Routine Use of Syringe Shields Reduces Risk of Exposure

“Syringe shields should be used for injecting high specific activity99mTc,” according to Use of Syringe Shields in Clinical Practice, a study published in the Journal of Clinical Nuclear Medicine.

As nuclear medicine professionals, we are well aware that the practice of nuclear medicine involves handling radioactive materials that can give rise to external and internal exposure to ionizing radiation. The level of exposure depends on the radionuclide, its activity, and the type of work within a department in which the person is involved. Traditionally, the most common forms of ionizing radiation are X-rays and gamma rays; however, over the course of the last decade, newer imaging modality that involves use of positron-emitting radionuclides for PET scanning have led to further increased exposure of nuclear medicine professionals.

To help minimize the amount of radiation to which they are exposed, and subsequently reduce the risk of stochastic and deterministic effects (e.g. cancer) of ionizing radiation, all physicians and technologists performing nuclear medicine procedures are trained to comply with the concept of ALARA (As Low As Reasonably Achievable). However, based on LNT (Linear-No-Threshold hypothesis), it is still generally assumed that even very small doses of ionizing radiation can be potentially harmful and persons must be protected from ionizing radiation at all dose levels.

Minimizing Occupational Exposure

Let me be clear in stating my firm belief that the benefits of nuclear testing are many. Time and again, nuclear medicine procedures have proven to be advantageous in the diagnosis of disease and injury. Diagnostic radiopharmaceuticals provide important information about the health of patients to their physicians and help ensure that they receive appropriate care. And the opportunity for even more accurate testing and expanded therapeutic options within the realm of nuclear medicine continues to grow.

However, as our field advances, we can not lose sight of the importance of also advancing ways to protect ourselves further from the risks of radiation exposure. Continuous efforts to improve utilization of the three main methods for minimizing radiation exposure are intrinsic to the concept of ALARA: Distance, Time, and Shielding. 

Source: The Essential Physics of Medical Imaging, by Jerrold T. Bushberg, J. Anthony Seibert, Edwin M. Leidholdt Jr, and John M. Boone, 3rd edition published by Wolters Kluwer

As the above chart reflects, the effect of distance on exposure rates can be profound. Based on those findings, the use of longer forceps or tongs have been recommended as a means to reduce the radiation exposure by increas­ing the distance between the source and the hands.  

However, while maximizing distance from the source and minimizing the time spent handling radiopharmaceuticals are best safety practices, realistically there will always be practical limitations on how far we can be from the source of radiation or, using time, how fast one can handle drawing or injecting a radiopharmaceutical.  As a result, numerous studies have focused on the benefits of shielding as an effective means to reduce radiation exposure. Those studies provide strong validation that the use of syringe shields helps reduce dose rates significantly. 

Subsequently, there have been improvements in the design of syringe shields, as well as the material used to even further protect nuclear medicine technicians and physicians when handling radioactive material. Tungsten has replaced lead in most new designs, providing thinner and lighter syringe shields which offer a higher level of protection than lead. In addition, incorporation of lead glass windows has improved visibility as well as viewing the syringe’s markings during injection. Tungsten syringe shields with no lead glass window are also available. These are indestructible, due to their solid tungsten construction, but still accommodate visual inspection for venous insertion since their design permits full exposure of needle hub prior to injection.

Jubilant Radiopharma Radiopharmacies Division is proud to serve as your department safety advocate. Our nuclear pharmacists can always provide consultation on what shields work the best against what kind of radiation. Just the other day, a customer phoned us at our Los Angeles pharmacy to order a replacement syringe shield. After asking a few questions, we were able to order parts instead of fully replacing the syringe shield, saving the customer and their department from unnecessary expenses. Further, Jubilant Radiopharma Radiopharmacies Division has developed solid relationships with a variety of vendors, which allow us to extend savings on a wide variety of ancillary supplies, whether that is new or replacement shielding equipment or other equipment essential to the safe and effective practice of nuclear medicine.

— Jubilant Radiopharma Radiopharmacies Division takes radiation safety very seriously. Two CE programs are available via the Institute of Learning. Go to our Online Learning Center to access the SNMMI-TS VOICE accredited course, “Basic Radiation Safety”. A non-accredited, introductory “Basic Radiation Safety Course” is also available for individuals working in and around nuclear medicine facilities.