# Evaluation of Operator and Patient Doses after Irradiation with Handheld X-ray Devices
## 4 Discussion
[19] involved the strategic placement of three TLDs on staff at key anatomical locations: eyes, thyroid, chest, abdominal region, gonads, hands, and feet. Their findings indicated the highest radiation exposure to the reproductive organs and the most minimal exposure to the thyroid gland. The annualized whole-body dosage for the operator was ascertained to be 0.0453 mSv, which represents a mere 0.9% of the prescribed annual limit. Specifically, the reproductive organ exposure was 0.095 mSv, equating to 0.19% of the permissible annual dose [19]. Within the scope of the present study, standardization was achieved by consistently positioning the handheld X-ray device at the greatest possible distance from the operator's body during all irradiation sessions. A distinctive feature of our study, diverging from that of [PERSON] et al., was the incorporation of three varying devices. For all these devices, peak radiation levels were observed in the hand region, while the nadir was identified in the gonadal region. This discrepancy in outcomes might be attributed to [PERSON] et al. 's operator holding the device proximal to the body, especially near the gonadal region, with their arms flexed at the elbows. In the United States, portable X-ray devices have become increasingly prevalent, with an estimated thousands of units employed across sectors such as dentistry, veterinary science, the military, forensics, and research. [PERSON] et al. [13] assessed the radiation dose from both portable and fixed X-ray machines during digital imaging. This comprehensive study spanned 18 dental clinics and utilized 661 personal dosimeters for measurements. The study's temporal assessments were delineated on a weekly and monthly basis, leveraging Optically Stimulated Luminescence (OSL) dosimeters or Thermoluminescent Dosimeters (TLD) for data collection. Notably, devices such as the NOMAD(tm) and NOMAD Pro 2(tm) were employed as portable X-ray units. Dosimeters were positioned on personnel associated with fixed (wall-mounted) X-ray machines, while those operating portable units had dosimeters on both their bodies and hands. However, [PERSON] et al. did not specify if the operator, during the irradiation with stationary X-ray devices, utilized a protective screen or shared the room with the patient. Further, there was no delineation regarding potential extraneous radiation exposure, such as sunlight or reflective radiation. Their results indicated that operators of fixed X-ray devices received a monthly body dosage of 27.3 \(\mu\)Sv, in contrast to the 9.01 \(\mu\)Sv recorded for portable device operators. Regarding hand exposure, out of 116 dosimeters, only 6 (5.2%) registered below the threshold value, suggesting negligible dosage [13]. In the present study, contrary to the methodology of [PERSON] et al., it was taken as a reference that operators using fixed X-ray devices are not exposed to any radiation when they adhere to radiation protection rules (distance and protection considerations). [PERSON] et al. reported elevated radiation values associated with fixed X-ray devices compared to their portable counterparts. This discrepancy might arise from operators' non-adherence to established radiation protection guidelines. Additionally, the utilization of digital films in portable devices, compared with the application of conventional films in fixed machines, could further contribute to this variation. Despite these findings, the recorded doses remained within the safety thresholds established by the National Council on Radiation Protection and Measurement (NCRP) [22]. Notably, [PERSON] et al. did not underscore the significant monthly hand dose of 208 \(\mu\)Sv. Similarly, our study indicated that the highest radiation doses were consistently observed in the hands (Table 3). The highest value for the right-hand region was 119.4 \(\mu\)Gy in the unprotected P irradiation in the Rextar X device, and the lowest value was 11.5 \(\mu\)Gy in the protected C irradiation in the NOMAD Pro 2 TM device.