Radiation exposure increases risk of health problems for medical staff

PATIENT health and safety are key priorities for any health care provider. But when it comes medical imaging, a new study suggests there should be increased focus on protecting the health of staff. Researchers found that health care workers who perform fluoroscopy for heart procedures are at greater risk for orthopedic problems, cataracts, skin lesions and cancers. Study leader Maria Grazia Andreassi, PhD, head of the Genetics and Molecular Epidemiology Unit at the National Research Council Institute of Clinical Physiology in Pisa, Italy, and colleagues publish their findings in the journal Circulation: Cardiovascular Interventions.
Fluoroscopy is a form of medical imaging that uses a continuous X-ray beam to see real-time images of certain parts of the body. The technique is used for a number of heart procedures, including coronary angiography – used to detect heart conditions – and coronary artery angioplasty – used to widen blocked or narrowed arteries. A number of medical staff in cath labs are exposed to fluoroscopy radiation, including doctors, nurses and technicians. Andreassi notes that, of all X-ray procedures, fluoroscopy-guided heart procedures lead to the greatest radiation exposure among health care workers. “Interventional cardiologists and electrophysiologists have a two to three times higher annual exposure than that of radiologists, as they are closer to the radiological source and experience radiation exposure with the patient, whereas diagnostic radiologists are generally shielded from radiation exposure,” she explains.
Andreassi says that busy cardiologists and electrophysiologists are exposed to around 5 millisieverts (mSv) of radiation each year; mSv is a measure of how much radiation is absorbed by the human body. This means that over a 30-year career, these health care workers may be exposed to around 50-200 mSv – the equivalent of 2,500-10,000 chest X-rays. But how does such exposure affect health? Andreassi and her team set out to investigate. The researchers assessed the results of an Italian survey that was completed by 746 health care workers. Of these, 466 worked in cardiac cath labs for a median of 10 years, while 280 worked in non-radiation health care settings. Fluoroscopy exposes the patient to ionizing radiation, with doses dependent on the procedure being performed.
Compared with health care workers who did not work in cath labs, those who did were found to be at 7.1 times greater risk for back, neck or knee problems, 6.3 times greater risk for cataracts and 2.8 times greater risk for skin lesions. The results accounted for subjects’ smoking habits and other influential factors. As expected, the estimated radiation exposure was highest for cardiologists and electrophysiologists. Individuals who had worked in a cath lab for at least 16 years were found to have the highest risk for such conditions, and these workers were also found to be at three times higher risk for developing cancer than those who worked in other health care settings.

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