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 Procedures in the “cath lab” – named for the catheters threaded into
the heart - are done for all forms of cardiac disease, like
congenital heart defects, ischemic heart disease or heart
arrhythmias, said lead author Maria Grazia Andreassi of the CNR
Institute of Clinical Physiology in Pisa, Italy.
“These procedures, highly effective and often life-saving, require
substantial radiation exposure to patients,” Andreassi told Reuters
Health by email.
But staff members, too, are exposed to radiation. In particular, for
the cardiologists and electrophysiologists who work near the patient
and the radiation source, “the cumulative dose in a professional
lifetime is not negligible,” Andreassi said.
The researchers used questionnaires to gather work-related and
lifestyle information, current medications and health status for 466
exposed hospital staff, including interventional cardiologists,
electrophysiologists, nurses and technicians, half of whom had been
working for at least 10 years. They also surveyed 280 staffers who
had not been exposed to radiation in the cath lab.
Almost 3 percent of interventional cardiology staff had a history of
cancer, compared to less than 1 percent of the unexposed comparison
group. Eight percent of lab workers had experienced skin lesions, 30
percent had an orthopedic illness and five percent had cataracts,
compared to two percent, five percent and less than one percent of
the unexposed group, respectively.
Doctors had higher risks than nurses or technicians, and risk was
higher for those who had been working more than 16 years, as
reported in Circulation: Cardiovascular Interventions.
Stroke and heart attack risk were similar in the radiation and
non-radiation exposure groups.
“Compared to healthcare professionals not exposed to radiation,
workers with more than 16 years of occupational work are
approximately 10 times more likely to experience cataracts and eight
times more likely to have cancer after adjusting for other
confounders,” like age and smoking status, Andreassi said.
Protective measures like leaded aprons, thyroid collars, leaded
glasses, and overhead radiation shields can reduce the radiation
dose to the operators, but are still not used regularly in every
laboratory, Andreassi said.
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Healthcare workers in the cath lab “sort of know there is a risk but
it’s typically presented to young people as something to know about
and not to worry about,” said Dr. Lloyd Klein of Advocate Illinois
Medical Center in Chicago, who coauthored an editorial accompanying
the new study.
“Everyone wears lead aprons, and increasingly, lead caps,” Klein
told Reuters Health by email. “We are careful about unnecessary
exposure.”
But wearing lead creates orthopedic problems and doesn’t completely
protect against the effects of radiation, he said.
The Occupational Safety and Health Administration and federal and
state agencies probably need to get more involved than they already
are, he said.
“Unfortunately, interventional cardiologists are often inadequately
trained in radiation safety and radiobiology, and hospitals have few
training programs regarding radiation risk and exposure,” Andreassi
said.
SOURCE: http://bit.ly/1SLoXYk Circulation: Cardiovascular
Interventions, online April 12, 2016.
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