Lack of Radiation Protection for Endoscopists Performing Endoscopic Retrograde Cholangiopancreatography

Byoung Kwan Son; Kyu Taek Lee; Jae Seon Kim; Seung Ok Lee

doi:10.4166/kjg.2011.58.2.93

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Son, Lee, Kim, and Lee: Lack of Radiation Protection for Endoscopists Performing Endoscopic Retrograde Cholangiopancreatography

Original Article

Korean J Gastroenterol 2011;58(2):93-99.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.58.2.93

Lack of Radiation Protection for Endoscopists Performing Endoscopic Retrograde Cholangiopancreatography

Byoung Kwan Son¹, Kyu Taek Lee², Jae Seon Kim³, Seung Ok Lee⁴

¹Committee Established for ERCP Guidelines on Radiological Protection, Korean Society of Pancreatobiliary Disease; Department of Internal Medicine, Eulji University Eulji-General Hospital, Seoul, Korea

²Department of Internal Medicine, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea

³Department of Internal Medicine, Korea University Medical Center, Guro-Hospital, Seoul, Korea

⁴Department of Internal Medicine, The Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea

Correspondence to: Seung Ok Lee, Department of Internal Medicine and The Research Institute of Clinical Medicine, Chonbuk National University Medical School, 634-18, Keumam-dong, Deokjin-gu, Jeonju 561-712, Korea. Tel: +82-63-250-1289, Fax: +82-63-254-1609, E-mail: solee@chonbuk.ac.kr

Received 22 February 201123 May 2011 Accepted 4 July 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

ERCP using fluoroscopy should be practiced with an adequate radiation protection. However, the awareness of gastrointestinal endoscopists to radiation protection was considered insufficient. In Korea, a country with a rapid increase the number of ERCP procedures, there is no data about radiation protection practices for gastrointestinal endoscopists. The purpose of this study was to investigate current clinical practices and the awareness on radiation protection in ERCP performing physicians in Korea.

Methods

An anonymous questionnaire regarding radiation protection practices was mailed to 100 members of Korean Pancreatobiliary Association who was porforming ERCP. The questionnaire included ERCP volume of each endoscopist, use of protection devices such as apron, thyroid shield, lead glasses and any mobile shield for scattered radiation, and whether they monitored their own radiation exposure dosage.

Results

All respondents wore lead aprons during ERCP. While 52.5% of endoscopists answered that they always wear thyroid guards, 26.9% rarely or never wore it. Only 14% wore lead glasses during the procedure and 69% never wore it. The preparation rates of mobile shields or lead curtains were only 14% and 24%, respectively. Only 10% of endoscopists attached an X-ray badge and 66.7% never used it. Moreover, 75% of endoscopists responded that they did not monitor their own exposure dose to radiation during ERCP.

Conclusions

The lack of radiation protection of ERCP endoscopists in Korea was seemed serious. Awareness of radiation hazard should be more concerned and educated in parallel with the preparation of radiation protection equipments.

Keywords: Radiation protection, Endoscopic retrograde cholangiopancreatography

References

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Fig. 1.

Use of lead aprons for ERCP endoscopists. (A) Lead apron types, (B) lead apron thickness, (C) lead apron dedicated hanger.

Fig. 2.

Thyroid and eye protection for ERCP endoscopists. (A) Wearing a thyroid guard, (B) wearing leaded glasses.

Fig. 3.

Use of equipment to protect scattered radiation for ERCP endoscopists. (A) Preparation and use of a mobile shield, (B) a lead curtain or table shield.

Fig. 4.

Monitoring of radiation dose for ERCP endoscopists. (A) Wearing a radiation dosimeter, (B) measuring radiation exposure doses.

Table 1.

Anonymous Questionare Regarding Radiation Protection Practices during ERCP

Question	Answers
1. What is your sex?	a) Male, b) Female
2. Where do you work?	a) University Hospital, b) General Hospital (not 1), c) Clinic
3. What is your ERCP volume per month?	a) ≤10, b) 11–15, c) 15–20, d) 21–25, e) 26–30, f) 31–35, g)
	36–40, h) 41–45, i) 46–50, j) 51–55, k) 56–60, l) ≥61
4. Do you work with an ERCP special team (such as a nurse practinioner and expert radiological technician)?	a) Yes, b) No
5. How many ERCP endoscopists work at your center?	a) 1, b) 2, c) 3, d) ≥4
6. How often do you wear a lead apron during ERCP?	a) always, b) mostly, c) rarely, d) never
7. Which type of lead apron is used to perform ERCP?	a) one-piece frontal cover,
	b) one-piece wrap apron (front, back, and sides covered),
	c) two-piece wrap apron, d) other
8. What is the thickness of the lead apron that you are using?	a) 0.25 mm, b) 0.5 mm, c) 1 mm, d) other
9. Do you have a dedicated hanger for apron storage?	a) Yes, b) No
10. How often do you wear a thyroid guard during ERCP?	a) always, b) mostly, c) rarely, d) never
11. How often do you wear lead glasses during ERCP?	a) always, b) mostly, c) rarely, d) never
12. Is a mobile shield (for upper body protection) prepared for radiation protection?	a) Yes, b) No
13. Is a lead curtain or table shield (for lower body protection) prepared for radiation protection?	a) Yes, b) No
14. Do you use any other radiation protective device except those mentioned above?	If yes, please write it (or them).
15. How often do you wear a radiation badge (dosimeter) during ERCP?	a) always, b) mostly, c) rarely, d) never
16. Have you been monitored with regard to your exposure dose?	a) Yes, b) No

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