The assessment of the ionizing radiation dose received by patients during some diagnostic X-ray examinations carried out on the basis of the working procedures in the health care entities

Background: X-ray examination is a popular and universally used injury and disease diagnostic method. A distinctive X ray examination feature is that it can be done quickly which is extremely important in case of the need for rapid diagnosis of patients in life threatening condition. Another advantage of the X-ray examinations is also relatively low cost of carry. However, X-ray examination involve adverse health effects. During the examination the patient is subjected to ionizing radiation that might have impact on his health. Objective: The aim of this study has been to determine and assess the size of the entrance surface doses (ESD) received by patients during selected X-ray examinations performed on the basis of the medical working procedures available in healthcare entities in Masovian Voivodeship in Poland. Materials and Method: The examinations were conducted for 71 X-ray units located in the Masovian Voivodeship. Measurements of doses received by the patients were based on our own validated test methods. Results: It was found that the range applied to the high voltage in healthcare entities does not always coincide with the values specified in the standard procedures. It was found in the skull projection radiography AP and LAT that the recorded values were from range 60 to 82 kV (the average value of 74 kV) while in accordance with a standard procedure they should be in the range from 65 to 75 kV. Only in case of cervical spine radiography in the AP projection, the LAT exposure conditions were matching with the standard obligatory procedures in Poland. The consequence of selecting exposure conditions are significant differences in the size of the doses the patient receive during the same medical procedures. The greatest range of ESD doses was found during radiography of the thoracic spine in the projection AP and LAT. The projection LAT measured values were in the range of 523 to 10550 µGy (average value 2175 µGy). Conclusions: It is necessary to update immediately the standard procedures and to develop detailed guidelines for the preparation of working procedures in X-ray rooms.

Dosages of ionizing radiation during limb diagnostic X-ray examinations.

BACKGROUND: X-ray examination is associated with the patient's exposure to ionizing radiation. The dose values depend on the type of the medical procedure used, the X-ray unit technical condition and exposure conditions selected by X-ray technicians. The aim of this study has been to assess the entrance surface dose (ESD) values received by patients during the limb X-ray examination. The results should help doctors in making the decision about sending patients for X-ray examination. At the same time the X-ray unit condition and examination method performance are important for the radiological protection of the medical staff. MATERIAL AND METHODS: The study covered the total number of 118 X-ray units located in 56 public healthcare entities and private medical centers in the Masovian Voivodeship. The measurement of the radiation dose rate received by patients was based on our own research procedures. RESULTS: The research has found that there are even more than 10-fold differences in the dose values received by adult patients with several-fold differences in the case of children patients. The broadest dose value range for adult patients was related to femur radiography. The ESD values for this procedure ranged 70.9-765.2 µGy (with the average value of 319.7 µGy). The broadest dose value range for children was related to the knee radiography. The range for children aged 5 years old was 11.8-95.8 µGy (with the average value of 48.9 µGy). CONCLUSIONS: It is essential to immediately implement X-ray room working procedures for the purpose of performing diagnostic examinations based on the existing model procedures. Med Pr 2016;67(3):321-326.

Assessing the dose values received by patients during conventional radiography X-ray examinations and the technical condition of the equipment used for this purpose.

BACKGROUND: X-ray examination is associated with patient exposure to ionizing radiation. Dose values depend on the type of medical procedure used, the X-ray unit technical condition and exposure conditions selected. The aim of this study was to determine the dose value received by patients during certain conventional radiography X-ray examinations and to assess the technical condition of medical equipment used for this purpose. MATERIAL AND METHODS: The study covered the total number of 118 conventional diagnostic X-ray units located in the Masovian Voivodeship. The methodology used to assess the conventional diagnostic X-ray unit technical condition and the measurement of the radiation dose rate received by patients are based on test procedures developed by the Department of Radiation Protection and Radiobiology of the National Institute of Public Health - National Institute of Hygiene (Warszawa, Poland) accredited for compliance with PN-EN 17025 standard by the Polish Centre for Accreditation. RESULTS: It was found that 84.7% of X-ray units fully meet the criteria set out in the Polish legislation regarding the safe use of ionizing radiation in medicine, while 15.3% of the units do not meet some of them. The broadest dose value range was recorded for adult patients. Particularly, during lateral (LATl) lumbar spine radiography the recorded entrance surface dose (ESD) values ranged from 283.5 to 7827 µGy (mean: 2183.3 µGy). CONCLUSIONS: It is absolutely necessary to constantly monitor the technical condition of all X-ray units, because it affects population exposure to ionizing radiation. Furthermore, it is essential to raise radiographers' awareness of the effects that ionizing radiation exposure can have on the human body.

How often are x-rays used as diagnostic tool by healthcare providers in the Mazovian province of Poland.

BACKGROUND: Within the medical facilities provided by state healthcare services, a universally applied technique for patient diagnosis and treatment relies on ionising radiation; for example in radiotherapy and X-ray (ie. examination). Human exposure to such radiation is not however entirely free of associated health risks. OBJECTIVES: To determine and estimate the numbers and types of X-ray based medical procedures that are performed in general and dental radiography, mammography and computer tomography on patients from the Mazovian province in Poland, which included children, women and men subjects. MATERIAL AND METHODS: The numbers of patient subjects undergoing X-rays was estimated by surveying the patient intake in X-ray testing rooms within the healthcare facilities of the Mazovian province. Questionnaires were either dispatched by mail to such healthcare centres or were completed by the X-ray operating staff during the testing of quality control. Results so obtained from the latter, were compared to entries from the X-ray rooms' register RESULTS: During 2009, the number of X-rays performed were 7612046 equivalent to 1460 examinations per 1000 inhabitants. The majority were done on women ie. 3847961 (50.55%), followed by 3193781 (41.96%) on men and 570 304 (7.49%) for children. CONCLUSIONS: Results indicated that the predominating medical procedure used of this type, was for making general diagnoses; especially through using chest radiography. Others included, in descending order; dental X-ray (mainly intra-oral examination), computer tomography (mainly CT head examinations) and mammography procedures. It was also found that the annual numbers of having X-rays has increased compared to previous years.

The dose received by patients during dental X-ray examination and the technical condition of radiological equipment.

BACKGROUND: Implementation of X-ray dental examination is associated with the patients exposure to ionizing radation. The size of the exposure depends on the type of medical procedure, the technical condition of the X-ray unit and selected exposure conditions. The aim of this study was to determine the dose received by patients during dental X-ray examination and the assessment of the technical condition of medical equipment, MATERIALS AND METHODS: The study included a total number of 79 dental X-ray units located in the region of Mazovia. The test methods for the assessment of the technical condition of dental X-ray units and measurement of radiation dose received by patients were based on the procedures elaborated in the Department of Radiation Hygiene and Radiobiology in the National Institute of Public Health - National Institute of Hygiene (Warszawa, Poland) accredited for the certification of compliance with PN-EN 17025. RESULTS: The research found that 69.6% fully meets the criteria set out in the Polish legislation regarding the safe use of ionizing radiation in medicine, while 30.4% did not meet some of them. A tenfold difference in the size of the dose received by patients during dental X-ray examinations was discovered. For example, during a radiography of the canine teeth of a child, the recorded entrance surface dose (ESD) ranged from 72.8 to 2430 microGy with the average value of 689.1 microGy. Cases where the dose reference level defined in Polish legislation of 5 mGy was exceeded were also found. CONCKUSIONS: It is essential to constantly monitor the situation regarding the technical condition of X-ray units which affects the size of the population's exposure to ionizing radiation as well as raising dentists' awareness about the effects of X-rays on the human body.

[Natural radioactivity of potassium 40K in curative and natural mineral waters and dose estimation]. / Promieniotwórczosc naturalna potasu 40K w wodach leczniczych i naturalnych wodach mineralnych oraz ocena dawek.

Natural mineral and curative waters often characterize elevated level of mineral components. If the mineralization grows, the concentration natural radionuclides, which are one population's exposure sources on ionizing radiation, also grows. The main purposes work were: (1) determine the concentration isotope potassium 40K in samples of water, (2) calculate effective doses caused by intake of water with potassium 40K, (3)- explore correlation between potassium 40K concentration and total dissolved solids (TDS). The concentration radioisotope 40K in analysed samples determined by means of gamma spectrometry. Received concentrations have values from the interval 0.65 to 28.42 Bq/dm3. Measured values compared to values calculated from physico-chemical analyses composition of water, which amounted from 0.07 to 22.87 Bq/dm3. The calculated effective dose resulting from intake water with potassium 40K, concentration 2.26 Bq/dm3 equaled 294 nSv by treatment and caused by inhalation water with concentration 40K 1.45 Bq/dm3 reached value 9 nSv by treatment.

[Occurrence of radon 222Rn in curative waters]. / Wystepowanie radonu 222Rn w wodach leczniczych.

Radon is one of the best known human carcinogens. Natural radon (222Rn) is formed by decay of uranium (238U), directly of radium (226Ra). The aim of this study was to determine the activity concentration of radon in curative waters in Poland. The measurements were performed using alpha and beta liquid scintillation method Over 220 water samples from Polish spas have been analyzed. Arithmetic mean of radon concentration for curative waters was found to be 14.51 Bq/m3 within the range between 0.90 Bq/m3 to 193.10 Bq/m3. The average concentrations of radon-222 were ten times higher in water from slaskie and dolnoslaskie voivodeship than other voivodeships. In two sampls: water from intake J-300 in Jedlina Zdrój (116.1 Bq/dm3) and intake Marta in Szczawno Zdrój (193.1 Bq/dm3) the level of radon 74 Bq/dm3 has been reached and those samples could be classified as radon water. There are no limits for the radon concentration levels in curative waters. There are only recommendation of the Commission of the European Communities 2001/928/Euratom on the protection of the public against exposure to radon in drinking water supplies (100 Bq/l).

[Assessment of mammographic units in Poland in the view of current requirements of radiation protection regulations]. / Ocena aparatów mammograficznych w Polsce pod katem spelnienia wymagan aktualnych przepisów ochrony radiologicznej.

The aim of mammography examination is to discover as soon as possible any structural changes in a breast tissue. Every X-ray examination exposure the patient to the radiation as it takes place in mamnography images might be a cause of cancer. In this publication the dynamics growth of mammnography units number in Poland in years 1995,1997 and 2002 has been analyzed. The distribution of mammography units in Poland has been examined. The places of mammography units exploitation in regard to the type of health service institution has been determined. In this publication the manufacturers and the age of mammography units as a prerequisite to determine whether the specified mammography unit complies with the actual requirements in radiation protection regulations have been taken into consideration. The mammography laboratory equipment for providing quality control and the method of developing X-ray films has been also analyzed. It has been ascertained that about 25 % of mammography units do not comply with current technical requirements and they should be withdrawn from exploitation. However, it should be pointed out that there were only 554 mammography units in Poland at the end of year 2002. Their unequal distribution do not provide satisfactory availability to examinations for patients. As a result of this, the principal method of withdrawing them from exploitation should be replacing the time-worn the X-ray apparatuses with the new ones.

[Radon-222 in drinking water of Karkonoskie Plateau]. / Radon 222Rn w wodzie do picia z terenu pogórza karkonoskiego.

Radon-222 concentration in surface water, wells water and tap water in the main towns and villages which are located in area of Karkonoskie Plateau has been quantitative determined. The measurements were performed using the alpha liquid scintillation counting method. Majority of waterworks in Karkonoskie Plateau is supplied with the ground water in which the radon concentration is high from 87.5 Bq/l to 818.1 Bq/l. The waterworks in Karpacz are supplied with the surface water, which main characteristic is low radon concentration (below 10 Bq/l) and with the ground water have a high radon concentration (to 541 Bq/l). Radon-222 concentration in water of individual wells was similar to concentration in the ground water.