• Title/Summary/Keyword: hospital exposure

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Consideration on Shielding Effect Based on Apron Wearing During Low-dose I-131 Administration (저용량 I-131 투여시 Apron 착용여부에 따른 차폐효과에 대한 고찰)

  • Kim, Ilsu;Kim, Hosin;Ryu, Hyeonggi;Kang, Yeongjik;Park, Suyoung;Kim, Seungchan;Lee, Guiwon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.32-36
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    • 2016
  • Purpose In nuclear medicine examination, $^{131}I$ is widely used in nuclear medicine examination such as diagnosis, treatment, and others of thyroid cancer and other diseases. $^{131}I$ conducts examination and treatment through emission of ${\gamma}$ ray and ${\beta}^-$ ray. Since $^{131}I$ (364 keV) contains more energy compared to $^{99m}Tc$ (140 keV) although it displays high integrated rate and enables quick discharge through kidney, the objective of this study lies in comparing the difference in exposure dose of $^{131}I$ before and after wearing apron when handling $^{131}I$ with focus on 3 elements of external exposure protection that are distance, time, and shield in order to reduce the exposure to technicians in comparison with $^{99m}Tc$ during the handling and administration process. When wearing apron (in general, Pb 0.5 mm), $^{99m}Tc$ presents shield of over 90% but shielding effect of $^{131}I$ is relatively low as it is of high energy and there may be even more exposure due to influence of scattered ray (secondary) and bremsstrahlung in case of high dose. However, there is no special report or guideline for low dose (74 MBq) high energy thus quantitative analysis on exposure dose of technicians will be conducted based on apron wearing during the handling of $^{131}I$. Materials and Methods With patients who visited Department of Nuclear Medicine of our hospital for low dose $^{131}I$ administration for thyroid cancer and diagnosis for 7 months from Jun 2014 to Dec 2014 as its subject, total 6 pieces of TLD was attached to interior and exterior of apron placed on thyroid, chest, and testicle from preparation to administration. Then, radiation exposure dose from $^{131}I$ examination to administration was measured. Total procedure time was set as within 5 min per person including 3 min of explanation, 1 min of distribution, and 1 min of administration. In regards to TLD location selection, chest at which exposure dose is generally measured and thyroid and testicle with high sensitivity were selected. For preparation, 74 MBq of $^{131}I$ shall be distributed with the use of $2m{\ell}$ syringe and then it shall be distributed after making it into dose of $2m{\ell}$ though dilution with normal saline. When distributing $^{131}I$ and administering it to the patient, $100m{\ell}$ of water shall be put into a cup, distributed $^{131}I$ shall be diluted, and then oral administration to patients shall be conducted with the distance of 1m from the patient. The process of withdrawing $2m{\ell}$ syringe and cup used for oral administration was conducted while wearing apron and TLD. Apron and TLD were stored at storage room without influence of radiation exposure and the exposure dose was measured with request to Seoul Radiology Services. Results With the result of monthly accumulated exposure dose of TLD worn inside and outside of apron placed on thyroid, chest, and testicle during low dose $^{131}I$ examination during the research period divided by number of people, statistics processing was conducted with Wilcoxon Signed Rank Test using SPSS Version. 12.0K. As a result, it was revealed that there was no significant difference since all of thyroid (p = 0.345), chest (p = 0.686), and testicle (p = 0.715) were presented to be p > 0.05. Also, when converting the change in total exposure dose during research period into percentage, it was revealed to be -23.5%, -8.3%, and 19.0% for thyroid, chest, and testicle respectively. Conclusion As a result of conducting Wilcoxon Signed Rank Test, it was revealed that there is no statistically significant difference (p > 0.05). Also, in case of calculating shielding rate with accumulate exposure dose during 7 months, it was revealed that there is irregular change in exposure dose for inside and outside of apron. Although the degree of change seems to be high when it is expressed in percentage, it cannot be considered a big change since the unit of accumulated exposure dose is in decimal points. Therefore, regardless of wearing apron during high energy low dose $^{131}I$ administration, placing certain distance and terminating the administration as soon as possible would be of great assistance in reducing the exposure dose. Although this study restricted $^{131}I$ administration time to be within 5 min per person and distance for oral administration to be 1m, there was a shortcoming to acquire accurate result as there was insufficient number of N for statistics and it could be processed only through non-parametric method. Also, exposure dose per person during lose dose $^{131}I$ administration was measured with accumulated exposure dose using TLD rather than through direct-reading exposure dose thus more accurate result could be acquired when measurement is conducted using electronic dosimeter and pocket dosimeter.

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Exposure to Formaldehyde of Ambulatory Care Nurses in University Hospital (대학병원 내 외래간호사의 포름알데히드 노출 평가)

  • Gu, Dongchul;Lee, Chaekwan;Lee, Jaewan;Lee, Suyeon;Yun, Soonyoung;Han, Areum;Kim, Hyunju;Park, Yeongbeom;Jeong, Seongwook;Moon, Chanseok
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.24 no.4
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    • pp.446-452
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    • 2014
  • Objective: This study aimed to evaluate the exposure status of formaldehyde(FA) among the nurses in ambulatory care departments of university hospital. Methods: Two university hospitals were surveyed. The FA concentration in air were measured to target 62 nurses in 8 ambulatory care departments(89 samples). Air sampling and analysis of FA were carried out according to the OSHA Method ID-205. The survey was conducted with questionnaire asking about how to control FA and whether the nurses use the formaldehyde protectors or not. Results: FA was detected in all samples. The maximum concentration of FA was 0.258 ppm and the geometric mean was 0.023 ppm. There was no sample that exceeded any of exposure standards by OSHA-TWA whereas there were 54 samples(60.7%) that exceeded the standards by NOISH-TWA. Among 62 nurses handling FA, 13 nurses(21.0%) used the protective gloves while nobody used a gas mask. It was assessed that any of 8 common ambulatory care departments did not use a safety cabinet for FA in which local exhaust ventilation was fixed. Conclusions: Nurses in ambulatory care departments were exposed to FA. Therefore, the environment management of a workplace, the health management of a nurses, FA handling education and installing a FA cabinet with a local exhaust ventilation were needed because FA as a carcinogen was able to cause any cancer to a human body if it was emitted in air for long time.

LATERAL CANTHOTOMY-CONJUNCTIVAL APPROACH TO THE LATERAL AND INFERIOR ORBIT (안와하연 및 측벽(frontozygomatic suture)에 대한 lateral canthotomy-conjunctival approach를 이용한 협골체 골절의 치료)

  • Kim, Hyoun-Chull;Byun, Sook;Yoon, Ok-Byung;Lee, Tae-Young;Esaki, Seiji;Kameyama, Tadamitsu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.99-103
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    • 1994
  • Various extraoral and intraoral approaches to reduction and fixation of zygomatic complex fractures were used. The method for exposure of inferior orbital area include the subciliary, inferior eyelid, infraorbital rim and conjunctions incisions. For exposure of frontozygomatic suture, lateral brow, coronal and b'ephaloplasty incisions were used. It is necessary that the usual approaches to the inferior and lateral orbit have two incisions. However, lateral canthotomy-conjunctival approach presented on this paper provide optimal exposure to lateral and inferior orbit.

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A Case of Huge Vocal Polyp in a Patient With Difficult Laryngeal Exposure Treated by Fiberoptic Laryngeal Laser Surgery Under Local Anesthesia (전신마취 하 후두미세수술이 불가능한 경추 손상 환자에게서 국소마취 하 굴곡내시경 후두 레이저 수술로 치료한 거대한 성대 폴립 1예)

  • An, You Young;Lee, Jeong Hyun;Park, Ki Nam;Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.3
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    • pp.153-156
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    • 2021
  • Indications of fiberoptic laryngeal laser surgery (FLS) procedure have broadened by the development of flexible fiberoptic endoscopes and flexible laser systems. FLS procedure performed under local anesthesia and it is the unique value of FLS. The surgery can be performed on patients who are impossible to undergo general anesthesia and difficult to be exposed by laryngeal microsurgery. Main indication of FLS procedure was small to moderate sized hemorrhagic vocal polyp, but we experienced a case of huge vocal polyp with difficult laryngeal exposure treated by FLS procedure under local anesthesia. The vocal polyp was removed successfully without vocal fold scar through fiberoptic laryngeal laser surgery under local anesthesia.

Review of a Case of Chronic Obstructive Pulmonary Disease in Workers Exposed to Synthetic Fibers

  • Hyeon-cheol Oh;Chae-seong Lim;Jung-won Kim;Eun-seok Kim;Ji-eun Lee;Sang-cheol Kim
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.33 no.3
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    • pp.273-279
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    • 2023
  • Objectives: Objectives of this study were: 1) to introduce industrial situation and health hazards of synthetic fiber, 2) to review a case of chronic obstructive pulmonary disease in a worker exposed to synthetic fiber reported to the Korea Occupational Disease Surveillance Center, and 3) to suggest supplementary measures for the occupational health system for workers exposed to synthetic fibers. Methods: Respiratory exposure, health hazards, and exposure standards for synthetic fiber dust in Korea and other countries were reviewed. In addition, a case of chronic obstructive pulmonary disease due to exposure to nylon dust reported to the Korea Occupational Disease Surveillance Center was reviewed and summarized. Results: The worker was a 53-year-old non-smoking male who had been involved in the nylon weaving process for 26 years. He had shortness of breath from three years ago. He was diagnosed with chronic obstructive pulmonary disease. PM1.0, PM2.5, and PM10 were measured at 26.6 ㎍/m3, 48.2 ㎍/m3, and 91.7 ㎍/m3, respectively. Fiber components estimated as nylon fiber were detected in the microscopic examination of a solid sample. Conclusions: For workers exposed to synthetic fiber dust, special health examinations of the respiratory system, regular work environment measurement, and work environment management through workplace health management should be performed. It is necessary to research on health effects of synthetic fibers.

Evaluation of Lead Exposure Characteristics Using Domestic Occupational Exposure Literature Data (납에 대한 국내 직업적 노출 문헌 자료 고찰을 통한 노출 특성 평가)

  • Choi, Sangjun;Seo, Sung Chul;Park, Ju-Hyun;Koh, Dong-Hee;Kim, Hwan-Cheol;Park, Donguk;Choi, Hee Eun;Sung, Yeji;Oh, Se-Eun;Ko, Kyoung Yoon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.32 no.1
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    • pp.1-9
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    • 2022
  • Objectives: The purpose of this study is to evaluate exposure characteristics of lead using data from the domestic occupational exposure literature. Methods: Occupational airborne exposure data on lead reported in the domestic literature from 1981 to 2018 were collected and re-analyzed. The exposure levels in the data were expressed as an estimated arithmetic mean and a weighted arithmetic mean (WAM) of the number of samples. Lead exposure characteristics were analyzed by industry, process, and year. Results: From a total of 14 documents, 8,305 airborne lead measurements for 17 industries were identified, and the WAM concentration in eight industries exceeded the occupational exposure limit of 50 ㎍/m3. Three industries (battery manufacturing, lead smelting, and litharge manufacturing) accounted for 95% of the total data, and exposure trends could be confirmed over 10 years. Exposure levels continue to decrease in all three industries. Conclusions: Considering the distribution outlook of lead and lead compounds, the main management targets are lead storage battery manufacturing and secondary smelting for lead regeneration.

Environment-wide association study of elevated liver enzymes: results from the Korean National Environmental Health Survey 2018-2022

  • Youngchan Chi;Jong-Tae Park;Sewhan Na;Kyeongmin Kwak
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.27.1-27.12
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    • 2023
  • Background: Environmental exposure is characterized by low concentration, chronic, and complex exposure. Traditional epidemiological studies show limitations in reflecting these characteristics since they usually focus on a single or very limited number of exposure factors at a time. In this study, we adopted the methodology of environment-wide association study (EWAS) to figure out the association of human liver function with various environmentally hazardous substances. Methods: We analyzed 2,961 participants from the Korean National Environmental Health Survey Cycle 4 (2018-2020). Using generalized linear model (GLM) analysis, we analyzed the association of 72 variables with 3 liver function indices (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and gamma glutamyl transferase [GGT]). Finally, we visualized our results with Manhattan plot. Results: In GLM analysis, perfluorooctanesulfonate were positively associated with ALT (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.39-3.46; padjusted = 0.0147) and perfluorodecanoic acid showed positive association with GGT (OR: 2.73; 95% CI: 1.36-5.5; padjusted = 0.0256). Plasma mercury showed positive association with GGT (OR: 1.45; 95% CI: 1.14-1.84; padjusted = 0.0315). Using a plastic container while keeping food in the refrigerator was associated with elevated GGT compared to using a glass container (OR: 1.51; 95% CI: 1.16-1.95; padjusted = 0.0153). 2-ethyl-5-oxohexyl phthalate, showed a negative trend with all 3 indices, with AST (OR: 0.54; 95% CI: 0.39-0.73; padjusted = 0.00357), ALT (OR: 0.5; 95% CI: 0.34-0.75; padjusted = 0.036), GGT (OR: 0.55; 95% CI: 0.4-0.76; padjusted = 0.00697). Bisphenol S and frequent use of sunblock cream showed negative association with ALT (OR: 0.77; 95% CI: 0.66-0.89), and GGT (OR: 0.25; 95% CI: 0.11-0.55), respectively. Conclusions: We conducted an exploratory study on environmental exposure and human liver function. By using EWAS methodology, we identified 7 factors that could have potential association with liver function.

3D CACT-assisted Radiofrequency Ablation Following Transarterial Chemoembolization for Hepatocellular Carcinoma: Early Experience

  • Jiao, De-Chao;Han, Xin-Wei;Wu, Gang;Ren, Jian-Zhuang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7897-7903
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    • 2015
  • Background: To explored the value of 3D C-arm CT (CACT) guidance system in performing radiofrequency ablation (RFA) following transarterial chemoembolizationon (TACE) for hepatocellular carcinomas. Materials and Methods: RFA of hepatocellular carcinomas (HCC) were performed on 15 patients (21 lesions) with the assistance of CACT guidance system. Technical success, procedure time, complications and patient radiation exposure were investigated. The puncture performance level was evaluated on a five-point scale (5-1: excellent-poor). Complete ablation rate was evaluated after two months follow-up using enhanced CT scans. Results: The technical success rate of RFA procedure under CACT navigation system was 100 %. Mean total procedure time was $24.24{\pm}6.53min$, resulting in a mean effective exposure dose of $15.4{\pm}5.1mSv$. The mean puncture performance level rated for CACT guided RFA procedure was $4.87{\pm}0.35$. Complete ablation (CA) was achieved in 20 (95.2%) of the treated 21 tumors after the first RFA session. None of patients developed intra-procedural complications. Conclusions: 3D CACT guidance system enables reliable and efficient needle positioning by providing real-time intraoperative guidance for performing RFA on HCCs.