QUANTIFICATION OF RADIATION EXPOSURE IN CANADIAN ORTHOPAEDIC SURGERY RESIDENTS

Background radiation exposure in the general population averages three milliSieverts (mSv) annually. Despite protective measures, evidence of radiation-related diseases in orthopaedic surgeons is increasing. Similarly, radiation exposure in orthopaedic residents is believed to be elevated, yet this has not been quantified in a Canadian orthopaedic training system. Therefore, the purpose of this study was to quantify radiation exposure in orthopaedic surgery residents and to determine the variability of exposure among post graduate year (PGY) of residency training. In this prospective cohort study, monthly radiation exposure was measured over a 12-month period in orthopaedic surgery residents from a single Canadian training program. Participants wore dosimeters above (“exposed”) and beneath (“shielded”) protective lead. The primary outcome measure was the absolute value of radiation exposure in mSv. Repeated measures analysis was used to determine which variables (age, sex, year of training, operating room (OR) days, height, and use of personalized protective equipment) correlated with radiation exposure. Mean monthly radiation was calculated per individual, continuous variables were assessed using linear regression and categorical variables were assessed using ANOVA and Tukey adjusted pairwise comparisons. Following research ethics board approval, 21 participants (mean age 28.4 (2.5) years, 38.9% female, 3 excluded) provided informed consent to participate in this study. The mean annual occupational radiation exposure was 3.30 ±0.64 mSv over an average of 107 ±38 OR days. Mean exposure per OR day was 0.03 ±0.01 mSv. PGY-2 and PGY-3 residents had the highest cumulative exposure, while PGY-5 residents had the highest mean exposure per OR day (0.04 ±0.01 mSv/day, Figure 1, Table 1). Number of OR days per month and PGY level were significant predictors of radiation exposure (p The annual radiation exposure that orthopaedic residents experience is nearly twice the general population's background exposure. Given that overall radiation exposure was highest during early residency years, radiation safety education and safe clinical practices are essential early in orthopaedic training. Notably, the PGY-5 residents were exposed to the highest average daily dose of radiation, which likely reflects the transition-to-practice phase of residency, during which there may be increased reliance on intra-operative fluoroscopy. Additional radiation safety reminders at this stage of training should also be formalized to promote career-long safe practices. For any figures or tables, please contact the authors directly.