Influence of radiation personal protection equipment design on surgeon stress-A randomised repeated-measures crossover study.

Abstract

Radiation Personal Protective Equipment (RPPE) is the subject of safety guidance from the British Orthopaedic Association (BOA). This pilot study aimed to examine potential performance differences in Trauma and Orthopaedic (T&O) Higher Surgical Trainees (HST) undertaking simulated Dynamic Hip Screw (DHS) surgery related to different RPPE attire. Fourteen Higher Surgical Trainees took part in a randomised, repeated-measures, crossover study (8 male, 6 female HSTs) performing two simulated DHS procedures wearing two RPPE attire styles (One Piece (OP) tabard 0.35 mm thickness, and Two-Piece skirt/top (TP), with a 0.5 mm thyroid guard). Primary outcome measures included continuous Heart Rate (HR) monitoring, body temperature, and Visual Analogue Scales (VAS) for comfort and fatigue before and after simulations. Mean (SD) HR in OP and TP were HR OP 98.8 bpm (10.3) vs. TP 98.1 bpm (10.8, p < 0.001), Maximum HR OP 115.1 bpm (SD 12.4) vs. TP 113.4 bpm (SD 11.9) (p < 0.001). Mean change in temperature were OP 0°C and TP -0.03 °C (p < 0.001). Mean temperature VAS scores in OP were 1.9 (1.7) vs. TP 2.0 (1.4, p < 0.001). Mean Comfort VAS scores were OP 3.1 (2.4) vs. TP 1.7 (2.1, p < 0.001) and Fatigue OP 1.4 (1.9) vs. TP 0.8 (1.5, p = 0.120). Important differences in surgeon physiological measures (HR, temperature) and self-reported measures of comfort and temperature were found related to RPPE style. Understanding the effects that specific RPPE attire has on performance should influence RPPE choice and the findings help inform future research into this important topic.