Occupational exposure in MR facilities due to movements in the static magnetic field

Semi-quantitative methodology to assess health and safety risks arising from exposure to electromagnetic fields up to 300 GHz at workplaces according to Italian regulations

This paper is focused a semi-quantitative methodology to assess and manage the health and safety risks arising from exposure to electromagnetic fields (EMF) up to 300 GHz at workplaces as well as to identify the priorities of intervention, based on the requirements of European directive 2013/35/EU and Italian regulations. The study includes a synthetic overview on the effects arising from EMF exposure and the related regulatory framework on protection. Furthermore, an in-depth analysis is carried-out on the risk assessment process as well as on the technical and organisational measures for risk mitigation and their adaptation to the specific requirements of workers at particular risk, based on technical standards and best practice guides issued by international and national (Italian) standardisation bodies.

Electromagnetic Exposure of Personnel Involved in Cardiac MRI Examinations in 1.5T, 3T and 7T Scanners

(1) Background: It has been hypothesised that a significant increase in the use of cardiac magnetic resonance (CMR), for example, when examining COVID-19 convalescents using magnetic resonance imaging (MRI), has an influence the exposure profiles of medical personnel to static magnetic fields (STmf). (2) Methods: Static exposure to STmf (SEmf) was recorded during activities that modelled performing CMR by radiographers. The motion-induced time variability of that exposure (TVEmf) was calculated from SEmf samples. The results were compared with: (i) labour law requirements; (ii) the distribution of vertigo perception probability near MRI magnets; and (iii) the exposure profile when actually performing a head MRI. (3) Results: The exposure profiles of personnel managing 42 CMR scans (modelled using medium (1.5T), high (3T) and ultrahigh (7T) field scanners) were significantly different than when managing a head MRI. The majority of SEmf and TVEmf samples (up to the 95th percentile) were at low vertigo perception probability (SEmf < 500 mT, TVEmf < 600 mT/s), but a small fraction were at medium/high levels; (4) Conclusion: Even under the “normal working conditions” defined for SEmf (STmf < 2T) by labour legislation (Directive 2013/35/EC), increased CMR usage increases vertigo-related hazards experienced by MRI personnel (a re-evaluation of electromagnetic safety hazards is suggested in the case of these or similar changes in work organisation).

Issues in the Implementation of Directive 2013/35/EU Regarding the Protection of Workers against Electromagnetic Fields

In 2016 the Directive 2013/35/EU regarding the protection of health and safety of workers exposed to electromagnetic fields was transposed in Italy. Since then, the authors of this paper have been faced with several issues related to the implementation of the provisions of the Directive, which pose some interpretative and operative concerns. A primary critical feature of the Directive is that, in some circumstances, conditions of "overexposure", i.e., of exceeding the exposure limits, are allowed. In the case of transient effects, the "flexibility" concerning the compliance with exposure limits is based on the approach introduced by ICNIRP in its guidelines on static magnetic fields and on time-varying electric and magnetic fields. On the contrary, the possibility of exceeding the exposure limits for health effects, formally recognized in the article of the Directive dealing with derogations, is not included in the ICNIRP guidelines. This paper analyzes the main concerns in interpreting and managing some provisions of the Directive with particular reference to the issue of how the employer can manage the situations of overexposure.

Occupational exposure to electromagnetic fields in magnetic resonance environment: an update on regulation, exposure assessment techniques, health risk evaluation, and surveillance

Magnetic resonance imaging (MRI) is one of the most-used diagnostic imaging methods worldwide. There are ∼50,000 MRI scanners worldwide each of which involves a minimum of five workers from different disciplines who spend their working days around MRI scanners. This review analyzes the state of the art of literature about the several aspects of the occupational exposure to electromagnetic fields (EMF) in MRI: regulations, literature studies on biological effects, and health surveillance are addressed here in detail, along with a summary of the main approaches for exposure assessment. The original research papers published from 2013 to 2021 in international peer-reviewed journals, in the English language, are analyzed, together with documents published by legislative bodies. The key points for each topic are identified and described together with useful tips for precise safeguarding of MRI operators, in terms of exposure assessment, studies on biological effects, and health surveillance.

Exposure levels of radiofrequency magnetic fields and static magnetic fields in 1.5 and 3.0 T MRI units

Magnetic resonance imaging (MRI) staff is exposed to a complex mixture of electromagnetic fields from MRI units. Exposure to these fields results in the development of transient exposure-related symptoms. This study aimed to investigate the exposure levels of radiofrequency (RF) magnetic fields and static magnetic fields (SMFs) from 1.5 and 3.0 T MRI scanners in two public hospitals in the Mangaung Metropolitan region, South Africa. The exposure levels of SMFs and RF magnetic fields were measured using the THM1176 3-Axis hall magnetometer and TM-196 3 Axis RF field strength meter, respectively. Measurements were collected at a distance of 1 m (m) and 2 m from the gantry for SMFs when the brain, cervical spine and extremities were scanned. Measurements for RF magnetic fields were collected at a distance of 1 m with an average scan duration of six minutes. Friedman’s test was used to compared exposure mean values from two 1.5 T scanners, and Wilcoxon test with Bonferroni adjustment was used to identify where the difference between exist. The Shapiro–Wilk test was also used to test for normality between exposure levels in 1.5 and 3.0 T scanners. The measured peak values for SMFs from the 3.0 T scanner at hospital A were 1300 milliTesla (mT) and 726 mT from 1.5 T scanner in hospital B. The difference in terms of SMFs exposure levels was observed between two 1.5 T scanners at a distance of 2 m. The difference between 1.5 T scanners at 1 m was also observed during repeated measurements when brain, cervical spine and extremities scans were performed. Scanners’ configurations, magnet type, clinical setting and location were identified as factors that could influence different propagation of SMFs between scanners of the same nominal B0. The RF pulse design, sequence setting flip-angle and scans performed influenced the measured RF magnetic fields. Three scanners were complaint with occupational exposure guidelines stipulated by the ICNIRP; however, peak levels that exist at 1 m could be managed through adoption of occupational health and safety programs.

Analysis, comparison and representation of occupational exposure to a static magnetic field in a 3-T MRI site

The purpose of this study is to analyze exposure to the time-varying magnetic field caused by worker movements in a 3-T clinical magnetic resonance imaging (MRI) scanner. Measurements of the static magnetic field (B) in the proximity of the MRI scanner were performed to create a detailed map of the spatial gradient of B, in order to indicate the areas at high risk of exposure. Moreover, a personal exposure recording system was used in order to analyze and compare exposure to the static magnetic field during different routine procedures in MRI. We found that for all of the performed work activities, exposure was compliant with International Commission on Non-Ionizing Radiation Protection levels. However, our findings confirm that there is great variability of exposure between different workers and suggest the importance of performing personal exposure measurements and of detailed knowledge of the magnetic field spatial distribution.

ASSESSMENT OF MOVEMENT-INDUCED TIME-VARYING MAGNETIC FIELDS EXPOSURE IN MAGNETIC RESONANCE IMAGING BY A COMMERCIAL PORTABLE MAGNETOMETER

The purpose of this study was to describe a simple procedure to assess head exposure of MRI workers to time-varying magnetic field, due to their movements in the static magnetic field of a 3T MRI scanner. A group of MRI workers were provided with a commercial portable meter that stored in its internal memory the instantaneous B values. The dB/dt was obtained by the post hoc processing of measured data. The movement-induced time-varying electric field (TVEF) was calculated from dB/dt. The weighted peak index was evaluated in the frequency domain, by first computing the spectrum of dB/dt waveform, to verify the compliance with the exposure limits. The portable magnetometer may be useful to locally explore the MRI workers exposure to time-varying magnetic field and perform the local risk assessments in order to carry out the obligations laid down by Directive 2013/35/EU.

Assessing Exposures to Magnetic Resonance Imaging's Complex Mixture of Magnetic Fields for In Vivo, In Vitro, and Epidemiologic Studies of Health Effects for Staff and Patients

A complex mixture of electromagnetic fields is used in magnetic resonance imaging (MRI): static, low-frequency, and radio frequency magnetic fields. Commonly, the static magnetic field ranges from one to three Tesla. The low-frequency field can reach several millitesla and with a time derivative of the order of some Tesla per second. The radiofrequency (RF) field has a magnitude in the microtesla range giving rise to specific absorption rate values of a few Watts per kilogram. Very little attention has been paid to the case where there is a combined exposure to several different fields at the same time. Some studies have shown genotoxic effects in cells after exposure to an MRI scan while others have not demonstrated any effects. A typical MRI exam includes muliple imaging sequences of varying length and intensity, to produce different types of images. Each sequence is designed with a particular purpose in mind, so one sequence can, for example, be optimized for clearly showing fat water contrast, while another is optimized for high-resolution detail. It is of the utmost importance that future experimental studies give a thorough description of the exposure they are using, and not just a statement such as “An ordinary MRI sequence was used.” Even if the sequence is specified, it can differ substantially between manufacturers on, e.g., RF pulse height, width, and duty cycle. In the latest SCENIHR opinion, it is stated that there is very little information regarding the health effects of occupational exposure to MRI fields, and long-term prospective or retrospective cohort studies on workers are recommended as a high priority. They also state that MRI is increasingly used in pediatric diagnostic imaging, and a cohort study into the effects of MRI exposure on children is recommended as a high priority. For the exposure assessment in epidemiological studies, there is a clear difference between patients and staff and further work is needed on this. Studies that explore the possible differences between MRI scan sequences and compare them in terms of exposure level are warranted.

Exposure Assessment and Biomonitoring of Workers in Magnetic Resonance Environment: An Exploratory Study

Magnetic resonance imaging (MRI) has evolved rapidly over the past few decades as one of the most flexible tools in medical research and diagnostic imaging. MRI facilities are important sources of multiple exposure to electromagnetic fields for both patients and health-care staff, due to the presence of electromagnetic fields of multiple frequency ranges, different temporal variations, and field strengths. Due to the increasing use and technological advancements of MRI systems, clearer insights into exposure assessment and a better understanding of possible harmful effects due to long-term exposures are highly needed. In the present exploratory study, exposure assessment and biomonitoring of MRI workers at the Radio-diagnostics Unit of the National Cancer Institute of Naples "Pascale Foundation" (Naples, Italy) have been carried out. In particular, exposure to the MRI static magnetic field (SMF) has been evaluated by means of personal monitoring, while an application tool has been developed to provide an estimate of motion-induced, time-varying electric fields. Measurement results have highlighted a high day-to-day and worker-to-worker variability of the exposure to the SMF, which strongly depends on the characteristics of the environment and on personal behaviors, and the developed application tool can be adopted as an easy-to-use tool for rapid and qualitative evaluation of motion-induced, time-varying electric field exposure. Regarding biomonitoring, the 24 workers of the Radio-diagnostics Unit were enrolled to evaluate both spontaneous and mitomycin C-induced chromosomal fragility in human peripheral blood lymphocytes, by means of the cytokinesis-block micronucleus assay. The study subjects were 12 MRI workers, representative of different professional categories, as the exposed group, and 12 workers with no MRI exposure history, as the reference group. The results show a high worker-to-worker variability for both field exposure assessment and biomonitoring, as well as several critical issues and practicalities to be faced with in this type of investigations. The procedures for risk assessment and biomonitoring proposed here can be used to inform future research in this field, which will require a refinement of exposure assessment methods and an enlargement of the number of subjects enrolled in the biomonitoring study to gain robust statistics and reliable results.