Efficiency of the RADPAD Surgical Cap in Reducing Brain Exposure During Pacemaker and Defibrillator Implantation.

OBJECTIVES: This study sought to investigate the RADPAD No Brainer (Worldwide Innovation and Technologies, Overland Park, Kansas) efficiency in reducing brain exposure to scattered radiation. BACKGROUND: Cranial radioprotective caps such as the RADPAD No Brainer are being marketed as devices that significantly reduce operator's brain exposure to scattered radiation. However, the efficiency of the RADPAD No Brainer in reducing brain exposure in clinical practice remains unknown to date. METHODS: Five electrophysiologists performing device implantations over a 2-month period wore the RADPAD cap with 2 strips of 11 thermoluminescent dosimeter pellets covering the front head above and under the shielded cap. Phantom measurements and Monte Carlo simulations were performed to further investigate brain dose distribution. RESULTS: Our study showed that the right half of the operators' front head was the most exposed region during left subpectoral device implantation; the RADPAD cap attenuated the skin front-head exposure but provided no protection to the brain. The exposure of the anterior part of the brain was decreased by a factor of 4.5 compared with the front-head skin value thanks to the skull. The RADPAD cap worn as a protruding horizontal plane, however, reduced brain exposure by a factor of 1.7 (interquartile range: 1.3 to 1.9). CONCLUSIONS: During device implantation, the RADPAD No Brainer decreased the skin front head exposure but had no impact on brain dose distribution. The RADPAD No Brainer worn as a horizontal plane worn around the neck reduces brain exposure and confirms that the exposure comes from upward scattered radiation.

Eye lens monitoring programme for medical staff involved in fluoroscopy guided interventional procedures in Switzerland.

Epidemiological studies indicate that radiation damages to the eye lens occurs at lower dose values than previously considered (Worgul et al., 2007; Chodick et al., 2008; Ciraj-Bjelac et al., 2010; Rehani et al., 2011; Vano et al., 2010) [1-5]. The International Commission on Radiological Protection lowered the equivalent dose limit value for the eye lens to 20 mSv/year (ICRP, n.d.) [6]. This new limit has been incorporated into the revised Swiss legislation [7]. Prior this change, it was agreed that if the effective dose limit was respected it would implicitly imply the respect of the limit to the eye lens, for penetrating radiation. The concept had to be reviewed in the light of necessary application of the new eye lens dose limit. The new Swiss legislation proposes to use the value of Hp(0.07) measured over the protective apron to estimate the eye lens dose. This study aims to investigate the validity of this approach for medical staff during fluoroscopy guided procedures. The results show that the ratio between thorax and eye lens doses varies greatly from one medical speciality to another, but also between surgeons within the same speciality. Moreover, for a given physician, the ratio varied over the periods of surveillance. Those variations confirmed the crucial influence of external parameters related to experience, practice and workload. The surveillance method is appropriate for most of the procedures performed in the department included in this study. Nevertheless, for the particular configuration in urology, the respect of the effective dose limit measured by the routine dosimetry does not allow direct compliance with the dose limit to the eye lens, unless appropriate protective eye wear gear are worn.