Radiation exposure during gastroenterologic fluoroscopy: risk assessment for pregnant workers

With more females in childbearing years participating in fluoroscopic examinations, safety guidelines need to be evaluated. Present recommendations suggest limiting fetal irradiation to less than 500 mrem (0.5 rad) during gestation, and to avoid doses above 100 mrem (0.1 rad) from 8 to 15 wk postconception. The average radiation dose delivered per case was monitored during 10 therapeutic biliary procedures with lithium fluoride dosimeters worn at the endoscopist's collar, over the suprapubic region outside a knee-length 0.5-mm leaded equivalent apron, and inside the apron over the mid-pelvis. A short survey of 15 female technicians and physicians was conducted to gather their opinions about working in fluoroscopy during pregnancy. We found that radiation doses beneath the leaded apron were comparable to environmental exposure. The dose measured at the endoscopist's collar was 0.083 mrem/min. The dose over the pelvis was 0.044 mrem/min. The survey revealed that 13 of those interviewed would not feel safe working near fluoroscopy, and 12 wished to be excluded from fluoroscopy if they became pregnant. We conclude that a high level of anxiety regarding fetal safety exists among females participating in fluoroscopic procedures. In this study, with proper use of standard safety equipment, radiation exposure does not exceed those levels currently recommended to avoid during pregnancy.