Abstract
Health care workers encounter many physical hazards in hospitals, including ionizing radiation, noise, and heat. Ionizing radiation is used in hospitals for diagnostic radiology, therapeutic radiology, dermatology, nuclear medicine, and in radiopharmaceutical laboratories. Radiation hazards may also exist in areas where radioactive materials are stored or discarded. Occupational exposure to ionizing radiation can lead to erythema or radiodermatitis. Ionizing radiation can cause gene mutation and chromosomal alteration. Other somatic effects that result from irradiation include several types of cancers (myelogenous leukemia, bone cancer, skin cancer, thyroid cancer, etc.), cataracts, aplastic anemia, and sterility. The chief methods for reducing doses of ionizing radiation from external X-rays and gamma rays are to limit the time of exposure, increase the distance from the source of the exposure, shield the source with protective materials, and avoid unnecessary exposures. Improved equipment, knowledge, and reduced exposures can greatly reduce the risk of radiation exposure for workers. Many work areas in hospitals were identified as noisy enough to decrease productivity. Noise may trigger changes in cardiovascular, endocrine, neurological, and other physiological functions. Working in high-noise areas makes it difficult for workers to communicate among themselves or to concentrate on critical job functions. Many places in hospitals including the laundry, boiler room, and kitchen may be hot during the summer months, especially in older facilities that have inadequate ventilation and cooling systems. Health care workers should pay attention to health disorders caused by physical factors to protect themselves against many hazards in hospitals.
References
1. Barbanel CS. McCunney RJ, editor. Medical center occupational health and safety. Medical center occupational health and safety. 1999. 1st ed. Philadelphia: Lippincott Williams and Wilkins;1–14.
2. Chung HK. Occupational injuries in health care workers: present situation and countermeasure. J Korean Med Assoc. 2000. 43:259–264.
4. Radiation Safety Information System. Information of radiation safety. Accessed Apr 11, 2010. Available at:
http://rasis.kins.re.kr/rasis/index.jsp.
5. Preston DL, Kusumi S, Tomonaga M, Izumi S, Ron E, Kuramoto A, Kamada N, Dohy H, Matsuo T, Nonaka H, Thompson DE, Soda M, Mabuchi K. Cancer incidence in atomic bomb survivors Part III Leukemia lymphoma and multiple myeloma 1950-1987. Radiat Res. 1994. 137:S68–S97.
6. Pierce DA, Shimizu Y, Preston DL, Vaeth M, Mabuchi K. Studies of the mortality of atomic bomb survivors Report 12, Part I. Cancer: 1950-1990. Radiat Res. 1996. 146:1–27.
7. Moysich KB, Menezes RJ, Michalek AM. Chernobyl-related ionising radiation exposure and cancer risk: an epidemiological review. Lancet Oncol. 2002. 3:269–279.
8. Lim HS, Cheong HK, Kim SK, Park BC, Lee K. A case of acute myelogenous leukemia occurring in a nuclear power plant worker. Dongguk J Med. 2002. 9:122–138.
9. Oh SH, Choi SM, Lee MJ, Park KN, Choi SP, Kim YM, So BH, Kim HJ, Cho YS, Hong TY. Survey of radiation exposure to emergency physicians. J Korean Soc Emerg Med. 2008. 19:541–550.
10. National Dose Registry. 2008 Report occupational radiation exposure in diagnostic radiology. 2009. Seoul: National Institute of Food and Drug Safety Evaluation, Korea Food and Drug Administration.
11. Jeong TS, Shin BC, Moon CW, Cho YD, Lee YH, Yum HY. The Analysis of radiation exposure of hospital radiation workers. J Korean Soc Ther Radiol Oncol. 2000. 18:157–166.
12. Jeong JH, Kwon JW, Lee JK. Occupational radiation exposure in Korea: 2002. J Radiat Prot. 2005. 30:175–183.
13. Broder J, Warshauer DM. Increasing utilization of computed tomography in the adult emergency department, 2000-2005. Emerg Radiol. 2006. 13:25–30.
14. Mettler FA Jr, Wiest PW, Locken JA, Kelsey CA. CT scanning: patterns of use and dose. J Radiol Prot. 2000. 20:353–359.
15. Hellawell GO, Mutch SJ, Thevendran G, Wells E, Morgan RJ. Radiation exposure and the urologist: what are the risks? J Urol. 2005. 174:948–952.
16. Vano E, Gonzalez L, Fernandez JM, Alfonso F, Macaya C. Occupational radiation doses in interventional cardiology: a 15-year follow-up. Br J Radiol. 2006. 79:383–388.
17. Kuipers G, Velders XL, de Winter RJ, Reekers JA, Piek JJ. Evaluation of the occupational doses of interventional radiologists. Cardiovasc Intervent Radiol. 2008. 31:483–489.
18. Kim KP, Miller DL. Minimising radiation exposure to physicians performing fluoroscopically guided cardiac catheterisation procedures: a review. Radiat Prot Dosimetry. 2009. 133:227–233.
19. Ciraulo DL, Marini CP, Lloyd GT, Fisher J. Do surgical residents, emergency medicine physicians, and nurses experience significant radiation exposure during the resuscitation of trauma patients? J Trauma. 1994. 36:703–705.
20. Braun BJ, Skiendzielewski JJ. Radiation exposure of emergency physicians. Ann Emerg Med. 1982. 11:535–540.
21. Grazer RE, Meislin HW, Westerman BR, Criss EA. Exposure to ionizing radiation in the emergency department from commonly performed portable radiographs. Ann Emerg Med. 1987. 16:417–420.
22. Jeong JH, Lim YS, Park KN, Kim YM, Choi SM, Lee MJ, Oh JS, Oh YM, Hong TY. Radiation exposure to physicians in the emergency department. J Korean Soc Emerg Med. 2008. 19:125–130.
23. Kim KS, Kim SG, Kim HJ, Lee JT, Lee CR, Ha MN. Joo YI, editor. Physical factor. Preventive medicine and public health. 2010. 1st ed. Seoul: Gye-chuk Munhwasa;585–619.
24. Kim ES. Diagnostic and therapeutic management of acute radiation syndrome and internal contamination. J Korean Med Assoc. 2003. 46:879–888.
25. Lee UJ. Radiation safety management. 2001. Seoul: Gold.
26. International commission on radiological protection. Annals of the ICRP supporting guidance 2-radiation and your patient: a guide for medical practitioners. 2001. Pergamon: Stockholm.
27. Ha SW. Is radiation harmful? J Korean Med Assoc. 1995. 38:1348–1354.
28. Ha JW. The basic concept of radiation protection. J Korean Med Assoc. 1995. 38:1355–1363.
29. Parmeggiani L. Encyclopaedia of occupational health and safety. 1983. Geneva: International labour office.
30. Singer CM, Baraff LJ, Benedict SH, Weiss EL, Singer BD. Exposure of emergency medicine personnel to ionizing radiation during cervical spine radiography. Ann Emerg Med. 1989. 18:822–825.
31. Niklason LT, Marx MV, Chan HP. Interventional radiologists: occupational radiation doses and risks. Radiology. 1993. 187:729–733.
32. Sander D, Brunner G. Studies on radiation exposure of personnel in endoscopy. Z Gastroenterol. 1992. 30:151–155.
33. Lee WJ, Cha ES, Ha M, Jin YW, Hwang SS, Kong KA, Lee SW, Lee HK, Lee KY, Kim HJ. Occupational radiation dosesamong diagnostic radiation workers in south Korea, 1996-2006. Radiat Prot Dosimetry. 2009. 136:50–55.
34. Department of health and human services. Guidelines for protecting the safety and health of health care workers. 1988. Washington DC: US government printing office.
35. Lee K, Lim HS, Kim SK. Status of the occupational health and safety programs of several hospitals in Korea. Korean J Occup Environ Med. 2003. 15:351–363.
36. Martin CJ. A review of radiology staff doses and dose monitoring requirements. Radiat Prot Dosimetry. 2009. 136:140–157.
37. Jeong MS, Jin YW, Lim HS, Kim CS. Use of screening dose to evaluate the work-relatedness of cancers occurring among Korean radiation workers. Korean J Occup Environ Med. 2007. 19:196–203.
38. Blomkvist V, Eriksen CA, Theorell T, Ulrich R, Rasmanis G. Acoustics and psychosocial environment in intensive coronary care. Occup Environ Med. 2005. 62:1–8.
39. Berglund B, Lindvall T, Schwela DH. Guidelines for community noise. 1999. Geneva: World Health Organization.
40. Busch-Vishniac IJ, West JE, Barnhill C, Hunter T, Orellana D, Chivukula R. Noise levels in Johns Hopkins Hospital. J Acoust Soc Am. 2005. 118:3629–3645.
41. Topf M, Dillon E. Noise-induced stress as a predictor of burnout in critical care nurses. Heart Lung. 1988. 17:567–574.
42. Morrison WE, Haas EC, Shaffner DH, Garrett ES, Fackler JC. Noise, stress, and annoyance in a pediatric intensive care unit. Crit Care Med. 2003. 31:113–119.
43. Bayo MV, García AM, García A. Noise levels in an urban hospital and workers' subjective responses. Arch Environ Health. 1995. 50:247–251.
44. Joseph A, Ulrich R. Sound control for improved outcomes in healthcare settings. 2007. Concord, CA: The center for health design.
45. Montague KN, Blietz CM, Kachur M. Ensuring quieter hospital environments. Am J Nurs. 2009. 109:65–67.
46. Lee CU. Environmental health for physicians (VII)-noise. J Korean Med Assoc. 1996. 39:992–996.