Dear cleve-ga;
Your concern for your friend’s well being is admirable, and your
question is certainly worth researching for the peace of mind it will
bring to you both.
Radiation safety in all health care fields, particularly those
involving electrophysiologic cineangiographic procedures, is at an all
time high due in part to the number of patients seeking such
treatments and the advent of technology that supports (or requires)
longer durations of exposure. In contrast, new technology that enables
the exposed worker to better protect himself or alert himself to
dangerous exposure levels have also been developed which helps, to
some degree, to offset some of the risks. In any case, each
caregiver’s potential health risks vary depending upon their field of
medicine, their required duties, and the protective measures they
practice.
Invasive and interventional cardiologists have frequent exposure
through fluoroscopy and cineangiography, as do electrophysiologists,
who rely heavily on fluoroscopy for the procedures they perform. For
obvious reasons, nuclear cardiologists are also frequently exposed to
radioactive materials while performing their duties, as are nurses
aids, medical practitioners, cardiologists-in-training, nurses,
laboratory technologists and support personnel by coming into contact
with area exposed to radiation in the cardiac laboratory setting and
through patients who have been injected with radioactive materials. As
trained medical professionals, each person bears the responsibility to
take whatever measures are necessary to minimize their own risks of
exposure (or over-exposure) in the prescribed manner.
Over-exposure, or exposure to significant levels of radiation poses a
number or risks including cancer, cataracts, genetic risks and fetal
injury. While radiation exposure (per case) among cardiologists is not
considered a major health issue on the larger scale, long-term
exposure could theoretically have a significant impact on one’s
health, especially if protective measures are ignored.
As mentioned previously, the advent of newer technology creates an
added risk to the caregivers in some areas while others are much safer
than before. During cardiac diagnostic and interventional procedures,
for example, higher intensity fluoroscopic imaging is used, resulting
in increased exposure times; whereas the electrophysiology laboratory,
for example, and other areas where high intensity fluoroscopic imaging
is not required, exposure times may not be as prolonged as they were
only a few years ago (except during ablation procedures because they
can require prolonged fluoroscopy time). Logically, pediatric
caregivers might be considered to be at one end of the spectrum
because they face a lesser exposure risk simply by virtue of the fact
that their patients are smaller, and therefore require much lower
doses of radiation. Nuclear biologists, on the other hand, might be
considered at the other end of the spectrum, because they practice
medicine using the very chemicals and treatments that pose the
greatest hazard.
Medical practitioners are certainly justified in their concern about
radiation exposure levels especially if they are not practicing
protective measures, are not receiving the proper training or not
afforded access to the proper equipment to prevent unnecessary
exposure. In most settings however, personnel are provided two-piece
wraparound aprons, eye protection, thyroid shields and monitoring
devices to prevent or record exposures to radiation. The proper use of
these devices is an important part of each cardiologist’s training.
Pregnant workers, in particular, are at greater risk and added
precautions are recommended during the worker’s pregnancy in order to
prevent potential risks such as fetal death, malformations, growth
retardation, congenital defects, mental retardation and cancer
induction.
In view of the number of cardiac procedures involving radiation
performed in US hospitals each year and the rising number of people
entering into the medical workforce, the various methods of
successfully preventing unnecessary exposure to radiation are not only
stressed in training but also routinely practiced. While exposure to
radiation does pose an occupational hazard to cardiologists, even
while performing “standard” procedures, the accepted safety measures
do seem to work. The fact that hospitals are not bursting at the seams
with cardiologists dying of radiation poisoning, blindness and cancer
as a direct result of their work is proof of that. When properly
observed, these methods are extremely reliable as a means of
protection and prevention.
Your friend will likely be safe as he/she enters into this noble
cause.
I hope my research has proven to be of value to you.
Best regards;
Tutuzdad-ga
American College of Cardiology
“Radiation Safety in the Practice of Cardiology”
LIMACHER ET AL., RADIATION SAFETY IN CARDIOLOGY
JACC Vol. 31, No. 4, March 15, 1998:892-913
http://www.acc.org/clinical/consensus/radiation/jac5526fla1.htm
CURRENT ACTIVITIES TO REDUCE RADIATION RISKS FROM INTERVENTIONAL
RADIOLOGY
By Thomas B. Shope, Center for Devices and Radiological Health, Food
and Drug Administration
http://www.crcpd.org/Proceedings/CRCPD%202001%20paper.doc
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES ADMINISTRATIVE GUIDE
NUMBER: 11.4.10
DATE: 04/05/96
REVISION: 01/18/02
SECTION: CAMPUS OPERATIONS
AREA: GENERAL AND OCCUPATIONAL SAFETY
SUBJECT: PREGNANT EMPLOYEES WORKING WITH IONIZING RADIATION
http://www.uams.edu/AdminGuide/WIN11410.html
Health and Family Welfare Department Government of Gujarat
“Medical Education and Research”
http://gujhealth.gov.in/medi-edu/x-ray/radiatio_protection_doctors/prescri_physician.htm
Radiation FAQ’s for Doctors
http://gujhealth.gov.in/medi-edu/x-ray/radiatio_protection_doctors/faq.htm
Coronary Brachytherapy: New Advancement in the Treatment of Coronary
Artery Disease Now Available at Carle
http://www.carle.com/WhatsNew/coronarybrachy.htm
RECOMMENDED READING
“Health Risk Communicator”
(A Publication of the Subcommittee on Risk Communication and Education
Public Health Service – offers a 1 year trial subscription)
http://www.health.gov/environment/HRC/HRCapr95.htm
Managing Editor: Tim Tinker, Dr.PH, Agency for Toxic Substances and
Disease Registry
1600 Clifton Rd., E33
Atlanta, GA 30333.
Tel 404/6396206
Fax 404/6396208
Email: txt2@atsod3.em.cdc.gov |
