Impact of patient obesity on radiation doses received by scrub technologists during coronary angiography

Patient Body Mass Index and Occupational Radiation Doses to Circulating Nurses During Coronary Angiography

BACKGROUND

Patient BMI is associated with radiation doses received by interventional cardiologists, yet the association between patient BMI and nurse radiation doses is unknown. This study evaluated the association between patient body mass index (BMI) and nurse radiation doses during coronary angiography.

METHODS

Nurse radiation doses were collected by real-time dosimeters during consecutive coronary angiography procedures and are reported as the personal dose equivalent (H_p10). Patient radiation doses were estimated using dose area product (DAP). Patient BMI was categorized in kg/m² as <25.0, 25.0-29.9, 30.0-34.9, 35.0-39.9, and ≥40. Multiple regression analysis determined procedural factors independently association with nurse radiation doses.

RESULTS

In 643 consecutive coronary angiography procedures, patient radiation doses increased significantly across increasing patient BMI categories (p < 0.001). Compared to a patient BMI <25, a patient BMI ≥40 was associated with a 2.3-fold increase in DAP (p < 0.001). Significant differences were also observed in nurse radiation doses across patient BMI categories (p = 0.036). Compared to a patient BMI <25, a patient BMI ≥40 was associated with a 4.0-fold increase in nurse radiation dose (BMI < 25: 0.3 [0.1, 1.3] μSv; BMI ≥ 40: 1.2 [0.2, 2.9] μSv; p = 0.003). By multiple regression analysis, each 1-unit kg/m² increase in patient BMI was associated with a 3.3% increase in nurse radiation dose (p = 0.002).

CONCLUSIONS

Patient BMI was significantly associated with nurse radiation doses during coronary angiography. These observations may have important implications on nurse radiation safety, especially in the setting of the ongoing obesity epidemic.