The typical insulation rock, slag and glass wool fibers are high volume materials. Current exposure levels in industry (generally ≤ 1 fiber/cm3 with a median diameter ∼1 μm and length ≥10 μm) are not considered carcinogenic or causing other types of severe lung effects. However, epidemiological studies are not informative on effects in humans at fiber levels >1 fiber/cm3. Effects may be inferred from valid rat studies, conducted with rat respirable fibers (diameter ≤ 1.5 μm). Therefore, we estimate delivery and deposition in human and rat airways of the industrial fibers. The deposition fractions in humans head regions by nasal (∼0.20) and by mouth breathing (≤0.08) are lower than in rats (0.50). The delivered dose into the lungs per unit lung surface area during a 1-day exposure at a similar air concentration is estimated to be about two times higher in humans than in rats. The deposition fractions in human lungs by nasal (∼0.20) and by mouth breathing (∼0.40) are higher than in rats (∼0.04). The human lung deposition may be up to three times by nasal breathing and up to six times higher by oral breathing than in rats, qualifying assessment factor setting for deposition.

BACKGROUND: Modern techniques in orthopaedic surgery using minimally invasive procedures, and increased use of fluoroscopic imaging present a potential increased risk to surgeons due to ionizing radiation exposure. This article is a systematic review of recent literature on radiation exposure of orthopaedic surgeons.
METHODS: Pubmed and Cochrane searches were performed on intraoperative radiation exposure covering English and German articles published between 1.1.2000 and 11.8.2014. Inclusion criteria were clinical studies and systematic literature reviews focusing on radiation exposure of orthopaedic surgeons during surgical procedures of the musculoskeletal system reporting either effective dose (whole body) or equivalent dose at the organ level. All included articles were reviewed with focus on the surgical specialty, the procedure type, the imaging system used, the radiation measurement method, the fluoroscopy time, the radiation exposure, the use of radiation protection, and any references to specific safety guidelines.
RESULTS: Thirty-four eligible publications were identified. However, the lack of well-designed studies focusing on radiation exposure of surgeons prevents pooling of data. Highest exposure and subsequent equivalent doses were reported from spinal surgery (up to 4.8mSv of equivalent dose to the hand) and intramedullary nailing (up to 0.142mSV of equivalent dose to the thyroid). Radiation exposure was reduced by 96.9% and 94.2% when wearing a thyroid collar and a lead apron.
CONCLUSIONS: With the increasing use of intraoperative imaging, there is a growing need for radiation awareness by the operating surgeon. Strict adherence to radiation protection should be enforced to protect in-training surgeons. Strategies to reduce exposure include C-arm position, distance, protective wear, and new imaging technologies. Radiation exposure is harmful and action should be taken to minimize exposure.