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Occupational Radiation Exposure of Emergency Medical Technicians in Emergency Medical Centers in Korea

우리나라 응급의료센터 응급구조사의 직업적 방사선 노출

  • Lee, Hyeongyeong (Agricultural Health and Safety Division, Department of Agricultural Engineering, National Institute of Agricultural Sciences) ;
  • Park, Jeongim (Department of Environmental Health Sciences, Soonchunhyang University)
  • 이현경 (국립농업과학원 농업공학부 농업인안전보건팀) ;
  • 박정임 (순천향대학교 환경보건학과)
  • Received : 2017.08.28
  • Accepted : 2017.09.19
  • Published : 2017.09.30

Abstract

Objectives: This study aims to investigate the occupational radiation exposures of emergency medical technicians(EMTs) in emergency medical centers in Korea. The results will provide a basis for developing prevention programs to minimize adverse health effects relating to radiation exposure among emergency medical technicians working in this area. Methods: Radiation exposure doses were measured for twenty-two EMTs working in six emergency medical centers. Thermo Luminescent Dosimeters(TLD) were placed on three representative body parts, including chest, neck, and a finger. Measurements were conducted over the entire working hours of the participants for foor weeks. Dosimeters were analyzed according to a standard method by a KFDA-designated lab. Detection rate, annual radiation exposure dose, and relative levels to dose limit were derived based on the measured doses from the dosimeters. SPSS/Win 18.0 software(IBM, US) was used for statistical analysis. Results: Detection rates were 45.5%, 36.4%, and 45.5% for the dosimeters sampled from chest, neck, and a finger, respectively. The average annual doses were $2.39{\pm}3.44mSv/year$(range 0.38-10.0 mSv/year) for the chest, $2.72{\pm}3.05mSv/year$(2.00-11.34) for the neck, and $20.98{\pm}17.57mSv/year$(1.25-53.50) for the hand dose. The average annual eye dose was estimated to $3.61{\pm}2.37mSv/year$(1.50-8.34). The exposure dose levels of EMTs were comparable to those of radiologists, who showed relatively higher radiation dose among health care workers, as reported in another study. Conclusions: EMTs working in emergency medical centers are considered to be at risk of radiation exposure. Although the radiation exposure dose of EMTs does not exceed the dose limit, it is not negligible comparing to other professionals in health care sectors.

Keywords

References

  1. Arnstein PM, Richards AM, Putney R. The risk from radiation exposure during operative X-ray screening in hand surgery. J Hand Surg Br 1994;19(3):393-6 https://doi.org/10.1016/0266-7681(94)90097-3
  2. Bae KS, Kim JH, Kim JY. Current state and needs of continuing education for emergency medical technicians. Jour. of Kocon. a 2012;12(10):376-384
  3. Brent RL. Radiation teratogenesis. Teratol 1980;21(3):281-298 https://doi.org/10.1002/tera.1420210304
  4. 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(5):703-705 https://doi.org/10.1097/00005373-199405000-00018
  5. Damilakis J, Koukourakis M, Hatjidakis A, Karabekios S, Gourtsoyiannis N. Radiation exposure to the hands of operators during angiographic procedures. Eur J Radiol 1995;21(1):72-5 https://doi.org/10.1016/0720-048X(95)00688-M
  6. Do KH. The health effects of low-dose radiation exposure. KMA 2011;54(12):1253-1261
  7. Dorevitch S, Forst L. The occupational hazards of emergency physicians. Am J Emerg Med 2000;18(3):300-11 https://doi.org/10.1016/S0735-6757(00)90125-6
  8. Han EO, Kwon DM. Analysis of the trend of knowledge, attitude and behavior related to radiation safety management; focused on radiation workers at medical institutions. JRST 2007;30(4):321-327
  9. International Atomic Energy Agency(IAEA). Training in radiation protection and the safe use of radiation sources. Safety Report Series 20.; 2001. p. 20
  10. Information Agency for Research on Cancer(IARC). Radiation: IARC monograph on the evaluation of carcinogenic risks humans. No. 100D.; 2001. p. 1-362
  11. International Commission on Radiological Protection (ICRP). Pregnancy and medical radiation. ICRP publication 84,; 2000. p. 115
  12. International Commission on Radiological Protection (ICRP). The 2007 recommendations of the international commission on radiological protection. ICRP Publication No. 103,; 2007. p. 5
  13. Jeong JH, Lim YS, Park KN, Kim YM, Choi SM et al. Radiation exposure to physicians in the emergency department. JKSEM 2008;19(1):125-130
  14. Jung GH, Jang JH, Kim JD, Kim CK. Radiation exposure over the course of a year from an image intensifier in the orthopaedic operating room. KOFS 2012;25(1):58-63
  15. Kang SG, Lee EN. Knowledge of radiation protection and the recognition and performance of radiation protection behavior among perioperative Nurses, J Muscle and Jt Health, 2013;20(3):247-257 https://doi.org/10.5953/JMJH.2013.20.3.247
  16. Kim HS, Ko SJ, Kang SS, Choi SY, Kim CS. Analysis of radiation/radioactivity-related knowledge, perception and behaviors of radiological technologists. JRST 2011;34(2):123-129
  17. Kim HS, Park SM, Lee SY, Baek SM, Chae SY. Safety guidelines for medical radiologist; Radiation safety management series No. 40. MDS,; 2014. p. 9
  18. Kim JW, Kim JJ. Radiation exposure to the orthopaedic surgeon during fracture surgery. KOA 2010;45(2):107-113
  19. Kim SM, Jeong MS. Role of Emergency Medical Technician (EMT) in Hospital. KSEMS 2000;4(1):31-34
  20. Kim YJ, Ahn HC, Sohn YD, Ahn JY, Park SM et al. Correlation between the portable X-ray and the radiation exposure dose in the emergency department: Cohort Study. J Radiat Prot Res 2013;11(2):101-105
  21. Kubo T, Ohno Y2, Kauczor HU, Hatabu H. Radiation dose reduction in chest CT--review of available options. Eur J Radiol 2014;83(10):1953-1961 https://doi.org/10.1016/j.ejrad.2014.06.033
  22. Langmack KA. Factors influencing occupational radiation doses to brachytherapy nurses. Radilography 1998;4(2):141-146 https://doi.org/10.1016/S1078-8174(98)90011-6
  23. Larkin CJ, Workman A, Wright RE, Tham TC. Radiation doses to patients during ERCP. Gastrointest Emdosc 2001;53(2):161-4 https://doi.org/10.1067/mge.2001.111389
  24. Lee HK, Lee HY, Lee JG, Park YJ, Kim HJ et al. 2015 report occupational radiation exposure in diagnostic radiology in Korea. CDCP, 2016; p. 11 [Accessed 10 July 2017] Avaliable from: http://www.cdc.go.kr/CDC/info/CdcKrInfo1217.jsp?menuIds=HOME001-MNU1130-MNU1062-MNU1081&fid=3058&q_type=&q_value=&cid=72959&pageNum=.html
  25. Lee OH. The work and job satisfaction of paramedics in the emergency room of university hospitals. KJEMS 2011;15(1):47-63
  26. Lim HS, Jung HG, Kim SG, Park BC, Lee G. A case of acute myelogenous leukemia occurring in a nuclear power plant worker, The CongGuk J of Med 2002;9(2):122-138
  27. Mehlman CT, DiPasquale TG. Radiation exposure to the orthopedic surgical team during fluoroscopy: "how far away is far enough?". J Orthop Trauma 1997;11(6):392-398 https://doi.org/10.1097/00005131-199708000-00002
  28. Ministry of Health and Welfare(MHW). Regulation on the safety management of diagnostic equipment for diagnostic equipment; Section 304. [Accessed 10 July 2017] Avaliable from: URL:http://www.law.go.kr/lsInfoP.do?lsiSeq=168846&efYd=20150401#0000.htm.
  29. Ministry of Health and Welfare(MHW). 2015 Emergency medical statistics report. Seoul; Central Emergency Medical Center(CEMC).; 2016. p. 37-115
  30. National Research Council(NRC). Committee to assess health risks from exposure to low levels of ionizing radiation. Health risks from exposure to low levels of ionizing radiation: BEIR VII phase 2. Washington DC: National Academies Press; 2006.
  31. Niklason LT, Marx MV, Chan HP. The estimation of occupational effective dose in diagnostic radiology with two dosimeters. Health Phys 1994;67(6):611-5 https://doi.org/10.1097/00004032-199412000-00003
  32. Park JK, Cho EH. The characteristic of radiation exposure for radiologist with applying condition in interventional radiology in cardiology. JDCS 2012;13(3):421-429
  33. Ramos M, Montroro A, Almonacid M, Ferrer S, Barquinero JF et al. Radiation effects analysis in a group of interventional radiologists using biological and physical dosimetry methods. Eur J Radiol 2010;75(2):259-264 https://doi.org/10.1016/j.ejrad.2009.03.035
  34. Ramsay J, Denny F, Szirotnyak K, Thomas J, Corneliuson E et al. Identifying nursing hazards in the emergency department: a new approach to nursing job hazard analysis. J Safety Res 2006;37(1):63-74 https://doi.org/10.1016/j.jsr.2005.10.018
  35. Rivera T. Thermoluminescence in medical dosimetry. Appl Radiat Isot 2012;71(S):30-34 https://doi.org/10.1016/j.apradiso.2012.04.018
  36. Shim DM, Kim MY, Oh SK, Lim CM, Kown BT. Radiation induced hand necrosis of an orthopedic surgeon sho had treated a patient with fluoroscopy-guided spine injection. J Korean Orthop Assoc 2014;14(3):250-254
  37. Sulieman A, Alzimami K, Gafar R, Babikir E, Alsafi K et al. Occupational and patient exposure in coronary angiography procedures. Radiat Phys Chem 2014;104(S):68-71 https://doi.org/10.1016/j.radphyschem.2013.12.028
  38. Wilburn SQ, Eijkemans G. Preventing needlestick injuries among healthcare workers: a WHO-ICN collaboration. International J Occup Environ Health 2004;10(4):451-456 https://doi.org/10.1179/oeh.2004.10.4.451
  39. Yoon JA, Yoon YS. A survey about the knowledge, attitudes and behavior for radiation safety management of operating room nurse and dental hygienists. KDHS 2014;14(2):230-9
  40. Yoon JG, Lee YH, Jeong JY. Emergency medical technician job in one local hospital. JKEMT 2005;9(2):21-28
  41. Zimmerman LE, Font RL. Congenital malformations of the eye some recent advances in knowledge of the pathogenesis and histopathological characteristics. JAMA 1996;196(8):96-104