Occupational study and zoning in an operational theatre: six-step practical methodology

The implementation of radiation protection in operating theatres is long and complex. Occupational studies and zoning are difficult. A methodology has been set up at the University Hospital of Nimes since 2012. This methodology, consisting of 6 steps, overcomes the difficulties. Observation of practices (step 1) allows familiarization with constraints and activity, integration of surgical teams, identification of the most penalizing procedures and establishment of a dosimetric database. Preparation (step 2) consists of grouping procedures by type of intervention and selecting the equipment needed for simulations. Simulations (step 3) allow us to obtain different exposures for different workstations. Extrapolation (step 4) is made to overcome the lack of information and the complexity of the activity. Zoning and occupational studies (step 5) are then conducted. Monitoring over time (step 6) and improving the dosimetric database enable us to follow the evolution of practices and achieve optimization in collaboration with the medical physicist. This methodology is applicable to all areas where fluoroscopically-guided medical procedures are performed by adapting to suit their structure and organization. (authors)