Radiation safety for the speech-language pathologist

It is the responsibility of the medical Speech-Language Pathologist (SLP) who performs video-assisted fluoroscopy of swallowing (VFSS) to be aware of guidelines, recommendations, and preventive measures to reduce radiation to oneself and the patient. Established parameters to reduce radiation during videofluoroscopy include keeping the exposure time brief, using lead aprons and other shielding, and maximizing the distance from the source of radiation. The purpose of this study was to measure radiation exposure to SLPs in the clinical setting and to provide practical recommendations to keep radiation exposure as low as reasonably achievable. Our study measured radiation exposure to six SLPs practicing in an acute-care university hospital. We monitored the radiation received during 130 examinations, 102 of which were of the pharynx only and the other 28 included pharynx and intrathoracic viscera. Individual times were documented, and average doses per exam were calculated from dosimetry badges worn on the lead apron of the SLP doing inpatient exams. Average fluoroscopy time per procedure was 165 s. Average radiation to the dosimeter worn on the front of the lead apron at chest level was 0.15 mR (0.0015 mGy) per procedure. SLPs stood behind the lead shield during fluoroscopy when feasible. Our measurements document the practical importance of reducing radiation exposure to health-care personnel by increasing the distance from the source of radiation and by shielding. While recommendations are not new, details of the findings may help guide and reinforce good radiation safety practice.