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2.
PLoS One ; 19(8): e0308479, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39106296

RESUMO

INTRODUCTION: Radiation exposure in medical settings stands as the primary source of artificial radiation, compounded by the yearly rise in healthcare worker numbers. Ensuring radiation protection is crucial for safeguarding their occupational health. Nevertheless, existing studies on radiation protection behavior exhibit considerable heterogeneity due to various factors. OBJECTIVE: This scoping review aims to explore the current status of research on radiation protection behavior and identify research gaps, intending to guide future research directions. METHODS AND ANALYSIS: The scoping review will follow the Arksey and O'Malley framework and the Joanna Briggs Institute methodology. A systematic search will be conducted across English databases including PubMed, Web of Science, Embase, and Medline, as well as Chinese databases such as CNKI, Wanfang, VIP, and China Biomedical Literature Database. Two independent reviewers will screen the studies based on predefined eligibility criteria and extract the data. Any disagreements will be resolved through discussion by a third reviewer. The review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. STRENGTHS AND LIMITATIONS OF THIS STUDY: A stakeholder consultation will provide an opportunity to validate the findings and address any potential gaps in the article. In this scoping review, all types of studies will be considered. The effectiveness of the methodological quality of the included studies will not be reported, which may lead to some studies of poor quality being included. Only studies published in English or Chinese after 2010 will be considered in this review, potentially leading to the omission of relevant papers.


Assuntos
Pessoal de Saúde , Proteção Radiológica , Humanos , Proteção Radiológica/métodos , Exposição Ocupacional/prevenção & controle , Exposição à Radiação/efeitos adversos , Exposição à Radiação/prevenção & controle
4.
Environ Geochem Health ; 46(9): 359, 2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39093343

RESUMO

This study investigates the radon concentration in groundwater in Kupwara, the northernmost district of the Kashmir valley. It further assesses the annual effective dose experienced by the district's diverse population-infants, children, and adults-attributable to both inhalation of airborne radon released from drinking water and direct ingestion. In addition to this, the calculation of gamma dose rate is also carried out at each of the sampling site of radon. A portable radon-thoron monitor and a portable gamma radiation detector were respectively employed to estimate the activity concentration of radon in water samples and to measure the gamma dose rate. The radon concentration was found to exhibit variability from a minimum of 2.9 BqL-1 to a maximum of 197.2 BqL-1, with a mean of 26.3 BqL-1 and a standard deviation of 23.3 BqL-1. From a total of 85 samples, 10.6% of the samples had radon activity concentrations exceeding the permissible limits of 40 BqL-1 set by the United Nations Scientific Committee on Effects of Atomic Radiations as reported by UNSCEAR (Sources and effects of ionizing radiation, 2008) and only 1.2% of the samples have radon activity concentration exceeding the permissible limits of 100 BqL-1 set by the World Health Organization as reported by WHO (WHO guidelines for drinking-water quality, World Health Organization, Geneva, 2008). The mean of the annual effective dose due to inhalation for all age groups as well as the annual ingestion dose for infants and children, surpasses the World Health Organization's limit of 100 µSv y-1 as reported by WHO (WHO guidelines for drinking-water quality, World Health Organization, Geneva, 2008). The observed gamma radiation dose rate in the vicinity of groundwater radon sites ranged from a minimum of 138 nSv h-1 to a maximum of 250 nSv h-1. The data indicated no significant correlation between the dose rate of gamma radiation and the radon levels in the groundwater. Radon concentration of potable water in the study area presents a non-negligible exposure pathway for residents. Therefore, the judicious application of established radon mitigation techniques is pivotal to minimize public health vulnerabilities.


Assuntos
Água Subterrânea , Monitoramento de Radiação , Radônio , Poluentes Radioativos da Água , Radônio/análise , Água Subterrânea/química , Índia , Poluentes Radioativos da Água/análise , Humanos , Água Potável/química , Água Potável/análise , Lactente , Criança , Doses de Radiação , Raios gama , Exposição à Radiação/análise , Adulto
5.
J Stroke Cerebrovasc Dis ; 33(9): 107908, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39094717

RESUMO

OBJECTIVES: Our aim is to evaluate the impact of surface ultraviolet radiation intensity on hospital admissions for stroke and to compare the correlation and differences among different subtypes of strokes. MATERIALS AND METHODS: We collected daily data on surface ultraviolet radiation intensity, temperature, air pollution, and hospital admissions for stroke in Harbin from 2015 to 2022. Using a distributed lag non-linear model, we determined the correlation between daily surface ultraviolet radiation intensity and the stroke admission rate. Relative risks (RR) with 95% confidence intervals (CI) and attributable fractions (AF) with 95% CI were calculated based on stroke subtypes, gender, and age groups. RESULTS: A total of 132,952 hospitalized stroke cases (including hemorrhagic and ischemic strokes) were included in the study. We assessed the non-linear effects of ultraviolet intensity on hospitalized patients with ischemic and hemorrhagic strokes. Compared to the maximum morbidity benchmark ultraviolet intensity (19.2 × 10^5 for ischemic stroke and 20.25 for hemorrhagic stroke), over the 0-10 day lag period, the RR for extreme low radiation (1st percentile) was 0.86 (95% CI: 0.77, 0.96), and the RR for extreme high radiation (99th percentile) was 0.86 (95% CI: 0.77, 0.96). In summary, -4.842% (95% CI: -7.721%, -2.167%) and -1.668% (95% CI: -3.061%, -0.33%) of ischemic strokes were attributed to extreme low radiation intensity with a lag of 0 to 10 days and extreme high radiation intensity with a lag of 0 to 5 days, respectively. The reduction in stroke hospitalization rates due to low or high ultraviolet intensity was more pronounced in females and younger individuals compared to males and older individuals. None of the mentioned ultraviolet intensity intensities and lag days had a statistically significant impact on hemorrhagic stroke. CONCLUSIONS: Our study fundamentally suggests that both lower and higher levels of surface ultraviolet radiation intensity in Harbin, China, contribute to a reduced incidence of ischemic stroke, with this effect lasting approximately 10 days. This finding holds significant potential for public health and clinical relevance.


Assuntos
Bases de Dados Factuais , Acidente Vascular Cerebral Hemorrágico , AVC Isquêmico , Dinâmica não Linear , Admissão do Paciente , Raios Ultravioleta , Humanos , China/epidemiologia , Masculino , Feminino , Idoso , Acidente Vascular Cerebral Hemorrágico/epidemiologia , Acidente Vascular Cerebral Hemorrágico/diagnóstico , Acidente Vascular Cerebral Hemorrágico/etiologia , Pessoa de Meia-Idade , Raios Ultravioleta/efeitos adversos , AVC Isquêmico/epidemiologia , AVC Isquêmico/diagnóstico , AVC Isquêmico/etiologia , Fatores de Tempo , Fatores de Risco , Medição de Risco , Idoso de 80 Anos ou mais , Adulto , Adulto Jovem , Exposição Ambiental/efeitos adversos , Adolescente , Exposição à Radiação/efeitos adversos
6.
J Radiol Prot ; 44(3)2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39178892

RESUMO

Patient doses cannot be limited; instead, radiological examinations should be justified and optimised to ensure the necessary diagnostic or therapeutic effect with the lowest patient dose achievable. Assessment of the radiation risks from patient exposure is important part of the justification process. Hence, medical staff within the framework of their professional activities should possess necessary information on the data on radiation risk from different types of radiological procedures. An approach has been developed that allows considering age and gender dependences of the risk coefficients of radiogenic cancer and the age and gender distribution of patients for various radiological examinations to assess the individual radiation risk for patient and collective risk for population from medical exposure. The approach is based on a new expanded use of the effective dose concept proposed in ICRP Publication 147 and demonstrated using the medical exposure in the Russian Federation as the example. For 30 radiological examinations that compose about 80% of the collective dose from medical exposure of the public in the Russian Federation radiation risk was assessed based on calculated age and gender specific risk coefficients per unit effective dose. For the rest of the examinations a simplified approach was used to assess the risk, which was based on using an age and gender specific risk coefficient determined for one of 4 anatomical regions (head, neck, chest and abdomen) or for uniform irradiation of the whole body. The proposed approach allows significantly improving the assessment of the radiation risk while continuing to use the effective dose as a dosimetric quantity within the framework of the state program in the Russian Federation. As a result the collective risk from medical examinations in the Russian Federation in 2022 was lower by the factor of 3 compared to the previous assessment based on the effective dose with the nominal risk coefficient.


Assuntos
Doses de Radiação , Humanos , Medição de Risco , Masculino , Feminino , Proteção Radiológica , Adulto , Federação Russa , Neoplasias Induzidas por Radiação/etiologia , Exposição à Radiação , Criança , Pessoa de Meia-Idade , Adolescente , Idoso , Radiografia/efeitos adversos
7.
Cancer Radiother ; 28(4): 380-384, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39098509

RESUMO

PURPOSE: Secondary breast cancer is a frequent late adverse event of mediastinal Hodgkin lymphoma radiotherapy. Secondary breast cancers overwhelmingly correspond to ductal carcinoma and develop from the glandular mammary tissue. In addition, during childhood, radiation overexposure of the glandular tissue may lead to a late breast hypotrophy at adult age. The aim of this study was to evaluate the radiation exposure to the glandular tissue in patients treated for mediastinal Hodgkin lymphoma with intensity-modulated proton therapy, in order to evaluate the potential dosimetric usefulness of its delineation for breast sparing. MATERIALS AND METHODS: Sixteen consecutive intermediate-risk mediastinal female patients with Hodgkin lymphoma treated with consolidation radiation with deep inspiration breath hold intensity-modulated proton therapy to the total dose of 30Gy were included. Breasts were delineated according to the European Society for Radiotherapy and Oncology guidelines for treatment optimization ("clinical organ at risk"). The glandular tissue ("glandular organ at risk") was retrospectively contoured on the initial simulation CT scans based on Hounsfield unit (HU) values, using a range between -80HU and 500HU. RESULTS: The mean and maximum doses delivered to the glandular organ at risk were significantly lower than the mean and maximum doses delivered to the clinical organ at risk, but were statistically correlated. Glandular organ at risk volumes were significantly smaller. CONCLUSION: Optimizing the treatment plans on the clinical breast contours will systematically lead to overestimation of the dose received to the glandular tissue and, consequently, to an indistinct and involuntary improved glandular tissue sparing. As such, our findings do not support the consideration of the glandular tissue as an additional organ at risk when planning intensity-modulated proton therapy for mediastinal Hodgkin lymphoma in female patients.


Assuntos
Neoplasias da Mama , Doença de Hodgkin , Neoplasias do Mediastino , Órgãos em Risco , Terapia com Prótons , Humanos , Doença de Hodgkin/radioterapia , Feminino , Neoplasias do Mediastino/radioterapia , Adulto , Órgãos em Risco/efeitos da radiação , Terapia com Prótons/efeitos adversos , Terapia com Prótons/métodos , Estudos Retrospectivos , Neoplasias da Mama/radioterapia , Pessoa de Meia-Idade , Adulto Jovem , Radioterapia de Intensidade Modulada/efeitos adversos , Radioterapia de Intensidade Modulada/métodos , Mama/efeitos da radiação , Mama/diagnóstico por imagem , Dosagem Radioterapêutica , Exposição à Radiação , Tratamentos com Preservação do Órgão/métodos , Suspensão da Respiração , Neoplasias Induzidas por Radiação/etiologia
8.
Sci Rep ; 14(1): 19345, 2024 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-39164366

RESUMO

There are currently no available FDA-cleared biodosimetry tools for rapid and accurate assessment of absorbed radiation dose following a radiation/nuclear incident. Previously we developed a protein biomarker-based FAST-DOSE bioassay system for biodosimetry. The aim of this study was to integrate an ELISA platform with two high-performing FAST-DOSE biomarkers, BAX and DDB2, and to construct machine learning models that employ a multiparametric biomarker strategy for enhancing the accuracy of exposure classification and radiation dose prediction. The bioassay showed 97.92% and 96% accuracy in classifying samples in human and non-human primate (NHP) blood samples exposed ex vivo to 0-5 Gy X-rays, respectively up to 48 h after exposure, and an adequate correlation between reconstructed and actual dose in the human samples (R2 = 0.79, RMSE = 0.80 Gy, and MAE = 0.63 Gy) and NHP (R2 = 0.80, RMSE = 0.78 Gy, and MAE = 0.61 Gy). Biomarker measurements in vivo from four NHPs exposed to a single 2.5 Gy total body dose showed a persistent upregulation in blood samples collected on days 2 and 5 after irradiation. The data indicates that using a combined approach of targeted proteins can increase bioassay sensitivity and provide a more accurate dose prediction.


Assuntos
Biomarcadores , Proteínas de Ligação a DNA , Proteína X Associada a bcl-2 , Animais , Humanos , Biomarcadores/sangue , Proteínas de Ligação a DNA/sangue , Proteína X Associada a bcl-2/metabolismo , Proteína X Associada a bcl-2/sangue , Exposição à Radiação/efeitos adversos , Masculino , Radiometria/métodos , Macaca mulatta , Feminino , Aprendizado de Máquina , Doses de Radiação
9.
Front Immunol ; 15: 1426635, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39148729

RESUMO

Introduction: Radiation induced lymphopenia (RIL) deteriorate survival and diminishes the benefit of immune checkpoint inhibitors in combined treatment of lung cancer. Given the inconsistent data across various studies on the predictors of RIL, we aim to methodically elucidate these predictors and formulate a practical guide for clinicians. Methods: We conducted observational cohort study in four tertiary cancer centers. Patients with non-small cell lung cancer and small cell lung cancer, without lymphopenia grade >1, who underwent standalone radiotherapy (RT) in minimum 15 fractions were eligible. Dose-volume parameters of structures and clinical factors were comprehensively analyzed using various predictors selection methods and statistical models (Linear Regressors, Elastic Net, Bayesian Regressors, Huber Regression, regression based on k-nearest neighbors, Gaussian Process Regressor, Decision Tree Regressor, Random Forest Regressor, eXtreme Gradient Boosting, Automated Machine Learning) and were ranked to predict lymphocytes count nadir (alc_nadir). Results: Two hundred thirty eight patients (stage I-3.4%, II-17.6%, III-75.2%, IV-3.8%) who underwent RT to median dose of 60 Gy were analyzed. Median alc_nadir was 0.68K/mm3. The 60 feature sets were evaluated in 600 models (RMSE 0.27-0.41K/mm³). The most important features were baseline lymphocyte count (alc_1), mean lung_dose, lung v05, lung v10, heart v05 and effective dose to immune cells (edic). In patients with alc_1 ≤ 2.005K/mm3, median alc_nadir predictions were 0.54K/mm3 for lung_v05p > 51.8% and 0.76K/mm3 for lung_v05p ≤ 51.8%. Lymphopenia was rare in patients with alc_1 > 2.005K/mm3. Discussion: RIL was most severe in patients with low early lymphocyte counts, primarily triggered by low RT doses in the heart and lungs.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Linfopenia , Humanos , Linfopenia/etiologia , Neoplasias Pulmonares/radioterapia , Neoplasias Pulmonares/imunologia , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Contagem de Linfócitos , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Carcinoma Pulmonar de Células não Pequenas/imunologia , Linfócitos/efeitos da radiação , Linfócitos/imunologia , Exposição à Radiação/efeitos adversos , Idoso de 80 Anos ou mais , Pulmão/efeitos da radiação , Pulmão/imunologia , Carcinoma de Pequenas Células do Pulmão/radioterapia , Carcinoma de Pequenas Células do Pulmão/imunologia
10.
Radiat Res ; 202(2): 432-487, 2024 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-39021204

RESUMO

In this article we review the history of key epidemiological studies of populations exposed to ionizing radiation. We highlight historical and recent findings regarding radiation-associated risks for incidence and mortality of cancer and non-cancer outcomes with emphasis on study design and methods of exposure assessment and dose estimation along with brief consideration of sources of bias for a few of the more important studies. We examine the findings from the epidemiological studies of the Japanese atomic bomb survivors, persons exposed to radiation for diagnostic or therapeutic purposes, those exposed to environmental sources including Chornobyl and other reactor accidents, and occupationally exposed cohorts. We also summarize results of pooled studies. These summaries are necessarily brief, but we provide references to more detailed information. We discuss possible future directions of study, to include assessment of susceptible populations, and possible new populations, data sources, study designs and methods of analysis.


Assuntos
Neoplasias Induzidas por Radiação , Exposição à Radiação , Radiação Ionizante , Humanos , Exposição à Radiação/efeitos adversos , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , História do Século XX , Estudos Epidemiológicos , História do Século XXI , Exposição Ocupacional
11.
Cardiovasc Toxicol ; 24(9): 870-878, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39030318

RESUMO

The population in the areas neighboring the Semipalatinsk Nuclear Test Site (SNTS) in the eastern region of Kazakhstan faces increased cardiovascular disease (CVD) risk. Previous research has not explored gene polymorphisms related to CVD in this population. Therefore, the present study examines the prevalence of six CVD-associated genotypes in three generations exposed to SNTS radiation. The genotyping of ApoE Leu28 → Pro, AGT Met174 → Thr, AGT Met235 → Thr, eNOS T786 → C, PON1 Gln192 → Arg, and EDN 1 Lys198 → Asn was performed using real-time polymerase chain reaction. The present study encompassed a cohort of 218 participants with a familial history of arterial hypertension and/or carotid artery disease spanning at least three generations. The analysis unveiled significant disparities in the prevalence of ApoE Leu28 → Pro, eNOS T786 → C, and PON1 Gln192 → Arg genotypes across different generations. Furthermore, a substantial variation in the distribution of the eNOS T786 → C genotype was observed between individuals of Kazakh and Russian ethnicities. Nevertheless, no significant discrepancies were detected in the frequencies of the investigated genotypes between genders. Further research in this area is warranted to enhance the understanding of the genetic factors contributing to CVD in the population exposed to radiation from the SNTS. Specifically, future studies should broaden the scope of genetic polymorphisms investigated and include representatives of healthy individuals who have not been exposed to radiation as controls.


Assuntos
Predisposição Genética para Doença , Óxido Nítrico Sintase Tipo III , Polimorfismo Genético , Exposição à Radiação , Humanos , Masculino , Feminino , Cazaquistão/epidemiologia , Pessoa de Meia-Idade , Óxido Nítrico Sintase Tipo III/genética , Exposição à Radiação/efeitos adversos , Adulto , Arildialquilfosfatase/genética , Armas Nucleares , Fenótipo , Apolipoproteínas E/genética , Medição de Risco , Hereditariedade , Frequência do Gene , Linhagem , Doenças Cardiovasculares/genética , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/diagnóstico , Fatores de Risco de Doenças Cardíacas , Idoso , Fatores de Risco , Interação Gene-Ambiente , Prevalência , Doenças das Artérias Carótidas/genética , Doenças das Artérias Carótidas/epidemiologia
12.
Radiat Environ Biophys ; 63(3): 385-394, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39031187

RESUMO

Monitoring of internal exposure to short-lived alpha-emitting radionuclides such as actinium-225 (225Ac), which are becoming increasingly important in nuclear medicine, plays an important role in the radiation protection of occupationally exposed persons. After having tested gamma spectrometry, liquid scintillation counting and alpha spectrometry for monitoring of internal exposure, the focus of the present study was on solid phase extraction of 225Ac from urine in combination with alpha spectrometry. The development of the method was based on recent findings from the literature on this topic. The method was used in a pilot phase to monitor internal exposure of four workers who were directly or indirectly involved in the manufacture and/or use of 225Ac. The monitoring protocol allowed a relatively short 24-hour urine sample analysis with excellent recovery of the internal standard, but it did not allow for a detection limit of less than 1 mBq nor a sufficient yield of 225Ac. Based on these results it is concluded that an in vitro excretion analysis alone is not appropriate for monitoring internal exposure to 225Ac. Instead, different radiation monitoring techniques have to be combined to ensure the radiation protection of employees.


Assuntos
Actínio , Partículas alfa , Exposição Ocupacional , Monitoramento de Radiação , Exposição Ocupacional/análise , Humanos , Monitoramento de Radiação/métodos , Medicina Nuclear , Radioisótopos/urina , Masculino , Extração em Fase Sólida , Proteção Radiológica , Exposição à Radiação , Doses de Radiação , Adulto
13.
Int J Occup Med Environ Health ; 37(3): 326-334, 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-38975634

RESUMO

OBJECTIVES: During computed tomography (CT), a large amount of ionizing radiation is emitted to ensure high quality of the obtained radiological image. This study measured the dose distribution around the CT scanner and the exposure of people staying near the CT scanner during the examination. MATERIAL AND METHODS: The measurements used an anthropomorphic phantom to assess human exposure to ionizing radiation. The probability of inducing leukemia and other cancers as a result of absorbing doses recorded around the CT device was also calculated. RESULTS: The highest exposure to scattered radiation in the proximity of the CT scanner is recorded at the gantry of the tomograph, i.e., 55.7 µGy, and the lowest, below lower detection limit of 6 µGy at the end of the diagnostic table. The whole-body detector placed on the anthropomorphic phantom located at the diagnostic table right next to the CT gantry recorded 59.5 µSv and at the end of the table 1.5 µSv. The average doses to the lenses in these locations were: 32.1 µSv and 2.9 µSv, respectively. CONCLUSIONS: The probability of induction of leukemia or other types of cancer is low, but the need for people to stay in the examination room during a CT examination should be limited to the necessary minimum. Int J Occup Med Environ Health. 2024;37(3):326-34.


Assuntos
Imagens de Fantasmas , Doses de Radiação , Tomografia Computadorizada por Raios X , Humanos , Cuidadores , Radiação Ionizante , Tomógrafos Computadorizados , Exposição à Radiação , Criança , Exposição Ocupacional , Espalhamento de Radiação
14.
Radiat Res ; 202(3): 523-540, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39038818

RESUMO

This study delves into the investigation of cosmic-ray radiation exposure levels for workers and their impact on the signal correlation subsystems at the Atacama Large Millimeter/submillimeter Array (ALMA) observatory sites. The analysis presents a detailed examination of secondary cosmic ray spectra and flux at the ALMA sites, encompassing the operational period from 2010 to the present day, with a particular focus on the consequences of extreme solar flares. In terms of radiation exposure for ALMA employees, the annual exposure at the highest site (AOS) reaches approximately 4.8 mSv. This value exceeds the exposure level of a typical nuclear fuel cycle worker or those working at high-altitude Antarctica stations. The exposure is approximately 2.7 times lower at the ALMA Operations Support Facility (OSF). Furthermore, the additional ambient dose equivalent resulting from solar events, while low for events similar to those observed since the 1950s, can reach up to approximately 1 mSv when considering more ancient solar events based on environmental archives. Our analysis includes radiation effects measurements in the Baseline Correlator at the AOS and, more generally, underscores the significance of employing accurate modeling and simulation techniques to assess the effects of galactic cosmic rays and extreme solar events on the integrated circuits utilized or planned in the ALMA correlation subsystem.


Assuntos
Radiação Cósmica , Exposição Ocupacional , Exposição à Radiação , Radiação Cósmica/efeitos adversos , Humanos , Exposição Ocupacional/análise , Exposição à Radiação/análise , Monitoramento de Radiação/métodos , Atividade Solar
15.
J Pediatr Orthop ; 44(9): e858-e862, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39021094

RESUMO

BACKGROUND: Orthopaedic surgeons routinely face exposure to ionizing radiation during intraoperative use of fluoroscopy. Lead personal protective equipment reduces occupational radiation exposure. Female-specific lead aprons are designed with expanded lateral coverage to improve protection of breast tissue against radiation beams. The purpose of this study was to identify current trends in knowledge and utilization of female-specific lead aprons as well as any barriers to utilization. METHODS: An anonymous electronic survey including 20 multiple choice and multiple selection responses was distributed to all members of the Pediatric Orthopaedic Society of North America (POSNA). Respondents who reported the use of intraoperative fluoroscopy in their practice were included in the study. RESULTS: Most respondents were attending surgeons (91%) and practiced in an academic setting (85%) in an urban environment (75%). Most respondents reported using a lead apron for every case (76%) and a thyroid shield for every case (75%), while most respondents reported they do not wear lead glasses (73%). Fifty-one percent of respondents were aware of female-specific lead aprons. The majority of respondents reported female-specific lead is unavailable (45%) or available in insufficient quantities (5.5%) at their institution. Ninety percent of females reported they do not wear female-specific lead with the common reasons being lack of availability and discomfort. CONCLUSIONS: Knowledge of female-specific lead is low with lack of availability as a common barrier to utilization. As female presence in the field of orthopaedic surgery expands, efforts should be made to improve education and availability of sex-specific lead aprons.


Assuntos
Exposição Ocupacional , Cirurgiões Ortopédicos , Roupa de Proteção , Proteção Radiológica , Humanos , Feminino , Masculino , Roupa de Proteção/estatística & dados numéricos , Proteção Radiológica/métodos , Exposição Ocupacional/prevenção & controle , Inquéritos e Questionários , Chumbo , Fluoroscopia , Conhecimentos, Atitudes e Prática em Saúde , Exposição à Radiação , Fatores Sexuais
16.
Curr Cardiol Rep ; 26(9): 1021-1029, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39052162

RESUMO

PURPOSE OF REVIEW: In this review, we discuss the status of novel radiation shielding and other methods to reduce radiation exposure and its associated health risks within the CCL. RECENT FINDINGS: There are many devices on the market each with its unique advantages and inherent flaws. Several are available for widespread use with promising data, while others still in development. The field of percutaneous transcatheter interventions includes complex procedures often involving significant radiation exposure. Increased radiation exposes the proceduralist and CCL staff to potential harm from both direct effects of radiation but also from the ergonomic consequences of daily use of heavy personal protective equipment. Here we discuss several innovative efforts to reduce both radiation exposure and orthopedic injury within the CCL that are available, leading to a safer daily routine in a "lead [apron]-free" environment.


Assuntos
Cateterismo Cardíaco , Exposição Ocupacional , Exposição à Radiação , Humanos , Cateterismo Cardíaco/métodos , Exposição Ocupacional/prevenção & controle , Exposição à Radiação/prevenção & controle , Proteção Radiológica/métodos , Proteção Radiológica/instrumentação , Equipamento de Proteção Individual , Roupa de Proteção
17.
Ecotoxicol Environ Saf ; 283: 116789, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-39067071

RESUMO

In the last three decades, an increase in thyroid cancer incidence has been observed worldwide, as well as in Lithuania. Although the rise was linked to overdiagnosis, the role of lifestyle and environmental factors, including exposure to ionizing radiation, cannot be excluded. In our retrospective study, we aimed to assess the association between the average age-specific thyroid dose due to the radioactive iodine uptake during childhood and adolescence from the Chernobyl fallout in Lithuania, and the trends of incidence of thyroid cancer from 1991 to 2015 in different regions. Averaged age-dependent thyroid doses were estimated for every municipality based on radioiodine activity in milk, reconstructed from available 131I activity measurements in the grass. Thyroid cancer incidence rates were calculated for the entire population and for two age at the time of exposure groups: 0-19 years and 0-9 years. Thyroid cancer relative risk (RR) was estimated for three municipality-specific thyroid dose (for 0-year-old babies) categories: less than 100 mGy (reference group), 100-199 mGy, and ≥200 mGy. Over the study period (1991-2015), a total of 5664 cases of thyroid cancer were registered in the entire Lithuanian population; 817 cases in the age group from 0 to 19 years at the time of the Chernobyl accident, and 266 cases in the age group from 0 to 9 years. Age-standardized thyroid cancer incidence rates have notably increased since 2000, peaked in 2009 (especially in females), and then slightly decreased and stabilized. The estimated average municipality-specific age-dependent thyroid doses ranged from 270 mGy in western Lithuania to 1.5 mGy in central and northern Lithuania. For the age group of 0-19 years at the time of the accident, in the period 1991-1995, the thyroid cancer relative risk was significantly increased (RR 3.91; 95 % CI: 1.27-10.29, p=0.01) in the highest dose category, compared to the lowest (although based on a small number of cases). For the age group 0-9 years at the time of the accident, a tendency of increased RR in the highest dose category appeared in the most recent period, 2011-2015. Our observations need to be confirmed by further following trends of thyroid cancer incidence in the cohort of 0-19-year-old Lithuanians at the time of the Chernobyl accident.


Assuntos
Acidente Nuclear de Chernobyl , Neoplasias da Glândula Tireoide , Lituânia/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Humanos , Criança , Lactente , Incidência , Pré-Escolar , Adolescente , Estudos Retrospectivos , Adulto Jovem , Recém-Nascido , Feminino , Masculino , Radioisótopos do Iodo , Neoplasias Induzidas por Radiação/epidemiologia , Cinza Radioativa/efeitos adversos , Adulto , Exposição à Radiação/efeitos adversos
18.
Eur J Radiol ; 178: 111523, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39013270

RESUMO

BACKGROUND: Neck computed tomography (NCT) is essential for diagnosing suspected neck tumors and abscesses, but radiation exposure can be an issue. In conventional reconstruction techniques, limiting radiation dose comes at the cost of diminished diagnostic accuracy. Therefore, this study aimed to evaluate the effects of an AI-based denoising post-processing software solution in low-dose neck computer tomography. MATERIALS AND METHODS: From 01 September 2023 to 01 December 2023, we retrospectively included patients with clinically suspected neck tumors from the same single-source scanner. The scans were reconstructed using Advanced Modeled Iterative Reconstruction (Original) at 100% and simulated 50% and 25% radiation doses. Each dataset was post-processed using a novel denoising software solution (Denoising). Three radiologists with varying experience levels subjectively rated image quality, diagnostic confidence, sharpness, and contrast for all pairwise combinations of radiation dose and reconstruction mode in a randomized, blinded forced-choice setup. Objective image quality was assessed using ROI measurements of mean CT numbers, noise, and a contrast-to-noise ratio (CNR). An adequately corrected mixed-effects analysis was used to compare objective and subjective image quality. RESULTS: At each radiation dose level, pairwise comparisons showed significantly lower image noise and higher CNR for Denoising than for Original (p < 0.001). In subjective analysis, image quality, diagnostic confidence, sharpness, and contrast were significantly higher for Denoising than for Original at 100 and 50 % (p < 0.001). However, there were no significant differences in the subjective ratings between Original 100 % and Denoising 25 % (p = 0.906). CONCLUSIONS: The investigated denoising algorithm enables diagnostic-quality neck CT images with radiation doses reduced to 25% of conventional levels, significantly minimizing patient exposure.


Assuntos
Aprendizado Profundo , Neoplasias de Cabeça e Pescoço , Exposição à Radiação , Interpretação de Imagem Radiográfica Assistida por Computador , Tomografia Computadorizada por Raios X , Humanos , Tomografia Computadorizada por Raios X/métodos , Masculino , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Estudos Retrospectivos , Exposição à Radiação/prevenção & controle , Exposição à Radiação/análise , Pessoa de Meia-Idade , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Doses de Radiação , Idoso , Adulto , Razão Sinal-Ruído , Pescoço/diagnóstico por imagem
19.
Eur J Radiol ; 178: 111629, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39024663

RESUMO

PURPOSE: When discussing radiation risks for patients who undergo many CT examinations, some question the risks, believing that most of these patients are already very sick and likely to die within a few years, thus negating worry about radiation risk. This study seeks to evaluate the validity of this notion. METHODS: In this retrospective single large-hospital study, patients who received CT exams in 2013 were sorted into four cumulative effective dose (CED) groups: Group A (>0 to <10 mSv), Group B (10 to <50 mSv), Group C (50 to < 100 mSv), and Group D (≥100 mSv). The death rates of patients in each group were analyzed, up to December 2023. RESULTS: 36,545 patients underwent CT examinations in 2013 (mean age, 56 ± 20 years, 51.4 % men). Death rates for all dose groups peaked in the year of imaging or 1 year after. At one year after imaging, Group D had 6.7 times and Group C had 4.3 times the death rate of Group A. However, a significant portion of these patients are alive after 10 years, with 1324/2756 patients (48.0 %) in Group C and 282/769 patients (36.7 %) in Group D with the potential to face radiation effects. CONCLUSIONS: While it is true that patients receiving relatively higher doses (≥50 mSv) are more likely to die within the first two years of receiving such doses, nearly one-third to half remain alive a decade after their CT scans, potentially facing the effects of radiation. This knowledge may help policymakers and practitioners.


Assuntos
Doses de Radiação , Tomografia Computadorizada por Raios X , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Adulto , Taxa de Sobrevida , Exposição à Radiação/estatística & dados numéricos
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