UKHSA/BOA Radiation Dose Monitoring Exercise

In conjunction with the UKHSA¹, the BOA conducted a radiation dose monitoring exercise to evaluate the exposure of UK orthopaedic surgeons to radiation during their working week.

Historically, doses received have been considered to be low, but recent concerns have been expressed about positioning of the surgeon during orthopaedic trauma procedures, and particularly the effect of axillary radiation on female surgeons.

Surgeons who regularly perform trauma procedures were requested to wear two thermoluminescence dosemeters (TLD): one on the chest and one in the axilla on the seam of the scrub top. Standard PPE was then worn, with the exact position of the TLDs in relation to this dependent on the type and size used.

A total of 294 TLDs from 154 orthopaedic surgeons at 22 different trusts were returned, with equal split between MTCs and Trauma Units, but with relative over-representation of female surgeons.

All doses were well below recommended levels (fig 1), with 137 TLDs reading zero doses, and no surgeons were found to have received a dose that would put them at risk of exceeding the 20 mSv yearly dose limit set by HSE’s Ionising Radiations Regulations 2017. However, results indicated that the type of PPE worn may affect doses, with male surgeons receiving a dose to the chest, which may reflect the use of tabard gowns. Female surgeons received a higher dose to the axillary area compared to the chest, although doses were still very low.

As with the EXPOSEd study, a lack of training in radiation protection was noted, and we will continue to work with IPEM and the UKHSA in ensuring safety in the workplace, and developing training that is relevant to surgeons, and surgeons can engage with in the future.

Figure 1 

Further guidance is available from the BOA here.