Interventional pain physicians are at risk for both types of radiation exposure injury (stochastic and deterministic effects) because of the chronic, low-dose radiation exposure over a lifetime. Individuals ideally should not receive more than 10% of the EDE limits annually. An occupational worker’s lifetime effective dose should be limited to their age in years times 1 rem.
In a survey of pain interventionalists, only 39% were educated on radiation safety, 8% knew the annual maximum permissible radiation doses, 39% used a dosimeter, 38% wore lead goggles and 18% wore lead gloves.
The primary source of ionizing radiation exposure during interventional pain procedures comes from scatter radiation that is reflected by the patient, which is difficult to avoid given the close proximity that the physician must maintain with the patient. Cumulative dose becomes of more concern if pain physicians routinely perform high volumes of interventional procedures with higher fluoroscopy times such as spinal cord stimulator and vertebral augmentation.