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Veillette JB, Carrier MA, Rinfret S, Mercier J, Arsenault J, Paradis JM. Occupational Risks of Radiation Exposure to Cardiologists. Curr Cardiol Rep 2024; 26:601-622. [PMID: 38625456 DOI: 10.1007/s11886-024-02056-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE OF REVIEW Invasive cardiologists are exposed to large amounts of ionizing radiation. This review aims to summarize the main occupational risks in a radiation-exposed cardiology practice. RECENT FINDINGS We carried out a literature review on the subject. The studies reviewed allowed us to list six main health risk categories possibly associated with radiation exposure among cardiologists: deoxyribonucleic acid (DNA) and biochemical damages; cancers; ocular manifestations; olfaction, vascular, and neuropsychological alterations; musculoskeletal problems; and reproductive risks. Our descriptive analysis demonstrates higher risks of DNA damage and lens opacities among radiation-exposed cardiology staff. Surveys and questionnaires have demonstrated a higher risk of musculoskeletal disease in exposed workers. Studies reported no difference in cancer frequency between radiation-exposed workers and controls. Changes in olfactory performance, neuropsychological aspects, and vascular changes have also been reported. Limited literature supports the security of continuing radiation-exposed work during pregnancy. Therefore, there is an urgent need to increase knowledge of the occupational risks of radiation exposure and to adopt technologies to reduce them.
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Affiliation(s)
- Jean-Benoît Veillette
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada
- Department of Cardiology, Quebec Heart and Lung Institute, Quebec City, QC, Canada
| | - Marc-Antoine Carrier
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada
- Department of Cardiology, Quebec Heart and Lung Institute, Quebec City, QC, Canada
| | - Stéphane Rinfret
- Department of Interventional Cardiology, Georgia Heart Institute, Gainesville, GA, USA
| | - Julien Mercier
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Jean Arsenault
- Department of Engineering, Quebec Heart and Lung Institute, Quebec City, QC, Canada
| | - Jean-Michel Paradis
- Faculty of Medicine, Université Laval, Quebec City, QC, Canada.
- Department of Cardiology, Quebec Heart and Lung Institute, Quebec City, QC, Canada.
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Mirjalili N, Tse J, Crowhurst JA, Dautov R. Investigation of scatter radiation intensities in the cardiac catheter laboratory: novel versus traditional shielding solutions. Phys Eng Sci Med 2024; 47:181-186. [PMID: 38048014 DOI: 10.1007/s13246-023-01354-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/12/2023] [Indexed: 12/05/2023]
Abstract
A manufacturer has released a novel shielding solution (NSS): Rampart M1128 and claimed that the personal protective equipment (PPE) can be removed. This study investigates the scatter intensities with the NSS or the traditional shielding solutions (TSS) including the ceiling-suspended screen and the tableside lead drape. Isodose maps were generated by two series of measurements with an anthropomorphic phantom using NSS and TSS. Three survey meters were positioned at different heights to measure the scatter intensities at the eye, chest, and pelvic levels. Additional measurements were made at the primary and secondary operators? locations to evaluate the scatter intensities with different clinical projections. For the main operator positions, the isodose maps showed that NSS could result in a scatter dose that reduced by 80% to 95% compared to the same positions with TSS at the eye and chest levels. The corresponding result at the pelvic level was a reduction of 50%. These reductions should be compared to the additional protection by PPE: up to 80% reduction from lead eyeglasses and up to 95% from protective garments. Considering both operators at clinically relevant LAO projections, NSS resulted in scatter dose that was 80% to 96%, 76% to 96% and 25% to 60% lower than those of the TSS at eye, chest and pelvis levels. The protection of NSS is comparable with that of TSS alongside PPE at the eye but not at the chest and the pelvic levels under the setup of coronary angiography.
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Affiliation(s)
- Negar Mirjalili
- Biomedical Technology Services, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD 4031, Australia.
| | - Jason Tse
- Biomedical Technology Services, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD 4031, Australia
| | - James A Crowhurst
- Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD 4031, Australia
- University of Queensland, St Lucia, Brisbane, QLD 4072, Australia
| | - Rustem Dautov
- Department of Cardiology, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD 4031, Australia
- University of Queensland, St Lucia, Brisbane, QLD 4072, Australia
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Ma J, Liu K, Chen W, Wang T, Xu Z, Li Y, Zhao B, Zhou L, Wang F, Li C. A dual-centre study on the radioprotective effect of a novel X-ray protection device during coronary intervention. Clin Radiol 2023; 78:e758-e763. [PMID: 37419771 DOI: 10.1016/j.crad.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/04/2023] [Accepted: 06/04/2023] [Indexed: 07/09/2023]
Abstract
AIM To investigate the shielding efficiency of a novel X-ray protection device (NPD) compared with the traditional lead clothing (TLC) during coronary intervention. MATERIALS AND METHODS This study was performed prospectively in two centres. A total of 200 coronary interventions were included and assigned equally into the NPD or TLC group. The NPD is a floor-standing X-ray protection device, which mainly composes of a barrel-like frame and two layers of lead rubber. Thermoluminescent dosimeters (TLDs) were adopted to detect the cumulative absorbed doses, and were attached outside the NPD or TLC or body of the first operator at four different height levels in four directions during the procedure. RESULTS The cumulative doses outside the NPD were comparable to that of the TLC (2,398.33 ± 2,341.64 versus 1,624.09 ± 1,732.20 μSv, p=0.366), and the cumulative doses inside the NPD were significantly lower than those inside the TLC (40 ± 0 versus 732.28 ± 919.83 μSv, p<0.001). As the TLC did not cover the calf segment of the operator, the area at 50 cm height from the floor in the TLC group was unshielded. The shielding efficiency of NPD was significantly higher than that of the TLC (98.2 ± 0.63% versus 52.11 ± 38.97%, p=0.021). CONCLUSION The NPD has a significantly higher shielding efficacy than that of the TLC, in particular, it protects the operators' lower limb, liberates their lower body from wearing heavy lead apron, and may consequently reduce the radiation or body-load associated complications.
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Affiliation(s)
- J Ma
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - K Liu
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Department of Cardiology, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
| | - W Chen
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu, China
| | - T Wang
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Department of Cardiology, The First People's Hospital of Yancheng, Yancheng, Jiangsu, China
| | - Z Xu
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Y Li
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - B Zhao
- Department of Cardiology, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
| | - L Zhou
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - F Wang
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu, China.
| | - C Li
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
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Crowhurst JA, Tse J, Mirjalili N, Savage ML, Raffel OC, Gaikwad N, Walters DL, Dautov R. Trial of a Novel Radiation Shielding Device to Protect Staff in the Cardiac Catheter Laboratory. Am J Cardiol 2023; 203:429-435. [PMID: 37536045 DOI: 10.1016/j.amjcard.2023.07.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/18/2023] [Accepted: 07/08/2023] [Indexed: 08/05/2023]
Abstract
Continuous exposure to low-level scattered radiation to staff performing cardiac angiography and intervention is of concern. A novel shielding solution (NSS) (Rampart IC M1128) has the potential to provide greater shielding for staff present at the table-side. This study aimed to investigate the effectiveness of the NSS compared with a traditional shielding solution (TSS) in a randomized controlled trial that enrolled 100 patients who underwent cardiac angiography and/or intervention which were randomized to the NSS or TSS. Baseline patient characteristics and radiation dose data were collected. Staff who were scrubbed at the table-side wore 5 real-time dosimeters on the head, collar, waist, ankle, and under the apron. The median primary operator radiation dose was significantly lower (p <0.001) for all dosimeter locations with the NSS when compared with the TSS, being reduced by 86%, 80.0%, 100%, and 50.0% for the head, collar, waist, and leg respectively. Median under-apron dose was 0.0 µSv for both NSS and TSS. Median second operator dose was reduced by 100%, 100%, and 100% for the head, collar, and waist respectively (p <0.001). Median NSS and TSS dose at the ankle and under apron was 0.0 µSv. Median scrub nurse dose was reduced by 50% and 100% for the head and collar respectively (p <0.001). Median NSS and TSS dose at the waist, ankle, and under apron was 0.0 µSv. In conclusion, the NSS tested in this study demonstrates a significant decrease in radiation dose to operators and scrub nurses when compared with traditional radiation protection measures.
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Affiliation(s)
- James A Crowhurst
- Cardiology Department, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Queensland, Australia; School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Jason Tse
- Biomedical Technical Services, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Negar Mirjalili
- Biomedical Technical Services, The Prince Charles Hospital, Chermside, Queensland, Australia
| | - Michael L Savage
- Cardiology Department, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Queensland, Australia
| | - Owen C Raffel
- Cardiology Department, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Queensland, Australia
| | - Niranjan Gaikwad
- Cardiology Department, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Queensland, Australia
| | - Darren L Walters
- Cardiology Department, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Queensland, Australia
| | - Rustem Dautov
- Cardiology Department, The Prince Charles Hospital, Chermside, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Queensland, Australia
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