Radiation Protection in Orthopaedic Surgery: A Regional Survey

Cureus. 2024 Nov 20;16(11):e74122. doi: 10.7759/cureus.74122. eCollection 2024 Nov.

Abstract

Introduction Orthopaedic surgery frequently involves the use of intra-operative radiographs, commonly taken with surgeons standing in close proximity to the X-ray machine. Radiation training and appropriate radiation protection minimise the harm that surgeons can face from ionising radiation. This study evaluates the current state of radiation training and protective equipment available to orthopaedic surgeons in the East of England. Methods A digital questionnaire on Google Forms (Google LLC, Mountain View, CA, USA) was disseminated to regional orthopaedic surgeons between October 2022 and January 2023. Results Of the 75 respondents, 49% were consultants and 51% were trainees at various stages. Regarding training and risk assessment, 62% of surgeons lacked radiation protection training, 45% of female trainees didn't undergo radiation risk assessments during pregnancy, and none did while breastfeeding. Concerning radiation protection, all respondents inadvertently X-rayed their hands; lead gloves and glasses were scarce, and X-ray gowns were in poor condition and in a limited range of sizes. Most surgeons were unwilling to purchase their own dosimeters, lead gowns, thyroid guards, and lead glasses, despite their limited availability, inadequate size range, and poor condition. No significant differences were observed between consultant and registrar responses. Conclusion The study reveals inadequate training and mitigation against radiation exposure in orthopaedics. The lack of radiation training prompted its inclusion in this year's trainee inductions. The shortage of proper radiation protective equipment exposes surgeons to radiation risks. Orthopaedic surgeons should not have to choose between workplace health and safety and affordability. Greater financial support and investment in radiation protection should be prioritised to minimise radiation-induced harm. We aim to raise awareness and encourage key decision-makers to address this critical issue.

Keywords: ionising radiation exposure; occupational health hazards; orthopaedic surgery; radiation protection; radiation training.