Evaluation of occupational radiation exposure and safety practices among orthopedic surgeons using C-arm fluoroscopy: a preliminary study at a hospital in Palestine

Abstract This study presents, to our knowledge, the first dosimetric evaluation of occupational radiation exposure among orthopedic teams using C-arm fluoroscopy in Palestine. Thermoluminescence dosemeters (LiF:Mg,Ti, TLD-100) measured $H_{p}(10)$ and $H_{p}(0.07)$ at five anatomical sites on one surgeon during six procedures over 32 days: unshielded upper arms and shielded thyroid, chest, and gonads. The highest measured personal dose equivalent, $H_{p}(10)$, was 0.21 mSv at the unshielded right upper arm (30-day normalized value: 0.19 mSv; 11.7% of the monthly reference value derived from the International Commission on Radiological Protection annual occupational effective-dose limit). Although shielding reduced torso exposure, safety compliance was poor: 37% of staff consistently used lead aprons, 22.2% used thyroid shields, and 13.3% used dosemeters. These findings identify systemic gaps requiring enforced protection measures, routine monitoring, and staff education.