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Alvandi M, Javid RN, Shaghaghi Z, Farzipour S, Nosrati S. An In-depth Analysis of the Adverse Effects of Ionizing Radiation Exposure on Cardiac Catheterization Staffs. Curr Radiopharm 2024; 17:219-228. [PMID: 38314600 DOI: 10.2174/0118744710283181231229112417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 02/06/2024]
Abstract
Diagnostic and interventional angiograms are instrumental in the multidisciplinary approach to CAD management, enabling accurate diagnosis and effective targeted treatments that significantly enhance patient care and cardiovascular outcomes. However, cath lab staff, including interventional cardiologists, is consistently exposed to ionizing radiation, which poses inherent health risks. Radiation exposure in the cath lab primarily results from the use of fluoroscopy and cineangiography during diagnostic and interventional procedures. Understanding these risks and implementing effective radiation protection measurements are imperative to ensure the well-being of healthcare professionals while delivering high-quality cardiac care. Prolonged and repeated exposure can lead to both deterministic and stochastic effects. Deterministic effects, such as skin erythema and tissue damage, are more likely to occur at high radiation doses. Interventional cardiologists and staff may experience these effects when safety measures are not rigorously followed. In fact, while ionizing radiation is essential in the practice of radiation cardiology ward, cath lab staff faces inherent risks from radiation exposure. Stochastic effects, on the other hand, are characterized by a probabilistic relationship between radiation exposure and the likelihood of harm. These effects include the increased risk of cancer, particularly for those with long-term exposure. Interventional cardiologists, due to their frequent presence in the cath lab, face a higher lifetime cumulative radiation dose, potentially elevating their cancer risk. Protective measures, including the use of lead aprons, thyroid shields, and radiation monitoring devices, play a crucial role in reducing radiation exposure for cath lab personnel. Adherence to strict dose optimization protocols, such as minimizing fluoroscopy time and maximizing distance from the radiation source, is also essential in mitigating these risks. Ongoing research and advancements in radiation safety technology are essential in further for minimizing the adverse effects of ionizing radiation in the cath lab.
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Affiliation(s)
- Maryam Alvandi
- Cardiovascular Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Zahra Shaghaghi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soghra Farzipour
- Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Guilan, Iran
| | - Sahar Nosrati
- Institute of Nuclear Chemistry and Technology, Dorodna 16 Str, 03-195, Warsaw, Poland
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Lin C, Aljuaid M, Tirada N. Needlestick injuries in radiology: prevention and management. Clin Radiol 2022; 77:496-502. [PMID: 35487781 DOI: 10.1016/j.crad.2022.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 03/25/2022] [Indexed: 01/01/2023]
Abstract
Needlestick injuries are common and often underreported in invasive radiological procedures. Prior needlestick injuries have been reported in 86-91% of interventional radiologists, and on average, one needlestick injury occurs for every 5 years of practice. Of those that have had a needlestick injury, only 58% had formal education on needlestick injury prevention. Needlestick injuries can often result in long-term debility if not properly managed. Injuries can result in transmission of blood-borne pathogens, such as hepatitis B, hepatitis C, and human immunodeficiency virus. Preventative measures, such as vaccination, proper sharps selection, handling, and disposal during radiological procedures, minimising procedure time, and team communication, can decrease the risk of needlestick injuries and pathogen transmission rate. Initial management involves proper cleaning of the wound and activating the injury reporting system. Further lab testing and post-exposure prophylaxis will depend on the serology status of the source and exposed patient. Needlestick injuries with pathogen transmission can result in long-term health issues and psychological damage, therefore, it is imperative for radiologists to understand factors that increase the risk for transmission, methods to prevent injury, and how to manage an injury when it occurs.
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Affiliation(s)
- C Lin
- University of Maryland Medical Center, 22 South Greene St., Baltimore, MD 21201, USA.
| | - M Aljuaid
- University of Maryland Medical Center, 22 South Greene St., Baltimore, MD 21201, USA; King Saud University, Riyadh 11451, Saudi Arabia
| | - N Tirada
- University of Maryland Medical Center, 22 South Greene St., Baltimore, MD 21201, USA
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Riesgo biológico en Cardiología intervencionista. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2019.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Chauvin A, Hutin A, Leredu T, Plaisance P, Pateron D, Yordanov Y. Accidental blood exposures among emergency medicine residents and young physicians in France: a national survey. Intern Emerg Med 2017; 12:221-227. [PMID: 27179649 DOI: 10.1007/s11739-016-1458-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
Abstract
The aim of the present study was to investigate the epidemiological characteristics of blood or fluid exposure (BFE) and occupational infection risk among emergency medicine (EM) residents and young physicians (<35 years old) in France. We led a cross-sectional, anonymous, online survey. 1779 participants were contacted with a response rate of 36 % (n = 633). Among the respondents, 459 (72 %) reported at least one BFE. Among participants with at least one BFE, 35 % (n = 163) never reported the exposure to the relevant medical authorities or support. Among participants who reported exposure, 63 % (n = 232) did it immediately. Among participants who never or not systematically reported their BFE, most of them (62 %, n = 181/289) did not do so because the procedure was too long, and 28 % (n = 82/289) estimated the risk as low even if only one-third (n = 166/458) checked their HIV status even though the BFE was at a transmission risk. Circumstances in which the participants had the most BFE were: suturing 57 % (n = 262/457) and when making precipitated gestures 24 % (n = 111/457). The latest exposures were caused by a solid needle in 42 % (n = 191/455) or hollow-bore needle in 27 % (n = 123/455). Post-exposure reporting rates were low. Reporting procedure itself and self-management were the main reasons for BFE underreporting. Simplifying procedures might increase BFE reporting, and allow appropriate post-exposure counseling and/or prophylaxis.
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Affiliation(s)
- Anthony Chauvin
- Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France.
- Faculté de Médecine, Université Diderot, Paris, France.
- AJMU, Association des Jeunes Médecins Urgentistes, Paris, France.
- Hospital Lariboisière, Service d'Accueil des Urgences, 2, rue Ambroise Pare, 75010, Paris, France.
| | - Alice Hutin
- AJMU, Association des Jeunes Médecins Urgentistes, Paris, France
- Emergency Département, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- Faculté de Médecine, Université Descartes, Paris, France
| | - Thomas Leredu
- AJMU, Association des Jeunes Médecins Urgentistes, Paris, France
- Emergency Département, Hôpital Mignot, Versailles, France
| | - Patrick Plaisance
- Emergency Département, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
- Faculté de Médecine, Université Diderot, Paris, France
| | - Dominique Pateron
- Emergency Département, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
- Faculté de Médecine, Université Pierre et Marie Curie, Paris, France
| | - Youri Yordanov
- Emergency Département, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
- Faculté de Médecine, Université Pierre et Marie Curie, Paris, France
- AJMU, Association des Jeunes Médecins Urgentistes, Paris, France
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Smilowitz NR, Balter S, Weisz G. Occupational hazards of interventional cardiology. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2013; 14:223-8. [DOI: 10.1016/j.carrev.2013.05.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 05/01/2013] [Accepted: 05/03/2013] [Indexed: 10/26/2022]
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