Chromosomal aberrations in C-arm fluoroscopy, CT-scan, lithotripsy, and digital radiology staff

Shafiee, Mohsen; Borzoueisileh, Sajad; Rashidfar, Razieh; Dehghan, Maryam; Sisakht, Zahra Jaafarian

doi:10.1016/j.mrgentox.2020.503131

Cited by 5 publications

(5 citation statements)

References 38 publications

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“…Indeed, most of the occupational exposures are below the lowest resolution power observed in ex vivo cytogenetic assays [ 92 , 93 , 94 ], but previous studies did show a significant increase in cytogenetic endpoints in patients who received radiation exposure during a single medical examination, such as a CT scan or catheterization procedure, where the radiation dose is far lower than 100 mSv [ 95 , 96 , 97 ]. Similarly the effect of confounding factors on CA frequencies was inconsistent between studies, with some authors reporting the effect of certain factors such as age, smoking and gender [ 54 , 57 , 60 , 72 ], while others showing no influence [ 62 , 64 , 76 , 87 ]. Furthermore, statistically significant differences in CA frequencies were reported between cohorts employed at different working places, with specificity of certain types of CA depending on the job.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers of Genotoxicity in Medical Workers Exposed to Low-Dose Ionizing Radiation: Systematic Review and Meta-Analyses

Baudin¹,

Bernier²,

Klokov

et al. 2021

IJMS

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Medical staff represent the largest group of workers occupationally exposed to ionizing radiation (IR). Chronic exposure to low-dose IR may result in DNA damage and genotoxicity associated with increased risk of cancer. This review aims to identify the genotoxicity biomarkers that are the most elevated in IR-exposed vs. unexposed health workers. A systematic review of the literature was performed to retrieve relevant studies with various biomarkers of genotoxicity. Subsequent meta-analyses produced a pooled effect size for several endpoints. The search procedure yielded 65 studies. Chromosome aberrations (CA) and micronuclei (MN) frequencies were significantly different between IR-exposed and unexposed workers (θpooled = 3.19, 95% CI 1.46–4.93; and θpooled = 1.41, 95% CI 0.97–1.86, for total aberrant cells and MN frequencies, respectively), which was not the case for ring chromosomes and nucleoplasmic bridges. Although less frequently used, stable translocations, sister chromatid exchanges (SCE) and comet assay endpoints were also statistically different between IR-exposed and unexposed workers. This review confirms the relevance of CA and MN as genotoxicity biomarkers that are consistently elevated in IR-exposed vs. unexposed workers. Other endpoints are strong candidates but require further studies to validate their usefulness. The integration of the identified biomarkers in future prospective epidemiological studies is encouraged.

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Section: Discussionmentioning

confidence: 99%

Biomarkers of Genotoxicity in Medical Workers Exposed to Low-Dose Ionizing Radiation: Systematic Review and Meta-Analyses

Baudin¹,

Bernier²,

Klokov

et al. 2021

IJMS

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“…The MN assay has been used as a biological dosimetry method in many studies, with some success. The results presented by Shafiee et al showed that this method might be able to detect occupational exposures as low as 0.1 mSv/year [52]. Some researchers show a dose-response correlation for occupational exposures, however, more thorough studies on larger groups should be conducted to verify this relationship.…”

Section: Cytokinesis-block Micronucleus Assaymentioning

confidence: 99%

“…Recently, Shafiee et al investigated the level of CA in blood lymphocytes of personnel working with C-arm fluoroscopy, multiscan CT slice, lithotripsy and digital radiology procedures [52]. The doses to which workers were exposed ranged from 0 to 2.99 mSv.…”

Section: Scoring Of Chromosomal Aberrationsmentioning

confidence: 99%

“…No correlation with the smoking status was observed, however, female workers showed higher frequency of binucleated MN cells than male workers. One of the most recent studies conducted by Shafiee et al evaluated the frequency of MNs in exposed radiation workers and matched controls [52]. The frequency of MN was significantly higher in the study group compared to the control group.…”

Section: Cytokinesis-block Micronucleus Assaymentioning

confidence: 99%

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Use of Biological Dosimetry for Monitoring Medical Workers Occupationally Exposed to Ionizing Radiation

Piotrowski

Dawid²,

Kulcenty

et al. 2021

Radiation

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Medical workers are the largest group exposed to man-made sources of ionizing radiation. The annual doses received by medical workers have decreased over the last several decades, however for some applications, like fluoroscopically guided procedures, the occupational doses still remain relatively high. Studies show that for some procedures the operator and staff still use insufficient protective and dosimetric equipment, which might cause an underestimation of medical exposures. Physical dosimetry methods are a staple for estimating occupational exposures, although due to the inconsistent use of protection measures, an alternative method such as biological dosimetry might complement the physical methods to achieve a more complete picture. Such methods were used to detect exposures to doses as low as 0.1 mSv/year, and could be useful for a more accurate assessment of genotoxic effects of ionizing radiation in medical workers. Biological dosimetry is usually based on the measurement of the effects present in peripheral blood lymphocytes. Although some methods, such as chromosome aberration scoring or micronucleus assay, show promising results, currently there is no one method recognized as most suitable for dosimetric application in the case of chronic, low-dose exposures. In this review we decided to evaluate different methods used for biological dosimetry in assessment of occupational exposures of medical workers.

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“…There have been reports of a potential causal relationship between occupational exposure and the development of skin, breast and brain cancer 14 – 16 . There are also reports of DNA damage, chromosomal aberrations, genomic instability 17 , 18 and cardiovascular damage at low levels of radiation exposure 19 . There is clear evidence of deterministic effects due to occupational exposure during fluoroscopically guided procedures.…”

Section: Introductionmentioning

confidence: 99%

A comparison of patient dose and occupational eye dose to the operator and nursing staff during transcatheter cardiac and endovascular procedures

Wilson‐Stewart

Fontanarosa

Malacova

et al. 2023

Sci Rep

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The number and complexity of transcatheter procedures continue to increase, raising concerns regarding radiation exposure to patients and staff. Procedures such as transaortic valve implantations (TAVI) have led to cardiologists adopting higher dose techniques, such as digital subtraction angiography (DSA). This study compared the estimated patient and occupational eye dose during coronary angiography (CA), percutaneous coronary intervention (PCI), TAVI workups (TWU), TAVI, endovascular aneurysm repairs (EVAR), and other peripheral diagnostic (VD) and interventional (VI) vascular procedures. A quantitative analysis was performed on patient dose during 299 endovascular and 1498 cardiac procedures. Occupational dose was measured for the cardiologists (n = 24), vascular surgeons (n = 3), scrub (n = 32) and circulator nurses (n = 35). TAVI and EVAR were associated with the highest average dose for all staff, and significantly higher patient dose area product, probably attributable to the use of DSA. Scrub nurses were exposed to higher average doses than the operator and scout nurse during CA, VD and VI. Circulating nurses had the highest average levels of exposure during TAVI. This study has demonstrated that EVAR and TAVI have similar levels of occupational and patient dose, with a notable increase in circulator dose during TAVI. The use of DSA during cardiac procedures is associated with an increase in patient and staff dose, and cardiologists should evaluate whether DSA is necessary. Scrub nurses may be exposed to higher levels of occupational dose than the operator.

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Chromosomal aberrations in C-arm fluoroscopy, CT-scan, lithotripsy, and digital radiology staff

Cited by 5 publications

References 38 publications

Biomarkers of Genotoxicity in Medical Workers Exposed to Low-Dose Ionizing Radiation: Systematic Review and Meta-Analyses

Biomarkers of Genotoxicity in Medical Workers Exposed to Low-Dose Ionizing Radiation: Systematic Review and Meta-Analyses

Use of Biological Dosimetry for Monitoring Medical Workers Occupationally Exposed to Ionizing Radiation

A comparison of patient dose and occupational eye dose to the operator and nursing staff during transcatheter cardiac and endovascular procedures

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