Results of individual dosimetric monitoring of the hands skin for personnel engaged in working with radiopharmaceuticals

With the active development and wide use of positron emission tomography, ensuring radiation safety in matters of irradiation of the skin of the hands of personnel, has become very important. Work with radiopharmaceuticals labeled with various radionuclides is characterized by fairly close contact with a source of ionizing radiation, during which the skin of the hands can be irradiated in significant doses. Thus, the effect of ionizing radiation on the skin of the hands is one of the main problems of radiation protection of personnel at nuclear medicine centers. The work of personnel at nuclear medicine centers, depending on the nature of the actions performed, can be divided into two types: predominantly manual processes (nurses – packaging and administration of drugs, analytical chemists – quality control) and predominantly automated processes (radiochemical engineers – synthesis, packaging into vials). The individual equivalent doses to the skin of the hands of nurses, analytical chemists and radiochemical engineers working with 18F-based radiopharmaceuticals were estimated using thermoluminescence dosimetry with individual dosimeters calibrated in terms of Hp(0.07). The maximum annual value obtained fo radiochemical engineers was 7.8 mSv, which is 1.56% of the dose limit, and for analytical chemists it was 171 mSv, which is 34% of the dose limit (mean value was 28 mSv, median was 8.8 mSv, minimum value was 4.6 mSv). At the same time, nurses, who are mainly engaged in the packaging and administration of radiopharmaceuticals, have higher values of annual doses in the skin of the hands (mean value – 114 mSv, median – 56 mSv, minimum value – 1.3 mSv). The maximum value of the annual dose in the skin of the hands, recorded during the work, for a nurse was 573 mSv, i.e. the dose limit of 500 mSv was exceeded. The results of the work indicate that specialists involved in manual processes when manipulating radiopharmaceuticals require special attention from the standpoint of individual dosimetric control of the irradiation dose to the skin of the hands and compliance with radiation safety requirements.

1. United Nations Scientific Committee on the Effects of Atomic Radiation. UNSCEAR 2008 Report to the General Assembly with Scientific Annexes. Sources and Effects of Ionizing Radiation. V.I, Annex A. Medical radiation exposures. NY: United Nations; 2010.

2. Chipiga LA, Zvonova IA, Ryzhkova DV, Menkov MA, Dolgushin МB. Levels of patients exposure and a potential for optimization of the pet diagnostics in the Russian Federation. Radiatsionnaya Gygiena = Radiation Hygiene. 2017;10(4): 31–43. (In Russian). DOI: 10.21514/1998-426X-2017-10-4-31-43.

3. Kubo ALSL, Mauricio CLP. TLD occupational dose distribution study in nuclear medicine. Radiation Measurements. 2014;71: 442–446. DOI: 10.1016/j.radmeas.2014.04.021.

4. Audi G, Wapstra AH, Thibault C. The Ame2003 atomic mass evaluation: (II). Tables, graphs and references. 2003;729(1): 337–676. DOI: 10.1016/j.nuclphysa.2003.11.003.

5. Nevzorov DI, Skripachev IA, Dolgushin MB, Odzharova AA, Eremin NV. Production of Radiopharmaceutical Medicinal Product 18F-Fluorodeoxyglucose. Onkologicheskiy zhurnal: luchevaya diagnostika, luchevaya terapiya = Journal of oncology: diagnostic radiology and radiotherapy. 2018;1(3): 10–14. (In Russian). DOI: 10.37174/2587-7593-2018-1-3-10-14.

6. Passport of the program of innovative development and technological modernization of the State Corporation Rosatom for the period up to 2030 (in the civil part). Moscow; 2016. 76 p. (In Russian).

7. Shimchuk GG, Bruskin AB, Shimchuk GrG. Opportunities and Prospects for Russia to Create PET Centers Based on Generator Radionuclides. Meditsinskaya radiologiya i radiatsionnaya bezopasnost = Medical Radiology and Radiation Safety. 2022;67(6): 62–66. (In Russian). DOI: 10.33266/1024-6177-2022-67-6-62-66

8. European Platform for Occupational Radiation Exposure 1997 ESOREX Platform. Available from: https://esorexplatform.org/database/query/skin?field_country_target_id) (Accessed: 03.06.2024).

9. Vanhavere F, Carinou E, Donadille L, Ginjaume M, Jankowski J, Rimpler A, et al. An overview on extremity dosimetryin medical applications. Radiation Protection Dosimetry. 2008;129(1–3): 350–355.

10. ORAMED: Optimization of Radiation Protection of Medical Staff: EURADOS Report 2012-02, Braunschweig, April 2012.

11. International Commission on Radiological Protection. Radiation dose to patients from radiopharmaceuticals. Addendum 3to ICRP Publication 53. ICRP Publication 106. Annex E. Radiationexposure of hands in radiopharmacies: Monitoring of doses andoptimisation of protection. Annals of the ICRP. 2008;38(1–2): 1–197.

12. Wrzesień M. The effect of work system on the hand exposure of workers in 18F-FDG production centres. Australasian Physical & Engineering Sciences in Medicine. 2018;41(2): 541–548. DOI: 10.1007/s13246-018-0644-9.

13. Kollaard R, Zorz A, Dabin J, Covens P, Cooke J, Crabbé M, et al. Review of extremity dosimetry in nuclear medicine. Journal of Radiological Protection. 2021;41(4). DOI: 10.1088/1361-6498/ac31a2. PMID: 34670207.

14. Cunha L, Dabin J, Leide-Svegborn S, Zorz A, Kollaard R, Covens P. Extremity exposure of nuclear medicine workers: results from an EANM and EURADOS survey. Journal of Nuclear Medicine and Molecular Imaging. 2023;67(1): 29-36. DOI: 10.23736/S1824-4785.22.03504-X . Epub 2023 Jan 11. PMID: 36630081.

15. Kyriakidou A, Schlief J, Ginjaume M, Kollaard R. Need for harmonisation of extremity dose monitoring in nuclear medicine: results of a survey amongst national dose registries in Europe. Journal of Radiological Protection. 2021;41(4). DOI: 10.1088/1361-6498/abfff3. PMID: 34723834.

16. Beganović A, Petrović B, Surić Mihić M. Extremity dosimetry for exposed workers in positron emission tomography in Bosnia and Herzegovina. Radiation Protection Dosimetry. 2023;199(8-9): 859–864. DOI: 10.1093/rpd/ncad117. PMID: 37225180.

17. Kaljevic J, Stankovic K, Stankovic J, Ciraj-Bjelac O, Arandjic D. Hand dose evaluation of occupationally exposed staff in nuclear medicine. Radiation Protection Dosimetry. 2016;170(1-4): 292–296. DOI: 10.1093/rpd/ncv500. Epub 2015 Dec 10. PMID: 26656262.