Prevalence of Shielding in Diagnostic X-ray Centers in the Islamic Republic of Iran: A Systematic Review
Keywords:
prevalence, shielding, diagnostic X-ray, radiation exposure, Iran
Abstract
Shielding has been recommended as an effective tool against radiation exposure. Several studies have published on the availability and use of shielding tools in diagnostic X-ray centers across the country and contradictory results been reported. Therefore, the aim of this systematic review was to find out the status of radiation protection in term of availability and use of shielding tools in diagnostic X-ray centers in Iran. An extensive literature search was conducted in the PubMed/Medline, Embase, ISI, Cochrane Library, SID, Magiran, IranMedex, Irandoc and Google-Scholar search engine. We also manually searched the reference lists of the relevant studies. Two authors independently assessed the eligibility of all studies and extracted data. Thirty-seven studies published from 1998 to 2019 were included in this systematic review. In all, 1089 diagnostic X-ray centers, 4439 radiographs and performance of 1472 radiographers were covered in these studies. The availability of lead apron, gonad shield and thyroid collar were ranged from 7 to 95.5%, 26.6 to 94% and 7 to 94%, respectively. Moreover, their usage was ranged from 0 to 85.5%, 0 to 35% and 0 to 38.4%, respectively. In addition, lens shield was discussed in one study with availability of 0%. During 1998 to 2019, the status of shielding had not improved across the country. Therefore adherence to the safety guideline as far as possible is required to protection patients from undue exposure to radiation.
References
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[2]Karami, V., & Zabihzadeh, M. (2016). Review on radiation protection in diagnostic radiology. Tehran University Medical Journal TUMS Publications, 74(7), 457-66.
[3]Rothenberg, B. M., & Korn, A. (2005). The opportunities and challenges posed by the rapid growth of diagnostic imaging. Journal of the American College of Radiology, 2(5), 407-410. https://doi.org/10.1016/j.jacr.2005.02.012
[4] Zabihzadeh, M., & Karami, V. (2016). The challenge of unnecessary radiological procedures. Hong Kong Journal of Radiology, 19(3), 23-4. https://doi.org/10.12809/hkjr1615363
[5] Karami, V., & Zabihzadeh, M. (2017). Beam collimation during lumbar spine radiography: A retrospective study. Journal of Biomedical Physics & Engineering, 7(2), 101-106.
[6]Shrieve, D. C., & Loeffler, J. S. (2010). Human radiation injury: Lippincott Williams & Wilkins.
]7] Karami, V. (2018). Fetography: The global outdated procedure, the national prevalent procedure: letters to the editor. Tehran University Medical Journal TUMS Publications, 76(2):153.
[8] Karami, V., & Zabihzadeh, M. (2016). Radiation protection in diagnostic X-ray imaging departments in Iran: a systematic review of published articles. Journal of Mazandaran University of Medical Sciences, 26(135), 175-88.
[9] Karami, V., & Zabihzadeh, M., Danyaei, A., & Shams, N. (2016). Efficacy of increasing focus to film distance (FFD) for patient’s dose and image quality in pediatric chest radiography. International Journal of Pediatrics, 4(9), 3421-9. https://doi.org/10.22038/IJP.2016.7319
[10] Karami, V., Zabihzadeh, M., & Keshtkar, M. (2017). Evaluation of the Entrance Surface Dose (ESD) and Radiation Dose to the Radiosensitive Organs in Pediatric Pelvic Radiography. International Journal of Pediatrics, 5(6), 5013-5022. https://doi.org/10.22038/IJP.2017.22364.1873
[11] Zabihzadeh, M., & Karami, V. (2016). Letter to Editor: Poor collimation in digital radiology: A growing concern. Internet Journal of Medical Update-EJOURNAL, 11(2), 29-30. https://doi.org/10.4314/ijmu.v11i2.7
[12] Karami, V., Zabihzadeh, M., Shams, N., & Gholami, M. (2017). Evaluation of the anode heel effect on the testes dose during pelvic radiography. Tehran University Medical Journal TUMS Publications, 75(2), 113-9.
[13] Karami, V., Zabihzadeh, M., Shams, N., & Malehi, A. S. (2017). Gonad Shielding during Pelvic Radiography: A Systematic Review and Meta-analysis. Archives of Iranian Medicine, 20(2), 113-23. https://doi.org/0172002/AIM.0011
[14] Zabihzadeh M, Karami V. Current status of the fetography: Preventing of the future radiation induced cancer. Iranian Journal of Cancer Prevention, 10(1), e5209. https://doi.org/10.17795/ijcp-5209
[15] Karami, V., Zabihzadeh, M., Shams, N., & Gilavand, A. (2017). Optimization of Radiological Protection in Pediatric Patients Undergoing Common Conventional Radiological Procedures: Effectiveness of Increasing the Film to Focus Distance (FFD). International Journal of Pediatrics, 5(4), 4771-4782. https://doi.org/10.22038/ijp.2017.22010.1841
[16] Hassanpour, N., Panahi, F., Naserpour, F., Karami, V., Asl, J. F., & Gholami, M. (2018). A Study on Radiation Dose Received by Patients during Extracorporeal Shock Wave Lithotripsy. Archives of Iranian Medicine (AIM), 21(12), 585-588.
[17] Behroozi, H., Tahmasebi, M., Mohebifar, B. (2018). Evaluation of the Prevalence of Shielding in Patients Undergoing Conventional Radiological Procedures (1 Work Shift–1 X-ray Room). Journal of Patient Safety, 14(3), 133-137. https://doi.org/10.1097/PTS.0000000000000180
[18] Karami, V., Zabihzadeh, M., Shams, N., Gholami, M. (2017). Radioprotection to the Gonads in Pediatric Pelvic Radiography: Effectiveness of Developed Bismuth Shield. Int. J. Pediatr, 5(6), 5153-5166. https://doi.org/10.22038/ijp.2017.23116.1939
[19] Karami, V., Zabihzadeh, M., Gilavand, A., & Shams, N. (2016). Survey of the use of X-ray beam collimator and shielding tools during infant chest radiography. International Journal of Pediatrics, 4(4), 1637-1642. https://doi.org/10.22038/ijp.2016.6708
[20] Karami, V., Zabihzadeh, M., Gholami, M., Shams, N. F., & Nezhad. Z. (2016). Dose reduction to the thyroid gland in pediatric chest radiography. Int. J. Pediatr, 4(7), 2183-91. https://doi.org/10.22038/ijp.2016.7081
[21] Karami, V. (2015). Report a concern: Letter to the editor. Tehran Univ. Med. J., 73(7), 544.
[22] Morford, K., & Watts, L. K. (2012) .Bismuth Shielding Durint CT Exams: A Literature Review. Radiology Management, 34(3).
[23] Hopper, K. D., Neuman, J. D., King, S. H., & Kunselman, A. R. (2001). Radioprotection to the eye during CT scanning. American Journal of Neuroradiology, 22(6), 1194-1198. https://doi.org/10.1016/S0002-9394(01)01224-7
[24] Karami, V., Zabihzadeh, M., & Shams, N. (2018). Bismuth radioprotective gonadal shields: Prevalence of use and effect on image quality during paediatric pelvic radiography. Hong Kong Journal of Radiology, 21(3), 178-183. https://doi.org/10.12809/hkjr1816863
[25] Karami, V., & Zabihzadeh, M. (2015). Prevalence of radiosensitive organ shielding in patients undergoing computed tomography examinations: An observational service audit in Ahvaz, Iran. Asian Biomedicine, 9(6), 771-775. https://doi.org/10.5372/1905-7415.0906.449
[26] Winfeld, M., Strubel, N., Pinkney, L., Lala, S., Milla, S., Babb, J., et al. (2013). Relative distribution of pertinent findings on portable neonatal abdominal radiographs: can we shield the gonads? Pediatric Radiology, 43(10), 1295-1302. https://doi.org/10.1007/s00247-013-2700-7
[27] Kim, S., Frush, D. P., & Yoshizumi, T. T. (2010). Bismuth shielding in CT: support for use in children. Pediatric Radiology, 40(11), 1739-43. https://doi.org/10.1007/s00247-010-1807-3
[28] Karami, V., Zabihzadeh, M., & Gholami, M. (2016). Gonad Shielding for Patients Undergoing Conventional Radiological Examinations: Is There Cause for Concern? Jentashapir Journal of Health Research, 7(2), e31170. https://doi.org/10.17795/jjhr-31170
[29] Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., et al. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews. 4(1), 1. https://doi.org/10.1186/2046-4053-4-1
[30] 34th Iranian Congress of Radiology. Retrieved October 2018, from https://en.symposia.ir/RADMED34
[31] 34th Iranian Congress of Radiology. Retrieved October 2018, from http://gsia.tums.ac.ir/en/dsem/ndt/351430/33rd-Iranian-Congress-of-Radiology--ICR
[32] Dowd, S. B., & Tilson, E. R. (2004). Practical radiation protection and applied radiobiology: WB Saunders; 1999.
[33] Doolan, A., Brennan, P. C., Rainford, L. A., & Healy, J. (2004). Gonad protection for the antero-posterior projection of the pelvis in diagnostic radiography in Dublin hospitals. Radiography, 10(1), 15-21. https://doi.org/10.1016/j.radi.2003.12.002
[34] Karami, V., Tahmasebi, M., Fatahi, & Asl, J. (2013). The protection knowledge and performance of Radiographers in some hospitals of Ahvaz County. Jentashapir Journal of Health Research, 4(5), 405-12.
[35] Borhani, P., & Mohammad, A. S. (2003). Evaluation of radiology personnel practice of Kerman university of medical sciences hospitals. 2003. https://doi.org/10.22038/ijmp.2015.6221
[36] Chaparian, A., Shamsi, F., & Heydari, A. (2013). Assessment of awareness, attitude, and practice of radiographers about radiation protection in Yazd Province. Occupational Medicine Quarterly Journal, 5(1), 16-23.
[37] Karami, V., Zabihzadeh, M., & Sarikhani, S. (2016). Evaluation of the frequency and accuracy of gonad shield placement in patients undergoing pelvic radiography. Brazilian Journal of Radiation Sciences, 4(1), 1-8. https://doi.org/10.15392/bjrs.v4i1.189.
[38] Karami, V., Zabihzadeh, M., Shams, N., & Sarikhani, S. (2016). Evaluation of the prevalence and utility of gonad shielding in pediatrics undergoing pelvic X-ray. International Journal of Pediatrics, 4(11), 3735-3740. https://doi.org/10.22038/ijp.2016.7589
[39] MacKay, M., Hancy, C., Crowe, A., D'Rozario, R., & Ng, C. (2012). Attitudes of medical imaging technologists on use of gonad shielding in general radiography. Radiographer, 59(2), 35-9. https://doi.org/10.1002/j.2051-3909.2012.tb00172.x
[40] Karami, V., & Zabihzadeh, M. (2012). Ovarian shielding during pelvis radiography: risk versus benefit. International Journal of Radiology and Radiation Therapy, 85, 442-447.
[41] Mehnati, P., & Refahi, S. (2007). Assessment of radiation protection in the radiological centers: A pilot study in Ardebil. Proceedings of the 1th congress of radiation protection in radiotherapy, diagnostic and interventionaal radiology; June 8-9 Tehran: shahid beheshti university of medical science, p. 1.
[42] Mirdoraghi, M., & Fatahi, A. J. (2017). Evaluation of Radiation Protection Condition in Educational Hospital Radiological Centers of Ahwaz University of Medical Sciences. Paramedical Sciences and Military Health, 11(4), 1-8.
[43] Rostamzadeh, A., Farzizadeh, M., & Fatehi, D. (2015). Evaluation of the level of protection in radiology departments of Kermanshah, Iran. Iranian Journal of Medical Physics, 12(3), 200-208. https://doi.org/10.22038/ijmp.2015.6221
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