美国放射技师队列中荧光透视引导介入程序的执行模式变化及对辐射安全规范的遵守情况
Changing Patterns in the Performance of Fluoroscopically Guided Interventional Procedures and Adherence to Radiation Safety Practices in a U.S. Cohort of Radiologic Technologists.
作者信息
Lim Hyeyeun, Linet Martha S, Van Dyke Miriam E, Miller Donald L, Simon Steven L, Sigurdson Alice J, Kitahara Cari M
机构信息
1 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9069 Medical Center Dr, Rockville, MD 20850.
2 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
出版信息
AJR Am J Roentgenol. 2016 Dec;207(6):1350-1359. doi: 10.2214/AJR.15.15979. Epub 2016 Aug 30.
OBJECTIVE
Information is limited on changes over time in the types of fluoroscopically guided interventional procedures performed and associated radiation safety practices used by radiologic technologists.
MATERIALS AND METHODS
Our study included 12,571 U.S. radiologic technologists who were certified for at least 2 years in 1926-1982 and who reported in a 2012-2013 survey that they ever performed or assisted with fluoroscopically guided interventional procedures. They completed a mailed questionnaire in 2013-2014 describing their detailed work practices for 21 fluoroscopically guided interventional procedures and associated radiation safety practices from the 1950s through 2009.
RESULTS
Overall, the proportion of technologists who reported working with therapeutic fluoroscopically guided interventional procedures, including percutaneous coronary interventions, increased over time, whereas the proportion of technologists who worked with diagnostic fluoroscopically guided interventional procedures, including diagnostic cardiovascular catheterization and neuroangiographic procedures, decreased. We also observed substantial increases in the median number of times per month that technologists worked with diagnostic cardiovascular catheterizations and percutaneous coronary interventions. In each time period, most technologists reported consistently (≥ 75% of work time) wearing radiation monitoring badges and lead aprons during fluoroscopically guided interventional procedures. However, fewer than 50% of the technologists reported consistent use of thyroid shields, lead glasses, and room shields during fluoroscopically guided interventional procedures, even in more recent time periods.
CONCLUSION
This study provides a detailed historical assessment of fluoroscopically guided interventional procedures performed and radiation safety practices used by radiologic technologists from the 1950s through 2009. Results can be used in conjunction with badge dose data to estimate organ radiation dose for studies of radiation-related health risks in radiologic technologists who have worked with fluoroscopically guided interventional procedures.
目的
关于放射技师所进行的透视引导介入操作类型以及相关辐射安全实践随时间的变化，相关信息有限。
材料与方法
我们的研究纳入了12571名美国放射技师，他们在1926年至1982年期间获得认证至少2年，并在2012 - 2013年的一项调查中报告曾进行或协助过透视引导介入操作。他们在2013 - 2014年完成了一份邮寄问卷，描述了他们在20世纪50年代至2009年期间针对21种透视引导介入操作的详细工作实践以及相关辐射安全实践。
结果
总体而言，报告从事包括经皮冠状动脉介入术在内的治疗性透视引导介入操作的技师比例随时间增加，而从事包括诊断性心血管导管插入术和神经血管造影术在内的诊断性透视引导介入操作的技师比例下降。我们还观察到技师每月进行诊断性心血管导管插入术和经皮冠状动脉介入术的次数中位数大幅增加。在每个时间段，大多数技师报告在透视引导介入操作期间始终（≥75%的工作时间）佩戴辐射监测徽章和铅围裙。然而，即使在最近的时间段，也不到50%的技师报告在透视引导介入操作期间始终使用甲状腺防护装置、铅眼镜和房间防护屏。
结论
本研究提供了对20世纪50年代至2009年期间放射技师所进行的透视引导介入操作以及所采用的辐射安全实践的详细历史评估。研究结果可与徽章剂量数据结合使用，以估计曾从事透视引导介入操作的放射技师辐射相关健康风险研究中的器官辐射剂量。
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