Protecting the Orthopaedic Surgeon: An Institutional Review of Radiation Safety Practices, Knowledge, and Risks

Orthopaedic surgeons are among the top 3 medical professionals most exposed to ionizing radiation and must minimize the risks of ionizing radiation to patients, themselves, and staff. Best practice principles, including "As low as reasonably achievable" (ALARA), guide clinical practice, ensuring radiation exposure is clinically justified and performed by trained professionals. Currently, few studies assess radiation knowledge among academic orthopaedic surgery departments. The aims of this study are to investigate the radiation fund of knowledge and safety practices within an academic Department of Orthopaedic Surgery and identify the availability of and level of satisfaction with communal lead personal protective equipment (PPE) at the various hospital locations associated with the academic institution.

A REDCap anonymous web-based survey was given to orthopaedic surgery residents, fellows, physician assistants, faculty, and others within the Department of Orthopaedic Surgery. Data on knowledge of radiation safety training and best operating practices were collected. Knowledge and practice scores were calculated. ANOVA and t-test analyses were used to compare score outcomes between adequately and inadequately trained personnel, with a p-value <0.05 indicating statistical significance.

Fifty-eight orthopaedic surgery personnel responded to the survey: 21 (36.21%) residents, 9 (15.52%) fellows, 5 (8.62%) professors, 6 (10.34%) associate professors, 6 (10.34%) assistant professors, and 11 (18.97%) physician assistants. The average knowledge and practice scores were 9.72/20 and 19.63/48 points, respectively. Comparison of scores based on self-reported adequacy level of training on radiation safety was statistically significant. PPE availability was low (43.11%), although satisfaction with communal lead aprons was high (60.8%) across hospital locations.

There is an opportunity to enhance radiation safety knowledge and practices among the personnel of the Department of Orthopaedic Surgery at the academic institution. Communal PPE availability across hospital locations also warrants improvement.