Standards of radiation protection amongst UK vascular surgeons: a clinician’s perspective

Objective: To evaluate training in radiation protection, knowledge of local policies and current practices regarding safe working with ionising radiation in vascular surgery units across the UK. Methods: A validated 37 question online survey was distributed to vascular surgery trainees (VTs) and consultants (VCs) by the Vascular Society of Great Britain and Ireland (VSGBI), British Society of Endovascular Therapy (BSET) and Rouleaux Club through their national mailing lists between March and May 2024. Responses were collated using the survey server SurveyMonkey. Results were summarised using descriptive statistics and appropriate tests. Results: Ninety-one VCs and 87 VTs, representing approximately 15% and 44% of the UK VC and VT workforce, respectively, responded. In total, 94% of VCs and 97% of VTs expressed concerns over the effects of ionising radiation on their health; 91% of VCs and only 74% of VTs had undergone formal radiation safety training. Of these, only 18% of VCs and 43% of VTs had undergone training within the last two years. Overall, 34% of VCs and most VTs (75%) did not know who their local radiation safety officer was; 4% of VCs and 32% of VTs (p<0.001) were completely unaware of local radiation safety policies. A total of 13% of both were not aware of ‘As Low As Reasonably Achievable’ (ALARA) principles, with 20% of VCs and 35% of VTs failing to consistently employ them. Custom-made or retrofitted lead gowns were accessible to 55% of VCs but only 2.4% of VTs (p<0.001). Radiation protection glasses were worn by 52% of VCs compared with 16% of VTs (p<0.001). 84% of VCs were allocated a dosimeter versus only 44% of VTs (p<0.001). Most VCs (76%) and VTs (86%) believed that their employer should prospectively record their annual radiation exposure into a National Registry. A total of 86% of VCs and 96% of VTs agreed that employers should record their cumulative radiation exposure during their entire working life. One in four VCs and VTs experienced a health condition potentially related to their work with ionising radiation. Musculoskeletal pain was the most common, prevalent in 17% and 18% of VCs and VTs, respectively. Overall, 2% of VCs had a malignancy and 5% cataracts. Almost all VCs (94%) and VTs (96%) agreed that these illnesses should be recorded in a national registry. Conclusion: This survey highlights significant and concerning deficiencies in knowledge, access to personal radiation protection and failures in monitoring individual exposure to ionising radiation amongst the UK vascular surgical workforce.