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Wilén, Jonna
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Publications (10 of 30) Show all publications
Glans, A., Wilén, J., Hansson, B., Audulv, Å. & Lindgren, L. (2024). Managing acoustic noise within MRI: a qualitative interview study among Swedish radiographers. Radiography, 30(3), 889-895
Open this publication in new window or tab >>Managing acoustic noise within MRI: a qualitative interview study among Swedish radiographers
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2024 (English)In: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 30, no 3, p. 889-895Article in journal (Refereed) Published
Abstract [en]

Introduction: Acoustic noise from magnetic resonance imaging (MRI) can cause hearing loss and needs to be mitigated to ensure the safety of patients and personnel. Capturing MR personnel's insights is crucial for guiding the development and future applications of noise-reduction technology. This study aimed to explore how MR radiographers manage acoustic noise in clinical MR settings.

Methods: Using a qualitative design, we conducted semi-structured individual interviews with fifteen MR radiographers from fifteen hospitals around Sweden. We focused on the clinical implications of participants’ noise management, using an interpretive description approach. We also identified sociotechnical interactions between People, Environment, Tools, and Tasks (PETT) by adopting a Human Factors/Ergonomics framework. Interview data were analyzed inductively with thematic analysis (Braun and Clarke).

Results: The analysis generated three main themes regarding MR radiographers’ noise management: (I) Navigating Occupational Noise: Risk Management and Adaptation; (II) Protecting the Patient and Serving the Exam, and (III) Establishing a Safe Healthcare Environment with Organizational Support.

Conclusion: This study offers insights into radiographers’ experiences of managing acoustic noise within MRI, and the associated challenges. Radiographers have adopted multiple strategies to protect patients and themselves from adverse noise-related effects. However, they require tools and support to manage this effectively, suggesting a need for organizations to adopt more proactive, holistic approaches to safety initiatives.

Implications for practice: The radiographers stressed the importance of a soundproofed work environment to minimize occupational adverse health effects and preserve work performance. They acknowledge noise as a common contributor to patient distress and discomfort. Providing options like earplugs, headphones, mold putty, software-optimized “quiet” sequences, and patient information were important tools. Fostering a safety culture requires proactive safety efforts and support from colleagues and management.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Acoustic noise, Human factors, MRI safety, Occupational health, Patient safety, Thematic analysis
National Category
Nursing Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-223498 (URN)10.1016/j.radi.2024.04.002 (DOI)2-s2.0-85189915794 (Scopus ID)
Available from: 2024-04-25 Created: 2024-04-25 Last updated: 2024-04-25Bibliographically approved
Sadeghi, B., Westerlund, P., Salles, R. S. & Wilén, J. (2023). Radiated emissions from an electric railway: review of methods and measurements mainly from 9 khz to 150 khz. In: CIRED 2023 proceedings, Rome: CIRED - congrès international des réseaux electriques de distribution, 2023. Paper presented at CIRED 27th International Conference on Electricity Distribution, Rome, 12-15 June, 2023. (pp. 3694-3698). Rom: CIRED - Congrès International des Réseaux Electriques de Distribution, 2023, 2023(6)
Open this publication in new window or tab >>Radiated emissions from an electric railway: review of methods and measurements mainly from 9 khz to 150 khz
2023 (English)In: CIRED 2023 proceedings, Rome: CIRED - congrès international des réseaux electriques de distribution, 2023, Rom: CIRED - Congrès International des Réseaux Electriques de Distribution, 2023 , 2023, Vol. 2023, no 6, p. 3694-3698Conference paper, Published paper (Refereed)
Abstract [en]

In this paper, a review has been done based on the study of articles and documents related to radiated electromagnetic emissions of the railway system, an example of measurements is presented, and the requirement of a unique procedure is discussed to obtain repeatable and reproducible electromagnetic compatibility (EMC) measurements. Regarding the measurement results, it could be noted that in the 9 kHz to 150 kHz range, some frequencies are dominant which might be generated from pantograph arcing and onboard power electronic devices.

Place, publisher, year, edition, pages
Rom: CIRED - Congrès International des Réseaux Electriques de Distribution, 2023, 2023
National Category
Vehicle Engineering
Identifiers
urn:nbn:se:umu:diva-219499 (URN)10.1049/icp.2023.0752 (DOI)2-s2.0-85181539731 (Scopus ID)
Conference
CIRED 27th International Conference on Electricity Distribution, Rome, 12-15 June, 2023.
Note

Paper 1347

Available from: 2024-01-24 Created: 2024-01-24 Last updated: 2024-01-24Bibliographically approved
Glans, A., Wilén, J., Lindgren, L., Björkman-Burtscher, I. M. & Hansson, B. (2022). Health effects related to exposure of static magnetic fields and acoustic noise—comparison between MR and CT radiographers. European Radiology, 32(11), 7896-7909
Open this publication in new window or tab >>Health effects related to exposure of static magnetic fields and acoustic noise—comparison between MR and CT radiographers
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2022 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 32, no 11, p. 7896-7909Article in journal (Refereed) Published
Abstract [en]

Objectives: We explored the prevalence of health complaints subjectively associated with static magnetic field (SMF) and acoustic noise exposure among MR radiographers in Sweden, using CT radiographers as a control group. Additionally, we explored radiographers’ use of strategies to mitigate adverse health effects.

Methods: A cross-sectional survey was sent to all hospitals with MR units in Sweden. MR and/or CT personnel reported prevalence and attribution of symptoms (vertigo/dizziness, nausea, metallic taste, illusion of movement, ringing sensations/tinnitus, headache, unusual drowsiness/tiredness, forgetfulness, difficulties concentrating, and difficulties sleeping) within the last year. We used logistic regression to test associations between sex, age, stress, SMF strength, working hours, and symptom prevalence. Data regarding hearing function, work-environmental noise, and strategies to mitigate adverse symptoms were also analysed.

Results: In total, 529 out of 546 respondents from 86 hospitals were eligible for participation. A ≥ 20 working hours/week/modality cut-off rendered 342 participants grouped into CT (n = 75), MR (n = 121), or mixed personnel (n = 146). No significant differences in symptom prevalence were seen between groups. Working at ≥ 3T increased SMF-associated symptoms as compared with working at ≤ 1.5T (OR: 2.03, CI95: 1.05–3.93). Stress was a significant confounder. Work-related noise was rated as more troublesome by CT than MR personnel (p < 0.01). MR personnel tended to use more strategies to mitigate adverse symptoms.

Conclusion: No significant differences in symptom prevalence were seen between MR and CT radiographers. However, working at 3T increased the risk of SMF symptoms, and stress increased adverse health effects. Noise nuisance was considered more problematic by CT than MR personnel.

Key Points:

  • No significant differences in symptom prevalence were seen between MR and CT radiographers.
  • Working at ≥ 3 T doubled the odds of experiencing SMF symptoms (vertigo/dizziness, nausea, metallic taste, and/or illusion of movement) as compared to working exclusively at ≤ 1.5 T.
  • Work-related acoustic noise was less well mitigated and was rated as more troublesome by CT personnel than by MR personnel.
Place, publisher, year, edition, pages
Springer, 2022
Keywords
Electromagnetic fields, Magnetic resonance imaging, Occupational health, Surveys and questionnaires, Tomography, X-ray computed
National Category
Radiology, Nuclear Medicine and Medical Imaging Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-203281 (URN)10.1007/s00330-022-08843-y (DOI)000807990400001 ()35674823 (PubMedID)2-s2.0-85131511465 (Scopus ID)
Available from: 2023-01-18 Created: 2023-01-18 Last updated: 2023-01-18Bibliographically approved
Jeschke, P., Alteköster, C., Hansson Mild, K., Israel, M., Ivanova, M., Schiessl, K., . . . Wilén, J. (2022). Protection of workers exposed to radiofrequency electromagnetic fields: a perspective on open questions in the context of the new ICNIRP 2020 guidelines. Frontiers In Public Health, 10, Article ID 875946.
Open this publication in new window or tab >>Protection of workers exposed to radiofrequency electromagnetic fields: a perspective on open questions in the context of the new ICNIRP 2020 guidelines
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2022 (English)In: Frontiers In Public Health, ISSN 2296-2565, Vol. 10, article id 875946Article, review/survey (Refereed) Published
Abstract [en]

Workers in occupational settings are usually exposed to numerous sources of electromagnetic fields (EMF) and to different physical agents. Risk assessment for industrial workplaces concerning EMF is not only relevant to operators of devices or machinery emitting EMF, but also to support-workers, bystanders, service and maintenance personnel, and even visitors. Radiofrequency EMF guidelines published in 2020 by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) may also be indirectly applied to assess risks emerging from EMF sources at workplaces by technical standards or legislation. To review the applicability and adequacy to assess exposure to EMF in occupational settings in the European Union, the most current ICNIRP guidelines on radiofrequency EMF are reviewed. Relevant ICNIRP fundamentals and principles are introduced, followed by practical aspects of exposure assessment. To conclude, open questions are formulated pointing out gaps between the guidelines' principles and occupational practice, such as the impact of hot and humid environments and physical activity or controversies around ICNIRPS's reduction factors in view of assessment uncertainty in general. Thus, the article aims to provide scientific policy advisors, labor inspectors, or experts developing standards with a profound understanding about ICNIRP guidelines' applicability to assess hazards related to radiofrequency EMF in occupational settings.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2022
Keywords
electric field, EMF Directive 2013/35/EU, ICNIRP 2020 RF Guidelines, magnetic field, occupational exposure, reduction factors, uncertainty
National Category
Occupational Health and Environmental Health Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-203190 (URN)10.3389/fpubh.2022.875946 (DOI)000814637300001 ()35757616 (PubMedID)2-s2.0-85133101720 (Scopus ID)
Available from: 2023-01-18 Created: 2023-01-18 Last updated: 2023-03-15Bibliographically approved
Glans, A., Wilén, J. & Lindgren, L. (2021). Maintaining Image Quality While Reducing Acoustic Noise and Switched Gradient Field Exposure During Lumbar MRI. Journal of Magnetic Resonance Imaging, 54(1), 315-325
Open this publication in new window or tab >>Maintaining Image Quality While Reducing Acoustic Noise and Switched Gradient Field Exposure During Lumbar MRI
2021 (English)In: Journal of Magnetic Resonance Imaging, ISSN 1053-1807, E-ISSN 1522-2586, Vol. 54, no 1, p. 315-325Article in journal (Refereed) Published
Abstract [en]

Background: MR-generated acoustic noise can contribute to patient discomfort and potentially be harmful. One way to reduce this noise is by altering the gradient output and/or waveform using software optimization. Such modifications might influence image quality and switched gradient field exposure, and different techniques appear to affect sound pressure levels (SPLs) to various degrees.

Purpose: To evaluate SPLs, image quality, switched gradient field exposure, and participants' perceived noise levels during two different acoustic noise reduction (ANR) techniques, Quiet Suite (QS) and Whisper Mode (WM), and to compare them with conventional T2-weighted turbo spin echo (T2W TSE) of the lumbar spine.

Design: Prospective.

Subjects: Forty adults referred for lumbar MRI.

Field strength/sequence: Conventional T2W TSE, T2W TSE with QS, and T2W TSE with WM were acquired at 1.5 T.

Assessment: Peak SPL (A-weighted decibels, dBA), perceived noise levels (Borg CR10®-scale), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), three radiologists' qualitative assessments in image quality on an ordinal scale 1-4, switched gradient field exposure (% general public), and gradient currents were measured. Interobserver reliability was reported as percentage agreement.

Statistical tests: Repeated measures ANOVA, Friedman's ANOVA, and Wilcoxon's Signed-Rank Test for acoustic noise measurements and image quality assessments.

Results: Mean peak SPLs were 89.9 dBA, 74.3 dBA, and 78.8 dBA for conventional, QS, and WM, respectively (P < 0.05). Participants perceived QS as the quietest and conventional as the loudest sequence (P < 0.05). No qualitative differences in image quality were seen (P > 0.05), although QS showed significantly improved SNR and CNR (P < 0.05). Switched gradient field exposure was reduced by 66% and 48% for QS and WM, respectively.

Data conclusion: Without degrading image quality, both QS and WM are viable ANR techniques in lumbar T2W TSE. QS provided the lowest SPL, the lowest gradient field exposure and was perceived as the most silent among the three sequences.

Level of evidence: 1 TECHNICAL EFFICACY STAGE: 5.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
MRI safety, magnetic field, patient comfort, quiet suite, whisper mode
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-179857 (URN)10.1002/jmri.27527 (DOI)000616367300001 ()33565199 (PubMedID)2-s2.0-85100635401 (Scopus ID)
Available from: 2021-02-11 Created: 2021-02-11 Last updated: 2022-05-12Bibliographically approved
Hansson, B., Olsrud, J., Wilén, J., Owman, T., Hoglund, P. & Bjorkman-Burtscher, I. M. (2020). Swedish national survey on MR safety compared with CT: a false sense of security?. European Radiology, 30(4), 1918-1926
Open this publication in new window or tab >>Swedish national survey on MR safety compared with CT: a false sense of security?
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2020 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 30, no 4, p. 1918-1926Article in journal (Refereed) Published
Abstract [en]

Objectives: The objectives were to survey MR safety incidents in Sweden during a 12-month period, to assess severity scores, and to evaluate the confidence of MR personnel in incident-reporting mechanisms.

Method: Data were collected within a web-based questionnaire on safety in clinical MR environments with CT for comparison. Data reported MR and CT safety incidents (human injury, material damage, and close calls), incident severity, and confidence of participants in incident-reporting systems.

Results: The study population consisted of 529 eligible participants. Participants reported 200 MR and 156 CT safety incidents. Among MR incidents, 16% were given the highest potential severity score. More MR workers (73%) than CT workers (50%) were confident in being aware of any incident occurring at their workplace. However, 69% MR workers (83% for CT) were not aware of reported incidents at their hospitals.

Conclusion: Safety incidents resulting in human injury, material damage, and close calls in clinical MR environments do occur. According to national risk assessment recommendations, risk level is high. Results indicated that MR personnel tend to a false sense of security, as a high proportion of staff members were sure that they would have been aware of any incident occurring in their own department, while in reality, incidents did occur without their knowledge. We conclude that false sense of security exists for MR.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Safety management, Magnetic resonance imaging, Risk assessment, Surveys and questionnaires, Patient safety
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-169480 (URN)10.1007/s00330-019-06465-5 (DOI)000519659200012 ()31834506 (PubMedID)2-s2.0-85076516044 (Scopus ID)
Available from: 2020-04-02 Created: 2020-04-02 Last updated: 2023-03-24Bibliographically approved
Wilén, J., Olsrud, J., Frankel, J. & Hansson Mild, K. (2020). Valid Exposure Protocols Needed in Magnetic Resonance Imaging Genotoxic Research [Letter to the editor]. Bioelectromagnetics, 41(3), 247-257
Open this publication in new window or tab >>Valid Exposure Protocols Needed in Magnetic Resonance Imaging Genotoxic Research
2020 (English)In: Bioelectromagnetics, ISSN 0197-8462, E-ISSN 1521-186X, Vol. 41, no 3, p. 247-257Article in journal, Letter (Refereed) Published
Abstract [en]

Several in vitro and in vivo studies have investigated if a magnetic resonance imaging (MRI) examination can cause DNA damage in human blood cells. However, the electromagnetic field (EMF) exposure that the cells received in the MR scanner was not sufficiently described. The first studies looking into this could be regarded as hypothesis-generating studies. However, for further exploration into the role of MRI exposure on DNA integrity, the exposure itself cannot be ignored. The lack of sufficient method descriptions makes the early experiments difficult, if not impossible, to repeat. The golden rule in all experimental work is that a study should be repeatable by someone with the right knowledge and equipment, and this is simply not the case with many of the recent studies on MRI and genotoxicity. Here we discuss what is lacking in previous studies, and how we think the next generation of in vitro and in vivo studies on MRI and genotoxicity should be performed. Bioelectromagnetics.

Place, publisher, year, edition, pages
WILEY, 2020
Keywords
DNA, magnetic field, pulse sequence, isocenter, genotoxicity
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-169358 (URN)10.1002/bem.22257 (DOI)000519338000008 ()32157722 (PubMedID)2-s2.0-85081679643 (Scopus ID)
Available from: 2020-04-07 Created: 2020-04-07 Last updated: 2023-03-24Bibliographically approved
Frankel, J., Hansson Mild, K., Olsrud, J. & Wilén, J. (2019). EMF exposure variation among MRI sequences from pediatric examination protocols. Bioelectromagnetics, 40(1), 3-15
Open this publication in new window or tab >>EMF exposure variation among MRI sequences from pediatric examination protocols
2019 (English)In: Bioelectromagnetics, ISSN 0197-8462, E-ISSN 1521-186X, Vol. 40, no 1, p. 3-15Article in journal (Refereed) Published
Abstract [en]

The magnetic resonance imaging (MRI) exposure environment is unique due to the mixture and intensity of magnetic fields involved. Current safety regulations are based on well-known acute effects of heating and neuroexcitation while the scientific grounds for possible long-term effects from MRI exposure are lacking. Epidemiological research requires careful exposure characterization, and as a first step toward improved exposure assessment we set out to characterize the MRI-patient exposure environment. Seven MRI sequences were run on a 3-Tesla scanner while the radiofrequency and gradient magnetic fields were measured inside the scanner bore. The sequences were compared in terms of 14 different exposure parameters. To study within-sequence variability, we varied sequence settings such as flip angle and slice thickness one at a time, to determine if they had any impact on exposure endpoints. There were significant differences between two or more sequences for all fourteen exposure parameters. Within-sequence differences were up to 60% of the corresponding between-sequence differences, and a 5-8 fold exposure increase was caused by variations in flip angle, slice spacing, and field of view. MRI exposure is therefore not only sequence-specific but also patient- and examination occurrence-specific, a complexity that requires careful consideration for an MRI exposure assessment in epidemiological studies to be meaningful. 

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
children, electromagnetic field, epidemiology, exposure assessment, radiofrequency
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-155086 (URN)10.1002/bem.22159 (DOI)000453860500001 ()30500987 (PubMedID)2-s2.0-85057846232 (Scopus ID)
Funder
Swedish Research Council, 521-2013-2702
Available from: 2019-01-10 Created: 2019-01-10 Last updated: 2023-03-24Bibliographically approved
Hansson Mild, K., Lundström, R. & Wilén, J. (2019). Non-Ionizing Radiation in Swedish Health CareExposure and Safety Aspects. International Journal of Environmental Research and Public Health, 16(7), Article ID 1186.
Open this publication in new window or tab >>Non-Ionizing Radiation in Swedish Health CareExposure and Safety Aspects
2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 7, article id 1186Article in journal (Refereed) Published
Abstract [en]

The main aim of the study was to identify and describe methods using non-ionizing radiation (NIR) such as electromagnetic fields (EMF) and optical radiation in Swedish health care. By examining anticipated exposure levels and by identifying possible health hazards we also aimed to recognize knowledge gaps in the field. NIR is mainly used in health care for diagnosis and therapy. Three applications were identified where acute effects cannot be ruled out: magnetic resonance imaging (MRI), transcranial magnetic stimulation (TMS) and electrosurgery. When using optical radiation, such as class 3 and 4 lasers for therapy or surgical procedures and ultra-violet light for therapy, acute effects such as unintentional burns, photo reactions, erythema and effects on the eyes need to be avoided. There is a need for more knowledge regarding long-term effects of MRI as well as on the combination of different NIR exposures. Based on literature and after consulting staff we conclude that the health care professionals' knowledge about the risks and safety measures should be improved and that there is a need for clear, evidence-based information from reliable sources, and it should be obvious to the user which source to address.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
NIR, health care, exposure, safety, EMF, MRI, TMS, UV, Laser
National Category
Occupational Health and Environmental Health Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-159074 (URN)10.3390/ijerph16071186 (DOI)000465595800099 ()30987016 (PubMedID)2-s2.0-85064901536 (Scopus ID)
Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2023-03-24Bibliographically approved
Hansson, B., Höglund, P., Markenroth Bloch, K., Nilsson, M., Olsrud, J., Wilén, J. & Björkman-Burtscher, I. M. (2019). Short-term effects experienced during examinations in an actively shielded 7 T MR. Bioelectromagnetics, 40(4), 234-249
Open this publication in new window or tab >>Short-term effects experienced during examinations in an actively shielded 7 T MR
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2019 (English)In: Bioelectromagnetics, ISSN 0197-8462, E-ISSN 1521-186X, Vol. 40, no 4, p. 234-249Article in journal (Refereed) Published
Abstract [en]

The objective of this study was to evaluate occurrence and strength of short‐term effects experienced by study participants in an actively shielded (AS) 7 tesla (7 T) magnetic resonance (MR) scanner, to compare results with earlier reports on passively shielded (PS) 7 T MR scanners, and to outline possible healthcare strategies to improve patient compliance. Study participants (n = 124) completed a web‐based questionnaire directly after being examined in an AS 7 T MR (n = 154 examinations). Most frequently experienced short‐term effects were dizziness (84%) and inconsistent movement (70%), especially while moving into or out of the magnet. Peripheral nerve stimulation (PNS)—twitching—was experienced in 67% of research examinations and showed a dependence between strength of twitches and recorded predicted PNS values. Of the participants, 74% experienced noise levels as acceptable and the majority experienced body and room temperature as comfortable. Of the study participants, 95% felt well‐informed and felt they had had good contact with the staff before the examination. Willingness to undergo a future 7 T examination was high (>90%). Our study concludes short‐term effects are often experienced during examinations in an AS 7 T MR, leaving room for improvement in nursing care strategies to increase patient compliance.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
dizziness, peripheral nerve stimulation, motion, patient compliance, bias
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-159063 (URN)10.1002/bem.22189 (DOI)000466559000002 ()30920671 (PubMedID)2-s2.0-85063578974 (Scopus ID)
Available from: 2019-05-21 Created: 2019-05-21 Last updated: 2023-03-24Bibliographically approved
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