INTRAOPERATIVE RADIATION EXPOSURE IN A LEVEL 1 TRAUMA CENTRE OPERATING ROOM

Fluoroscopy is often required intra-operatively in orthopedics in order to better visualize either a reduction or the position of internal fixation. Although patient exposure is punctual, Trauma surgeons and operating room (OR) staff are exposed to high cumulative amounts of radiation. The goal of this study is to report the average radiation exposure for common orthopedic trauma procedures for different OR members: orthopedic surgeon, anesthesia team and nursing staff. We did a prospective observational study in 100 cases over 4 months at our level 1 trauma center where we collected radiation levels from dosimeters in different OR areas. Data was collected simultaneously at 1 meter from the C-arm (A, surgeon), 2m (B, anesthesia bay) and 3m (C, nursing computer). Data was subdivised according to the radiated body part and compared to common radiology procedures and daily exposure. Data was analyzed using one-way ANOVA. Dosimeter A recorded a significantly higher amount of radiation than the other 2, regardless of the fracture location. Higher levels of radiation were recorded for fixation of centrally located fractures (pelvis, p<0.001) followed by lower extremity fractures (p<0.001), and upper extremity fractures (p<0.001) regardless of the dosimeter. For fractures distal to the elbow, the average radiation exposure to the surgeon was 19.77 ± 54.40 µSv and 0.49 ± 0.93 µSv at 3 meters (nursing station). Numbers were much higher for pelvis and acetabulum surgery with averages between 62.88 ± 79.62 µSv (1 meter) to 1.4 ± 1.89 µSv (3 meters). As a comparison the average natural radiation exposure from being 1 hour in our OR, which is on the 6th floor of our hospital, is around 0,14 µSv. With the following results, we can confidently say that the surgeon, resident and scrub nurse in proximity of the C-Arm are the most exposed to cumulative radiation throughout operative cases. Radiation can be quite low and almost negligible at 3 meters, especially for extremity fractures (distal to the elbow, distal to the knee). On the other hand, femur and pelvic surgery generate much higher doses of radiations and lead protection is still highly recommended for the OR team.