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Radiation Safety Education in Vascular Surgery Training: An Unmet Requirement
Stefano J. Bordoli, MD, Christopher G. Carsten, III, MD, David L. Cull, MD, Brent L. Johnson, MS, Spence M. Taylor, MD. Greenville Hospital System, Greenville, SC, USA.
Background: Over the past two decades, a profound shift in the number of endovascular procedures performed by vascular surgeons has occurred, providing heavy exposure to ionizing radiation. Shortcomings in radiation safety training and knowledge were recently discovered in a survey of interventional cardiology fellows, but this has not been investigated in vascular surgery trainees. The purpose of this study was to examine the radiation safety training and practices of current vascular surgery trainees. Methods: In March of 2012, an anonymous 10-item survey was sent to all vascular surgery fellowship program coordinators for distribution to the 311 current U.S. vascular surgery trainees. A reminder was sent out at two weeks and responses were collected for up to six weeks. Responses were summarized and compared according to the presence or absence of formal radiation safety training, as well as the trainee's perception of his/her attending surgeons' adherence to As Low As Reasonably Achievable (ALARA) strategies. Results: The survey response rate was 14% (42/311). 45% had not received any formal radiation safety training, 74% were unaware of their hospital's radiation safety work policy for pregnant females, and 48% did not know the contact information for their hospital's radiation safety officer. 43% were unaware of the yearly acceptable levels of radiation exposure as recommended by the National Council on Radiation Protection and Measurement (NCRP). Fellows who received radiation safety training were more knowledgeable of 1) their hospitals pregnancy work policy, 2) their radiation safety officer's contact information, 3) the acceptable yearly levels of radiation exposure, and 4) were more likely to wear their dosimeter badges (p<0.05). Trained fellows found their radiation safety officer helpful in developing their safety habits, while untrained fellows relied more heavily on other vascular fellows (p<0.05). Trainees who felt their attendings consistently practiced ALARA strategies were more likely to practice ALARA themselves, and were more likely to wear radiation safety goggles and dosimeter badges (p<0.05). Conclusions: Both the poor response to this survey as well as the lack of formal training in nearly 50% of responding trainees reflect an inadequate culture of radiation safety among U.S. vascular surgery training programs.
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