Why use radiation protection glasses for fluoroscopy room? Any medical imaging procedure that involves radiation, particularly X-rays, involves hazards to the operating technician. Fluoroscopy, a type of x-ray imaging that involves the monitoring of moving body parts, has a number of safety challenges, particularly to the eyes. The use of eye protection glasses in generally recommended for the protection of the operator.
What is fluoroscopy?
Fluoroscopy is defined by the FDA as, “a type of medical imaging that shows a continuous X-ray image on a monitor, much like an X-ray movie. During a fluoroscopy procedure, an X-ray beam is passed through the body. The image is transmitted to a monitor so the movement of a body part or of an instrument or contrast agent (“X-ray dye”) through the body can be seen in detail.”
Unlike standard X-rays, which take still images of the inside of a human body, fluoroscopy is more like “X-ray television.” The imaging technology is often used to help guide a surgeon during certain procedures, such as the insertion of a stent in a blood vessel or a joint replacement during an orthopedic surgery. Fluoroscopy is also useful for determining what is taking place in the cardiovascular system or the gastrointestinal tract.
Risks of fluoroscopy
As with any technology that involves radiation, the use of fluoroscopy involves some risks. Obviously, the risk to the patient has to be weighed against the possible benefit of using the technology. Fluoroscopy involves a bit more risk than standard X-rays because, especially due to the length and the complexity of the procedures in which it is involved. While the risk of damage is small, in the form of skin burns and even cancers later in life, they do exist and have to be accounted for, especially in measuring the dose.
The risk to the operator
While a patient might be exposed to a fluoroscope once or twice in a lifetime, the technician operating the machine runs the risk of accumulated exposure to the radiation being emitted from the machine. The FDA mandates that fluoroscope machines be regularly maintained for quality assurance, especially to make sure that radiation leaks are prevented. The imaging team, which includes not only the operating technician but surgeons and other health care workers who will be in the fluoroscope room during a procedure, has to be trained in safety protocols, including the wearing of protective gear.
What X Rays can do to the human eye
A paper published in Radiology Research and Practice describes the risk inherent in using X-ray equipment, including fluoroscopes, to eyes of operators and those of other people in the room. The main hazard consists of the creation of cataracts in the eyes due to long term exposure to the radiation being emitted from the machine.
The National Eye Institute defines a cataract as, “a clouding of the lens in the eye that affects vision.” Most cataracts are the result of aging, with more than half of Americans have either had cataracts or having had cataract surgery by the age of 80. Cataracts can also be caused by damage to the eye, either during a surgery or by blunt force trauma, or by exposure to radiation such as X-rays. Cataracts can often only manifest years after the damage has happened.
Cataracts can be treated with a surgery that involves the removal of the growth and the insertion of an intraocular lens. As with all medical conditions, it is best not to develop a cataract rather than to rely on medical science once it starts to form.
How fluoroscopic radiation hits the eye of an operating technician
X-rays that can hit a fluoroscope operating technician usually consists of “back scatter” that bounces off the body of the patient when the beam enters his or her body. What kind of dose the operator gets depends on safety protocols that the imaging staff is employing, including eye protection, and their relative position to the body of the patient during the fluoroscopic imaging procedure.
The International Commission on Radiological Protection states that the threshold for eye damage from a single radiation dose is 500 REMs and 800 REMs for protracted or fractionalize exposure. The Radiology Research and Practice suggests that the average fluoroscope technician operator in the pain intervention specialty performs 40 imaging procedures a week with an exposure in each procedure being less than 2.0 mRem. That would mean an annual exposure of about ten times less than the cumulative threshold for radiation damage to the eyes.
However, a number of factors go into how much exposure is “safe” for a technician operator. Other procedures, such as a spinal cord operation, might involve higher radiation doses. Other factors include the position of the operator technician, his or her height and genetic predisposition for developing cataracts, the size and age of the patient, and so on. Also, the ICRP guidelines are not without controversy, with some studies suggesting that the thresholds should be lower.
Using protective eyewear
Clearly, using protective eye wear in the fluoroscopy room will go a long way toward shielding the eyes of the imaging staff and preventing the formation of cataracts later in life. Two studies cited in the Radiology Research and Practice paper suggest that protective eyewear can reduce radiation exposure to the eyes by between 70 and 98 percent. How much this kind of protection will reduce the damage to the eyes has yet to be determined, but combined with situational awareness and proper safety protocols, protective eye wear will surely mitigate damage to the eyes of the imaging team, thus avoiding later health care issues.
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