjog P. The Risk of Radiation Exposure to the Eyes of the Interventional Pain. Physician Radiology Research and Practice. 2011;2011:609537. doi:10.1155/2011/609537.
9. Radiation Protection and Safety of Radiation Sources. International Basic Safety Standards. IAEA. 2011. 329 p.
10. Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards No. GSR Part 3. Vienna, IAEA, 2015.
11. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Annals of the ICRP. 2007;37:1–332.
12. Statement on Tissue Reactions. ICRP, ref.4825-3093-1464. 2011. 12 p.
13. Implications for Occupational Radiation Protection of the New Dose Limit for the Lens of the Eye: Interim Guidance for Use and Comment. Draft 1. ICRP, 2013. 110 p.
14. 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. Publication 118. ICRP.
15. Summary of Low-Dose Radiation Effects on Health. Report of the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR 2010). 2011. P. 51-64.
16. Ivanov S.I., Loginova S.V., Akopova N.A., Okhrimenko S.E., Nurlybaev K.N. Problems of Dosimetry of the Eye Lens. Meditsinskaya Radiologiya i Radiatsionnaya Bezopasnost = Мedical Radiology and Radiation Safety. 2014;59;4:67–72 (In Russ.).
17. Kaydanovskiy G.N., Shleyenkova Ye.N. On Problems of the Lens of the Eye Radiation Dose Monitoring. Radiatsionnaya Gigiyena = Radiation Hygiene. 2016;9;3:75–80. DOI: 10.21514/1998-426Х-2016-9-3-75-80 (In Russ.).
18. Shleyenkova Ye.N., Golikov V.Yu., Kaydanovskiy G.N., Bazhin S.Yu., Ilin V.A. Results of Eye Lens Doses Control of Medical Personnel in St. Petersburg. Radiatsionnaya Gigiyena = Radiation Hygiene. 2019;12;4: 29-36. DOI: 10.21514/1998-426X-2019-12-4-29-36 (In Russ.).
19. ORAMED: Optimization of Radiation Protection of Medical Staff. EURADOS Report 2012-02, Braunschweig, 2012.
20. Vanhavere F., Carinou E., Domienik J., Donadille L., Ginjaume M., Gualdrini G., et al. Measurements of Eye Lens Doses in Interventional Radiology and Cardiology: Final Results of the ORAMED Project. Radiation Measurements. 2011;46;11:1243-1247. DOI: 10.1016/j.radmeas.2011.08.013.
21. European Commission 2014 Council Directive 2013/59/ Euratom of 5 December 2013 Laying Down Basic Safety Standards for Protection Against the Dangers Arising from Exposure to Ionising Radiation, and Repealing Directives 89/618/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/ Euratom and 2003/122/Euratom 13 1–73.
22. Kuzin V.I. Angiography: Radiation-Hygienic Characteristics of the Personnel Working Conditions. Radiatsionnaya Gigiyena = Radiation Hygiene. 2009;2;1:52-58 (In Russ.).
23. Ryzhkin S.A., Slesareva A.N., Galeyeva G.Z., Ivanov S.I. Clinical Examination of the Eyes Functional Status and Assessment of Equivalent Dose to Eye Lens in Medical Staff Performing Endovascular Interventions under X-ray Guidance. Radiatsiya i risk = Radiation and Risks. 2017;26;3:90-99. DOI: 10.21870/0131-3878-2017-26-3-90-99 (In Russ.).
24. Karpov N.A., Okhrimenko S.YE., Ivanov S.I., Kiryukhin O.V., Akopova N.A., Loginova S.V., Afinogenov A.M. Doza v Khrustalike Glaza: Blizhayshiye Perspektivy = Dose in the Lens of the Eye: Immediate Prospects. Sbornik mat. Vserossiyskoy Konferentsii s Mezhdunarodnym Uchastiyem, Posvyashchennoy 85-Letiyu so Dnya Rozhdeniya V. A. Kukhtina. = Collection of Mat. All-Russian Conference with International Participation Dedicated to the 85th Anniversary of the Birth V.A. Kuhtina Cheboksary April 3-4, 2014. Cheboksary Publ., 2014. P. 235-236 (In Russ.).
25. Okhrimenko S.E., Korenkov I.P., Prokhorov N.I., Shandala N.K., Zakharova A.V. Radiation-Hygienic Assessment of Modern Medical Technologies. Gigiyena i Sanitariya = Hygiene and Sanitation 2020;99;9:939-946. https://doi.org/10.47470/0016-9900-2020-99-9-939-946 (In Russ.).
26. Malgorzata Wrzesień. 18F-FDG Production Procedures as a Source of Eye Lens Exposure to Radiation. J. Radiol. Prot. 2018;38;1:382–393. https://doi.org/10.1088 /1361-6498/aaa287.
27. Malgorzata Wrzesień. The Effect of Work System on the Hand Exposure of Workers in 18F-FDG Production Centers. Australasian Physical & Engineering Sciences in Medicine. 2018;41:541-548. https://doi.org/10.1007/s13246-018-0644-9.
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 17.07.2021.
Accepted for publication: 05.09.2021