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  1. Article ; Online: NCRP commentary no. 33-recommendations for stratification of equipment use and radiation safety training for fluoroscopy.

    Miller, Donald L / Balter, Stephen

    Journal of radiological protection : official journal of the Society for Radiological Protection

    2024  Volume 44, Issue 2

    Abstract: National Council on Radiation Protection and Measurements Commentary No. 33 'Recommendations for Stratification of Equipment Use and Radiation Safety Training for Fluoroscopy' defines an evidence-based, radiation risk classification for fluoroscopically ... ...

    Abstract National Council on Radiation Protection and Measurements Commentary No. 33 'Recommendations for Stratification of Equipment Use and Radiation Safety Training for Fluoroscopy' defines an evidence-based, radiation risk classification for fluoroscopically guided procedures (FGPs), provides radiation-related recommendations for the types of fluoroscopes suitable for each class of procedure, and indicates the extent and content of training that ought to be provided to different categories of facility staff who might enter a room where fluoroscopy is or may be performed. For FGP, radiation risk is defined by the type and likelihood of radiation hazards that could be incurred by a patient undergoing a FGP. The Commentary also defines six training groups of facility staff based on their role in the fluoroscopy room. The training groups are based on a combination of job descriptions and the procedures in which these individuals might be involved. The Commentary recommends the extent and content of training that should be provided to each of these training groups. It also provides recommendations on training formats, training frequency, and methods for demonstrating that the learner has acquired the necessary knowledge.
    MeSH term(s) Fluoroscopy ; Radiation Protection ; Humans ; Occupational Exposure/prevention & control ; Radiation Injuries/prevention & control
    Language English
    Publishing date 2024-05-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 639411-5
    ISSN 1361-6498 ; 0952-4746
    ISSN (online) 1361-6498
    ISSN 0952-4746
    DOI 10.1088/1361-6498/ad4042
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  2. Article ; Online: Illegal handheld dental radiography units: Caveat emptor!

    Miller, Donald L / Lurie, Alan G

    Journal of the American Dental Association (1939)

    2023  

    Language English
    Publishing date 2023-09-26
    Publishing country England
    Document type Editorial
    ZDB-ID 220622-5
    ISSN 1943-4723 ; 0002-8177 ; 1048-6364
    ISSN (online) 1943-4723
    ISSN 0002-8177 ; 1048-6364
    DOI 10.1016/j.adaj.2023.08.010
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  3. Article ; Online: Review of air kerma-area product, effective dose and dose conversion coefficients for non-cardiac interventional fluoroscopy procedures.

    Miller, Donald L

    Medical physics

    2020  Volume 47, Issue 3, Page(s) 975–982

    Abstract: Purpose: To provide current data on average air kerma-area product (P: Methods: A PubMed literature search covering the time period from 2006 to August 2019 was performed to obtain recent data on P: Results: There is very wide variation in the ... ...

    Abstract Purpose: To provide current data on average air kerma-area product (P
    Methods: A PubMed literature search covering the time period from 2006 to August 2019 was performed to obtain recent data on P
    Results: There is very wide variation in the reported values of P
    Conclusions: The values of P
    MeSH term(s) Air ; Fluoroscopy/methods ; Humans ; Radiation Dosage ; Radiography, Interventional/methods ; Uncertainty
    Language English
    Publishing date 2020-01-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 188780-4
    ISSN 2473-4209 ; 0094-2405
    ISSN (online) 2473-4209
    ISSN 0094-2405
    DOI 10.1002/mp.13990
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  4. Article ; Online: Erratum: "Review of kerma-area product, effective dose and dose conversion coefficients for non-cardiac interventional fluoroscopy procedures" [Med. Phys. 47, 975-982 (2020).

    Miller, Donald L

    Medical physics

    2020  Volume 47, Issue 11, Page(s) 5966–5967

    Language English
    Publishing date 2020-10-11
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 188780-4
    ISSN 2473-4209 ; 0094-2405
    ISSN (online) 2473-4209
    ISSN 0094-2405
    DOI 10.1002/mp.14458
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  5. Article ; Online: Make Radiation Protection a Habit.

    Miller, Donald L

    Techniques in vascular and interventional radiology

    2017  Volume 21, Issue 1, Page(s) 37–42

    Abstract: This review describes the basic concepts and methods for optimization of occupational dose in the interventional suite. In fluoroscopy, the source of virtually all radiation exposure to the operator is scattered radiation from the patient. All other ... ...

    Abstract This review describes the basic concepts and methods for optimization of occupational dose in the interventional suite. In fluoroscopy, the source of virtually all radiation exposure to the operator is scattered radiation from the patient. All other things being equal, reducing patient radiation dose will reduce operator and staff dose. Most tools and methods of occupational radiation protection are entirely operator dependent. These methods must be used routinely and properly to be effective. Your occupational dose depends on how well you follow good radiation protection practices and on the kinds of procedures you do. The only way to know your own occupational dose is to wear your dosimeters for every case. If proper protection practices are followed and appropriate protection tools are used, annual effective dose for an interventionalist should be well below 10mSv/y, and will more likely be in the range of 2-4mSv/y. However, if proper protection practices and tools are not used, annual effective doses may be much higher. You should review your own doses periodically.
    MeSH term(s) Attitude of Health Personnel ; Habits ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Humans ; Job Description ; Occupational Exposure/adverse effects ; Occupational Exposure/prevention & control ; Occupational Health ; Occupational Injuries/etiology ; Occupational Injuries/prevention & control ; Protective Factors ; Radiation Dosage ; Radiation Exposure/adverse effects ; Radiation Exposure/prevention & control ; Radiation Injuries/etiology ; Radiation Injuries/prevention & control ; Radiation Protection/methods ; Radiology, Interventional/manpower ; Risk Factors
    Language English
    Publishing date 2017-12-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2170922-1
    ISSN 1557-9808 ; 1089-2516
    ISSN (online) 1557-9808
    ISSN 1089-2516
    DOI 10.1053/j.tvir.2017.12.008
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  6. Article ; Online: NCRP Program Area Committee 4: Radiation Protection in Medicine.

    Brink, James A / Miller, Donald L

    Health physics

    2018  Volume 114, Issue 2, Page(s) 251–253

    Abstract: Program Area Committee 4 (PAC 4) addresses radiation protection issues in health care environments. Reports from two scientific committees (SC 4-5 and SC 4-7) are soon to be released and have entered council review, respectively. A report from SC 4-8 ... ...

    Abstract Program Area Committee 4 (PAC 4) addresses radiation protection issues in health care environments. Reports from two scientific committees (SC 4-5 and SC 4-7) are soon to be released and have entered council review, respectively. A report from SC 4-8 will be submitted for PAC 4 review in July 2017. Five additional proposals for potential PAC 4 publications are under consideration.
    MeSH term(s) Humans ; Medicine ; Occupational Diseases/prevention & control ; Practice Guidelines as Topic/standards ; Radiation Monitoring/standards ; Radiation Protection/standards ; Risk Factors ; Safety Management ; Societies, Scientific/organization & administration
    Language English
    Publishing date 2018-08-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2406-5
    ISSN 1538-5159 ; 0017-9078
    ISSN (online) 1538-5159
    ISSN 0017-9078
    DOI 10.1097/HP.0000000000000745
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    Zs.A 128: Show issues Location:
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    Zs.MO 253: Show issues

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  7. Article ; Online: High-Dose Fluoroscopically Guided Procedures in Patients: Radiation Management Recommendations for Interventionalists.

    Rehani, Madan M / Miller, Donald L / Baliyan, Vinit

    Cardiovascular and interventional radiology

    2020  

    Abstract: The article is part of the series of articles on radiation protection. You can find further articles in the special section of the CVIR issue. In addition to the risks from fluoroscopic-guided interventional procedures of tissue injuries, recent studies ... ...

    Abstract The article is part of the series of articles on radiation protection. You can find further articles in the special section of the CVIR issue. In addition to the risks from fluoroscopic-guided interventional procedures of tissue injuries, recent studies have drawn attention to the risk of stochastic effects. Guidelines exist for preprocedural planning and radiation management during the procedure. The concept of a substantial radiation dose level (SRDL) is helpful for patient follow-up for tissue injury. The uncommon nature of tissue injuries requires the interventionalist to be responsible for follow-up of patients who receive substantial radiation doses. Dose management systems for recognizing and avoiding higher patient exposures have been introduced. The European Directive provides a legal framework and requirements for equipment, training, dose monitoring, recording and optimization that are helpful in radiation risk management.
    Language English
    Publishing date 2020-11-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 603082-8
    ISSN 1432-086X ; 0342-7196 ; 0174-1551
    ISSN (online) 1432-086X
    ISSN 0342-7196 ; 0174-1551
    DOI 10.1007/s00270-020-02703-2
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  8. Article ; Online: Efforts to optimize radiation protection in interventional fluoroscopy.

    Miller, Donald L

    Health physics

    2013  Volume 105, Issue 5, Page(s) 435–444

    Abstract: While it has been known for more than a century that radiation presents risks to both the physician and the patient, skin injuries from fluoroscopy became increasingly rare after the 1930s, and radiation risk from fluoroscopy appeared to be adequately ... ...

    Abstract While it has been known for more than a century that radiation presents risks to both the physician and the patient, skin injuries from fluoroscopy became increasingly rare after the 1930s, and radiation risk from fluoroscopy appeared to be adequately controlled. However, beginning in approximately 1975, new technologies and materials for interventional devices were developed. These enabled new procedures, and as these were instituted, skin injuries again occurred in patients. Four central issues were identified: equipment, quality management, operator training, and occupational radiation protection. Recognition that these were areas for improvement provoked changes in technology and practice that continue today.
    MeSH term(s) Fluoroscopy/adverse effects ; Fluoroscopy/instrumentation ; Fluoroscopy/methods ; Humans ; Radiation Dosage ; Radiation Protection/methods ; Stochastic Processes
    Language English
    Publishing date 2013-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2406-5
    ISSN 1538-5159 ; 0017-9078
    ISSN (online) 1538-5159
    ISSN 0017-9078
    DOI 10.1097/HP.0b013e31829c355a
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  9. Article ; Online: Reply to "Occupational Radiation Exposure in Interventional Radiology and the Risks of Acquiring a Brain Tumor".

    Kitahara, Cari M / Miller, Donald L

    AJR. American journal of roentgenology

    2017  Volume 209, Issue 6, Page(s) W403

    MeSH term(s) Brain Neoplasms ; Humans ; Occupational Exposure ; Radiation Dosage ; Radiation Exposure ; Radiation Injuries ; Radiation Protection ; Radiography, Interventional ; Radiology, Interventional
    Language English
    Publishing date 2017
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 82076-3
    ISSN 1546-3141 ; 0361-803X ; 0092-5381
    ISSN (online) 1546-3141
    ISSN 0361-803X ; 0092-5381
    DOI 10.2214/AJR.17.18768
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  10. Article ; Online: Occupational radiation dose trends in U.S. radiologic technologists assisting with fluoroscopically-guided interventional procedures, 1980-2020.

    Milder, Cato M / Borrego, David / Preston, Dale L / Villoing, Daphnée / Kwon, Tae-Eun / Miller, Donald L / Alexander, Bruce H / Linet, Martha S / Lee, Choonsik / Kitahara, Cari M

    Journal of vascular and interventional radiology : JVIR

    2024  

    Abstract: Purpose: To summarize dose trends from 1980-2020 for 19,651 U.S. radiologic technologists who reported assisting with fluoroscopically-guided interventional procedures (FGIP), overall and by work history characteristics.: Methods: We summarized 762, ... ...

    Abstract Purpose: To summarize dose trends from 1980-2020 for 19,651 U.S. radiologic technologists who reported assisting with fluoroscopically-guided interventional procedures (FGIP), overall and by work history characteristics.
    Methods: We summarized 762,310 annual personal dose equivalents at a 10 mm-reference depth ("doses") during 1980-2020 for 43,823 participants of the U.S. Radiologic Technologists (USRT) cohort who responded to work history questionnaires administered during 2012-2014. This population included 19,651 technologists who reported assisting with FGIP (≥1 time per month for ≥12 consecutive months) at any time during the study period. We estimated doses corresponding to assistance with FGIP by proximity to patients, monthly procedure frequency, and procedure type. We used box plots and summary statistics (e.g., median, percentiles) to describe annual doses and dose trends.
    Results: Median annual dose corresponding to assistance with FGIP was 0.65 mSv, [interquartile range (IQR)=0.60-1.40; 95
    Conclusion: Occupational doses corresponding to assistance with FGIP were generally low but varied with exposure frequency, procedure type, and proximity to patients. These results highlight the need for vigilant dose monitoring, radiation safety training, and proper protective equipment.
    Language English
    Publishing date 2024-04-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1137756-2
    ISSN 1535-7732 ; 1051-0443
    ISSN (online) 1535-7732
    ISSN 1051-0443
    DOI 10.1016/j.jvir.2024.03.032
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