Investigating Tertiary X-radiation Exposure in C-arm Units: Risks and Mitigation

Fluoroscopic C-arm units are used routinely in surgical procedures, but they pose potential radiation hazards, particularly in terms of scatter and tertiary exposure to healthcare providers, which can lead to long-term health effects. This study investigates the level of scatter radiation emitted by the C-arm during Dynamic Hip Screw (DHS) surgery across four general hospitals. A water phantom was placed in the center of the operating table, simulating an average patient. OSL dosimeters were placed at standardized distances and heights around all sides of the phantom to measure scatter radiation exposure. The OSL dosimeter readings recorded consistent scatter radiation levels for all positions (A, B, C, D, and E) and heights (0.5 m, 1.0 m, and 2.0 m). Exposure levels ranged from 0.06 to 0.09 mSv, with negligible variations based on distance from the phantom. One-way ANOVA results showed differences in scatter radiation exposure between hospitals (F-statistic = 2.68, p = 0.044). Despite inter-hospital variations, exposure levels were below international safety levels. Results indicate that healthcare workers are unlikely to surpass the yearly dose levels of radiation during normal use. Routine exposure highlights the necessity for proper safety precautions, such as lead aprons, shielding barriers, and room layout optimization. Future studies should take C-arm shielding and positioning into account to continue reducing exposure to scatter radiation. Further research is recommended to evaluate long-term cumulative exposure and improve radiation safety protocols.