Z. You et al.: Radioprotection 2025, 60( 1), 20 – 27 23
Fig. 2. Radiation dose of 22 areas under 8 projection angles.
in the left anterior oblique position( LAO 45 °), as shown in Figure 5.
In the analysis of the radiation dose in area( 7) and area( 8) under each projection angle, it was found that the radiation dose in area( 7) was greater than that in area( 8) at the RAO projection angle( p < 0.05); while the radiation dose in area( 8) was greater than that in area( 7) at the LAO projection angle( p < 0.05), as shown in Figure 6.
4 Discussion
During cardiac catheterization interventions, the use of X- rays is indispensable, leading to radiation exposure among operators and nurses. Several studies have highlighted that in specific regions, the annual radiation doses received by these professionals exceed the thresholds recommended by the ICRP( Domienik et al., 2016; D’ Avino et al., 2019). Moreover, there have been instances where operators and nurses have manifested radiation-induced health complications( Papp et al., 2017; Lee et al., 2021), emphasizing the imperative to monitor and ensure their occupational safety.
The duration of exposure is a primary factor influencing the radiation dose during cardiac catheterization interventions. However, the dynamic nature of the procedure, characterized by the continuous adjustment of the DSA machine’ s C-arm angle, results in variable radiation doses across the operating room. This variability implies that professionals positioned at different locations are subjected to distinct radiation doses. Notably, while an operator’ s position is relatively static, nurses have the flexibility to move around, leading to differential exposure.
Our data indicates that the radiation doses are consistently lowest in areas( 18)–( 21), situated at the extremity of the operating table. This observation can be rationalized by the inverse square law of radiation( Zhao et al., 2017), suggesting that these areas, being most distant from the X-ray source and shielded by equipment, are least exposed.
The study delineated that the radiation doses in the highest radiation dose areas( 7) and( 8) are contingent on the projection angle. Specifically, the radiation dose in area( 8) surpasses that in area( 7) at the LAO angle and vice versa for the RAO angle. This variation can be attributed to the interplay between the X-ray tube’ s orientation, the operating table, and the specific area under consideration. To optimize safety, it is advisable for nurses to preferentially occupy low-radiation areas like area( 18)–( 21), and avoid standing in areas of high-radiation like area( 7) and( 8). Furthermore, strategic placement of equipment and consumables in these low radiation dose areas can minimize the necessity for nurses to traverse highradiation areas.
Areas( 11) and( 15) were demarcated as the standard operational areas for the first and second operators, respectively. Typically, a ceiling-suspended lead screen is positioned between area( 7) and the first operator, serving as a radiation barrier. Our findings corroborate the efficacy of this