BMJ  2003;327:1167 (15 November), doi:10.1136/bmj.327.7424.1167-a

Letter

Doctors' knowledge of exposure to ionising radiation

Doctors' exposure to ionising radiation may be cause for concern

EDITOR—Concerns about patients' exposure to radiation at the hands of their doctors should extend to health professionals.¹ Orthopaedic theatre staff may be unaware of the following simple facts:

• Lead gowns should be 0.35 mm thick
  
• Surgeons' exposure is reduced by the inverted C-arm (image intensifier) technique²
  
• Any distance < 90 cm from the C-arm is unsafe³
  
• The thyroid gland should be protected at all times⁴
  
• Hands are at high risk from radiation and orthopaedic surgeons controlling the image intensifier can reduce hand exposure.⁵
  

In addition to the Ionising Radiation (Medical Exposure) Regulations 2000 (www.doh.gov.uk/irmer.htm), all orthopaedic theatre staff should be monitored for central and peripheral exposure to radiation. Lead gowns should be regularly checked for cracks and thickness, and the image intensifier for radiation scattering. A study of all radiation related head and neck and upper limb malignancies would, no doubt, be of great interest to the British Orthopaedic Association.

etsiridis{at}hotmail.com

Whittington Hospital, London N19 5NF

King's College Hospital, London SE5 8AF

---

Competing interests: None declared.

References

1. Shiralkar S, Rennie A, Snow M, Galland RB, Lewis MH, Gower-Thomas K. Doctors' knowledge of radiation exposure: questionnaire study. BMJ 2003;327: 371-2. (16 August.)[Free Full Text]
2. Tremains MR, Georgiadis GM, Dennis MJ. Radiation exposure with use of the inverted-c-arm technique in upper-extremity surgery. J Bone Joint Surg Am 2001;83-A: 674-8.[Abstract/Free Full Text]
3. Mehlman CT, DiPasquale TG. Radiation exposure to the orthopaedic surgical team during fluoroscopy: "how far away is far enough?". J Orthop Trauma 1997;11: 392-8.[CrossRef][ISI][Medline]
4. Tse V, Lising J, Khadra M, Chiam Q, Nugent R, Yeaman L, Mulcahy M. Radiation exposure during fluoroscopy: should we be protecting our thyroids? Aust N Z J Surg 1999;69: 847-8.[Medline]
5. Noordeen MH, Shergill N, Twyman RS, Cobb JP, Briggs T. Hazard of ionizing radiation to trauma surgeons: reducing the risk. Injury 1993;24: 562-4.[CrossRef][ISI][Medline]

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Relevant Article

Doctors' knowledge of radiation exposure: questionnaire study

S Shiralkar, A Rennie, M Snow, R B Galland, M H Lewis, and K Gower-Thomas
BMJ 2003 327: 371-372. [Full Text] [PDF]