Assessment of radiation protection of patients and staff in interventional procedures in four Algerian hospitals.

This study was aimed to assess patient dosimetry in interventional cardiology (IC) and radiology (IR) and radiation safety of the medical operating staff. For this purpose, four major Algerian hospitals were investigated. The data collected cover radiation protection tools assigned to the operating staff and measured radiation doses to some selected patient populations. The analysis revealed that lead aprons are systematically worn by the staff but not lead eye glasses, and only a single personal monitoring badge is assigned to the operating staff. Measured doses to patients exhibited large variations in the maximum skin dose (MSD) and in the dose area product (DAP). The mean MSD registered values are as follows: 0.20, 0.14 and 1.28 Gy in endoscopic retrograde cholangiopancreatography (ERCP), coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) procedures, respectively. In PTCA, doses to 3 out of 22 patients (13.6 %) had even reached the threshold value of 2 Gy. The mean DAP recorded values are as follows: 21.6, 60.1 and 126 Gy cm(2) in ERCP, CA and PTCA procedures, respectively. Mean fluoroscopic times are 2.5, 5 and 15 min in ERCP, CA and PTCA procedures, respectively. The correlation between DAP and MSD is fair in CA (r = 0.62) and poor in PTCA (r = 0.28). Fluoroscopic time was moderately correlated with DAP in CA (r = 0.55) and PTCA (r = 0.61) procedures. Local diagnostic reference levels (DRLs) in CA and PTCA procedures have been proposed. In conclusion, this study stresses the need for a continuous patient dose monitoring in interventional procedures with a special emphasis in IC procedures. Common strategies must be undertaken to substantially reduce radiation doses to both patients and medical staff.

Level of natural and artificial radioactivity in Algeria.

A national environmental sampling program was carried out during 1993 to determine natural and artificial radionuclides contents in the (0-15 cm) upper layer of the soil. The main objective was to establish a radioactive reference level in the whole territory, since 131I, 134Cs and 137Cs were detected in most of the analysed samples collected right after the Chernobyl accident (May 1986). Soil samples were analysed by direct counting by gamma-ray spectrometry. In addition, terrestrial gamma-ray dose rates in air have been measured out of doors throughout Algeria. In each of the 48 administrative divisions of the country selected sites were chosen to collect soil samples and measure gamma-ray dose rates. The gamma-emitting radionuclides resulting from the radioactive decay of 238U and 232Th, 40K and 137Cs were detected in most of the analysed samples. Radioactivity concentrations in Bq kg-1 dry mass in soil samples of 226Ra, 214Pb, 214Bi, 212Pb, 228Ac, 40K and 137Cs range between (5-176), (2-107), (3-65), (2-97), (3-144), (36-1405) and (0.3-41) respectively. In addition, six selected soil samples were analysed to determine plutonium isotopes contents. Radioactivity concentrations in Bq kg-1 dry mass of 238Pu and 239 + 240Pu vary between (0.012-0.013) and (0.24-0.61) respectively. The dose rates in air measured over the whole country were found to range between 20 and 133 nGy h-1. Presence of 137Cs has been clearly observed. An approach has been made to determine its origin, considering the global fallout, the Chernobyl accident and the French nuclear bomb tests in the 60s as the main potential sources. It is concluded that Algeria has indeed been affected by the Chernobyl accident.