Use of Double vs. Single Radiation Monitoring Badge System for Fluoroscopy Users

To analyze historical radiation dose data from fluoroscopy users at a major university medical center and compare the impact of two alternate dose monitoring methodologies.

Interventional radiologists have traditionally worn two radiation monitoring badges to estimate their radiation dose. This study evaluates if a single badge monitoring system can reduce the administrative burden of radiation monitoring without negatively impacting safety or compliance. This study reviewed the dose history data for a 10-y period including 114,500 individual dose measurements. These individuals were each issued two badges for each wear period, including one worn at the collar (outside a protective garment) and one worn at the chest or waist (beneath a protective garment). The dose for each of the badges was derived from the database of personnel dose records. Badges that could be clearly identified as improperly worn were excluded from the study. The EDE as assigned from the two-badge system and as derived from the wear of the collar badge only were both compared to the thresholds for ALARA notifications currently in use.

Calculated EDE values are an average of 2.7 times higher when applying a one-badge system as compared to a two-badge system. This is observed to result in a slight increase in the ALARA notification frequency (excluding badges improperly worn in the two-badge system). The overall increase in notification frequency is small because notifications are dominated by dose to the lens of the eye.

Although providing less accurate personnel dose estimates relative to a two-badge system, the use of a one-badge monitoring system for fluoroscopy users may have a minimal effect on radiation dose records and "as low as (is) reasonably achievable" (ALARA) notifications, with potentially significant savings in notifications due to improper badge wear, volume of radiation monitoring badges handled, and cost of the radiation monitoring system.