Exposed medical staff: challenges, available tools, and opportunities for improvement.

Medical staff doses have increased over the past decade, as there is an increasing need for the benefits and use of radiation in medicine. While current average medical staff doses are well within limits, some doses to individuals could exceed 20 mSv y deep dose equivalent or lens dose equivalent (if unprotected), and there is the potential for some workers to exceed 500 mSv y shallow dose equivalent without careful assessment and protection. Nuclear medicine radiochemistry and patient dose preparation present challenging opportunities for improved dose control. In addition, fluoroscopically guided intervention procedures continue to represent an important area for careful protection implementation. Optimization of radiation protection in the medical setting should include tried and true principles of justification, optimization, and limitation with emphasis on training, credentialing, planning, and quality management. As newer and developing uses of radiation in medicine are tested and implemented, it is important to consider effective dosimetric monitoring, lens of eye doses, extremity doses, novel uses, and novel radionuclide characteristics. An ongoing assessment of current and future patterns of use for radiation in medicine is an essential activity to assist in prioritizing limited resources for staff protection. Introduction of Exposed Medical Staff (Video 1:27, http://links.lww.com/HP/A20).