Radiation Safety

The guiding principle of radiation safety is "ALARA," which stands for "as low as reasonably achievable." This principle implies that unnecessary radiation exposure, regardless of dose size, should be minimized or avoided. The three central protective measures for radiation safety are time, distance, and shielding.

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Pain physicians frequently use C-arm fluoroscopy to treat patients, a crucial device for pain interventions. Unfortunately, this usage exposes physicians to radiation, raising concerns about potential biological effects. A study in Korea revealed that while most pain physicians were aware of the risks, many lacked sufficient knowledge on radiation safety and did not consistently use protective measures. Common protective gear like thyroid shields and aprons were used by the majority, but fewer physicians utilized lead glasses and gloves.

The core strategies for reducing radiation exposure include minimizing time, maintaining distance, and using adequate shielding.

Radiation builds up over time. During C-arm fluoroscopy-guided procedures, prolonged exposure increases radiation risk for pain physicians. Thus, reducing the C-arm fluoroscopy usage time is vital. Physicians can develop their intervention skills and radiographers can work on capturing accurate X-rays efficiently to mitigate exposure.

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Maintaining a greater distance from the radiation source significantly reduces exposure. The reduction is not linear but follows an inverse square law—doubling the distance reduces exposure to one-quarter. Research indicates that even minor increases in distance can lead to substantial decreases in radiation exposure.

Various shielding devices such as caps, lead glasses, thyroid protectors, aprons, and radiation-reducing gloves are available to minimize radiation exposure during procedures. Although these devices are effective, their usage rates are not optimal. Cost and discomfort are barriers that often discourage their use. However, employing these devices can provide significant protection.

Combining time reduction, distance maintenance, and shielding is imperative for radiation safety. Of the three, maintaining a greater distance from the radiation source proves to be the most effective and economical method. Doubling the distance from the source can reduce exposure to one-quarter, offering significant protection without additional costs.

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