Are orthopedic surgeons exposed to excessive eye irradiation? A prospective study of lens irradiation in orthopedics and traumatology

• Published in: Orthopaedics & traumatology, surgery & research Vol. 105; no. 3; pp. 569 - 572
• Main Authors: Cuenca, Céline, Mention, Pierre-Jean, Vergnenegre, Guillaume, Matthieu, Pierre-Alain, Charissoux, Jean-Louis, Marcheix, Pierre-Sylvain
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.05.2019; Elsevier
• Subjects: Adult; Chemical Sciences; Engineering Sciences; Female; Fluoroscopy; Forehead; France; Humans; Lens; Lens, Crystalline; Male; Material chemistry; Materials; Occupational Exposure - analysis; Occupational Exposure - standards; Operating Rooms; Orthopedic Procedures; Orthopedics; Prospective Studies; Radiation; Radiation Dosage; Radiation Monitoring; Radiation, Ionizing; Radioprotection; Traumatology; France; Lens; Traumatology; Radioprotection; Orthopedics; Radiation
• DOI: 10.1016/j.otsr.2019.01.013
• ISSN: 1877-0568

Numerous studies in recent years highlighted an increased risk of pathologies related to ionizing radiation in caregivers. A new French decree was adopted on June 4, 2018, dividing by 7.5 the radiation dose authorized in the lens for exposed workers. The hypothesis of the present study was that ocular irradiation in orthopedic surgeons was below the new legal threshold. The equivalent dose (mSv) received by the lens was prospectively assessed in 10 orthopedic surgeons (5 senior, 5 residents), using 3 passive dosimeters placed at the forehead and either temple. Each intervention of each operator was recorded, with dose per area in the operating room at each use of the fluoroscope. All equivalent doses to the lens at the end of the 4 month study period were well below threshold. Doses were not significantly different between forehead and either temple (p=0.7, p=0.6 for the 2 temples). There was no difference according to side of the head (p=0.3). The dose received in the lens correlated with the dose delivered in the room (p=0.004). There were no significant differences in irradiation according to the surgeon's experience (p=0.2) or trauma activity rate (p=0.4). No studies have reported equivalent doses to the lens exceeding the authorized limit. But none previously measured equivalent dose to the lens according to the axis of irradiation in the eyes. The present study showed that orthopedic surgeons received as much eye radiation laterally as frontally. Ocular radiation protection needs therefore to be as effective laterally as frontally. The surgeon's experience did not emerge as a protective factor against ocular irradiation.