Journal of medical imaging and radiation sciences · 2026
Prevalence of the use of protective equipment for ionizing radiation from fluoroscopy: A systematic literature review and meta-analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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Videira Sara, Rodrigues Matilde A, Santos Joana, Guedes Joana, Martins João, V da Silva Manuela
Аннотация
INTRODUCTION: Exposure to ionizing radiation can adversely affect workers' health and well-being. Minimally invasive surgery has become popular across various medical specialties due to its benefits, technological advances, and greater access to equipment, leading to a significant increase in fluoroscopy use. The growing scientific and clinical evidence has highlighted the risks associated with chronic fluoroscopy exposure. The purpose of this study is to evaluate the prevalence of protective equipment use among workers exposed to ionizing radiation from fluoroscopy during surgical and interventional procedures and identify the factors influencing its use.
METHODS: Studies were identified through searches of 5 databases on March 25, 2024: PubMed, Academic Search Complete, Scopus, Web of Science Core Collection, and ScienceDirect. Additional studies were identified through snowballing. The review followed PRISMA guidelines and the CoCoPop strategic model. A narrative synthesis, bibliometric analysis, and meta-analysis were conducted. The quality of the studies was assessed using the Joanna Briggs Institute checklist for prevalence studies.
RESULTS: A total of 64 studies (15,014 participants) were included. Most participants were physicians (94%), and orthopedics/traumatology was the most represented specialty (45%). The prevalence of consistent ("always") use of personal protective equipment was 87% (95% CI:78-94; n = 6,383) for lead aprons, 46% (95% CI: 26-66, n = 5,236) for thyroid shields, and 17% (95% CI:8-29; n = 3,704) for lead goggles. Subgroup analysis showed higher apron use in countries with a very high Human Development Index, with a significant association (p = 0.03), and lower use of thyroid shields and protective goggles (p < 0.01). The risk of bias was moderate, with minimal evidence of publication bias.
DISCUSSION: Use of protective equipment remains inconsistent, particularly for thyroid shields and lead goggles. Differences across Human Development Index levels suggest that both resource availability and behavioral factors may influence compliance.
CONCLUSION: Inconsistent use of protective equipment may increase occupational radiation exposure. Strengthening training, improving equipment design, and promoting a safety culture are essential to enhance compliance.
PLAIN LANGUAGE SUMMARY: Some medical workers are exposed to radiation during imaging procedures, which can affect their health over time. This study reviewed many research papers to examine how often protective equipment, such as lead aprons, neck shields, and eye protection, is used and what affects their use. This study found that while most workers regularly used lead aprons, far fewer consistently used thyroid shields and lead goggles, with differences linked to resources and workplace factors. This matters because better use of protection can reduce harmful exposure and improve safety for people working in these clinical settings.
METHODS: Studies were identified through searches of 5 databases on March 25, 2024: PubMed, Academic Search Complete, Scopus, Web of Science Core Collection, and ScienceDirect. Additional studies were identified through snowballing. The review followed PRISMA guidelines and the CoCoPop strategic model. A narrative synthesis, bibliometric analysis, and meta-analysis were conducted. The quality of the studies was assessed using the Joanna Briggs Institute checklist for prevalence studies.
RESULTS: A total of 64 studies (15,014 participants) were included. Most participants were physicians (94%), and orthopedics/traumatology was the most represented specialty (45%). The prevalence of consistent ("always") use of personal protective equipment was 87% (95% CI:78-94; n = 6,383) for lead aprons, 46% (95% CI: 26-66, n = 5,236) for thyroid shields, and 17% (95% CI:8-29; n = 3,704) for lead goggles. Subgroup analysis showed higher apron use in countries with a very high Human Development Index, with a significant association (p = 0.03), and lower use of thyroid shields and protective goggles (p < 0.01). The risk of bias was moderate, with minimal evidence of publication bias.
DISCUSSION: Use of protective equipment remains inconsistent, particularly for thyroid shields and lead goggles. Differences across Human Development Index levels suggest that both resource availability and behavioral factors may influence compliance.
CONCLUSION: Inconsistent use of protective equipment may increase occupational radiation exposure. Strengthening training, improving equipment design, and promoting a safety culture are essential to enhance compliance.
PLAIN LANGUAGE SUMMARY: Some medical workers are exposed to radiation during imaging procedures, which can affect their health over time. This study reviewed many research papers to examine how often protective equipment, such as lead aprons, neck shields, and eye protection, is used and what affects their use. This study found that while most workers regularly used lead aprons, far fewer consistently used thyroid shields and lead goggles, with differences linked to resources and workplace factors. This matters because better use of protection can reduce harmful exposure and improve safety for people working in these clinical settings.