Over the past several years, as more data is published, the discussion about the harmful health effects of chronic, low-level exposure to ionizing radiation among interventional cardiologists and their teams has become more prominent. Now, another study on occupational health risks in the cath lab receiving national media attention has called attention to this issue and highlighted additional risks.
The study, led by Maria Grazia Andreassi, MSc, PhD of the CNR Institute of Clinical Physiology in Pisa, Italy, reported that healthcare workers performing cath lab heart procedures, particularly those working with radiation for at least 10 years or more, may be at higher risk for health issues such as cataracts, skin lesions, bone disorders and cancer compared to other healthcare workers.
Researchers in the Italian study gathered work-related and lifestyle information, current medications and health status for 466 hospital staff regularly exposed to ionizing radiation, including interventional cardiologists, electrophysiologists, nurses and technicians, half of whom had been working in cath labs for a minimum of 10 years. They also surveyed 280 staffers who had not been exposed to radiation, for comparison.
Referring to the interventional cardiologists and electrophysiologists who work near the radiation source, Andreassi said that “the cumulative dose in a professional lifetime is not negligible.”
Among the key conclusions of the study:
- Almost 3% of interventional cardiology staff had a history of cancer, compared to less than 1% of the unexposed comparison group.
- 8% of cath lab workers had experienced skin lesions (P=0.002); 30% had an orthopedic illness (P<0.001) and 5% had cataracts (P=0.003), compared to 2%, 5% and less than 1% of the unexposed group, respectively.
- Overall, physicians were at higher risk for health issues than nurses or technicians, and risk was higher among those who had been working more than 16 years.
In fact, workers who spent more than 16 years working in cath labs are 10 times more likely to develop cataracts and eight times more likely to have cancer after adjusting for other factors such as age and smoking status.
Heavy lead personal protective equipment (PPE) can reduce the radiation dose to operators but does not completely protect against the harmful effects of radiation exposure. Most importantly, serious, painful and in some instances, career-altering musculoskeletal issues can result from wearing the lead PPE.
While there is growing awareness of the health problems associated with long-term exposure to radiation, many hospitals are still not adequately training interventional cardiologists and teams in radiation safety and radiobiology, and few have programs that address radiation risk and exposure, Andreassi said.
Dr. Lloyd Klein, an interventional cardiologist at Advocate Illinois Medical Center in Chicago who co-authored an editorial accompanying the Italian study, noted that 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.” While this has been the cultural norm in interventional cardiology, perspectives are changing and data is showing that the risks are real.
Today, interventionalists and cath lab staff have access to many technologies designed to reduce these risks and provide a safer work environment. Corindus is dedicated to helping mitigate these issues through innovative robotic technology that can help protect interventional cardiologists and their teams. In addition, we will continue to raise awareness of this on-going problem and potential solutions.