Occupational Hazards in the Cath Lab
Interventional Cardiologists experience the highest amounts of radiation exposure of any medical professional.1
The risks of occupational radiation exposure in the cath lab are serious and can have lasting effects on physicians and staff. Chronic low-dose exposure to ionizing radiation has been linked to radiation illness including:
In addition, the heavy leaded personal protective equipment worn to protect against exposure can lead to serious orthopedic injury that could shorten a physician's career.
Average 20 year IC Career
|Exposure ||Head ||Lower Body |
|Intensity ||1,000 mSv ||100 mSv |
|Equivalence ||50,000 |
Long, Complex Cases Increase Risks
PCI procedures are getting ever more complex and as a result, physicians are performing longer procedures which may increase radiation exposure and time in heavy lead. In addition, recent studies suggest that while the recent adoption of radial access PCI can have measurable benefits for patients, in certain instances such as during left radial cases, operator radiation exposure is increased.5 All of these factors can increase the risk of occupational illness or injury.
Operator Exposure Levels by Access Site
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THE RISKS OF RADIATION EXPOSURE TO PHYSICIANS & STAFF GROW OVER TIME
10 - 15 YEARS IN PRACTICE
- Accelerated vascular aging and early atherosclerosis in the carotid vessel4
- Mean age of exposed workers was 45 years
16 YEARS IN PRACTICE
- 50% have significant posterior subcapsular lens changes
- Changes due to radiation exposure and not aging
21 YEARS IN PRACTICE
- 60% incidence of spine issues after 21 years in practice
- 28% report hip, knee, or ankle problems
- 33% miss work due to orthopedic issues
12 - 32 YEARS IN PRACTICE
- In a study of brain tumors in interventionalists, where tumor location is known, 86% occur on the left side.
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- Roguin, A, et. Al. Brain tumours among interventional cardiologists: a cause for alarm? Report of four new cases from two cities and a review of the literature Eurointervention 2012;7:1081-1086.
- Picano, E. et al., Cancer and non-cancer brain and eye effects of chronic low-dose ionizing radiation exposure. BMC Cancer, (2012) 2: (1), 157.
- International Atomic Energy Agency, Radiation Protection for Patients (RPOP) "X-rays: What Patients Need to Know" www.rpopliaea.org.
- Reeves RR et al. Invasive Cardiologists are exposed to Greater Left Sided Cranial Radiation: The BRAIN Study. J Am Coll Cardiol Intv 2015;8:1197–206.
- Pancholy SB, Joshi P, Shah S, et al. Randomized evaluation of vascular entry site and radiation exposure: the REVERE trial. J Am Coll Cardiol Intv. 2015; Epub ahead of print.
- Maria Grazia Andreassi et al.,Subclinical Carotid Atherosclerosis and Early Vascular Aging From Long-Term Low- Dose Ionizing Radiation Exposure. J Am Coll Cardiol Intv. 2015;8(4):616-627 1.
- E. Vano, et al. Radiation-associated lens opacities in catheterization personnel: results of a survey and direct assessments. 24 Journal of Vascular Interventional Radiology 2: 197-204 (2013).
- Goldstein JA, Balter S, Cowley M et al. Occupational hazards of interventional cardiologists: prevalence of orthopedic health problems in contemporary practice. Catheter Cardiovasc Interv 2004; 63:407-211. 15558765
- Gregory Dehmer et al., Occupational Hazards for Interventional Cardiologists, The Society for Cardiovascular Angiography and Interventions, 68 Catheterization and Cardiovascular Interventions 974, 975 (2006)
- Roguin A. Radiation hazards to interventional cardiologists: A report on increased brain tumors among physicians working in the cath lab. SOLACI 2014; April 23, 2014; Buenos Aires, Argentina.
- Weisz, G. et al. Safety and Feasibility of Robotic Percutaneous Coronary Intervention: PRECISE Study. J Am Coll Cardiol. 2013;61(15):1596-1600. PRECISE Trial demonstrated 95.2% reduction in radiation exposure to the primary operator.
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