Evaluation of X-ray Personal protective equipment for Orthopaedic Surgeons in theatrE (EXPOSEd) study : a national survey of Trauma & Orthopaedic surgeons.

Aims: To evaluate the accessibility and utility of current radiation personal protective equipment (PPE) provision and understand the experiences and radiation protection practices offered to all levels of Trauma & Orthopaedic (T&O) surgeons in the UK. Methods: An incentivized electronic survey was sent to all UK T&O surgeons during a six-week period in 2024. Responses to 27 multiple-choice questions were collected and free-text responses analyzed by theme. Results: A total of 677 responses from 196 UK NHS hospitals were received: 228 recepients (33%) were female, 455 (67%) were resident doctors, and 222 (33%) were consultants, representing a response rate of 38% (341/897) for trainees and 11% (222/2114) for consultants. Overall, 171 (25%) agreed they could find appropriate lead gown PPE; 80 (12%) had been given dosimeters, although few had received feedback; 173 (26%) received mandatory training, but many more (328, 48%) had sought training individually. When undertaken, it was felt useful. Symptoms attributed to ill-fitting PPE were common and more likely to be reported by females (odds ratio 2.5). In total, 372 (55%) did not feel protected by their current PPE, and 569 (84%) were concerned about the effects of ionizing radiation (IR) on their health. Thematic analysis confirmed concerns relating to PPE availability, education, and inconsistent advice and guidance across hospitals. Health concerns and poor morale were also highlighted. Conclusion: Employers must address the lack of compliance with the UK legislation, IR Regulations 2017 (IRR17), in relation to access to PPE, training, and monitoring. There is a need for standardized national guidelines and training.