30 Medical Imaging and Radiotherapy Journal (MIRTJ) 41 (Suppl. 1) Medical Imaging and Radiotherapy Journal (MIRTJ) 41 (Suppl. 1) NOSEČE RADIOLOŠKE INŽENIRKE IN DELO NA RADIOLOŠKIH DIAGNOSTIKAH PREGNANT RADIOGRAPHERS AND WORK IN DIAGNOSTIC RADIOLOGY Nina Gračner, Matic Pinter, Nejc Mekiš, Laura Dolenc Univerza v Ljubljani, Zdravstvena fakulteta, Oddelek za radiologijo, Zdravstvena pot 5, 1000 Ljubljana, Slovenija / University of Ljubljana, Faculty of Health Sciences, Department of Medical Imaging and Radiotherapy, Zdravstvena pot 5, 1000 Ljubljana, Slovenia Korespondenca / Corresponding author: maticpinter7@gmail.com Prejeto/Recived: 24. 1. 2024 Sprejeto/Accepted: 14. 2. 2024 IZVLEČEK Uvod in namen: Radiološke inženirke se v obdobju nosečnosti srečujejo z raznimi rizičnimi dejavniki, ki bi lahko ogrozili potek nosečnosti. To so na primer bolnišnične okužbe, stresni dejavniki, fi zični napor ter ionizirajoča sevanja. To področje ureja Zakon o varstvu pred ionizirajočim sevanjem in jedrski varnosti, ki navaja, da je treba tako kot ostalim prebivalcem pozornost nameniti tudi plodu. Namen tega dela je predstaviti pogoje, pod katerimi delajo noseče radiološke inženirke na diagnostikah, zakonodajo, ki ureja to področje, in protokol po ugotovljeni nosečnosti. Metode: Uporabili smo kvantitativno in kvalitativno metodo dela. Podatke smo zbirali s pomočjo spletnega anketnega vprašalnika, ki smo ga poslali članom ZDRI. Zanimali so nas le odgovori radioloških inženirk. Rezultati: Večinoma so se na anketni vprašalnik odzvale radiološke inženirke, pri čemer je bilo približno 80 % anketirank že nosečih. Ugotovili smo, da je večina nosečih radioloških inženirk imela možnost odločanja o nadaljnjem delu na diagnostiki in skoraj vse so se odločile za delo brez ionizirajočega sevanja (administracija, arhivska dela, magnetna resonanca ipd.). Omenjeno možnost so izbrale iz preventivnih razlogov. O nosečnosti so nadrejene obveščale na različne načine, najpogosteje ustno. Enako kot noseče radiološke inženirke bi v enaki situaciji ravnale tudi radiološke inženirke, ki v času ankete še niso bile noseče. Razprava in zaključek: V literaturi, ki smo jo preučili, so navedena priporočila, da je za nosečo radiološko inženirko najbolje, da nadaljuje delo brez izpostavljanja ionizirajočem sevanju. V skladu s pričakovanji so se oziroma bi se tako odločile tudi inženirke, ki smo jih anketirali. V Sloveniji se ne uporablja dodatnega dozimetra za merjenje doze, ki bi služila kot pomoč pri natančnejši oceni doze na plod. Možnost njegove uporabe je v literaturi omenjal Faulkner. Ugotovili smo tudi, da ni določeno, kako naj bi se sporočila informacija o nosečnosti. Naš predlog za prihodnost je, da bi se nadrejenim uredil sistem sporočanja nosečnosti, ki bi beležil tudi, kdaj je nadrejeni informacijo o nosečnosti prejel. Ključne besede: nosečnost, ionizirajoče sevanje, izpostavljenost ploda, varstvo pred sevanjem, učinki ionizirajočega sevanja ABSTRACT Introduction and purpose: Pregnant radiographers are exposed to many risk factors, that could endanger the course of their pregnancy. The most common are hospital-acquired diseases, stress factors, physical work and ionising radiation. That last area is covered by the law governing radiation and nuclear safety, where it states that the care for an unborn child should be the same as for an adult person. The purpose of this work was to present the conditions that pregnant radiographers work under, the law that governs this area of radiation safety and what is the protocol after the radiographer fi nds out she is pregnant. Methods: We used quantitative and qualitative working methods. The information was gathered with the help of a survey in the form of a online questionnaire. The survey was sent to members of the Professional Association of Radiographers, but we were only interested in the answers of female radiographers. Results: The majority of the answers were provided by female radiographers, 80% of who were previously pregnant at some point in time. We determined that most pregnant radiographers had the chance to make a choice about future work in diagnostics. Most of them made a choice to work at jobs without exposure to ionising radiation (administration, archive, magnetic resonance, etc.. They chose that option out of precaution. They informed their employers about their pregnancy in diff erent ways, but most of them only did it verbally. Female radiographers that were not yet pregnant said that they would make the same choices as their pregnant co-workers. Discussion and conclusion: In the literature we studied, we found some recommendations saying that it is best for a pregnant radiographer to continue work in a working place without exposure to ionising radiation. The majority of the surveyed pregnant radiographers chose that option, which was in line of our expectations. In Slovenia, we do not use an extra dosimeter that could be used for dose measurement to more accurately calculate dose that a foetus is exposed to. This option is mentioned by Faulkner in his work. We also determined that there are not any rules or laws that defi ne how the information should be communicated to their employers. Our proposal for the future is the establishment of a system for informing employers about pregnancy and for receiving information from employer’s side, in terms of documentation regarding the receipt of information, etc. Keywords: pregnancy, ionising radiation, foetus exposure, radiation safety, eff ects of ionising radiation Medical Imaging and Radiotherapy Journal (MIRTJ) 41 (Suppl. 1) 31 Medical Imaging and Radiotherapy Journal (MIRTJ) 41 (Suppl. 1) LITERATURA / REFERENCES Continuing education for radiologic tehnologists (2021). Radiography and pregnancy. https://ce4rt.com/rad-tech-talk/cautions-for-pregnant- radiographers-and-radiation-workers/ Dauer, Lawrence T.; Miller, Donald L.; Schueler, Beth; Silberzweig, James; Balter, Stephen; Bartal, Gabriel; Chambers, Charles; Collins, Jeremy D.; Damilakis, John; Dixon, Robert G.; Victoria Marx, M.; Stecker, Michael S.; Vañó, Eliseo; Venkatesan, Aradhana M.; Nikolic, Boris (2015). Occupational Radiation Protection of Pregnant or Potentially Pregnant Workers in IR: A Joint Guideline of the Society of Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe. Journal of Vascular and Interventional Radiology, 26(2), 171–181. https://pubmed.ncbi.nlm.nih.gov/25645407/ Encyclopædia Britannica, inc. (21. 8. 2023). Pregnancy. Encyclopædia Britannica. https://www.britannica.com/science/pregnancy Faulkner, K. (2002). Fetal Dosimetry In Diagnostic Radiology. https://www.osti.gov/etdeweb/servlets/purl/20815983 Gorenc Jazbec, Š. (8. 4. 2019). Dejavniki tveganja v nosečnosti in pri porodu. https://www.baby-handling.com/dejavniki-tveganja-v- nosecnosti-in-pri-porodu/ IAEA. (27. 7. 2017). Radiation exposure of pregnant woman in radiology. https://www.iaea.org/resources/rpop/health-professionals/ radiology/pregnant-women#9 IARC. (2016). Evropski kodeks proti raku. 12 nasvetov za zmanjšanje ogroženosti z rakom. Kaj je ˝sevanje˝? Katere vrste sevanja obstajajo? https://cancer-code-europe.iarc.fr/index.php/sl/12- nasvetov/sevanje/4103-kaj-je-sevanje-kaksne-vrste- sevanja-obstajajo North Carolina State University. (1993). Pregnant Employee`s Guide to Radiation http://www.ncsu.edu/ehs/radiation/forms/Pregnant Handout.pdf Nadamuni, S.; Fulghum, Bruce, D. (2022). Castle Connolly: Top doctors. What is Diagnostic Radiology? https://www.castleconnolly.com/topics/diagnostic- radiology/what-is-diagnostic-radiology Portal GOV.SI. (n. d.). Varstvo pred sevanji. https://www.gov.si/podrocja/zdravje/varstvo-pred- sevanji/ Prashar, S. (2020). Occupational Radiation Exposure during Pregnancy: A personal Experience. Journal of Postgraduate Medicine, Education and Resarch 54(1), 5–7. https://doi.org/10.5005/jp-journals-10028-1347 Serša, G.; Čemažar, M.; Strojan, P.; Cesar, B.; Dežman, R.; Zdešar, U.; Škrk, D.; Gajšek, P.; Zodnik, V.; Tomšič, S.; Benedičič, A.; Perić, B.; Bešič, N.; Štrbac, D.; Zadravec, Zaletel, L. (12. 11. 2019). Sevanje in rak. Biološki učinki sevanj. Zveza slovenskih društev za boj proti raku. 21–23. https://www.protiraku.si/Portals/0/Publikacije/Stroko/ Zbornik%20Reja%202019.pdf#page=15 Sunley, K. (2007). Health and Safety and Pregnancy. Guidance to Health and Safety Representatives and Members. Society of Radiographers, 10. United States Enviromental Protection Agency. Radiation Protection. https://www.epa.gov/radiation University of Pittsburgh. (29. 10. 2020). Pregnant worker policy. https://www.radsafe.pitt.edu/dosimetry/pregnant- worker-policy Zakon o varstvu pred ionizirajočimi sevanji in jedrski varnosti (ZVISJV). (2017). Uradni list RS, št. 76/17, 26/19, 172/21 in 18/23. http://www.pisrs.si/Pis.web/pregledPredpisa?id= ZAKO7385