Radiation Exposure for Anesthesia Providers
Anesthesia providers may face radiation exposure in their daily work, particularly during procedures that employ imaging technologies such as fluoroscopy. While most attention tends to focus on radiologists and interventional cardiologists, anesthesiologists and nurse anesthetists often stand close to radiation sources, sometimes without full awareness of the risk.
Anesthesia providers experience radiation exposure from both operating rooms and non-operative settings like interventional radiology or catheterization labs. The main source of exposure is scattered radiation from the patient and not the primary beam—increasing physical distance from the patient is critical to reducing exposure. Dosimeter monitoring has revealed that residents’ maximum deep dose equivalent over a three-month period was around 0.50 mSv, and eye exposure was about 0.52 mSv, both well below recommended occupational limits 1.
In interventional cardiology settings, exposure levels remain low. Analyses of the annual mean effective dose from 2019 to 2023 found values ranging from approximately 0.92 mSv in 2020 down to about 0.65 mSv in 2023. These levels are significantly below the 20 mSv annual occupational limit, though some individual readings did exceed the 1 mSv public exposure threshold 2.
Additional research carried out across three Mid-Atlantic hospitals assessed anesthesia providers’ compliance with radiation safety measures in operating rooms. Data from initial observations demonstrated that almost 83% of providers followed appropriate safety precautions such as wearing lead aprons, thyroid shields, or standing more than one meter from radiation sources. Following a brief educational intervention, compliance increased to nearly 96%. This suggests that education and awareness significantly influence safety behaviors 3. In addition, clinical research continues to reinforce the “time, distance, and shielding” principle as foundational for radiation protection, urging heightened awareness among anesthesia providers 4.
Anesthesia providers have a certain degree of control over two key factors in their levels of radiation exposure: distance and shielding. While time spent near radiation sources is often dictated by patient care, adhering to proper distance (ideally more than one meter) and utilizing protective equipment (lead aprons, thyroid collars, eye protection) can substantially reduce risk.
Routine use of dosimeters is also advised, though observational data indicate that usage remains low among providers. Working closely with procedural teams, such as by ensuring imaging is paused until protective gear is donned, can further minimize unnecessary exposure.
In general, education initiatives have already demonstrated an impact in boosting compliance, and broader adoption of safety protocols and consistent monitoring will continue to safeguard anesthesia professionals in radiation-prone environments 5–7.
Radiation exposure among anesthesia providers is generally low, often well within regulatory limits. However, the cumulative effect of repeated exposure, particularly during frequent imaging-guided procedures, warrants continued vigilance. Scattered radiation remains the principal risk, but adherence to basic safety principles (like limiting time near the source, maximizing distance, and employing shielding) can effectively minimize potential harm.
References
1. Wang, R. R., Kumar, A. H., Tanaka, P. & Macario, A. Occupational Radiation Exposure of Anesthesia Providers: A Summary of Key Learning Points and Resident-Led Radiation Safety Projects. Semin Cardiothorac Vasc Anesth 21, 165–171 (2017). DOI: 10.1177/1089253217692110
2. Shbeer, A. Assessment of the Occupational Radiation Exposure of Anesthesia Staff in Interventional Cardiology. Risk Manag Healthc Policy 17, 1093–1100 (2024). DOI: 10.2147/RMHP.S460054
3. Spinella, J. et al. Radiation Safety Practices Among Anesthesia Providers: A Multi-Site Observational Pilot Study. Journal of Radiology Nursing 43, 230–234 (2024). DOI: 10.1016/j.jradnu.2024.08.003
4. Kim, J. H. Three principles for radiation safety: time, distance, and shielding. Korean J Pain 31, 145–146 (2018). DOI: 10.3344/kjp.2018.31.3.145
5. Kim, T. H., Hong, S. W., Woo, N. S., Kim, H. K. & Kim, J. H. The radiation safety education and the pain physicians’ efforts to reduce radiation exposure. Korean J Pain 30, 104–115 (2017). DOI: 10.3344/kjp.2017.30.2.104
6. Ali, M. A., Salim, B., Siddiqui, K. M. & Khan, M. F. Attitudes and knowledge of anesthesiology trainees to radiation exposure in a Tertiary care hospital. Saudi J Anaesth 14, 459–463 (2020). DOI: 10.4103/sja.SJA_659_19
7. Lalabekyan, B., Rennie, A. & Luoma, V. Principles of radiation safety for anaesthetists. BJA Education 25, 181–190 (2025). DOI: 10.1016/j.bjae.2025.01.005