Our initial foray with radiation didn’t go as expected. Marie Curie succumbed to her death due to exposure to radium. Thomas Edison stopped research into the fluoroscope after his assistant died with x-ray overdose. Today, we have a far better understanding of radiation and the dangers it poses to the human body. We also have adequate radiation shielding measures, but we still tend to get complacent, often overlooking this odorless colorless threat.
One of the biggest dangers can be seen in hospitals, as has been highlighted by the New York Times in a series of exposes on radiation treatment over-exposure and accidents. In fact, the primary sources of excessive radiation are computed tomography, fluoroscopy and nuclear medicine.
So Why Is It Still An Issue?
Sure, we all understand the dangers posed by radiation, but we tend to get complacent while using tools on a day-to-day basis. One of the biggest causes of over-exposure is that many workers in the field only receive rudimentary radiation protection training. Most are unfamiliar with the various sources of exposure and know very little about reducing risks and implementing proper radiation shielding measures. A vascular surgeon or an interventional cardiologist is as exposed to the dangers of radiation as a radiologist. However, while radiologists have a radiologic technologist to support them (individuals who receive proper radiation safety training), surgeons and cardiologists have nurses to support them, most of who likely receive little to no training at all.
There is the case of using more radiation than necessary as well. The US stresses on the best-quality images, and this means more radiation. This isn’t the case in Japan or Europe where radiation protection and safety is paramount. After all, one doesn’t need excessive radiation to produce a decent workable image.
What AboutRadiation Shielding? Who’s Keeping a Check?
Radiation protection is the responsibility of technologists and radiation safety officers who work in a particular department. The radiation safety officer keeps a track of workers’ exposure to radiation and ensures that all safety guidelines are met. An external company presents exposure assessment on a monthly basis. The state performs an inspection once or twice a year as well. In addition to these measures, the Joint Commission requires all hospitals to have written procedures regarding the precautions to take while using hazardous equipment and ensure that enough radiation shielding materials and protective devices are available to keep worker exposure in check. However, it’s easy to become a victim to complacency and bad habits.
Improving Safety Standards
Everything isn’t gloom and doom when it comes to radiation exposure. The good news is that with a few key changes, it is easy to bring the level of exposure in check. The first step that any hospital needs to take is to ensure that all workers working around radiation are made to undertake a radiation safety course. It is equally important to ensure proper communication within the healthcare team and make each worker understand that radiation safety is a part of the team’s job and not a responsibility of one individual. Controlling patient dosage is also important as most workers get exposed to radiation due to radiation scatter from the patient.
Other safety mechanisms that need to be looked at include radiation shielding. Hospitals need to make the most of the different kinds of radiation shielding materials available, but they also need to ensure that these devices are used effectively.
Another area that often gets overlooked is the positioning of the tube that creates the x-ray. The detector should be as close to the patient as possible so as to block any scatter radiation and also improve image quality. Many operators find it convenient to keep the detector further away so that it can be moved easily and this usually accounts for as much as 60% more radiation in some cases.
Radiation is essential for diagnostics, but it should be given the respect it deserves. There is a lot of scope for improvement in radiation safety practices, and the healthcare industry needs each person involved to step up and commit themselves to use radiation in a safer, more organized manner, for the betterment of the community.