Cardiology fellows-in-training are exposed to relatively high levels of radiation in the cath lab compared with staff interventional cardiologists—insights from the RECAP trial

Abstract

Background Interventional cardiologists are inevitably exposed to low-dose radiation, and consequently are at risk for radiation induced diseases like cataract and left-sided brain tumours. Operator behaviour may possibly be the largest influencer on radiation exposure. We hypothesised that awareness regarding radiation exposure grows as skill and the general experience in the catheterization laboratory increase. Objectives In this study we determined the difference in the relative radiation exposure of staff interventional cardiologists compared with cardiology fellows-in-training. Methods During this prospective trial the operator’s radiation exposure (E in µSv) was measured at chest height during 766 diagnostic catheterisations and percutaneous coronary interventions. Also, the patient exposure (DAP in mGy·cm 2 ), representing the amount of radiation administered by the operator per procedure, was collected. The primary outcome of this study was the difference in relative exposure between staff interventional cardiologists versus cardiology fellows-in-training (E/DAP). Results From January to May 2017, staff interventional cardiologists performed 637 procedures and cardiology fellows-in-training 129 procedures. The performance of relatively complex procedures by staff interventional cardiologists resulted in a 74% higher use of radiation compared with fellows-in-training. Consequently, staff interventional cardiologists were exposed to 50% higher levels of actual radiation exposure. However, when correcting for the complexity of the procedure, by comparing the relative operator exposure (E/DAP), fellows-in-training were exposed to a 34% higher relative exposure compared with staff interventional cardiologists ( p = 0.025). Conclusions In the current study, when corrected for complexity, cardiology fellows-in-training were exposed to significantly higher radiation levels than staff interventional cardiologists during catheterisation procedures.

A multicentre survey of knowledge and implementation of radiation protection techniques in cardiac cath-lab medical personnel

“…The same results were reported by the study conducted by Vlastra W et al [ 10 ] in 2019 who concluded that fellows-in-training were exposed to a 34% higher relative radiation exposure compared with the staff interventional cardiologists ( p = 0.025). This signifies that these subgroups are at relatively higher risk of radiation hazards, requiring a special attention to both awareness and protection.…”

“…We also found that among the group of physicians, residents and fellows were the highest subgroups in terms of exposure to radiation because they were exposed to almost the same workload as nurses and technicians when compared to the consultants with P-value < 0.01. The same results were reported by the study conducted by Vlastra W et al [10] in 2019 who concluded that fellows-in-training were exposed to a 34% higher relative radiation exposure compared with the staff interventional cardiologists (p = 0.025). This signifies that these subgroups are at relatively higher risk of radiation hazards, requiring a special attention to both awareness and protection.…”

Evaluating the Cumulative Effects of Fundamental Radiation Safety Measures on Health Professionals in Cath Lab

“…The length of the procedure plays a significant role in increasing the staff and patient dose. An experienced doctor might finish the procedure more quickly than a new Cardiology fellows-in-training (12) . The effect of the time of procedure against the dose was evaluated by measuring the dose at the M P explained in the above section.…”

Prevalence of Brain and Neck Neoplasms among Interventional Cardiologists; A Multicenter Study

“…Rest, physiotherapy and other conservative therapies help in relieving these orthopedic disorders. 16,17 Interventional Cardiologists' working in the cardiac catheterization labs and doing PCI's frequently are exposed to high levels of radiation, which may increase their cancer risk as compared to those cardiologists who are not working in the catheterization labs. 18 In this study, it was observed that the mean duration of working in cardiac catheterization labs was 17.92±4.57 years.…”