Estimating effective dose using non-lead protective aprons and a single dosimeter method

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Abstract
Objective: Fluoroscopic interventional procedures subject healthcare personnel to significant ionizing radiation exposure, necessitating the use of protective aprons. Protective aprons are made of varying materials and may be subjected to inadequate testing standards, leading to potential inaccuracies estimating effective dose when using single dosimeter methods. This study aims to develop an appropriate method to estimate effective dose for non-lead aprons using a single dosimeter worn outside the apron, thereby enhancing radiation protection and reducing musculoskeletal injuries to workers. Approach: A retrospective, secondary analysis of existing literature was conducted to derive a dataset suitable for algorithm development. Transmission of radiation through the protective apron at various thicknesses was modeled using exponential regression. The resulting equation incorporates the nominal lead equivalent thickness to estimate effective dose. Validation was performed by comparing algorithms using two-dosimeters, which do not rely on apron shielding assumptions. Main Results: The dataset comprised 205 dosimeter readings from 42 physicians across 8,243 procedures (Fetterly et al.). The derived equation, E=H_0 (0.13+1.02e^((-11.33x) ) ), demonstrated minimal underestimation, and a potential overestimation of up to 1.3-fold relative to the true effective dose, improving upon previous methods by 15%. Inclusion of a non-lead thyroid collar reduced effective dose by 17-30%. Use of accessory upper body shielding is required when using this method. Significance: This novel method provides a method to estimate the effective dose using non-lead aprons at varying nominal lead equivalent thicknesses, surpassing previous single dosimeter approaches. The findings support improved optimization of radiation protection during fluoroscopic interventional procedures, may inform radiation safety regulations, and support ergonomic improvements.

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