Supplementary Material for: Radiation Safety and Electrophysiologists: Radiation Protection Status – Go for Zero Fluoroscopy European Heart Rhythm Association Registry

Background: The purpose of this study was to analyze elec?trophysiologists’ radiation-protective devices for occupa?tional exposure across European countries. Methods: Data reported herein were gathered from the international, mul?ticenter prospective Go for Zero Fluoroscopy registry per?formed in years 2018–2019. The registry encompassed 25 European electrophysiological centers from 14 countries and up to 5 operators from each center. Results: The analysis included 95 operators (median age: 39 years, 85% of male, median training time: 5 years). The most frequently used X-ray protection tools (used by ≥80% of the group) were lead aprons, thyroid shields, screens below the table, glass in the laboratory, and least often (<7%) protective gloves and cab?in. No statistically significant differences regarding the number of procedures performed monthly, electrophysiologists’ experience and gender, and radiation exposure dose or radiation protection tools were observed, except lead thyroid shields and eyeglasses, which were more often used in case of fewer electrophysiological procedures performed (<20 procedures per month). Operators who were protected by >4 X-ray protection tools were exposed to lower radiation levels than those who were protected by ≤4 X-ray protection tools (median radiation exposure: 0.6 [0.2–1.1] vs. 0.2 [0.1– 0.2] mSv per month, p < 0.0001; 1.1 [0.1–12.0] vs. 0.5 [0.1–1.1] mSv per year, p < 0.0001), respectively. Conclusions: Electro?physiologists’ radiation-protective devices for occupational exposure are similar across European centers and in accor?dance with the applicable X-ray protection protocols, irre?spective of the level of experience, number of monthly per?formed EP procedures, and gender.背景：本研究旨在分析欧洲各国范围内，电生理医师（electrophysiologists）职业暴露（occupational exposure）所使用的辐射防护设备。 方法：本研究所用数据来源于2018-2019年开展的国际多中心前瞻性"Go for Zero Fluoroscopy"注册研究。该注册研究纳入了14个国家的25家欧洲电生理中心，每家中心最多招募5名手术操作者（operators）。 结果：本分析共纳入95名手术操作者，年龄中位数为39岁，男性占比85%，从业培训时长中位数为5年。使用率≥80%的高频X射线防护工具（X-ray protection tools）包括铅防护围裙、甲状腺防护盾（thyroid shields）、手术床下方防护屏（screens below the table）、实验室防护玻璃（glass in the laboratory）；使用率最低（<7%）的为防护手套（protective gloves）与放射防护舱（cabin）。未观察到每月手术量、电生理医师从业年限与性别，以及辐射暴露剂量（radiation exposure dose）或X射线防护工具使用情况之间存在统计学显著差异，但甲状腺防护盾与防护眼镜（eyeglasses）例外：当月手术量较少（<20台/月）的操作者更常使用这两类设备。使用≥5种X射线防护工具的操作者，其辐射暴露水平低于使用≤4种的操作者：月均辐射暴露中位数分别为0.6[0.2~1.1]与0.2[0.1~0.2]毫西弗（mSv），p<0.0001；年均辐射暴露中位数分别为1.1[0.1~12.0]与0.5[0.1~1.1]毫西弗，p<0.0001。 结论：欧洲各中心电生理医师用于职业暴露防护的辐射防护设备配置情况基本一致，且均符合现行X射线防护规范（X-ray protection protocols），这一结果不受医师从业年限、每月电生理手术（EP procedures）量以及性别的影响。