Issues in monitoring orthopedic surgeons with active personal dosemeters when exposed to pulsed X-ray fields during orthopedic procedures

Abstract It is crucial to monitor healthcare workers’ radiation exposure, especially given the increasing reliance on X-ray imaging technologies. In response to new evidence that the threshold for lens opacity is lower than previously thought, the International Commission on Radiological Protection (ICRP) has revised the annual dose limit for exposure to the lens of the eye. After the revision of the annual eye lens dose limit, the new survey on the dosemeter wearing rate was conducted in Japan. The result showed that despite the presence of monitoring protocols, the dosemeter wearing rate among healthcare workers was still low. Compliance often lacked robust verification measures, especially in smaller medical facilities. Active personal dosemeters (APDs) are commonly used in Japan, although studies suggest that they may underestimate exposure in certain settings, such as pulsed X-ray fields. Passive dosemeters, on the other hand, serve as legal dosemeters, offering a more accurate assessment of radiation exposure. This article addresses issues related to the monitoring of healthcare workers using APDs and clarifies concerns regarding the use of APDs by orthopedic surgeons during procedures involving high-dose X-ray exposure. A series of performance tests suggested that the APDs worn by orthopedic surgeons, who are often exposed to higher dose rates near patients, may underestimate radiation levels during procedures. This underestimation occurs because the surgeons are exposed to pulsed, scattered X-ray fields with energies ranging from 20 and 100 keV. The results also suggest monitoring techniques should be improved to ensure the safety of healthcare workers.