Eye Lens Radiation Exposure in Greek Interventional Cardiology Article

Thrapsanioti, Zoi; Askounis, Panagiotis; Datseris, Ioannis; Diamanti, Ramza Anastasia; Papathanasiou, Miltiadis; Carinou, E.

doi:10.1093/rpd/ncw356

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…The radiation dose received by the lenses of the eyes of interventional radiologists and cardiologists has been investigated extensively over the past decade [1][2][3][4]. These individuals use radiological imaging while manipulating surgical devices through catheters and need to be close to their patient and as a result have a higher risk for incidence of radiation-induced cataracts [5,6].…”

Section: Introductionmentioning

confidence: 99%

A study of the underestimation of eye lens dose with current eye dosemeters for interventional clinicians wearing lead glasses

et al. 2020

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The reduction in the occupational dose limit of the eye lens has created the need for optimising eye protection and dose assessment, in particular for interventional clinicians. Lead glasses are one of the protection tools for shielding the eyes, but assessing the eye lens dose when these are in place remains challenging. In this study, we evaluated the impact of the position of Hp(3) dosemeters on the estimated eye lens dose when lead glasses are used in interventional settings. Using the Monte Carlo method (MCNPX), an interventional cardiology setup was simulated for two models of lead glasses, five beam projections and two patient access routes. Hp(3) dosemeters were placed at several positions on the operator and the obtained dose was compared to the dose to the sensitive part of the eye lens (Hlens). Furthermore, to reproduce an experimental setup, a reference dosemeter, Hp(3)ref, was placed on the surface of the eye. The dose measured by Hp(3)ref was, on average, only 60% of Hlens. Dosemeters placed on the glasses, under their shielding, underestimated Hlens for all parameters considered, by from 10% up to 90%. Conversely, dosemeters placed on the head or on the glasses, over their shielding, overestimated Hlens, on average, up to 60%. The presence or lack of side shielding in lead glasses affected mostly dosemeters placed on the forehead, at the left side. Results suggest that both use of a correction factor of 0.5 to account for the presence of lead glasses in doses measured outside their shielding and placing an eye lens dosemeter immediately beneath the lenses of lead glasses may lead to the underestimation of the eye lens dose. Most suitable positions for eye lens dose assessment were on the skin, unshielded by the glasses or close to the eye, with no correction to the dose measured.

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Section: Introductionmentioning

confidence: 99%

A study of the underestimation of eye lens dose with current eye dosemeters for interventional clinicians wearing lead glasses

et al. 2020

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“…11,12,32 Our findings, however, corroborate those of two other studies that showed a lower prevalence of radiation associated cataracts compared with the preceding studies cited. 13,14 The combined prevalence of cataracts for both PSC and cortical was 18.8%. There is evidence to suggest that cortical cataracts may also be associated with radiation.…”

Section: Discussionmentioning

confidence: 96%

“…In contrast, separate Greek and Finnish studies showed that there was no statistically significant difference between cataract findings in interventionalists occupationally exposed to IR and a group of doctors not occupationally exposed to IR. 13,14 In the Greek study, Thrapsanioti, et al (2017), included 44 interventional cardiologists. 13 In the Finnish study by Auvinen, et al (2015) PSC cataracts were detected in 3/21 exposed participants compared with 1/15 unexposed participants (the prevalence ratio was 2.29 [CI: 0.29-19.97] for the exposed group) and the mean age was 54.…”

Section: Introductionmentioning

confidence: 99%

“…13,14 In the Greek study, Thrapsanioti, et al (2017), included 44 interventional cardiologists. 13 In the Finnish study by Auvinen, et al (2015) PSC cataracts were detected in 3/21 exposed participants compared with 1/15 unexposed participants (the prevalence ratio was 2.29 [CI: 0.29-19.97] for the exposed group) and the mean age was 54. 14 It is, however, difficult to compare studies on the prevalence of occupational radiation-induced cataracts as these studies used different grading systems, different assessments of risk factors and there are concerns about dosimetry because of dose uncertainties.…”

Section: Introductionmentioning

confidence: 99%

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Radiation induced cataracts in interventionalists occupationally exposed to ionising radiation

et al. 2022

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Background: Occupational exposure to ionising radiation may have detrimental health effects. Longer and more complex fluoroscopic procedures have placed interventionalists at increased occupational health risks especially for developing cataracts in the radiosensitive lenses of the eyes.Objectives: This study aimed to determine the prevalence of occupational related cataracts and describe the risk factors for cataracts in occupationally exposed interventionalists compared with unexposed doctors.Method: A cross-sectional study using multiple methods. A survey was conducted. The radiation workload was determined based on a self-administered questionnaire and dose area product values determined in previous studies. Both groups had slit lamp examinations. The data were analysed analytically using R software version 9.3.Results: The study included 98 interventionalists. The combined prevalence of posterior sub-capsular (PSC) and cortical cataracts was 18.8% in the exposed and 13.9% in the unexposed group. The prevalence of PSC cataracts in the exposed group was 5.9% and 2.8% in the unexposed group, with an odds ratio (OR) of 2.2 (95% confidence interval [CI]: 0.58; 8.61). Posterior sub-capsular cataracts were more common in the left eye. The increase in cataracts was not statistically significant in the exposed group but is of clinical significance.Conclusion: The findings are important as they highlight the need for greater vigilance for protecting the radiation healthcare workforce in a developing country setting.Contribution: The research is the first of its kind in South Africa and Africa and contributes to determining the prevalence in this highly skilled and occupationally vulnerable group.

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“…The most radiosensitive ocular component is the lens: therefore, the most common consequence of eyes IR exposure in interventional radiology operators is the lens opacity, which can progress up to cataracts [79,85,86]. Several data demonstrated a higher frequency of early lens opacity and cataracts in these workers [87][88][89][90], especially among interventional cardiology [88,[91][92][93][94]. A recent study indicated that around 25% of interventional cardiologists might be at risk of developing an early radio-induced cataract [88].…”

Section: Ophthalmic Ir Effects In Interventional Radiologymentioning

confidence: 99%

Radiation-Induced Cerebro-Ophthalmic Effects in Humans

Loganovsky

Marazziti

Fedirko

et al. 2020

Life

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Exposure to ionizing radiation (IR) could affect the human brain and eyes leading to both cognitive and visual impairments. The aim of this paper was to review and analyze the current literature, and to comment on the ensuing findings in the light of our personal contributions in this field. The review was carried out according to the PRISMA guidelines by searching PubMed, Scopus, Embase, PsycINFO and Google Scholar English papers published from January 2000 to January 2020. The results showed that prenatally or childhood-exposed individuals are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. In adulthood and medical/interventional radiologists, the most frequent IR-induced ophthalmic effects include cataracts, glaucoma, optic neuropathy, retinopathy and angiopathy, sometimes associated with specific neurocognitive deficits. According to available information that eye alterations may induce or may be associated with brain dysfunctions and vice versa, we propose to label this relationship “eye-brain axis”, as well as to deepen the diagnosis of eye pathologies as early and easily obtainable markers of possible low dose IR-induced brain damage.

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Eye Lens Radiation Exposure in Greek Interventional Cardiology Article

Cited by 9 publications

References 21 publications

A study of the underestimation of eye lens dose with current eye dosemeters for interventional clinicians wearing lead glasses

A study of the underestimation of eye lens dose with current eye dosemeters for interventional clinicians wearing lead glasses

Radiation induced cataracts in interventionalists occupationally exposed to ionising radiation

Radiation-Induced Cerebro-Ophthalmic Effects in Humans

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