Radiation exposure to patients during interventional procedures in 20 countries: initial IAEA project results

AJR Am J Roentgenol. 2009 Aug;193(2):559-69. doi: 10.2214/AJR.08.2115.


Objective: The purpose of our study was to investigate the level of radiation protection of patients and staff during interventional procedures in 20 countries of Africa, Asia, and Europe.

Subjects and methods: In a multinational prospective study, information on radiation protection tools, peak skin dose (PSD), and kerma-area product (KAP) was provided by 55 hospitals in 20 mainly developing countries (nine mostly in Eastern Europe, five in Africa, and six in Asia).

Results: Nearly 40% of the interventional rooms had an annual workload of more than 2,000 patients. It is remarkable that the workload of pediatric interventional procedures can reach the levels of adult procedures even in developing countries. About 30% of participating countries have shown a 100% increase in workload in 3 years. Lead aprons are used in all participating rooms. Even though KAP was available in almost half of the facilities, none had experience in its use. One hundred of 505 patients monitored for PSD (20%) were above the 2-Gy threshold for deterministic effects.

Conclusion: Interventional procedures are increasing in developing countries, not only for adults but also for pediatric patients. The situation with respect to staff protection is considered generally acceptable, but this is not the case for patient protection. Many patients exceeded the dose threshold for erythema. A substantial number (62%) of percutaneous transluminal coronary angioplasty procedures performed in developing countries in this study are above the currently known dose reference level and thus could be optimized. Therefore, this study has significance in introducing the concept of patient dose estimation and dose management.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Africa
  • Air Pollutants, Radioactive / analysis
  • Asia
  • Calibration
  • Child
  • Environmental Exposure / statistics & numerical data*
  • Europe
  • Female
  • Humans
  • Male
  • Occupational Exposure / analysis
  • Occupational Exposure / statistics & numerical data
  • Pilot Projects
  • Prospective Studies
  • Radiation Dosage*
  • Radiation Monitoring / methods
  • Radiation Monitoring / statistics & numerical data*
  • Radiation Protection / methods
  • Radiation Protection / statistics & numerical data*
  • Radiography, Interventional / statistics & numerical data*
  • Scattering, Radiation
  • Workload / statistics & numerical data


  • Air Pollutants, Radioactive