# Evaluation of Operator and Patient Doses after Irradiation with Handheld X-ray Devices
## 4 Discussion
Nonetheless, the proximity of the device to the practitioner's body can vary based on hand positioning and the specific manner in which the device is held. While these devices often feature inherent protective measures, with certain models boasting an additional acrylic protective shield, there remains an ongoing debate regarding the adequacy of these safeguards in negating undue radiation exposure to the practitioner. Consequently, it is advocated that operators employ personal dosimeters for added safety [13]. In the present study, radiation dose measurements from the practitioner operator and the patient were taken using the thermoluminescence dosimetry method using various mobile X-ray devices. The devices utilized for irradiations included the NOMAD Pro 2 TM, Rextar X, and Diox 602, with TLD 100H employed for dose assessments. Given the 1 \(\upmu\)Gy sensitivity of the TLD 100H dosimeters, the precision of these measurements is purportedly high [14]. [PERSON] et al. [15] employed a single TLD for each region, subjecting it to a single irradiation, citing prior studies that demonstrated that the employed TLDs could adequately absorb radiation for a measurable outcome with just one irradiation [16; 17]. However, irradiations expose a vast area to radiation, with the central beam differing in angle across various intraoral periapical film exposures. [PERSON] et al. [18] have indicated that when fewer TLDs are utilized for repeated measurements, there can be disparities of up to 80% in organ and tissue dose outcomes [18]. As such, enhancing the number of TLDs undeniably augments measurement accuracy. For this study, three TLDs were positioned for each designated organ and tissue, with each irradiation being performed thrice to bolster measurement reliability. A mannequin, standing at 185 cm, was employed to simulate the practitioner, while a phantom head was used in lieu of an actual patient. All irradiations were conducted from a distance of 250 cm and executed from behind a protective screen (1 mm Pb). In previous studies, the radiation dosages from handheld X-ray devices were consistently found to be below the recommended thresholds. A majority of these investigations were conducted in the USA, with others originating from Italy, Belgium, Korea, and England [2; 3; 5; 12; 19; 20]. Notably, despite the presence of handheld X-ray devices in our national market, there has been an absence of related studies. As such, the current investigation holds significant relevance, serving as a pioneering effort within our nation to evaluate the risks associated with handheld X-ray devices. [PERSON] et al. [20] constructed their research framework based on the premise that an operator would conduct 300 irradiations weekly, cumulating to 15,000 irradiations annually. For dose assessment, the TLD-700 was employed, with the NOMADTM serving as the chosen portable X-ray device. TLDs were placed in the eye, thyroid, finger, and chest areas of the practitioner staff. The deduced annual radiation exposure for the operator was quantified as 18 mR for the chest region, 22.5 mR for the eyes, and 45 mR for the fingers. Given the contextual understanding that handheld X-ray devices are primarily utilized in specialized scenarios--including patients with limited mobility, elder care facilities, temporary healthcare clinics, forensic field investigations, remote locales, and military contexts--[PERSON] et al. posited that these values remained comfortably within acceptable limits [20]. In the study undertaken by [PERSON] et al. [21], radiation doses to both the operating practitioner and ancillary staff were gauged utilizing the ion chamber methodology, with the NOMADTM device deployed in disaster relief efforts post-Hurricane Katrina. In contrast to this, the current study employed a mannequin to simulate the position of the operator. Furthermore, to mitigate radiation exposure, irradiation was conducted from a distance of 250 cm, shielded by a 1 mm Pb screen. A study by [PERSON] et al.