Anticipation of radiation dose to the conceptus from occupational exposure of pregnant staff during fluoroscopically guided electrophysiological procedures

Introduction: A female employee working in the electrophysiology suite has the right to know potential radiation hazards to the unborn child before she is pregnant or before she decides to formally declare her pregnancy. Moreover, the employer of a declared pregnant worker must evaluate the work situation and ensure that the conceptus dose is kept below the maximum permissible level during the remaining gestation period. The aim of this study was to develop a method for conceptus dose anticipation and determination of maximum workload allowed for the pregnant employee who participates in fluoroscopically guided electrophysiological procedures. Methods and Results: A C-arm fluoroscopy system, an anthropomorphic phantom, and a radiation meter were used to obtain scattered air kerma dose rates separately for each of the three fluoroscopic projections typically used in the electrophysiology suite. Air kerma to conceptus dose conversion factors for all trimesters of gestation were calculated using Monte Carlo simulation. A formula is presented for the anticipation of the conceptus dose from occupational exposure of pregnant staff during fluoroscopically guided electrophysiological procedures. Normalized data are provided for conceptus dose estimation from occupational exposure of pregnant staff working in any electrophysiology laboratory. A methodology for estimation of maximum workload allowed for each month of the remaining gestation period of a worker who declared her pregnancy is proposed, which ensures that the regulatory dose limits are not exceeded. Conclusion: Data presented may be used for the implementation of a radiation protection program designed for pregnant staff working in an electrophysiological suite.