Radiation exposure and fluoroscopically-guided interventional procedures among orthopedic surgeons in South Korea

Seonghoon Kang; Eun Shil Cha; Ye Jin Bang; Teresa W Na; Dalnim Lee; Sang Youn Song; Won Jin Lee

doi:10.1186/s12995-020-00276-x

Radiation exposure and fluoroscopically-guided interventional procedures among orthopedic surgeons in South Korea

J Occup Med Toxicol. 2020 Aug 11:15:24. doi: 10.1186/s12995-020-00276-x. eCollection 2020.

Authors

Seonghoon Kang^{1

2}, Eun Shil Cha³, Ye Jin Bang^{2

3}, Teresa W Na^{2

4}, Dalnim Lee^{2

5}, Sang Youn Song⁶, Won Jin Lee^{2

3}

Affiliations

¹ Department of Occupational and Environmental Medicine, COMWEL Ansan Hospital, Korea Workers' Compensation & Welfare Service, Gyeonggi-do, South Korea.
² Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, South Korea.
³ Department of Preventive Medicine, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841 South Korea.
⁴ Department of Policy and Administration, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea.
⁵ Department of Radiation Effects Research, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea.
⁶ Department of Orthopedic Surgery, Gyeongsang National University Hospital, Jinju, South Korea.

Abstract

Background: The use of fluoroscopically-guided interventional (FGI) procedures by orthopedic surgeons has been increasing. This study aimed to investigate the occupational radiation exposure among orthopedic surgeons in South Korea.

Methods: A nationwide survey of orthopedic surgeons was conducted in South Korea in October 2017. The dosimetry data of the participants were obtained from the National Dosimetry Registry. The orthopedic surgeons were categorized by job specialty [spine or trauma specialists, other orthopedic specialists, and residents], and descriptive statistics for the demographics and work-related characteristics were presented. Multivariable logistic regression analysis was used to evaluate the risk factors for the orthopedic surgeons who were not linked with the dosimetry data.

Results: Among the total participants (n = 513), 40.5% of the orthopedic surgeons spent more than 50% of their time working with the FGI procedures when compared with their overall work. The average frequency of the FGI procedures among the orthopedic surgeons was 12.3 days per month. Less than 30% of the participants were regularly provided with radiation monitoring badges. The proportion of subjects who always wore lead aprons and thyroid shields were 52 and 29%, respectively. The residents group experienced more unfavorable working conditions of radiation exposure than the other specialists. The dosimetry data were not significantly linked among the residents (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.11-3.95) and orthopedic surgeons working at small hospitals (OR 4.76, 95% CI 1.05-21.51).

Conclusions: Although orthopedic surgeons often performed FGI procedures, they wore protective gear less frequently, and a large proportion of orthopedic surgeons were not monitored by the national radiation dosimetry system. As the number of radiation procedures performed by the orthopedic surgeons increases, more intensive approaches are needed to reduce radiation exposure, especially for spine and trauma surgeons.

Keywords: Fluoroscopy; Health professional; Occupational exposure; Orthopedics; Radiation.