The Risk of Radiation Exposure To Assisting Staff in Urological Procedures

A Literature Review

Tarun Jindal, MS

Urol Nurs. 2013;33(3):136-139.

Quantification of Radiation Exposure

Many different units are used to quantify radiation. The most commonly used units are Système international d'unités (SI units) and conventional units. SI units are the standard units of measurement recommended by the International System of Units, and conventional units are often used by various authors for quantification of radiation. See Table 1 for details of the commonly used units.

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Table 1. Quantification of Radiation Exposure: Details of the Commonly Used Units
Unit (Abbreviation)	SI/Conventional	Definition
Coulomb per kilogram (C/kg)	SI	Measures the amount of radiation exposure. It is the radiation required to create 1 coulomb of charge in 1 kilogram of matter.
Roentgen (R)	Conventional	Measures the amount of radiation exposure. 1 Roentgen = 2.58×10⁻⁴ C/kg
Gray (Gy)	SI	It is the unit of radiation absorption. It is the amount of radiation required to deposit 1 Joule of energy in 1 kilogram of matter.
Radiation absorbed dose (rad)	Conventional	Measures the amount of radiation absorbed by a target. A dose of 1 rad means the 100 ergs of radiation energy has been absorbed per gram of absorbing material/tissue. 100 rad = 1 Gy
Sievert (Sv)	SI	It is the unit for equivalent absorbed radiation dose. It quantifies the biological risk of radiation exposure. 1 Sv = 1000 mSv = 10⁶ μSv
Roentgen equivalent man (rem)	Conventional	It is the unit for equivalent absorbed radiation dose. 100 rem = 1 Sv

Note: SI = Système international d'unités.

Table 2. Review of Major Studies Quantifying Radiation Exposure to the Assisting and Nursing Staff during Urologic Procedures
Number	Author	Medical Personnel	Number of Procedures	Types of Procedures	Duration of Exposure	Mean Dose
1	Bush, Jones, & Brannen, 1985	Assisting nurse	77	PCNL	24 minutes (mean)	40 μSv/case (measured at the level of the neck)
2	Lowe, Auster, Beck, Chang, & Marshall, 1986	Surgical assistant	7	PCNL	27.8 minutes (mean)	37 μSv/case to neck and 25 μSv/case to right and left hand
		Scrub nurse	7	PCNL	27.8 minutes (mean)	12 μSv/case (measured at the level of the neck)
		Circulating nurse	6	PCNL	Information not available	19 μSv/case (measured at the level of the neck)
3	Rao et al., 1987	Scrub nurse	18	PCNL	21.9 minutes (mean)	Information not available Measurement done for eyes and hands
4	Baldock, Greener, & Batchelor, 1992	Assisting staff	Information not available	ESWL	Information not available	4800 μSv annually
5	Giblin, Rubenstein, Taylor, & Pahira, 1996	Assistant	5	PCNL	Information not available	500 μSv/hour
6	Tse et al., 1999	Scrub nurse	20	PCNL, RGP, stenting, URS	63.1 minutes (for 20 cases)	40 μSV (for 20 cases) to the thyroid
7	Hellawell, Mutch, Thevendran, Wells, & Morgan, 2005	Assistant	24	PCNL, RGP, stenting, URS	0.1 to 22.9 minutes	2.1 ± 0.5 to 120 ± 30 μSv/case Higher dose to legs
7	Hellawell, Mutch, Thevendran, Wells, & Morgan, 2005	Nurse	24	PCNL, RGP, stenting, URS	0.1 to 22.9 minutes	0.5 ± 0.1 to 24 ± 6 μSv/case Higher dose to legs
8	Kumari et al., 2006	Assisting surgeon	50	PCNL	6.04 minutes (range 1.8 to 12.16 minutes)	12 μSv/case
		Technical assistant	50	PCNL	6.04 minutes (range 1.8 to 12.16 minutes)	2.6 μSv/case
		Scrub nurse	50	PCNL	6.04 minutes (range 1.8 to 12.16 minutes)	0.3 μSv/case
		Floor nurse	50	PCNL	6.04 minutes (range 1.8 to 12.16 minutes)	0.16 μSv/case
9	Majidpour, 2010	Assistant	100	PCNL	4.5 minutes (range 1 to 8 minutes)	0.05, 0.01, 0.025, and 0.1 μSv to the head, eye glasses, fingers, and legs, respectively, per case
9		Circulating nurse	100	PCNL	4.5 minutes (range 1 to 8 minutes)	Zero (0)

Notes: PCNL = percutaneous nephrolithotomy, ESWL = extra corporeal shock wave lithotripsy, URS = ureterorenoscopy.

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The Risk of Radiation Exposure To Assisting Staff in Urological Procedures

A Literature Review

Quantification of Radiation Exposure

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