Radiation doses in interventional radiology: issues for patients and staff within the UK

Preface
i. The Committee on Medical Aspects of Radiation in the Environment (COMARE) is a Department of Health and Social Care (DHSC) expert committee that provides independent expert advice to the UK Government on the health effects of natural and man-made radiation. In over 30 years the committee has provided advice on a range of issues from childhood cancer clusters in the vicinity of nuclear installations to sunbeds and to radiation doses resulting from the use of computed tomography (CT) in the UK.
ii. The aim of this COMARE report is to provide advice to DHSC on the radiation doseissues associated with the use of interventional radiology (IR), both for staff and patients. A particular concern is the recent reduction in the dose limit to the eye and the potential impact this may have on staffing numbers.
iii. The report provides an introduction to IR and an overview of the benefits, including shorter hospital stays and reduced mortality and morbidity, of these procedures in
comparison to other possible treatments. In many cases the use of IR has
revolutionised the ease and effectiveness of treatments. However, one of the main associated risks is the exposure to some level of ionising radiation. This report explains the level of risk and provides an overview of the wide range of radiation protection measures to minimise risks to both patient and staff.
iv. Initially to establish whether relevant data were available, letters were written to several bodies including the Health and Safety Executive (HSE), the Institute of Physics and Engineering in Medicine (IPEM), Public Health England (PHE) and the Royal College of Radiologists (RCR). Some radiologist staffing information was kindly supplied by RCR in their annual reports. The British Cardiovascular Intervention Society (BCIS) also permitted access to its audit data relating to percutaneous cardiac intervention (PCI). Aside from these, few data were extant.
v. The Subcommittee therefore had to carry out a sample survey of hospitals across the UK, using the questionnaire shown in Appendix E, to obtain better information on the range and numbers of procedures being undertaken, staff numbers involved and the range of radiation doses to patients and staff. From these and other data, the Subcommittee has attempted to forecast the future requirements for facilities, equipment and staff.
vi. The report has also highlighted a number of issues which are elaborated in the conclusions.