Factors affecting the radiation dose to the lens of the eye during cardiac catheterization procedures

Abstract

Concern has been expressed about the relatively high radiation doses to the lens of the eye received by the operator during cardiac catheterization studies. A study was undertaken to assess the occupational doses received by cardiologists and to examine the factors that affect the individual's eye dose. Eighteen cardiologists working in five catheterization laboratories at three centres were included in the study. Their eye doses, workload and individual study details were monitored at each centre. Operating dose rates and scattered radiation were also measured for each unit to compare equipment performance. The study demonstrated that the relationships between the cardiologist's eye dose and factors such as the dose efficiency of the X-ray equipment, scattered dose rates, examination protocols and workload are complex and vary from centre to centre. Because of these variations general workload limits may be inaccurate and should only be used for general guidance when no direct measurements are available. Such limits should be verified by local measurements as soon as is practical.

Evaluation of a Suspended Personal Radiation Protection System vs. Conventional Apron and Shields in Clinical Interventional Procedures

“…Combinations of lead apron, attenuating drapes, accessory shields and glasses have been studied using phantoms to extrapolate radiation protection theoretically provided to the practicing interventionalist [13,14,[20][21][22]26,27]. Although phantom studies provide preliminary information, application to clinical practice is problematic due to many dynamic factors including large patients, interference with operator's hands or arms from accessory shields, and inability to use shielding in certain image receptor obliquities or operator stances.…”

“…Although phantom studies provide preliminary information, application to clinical practice is problematic due to many dynamic factors including large patients, interference with operator's hands or arms from accessory shields, and inability to use shielding in certain image receptor obliquities or operator stances. Results with phantoms showing significantly reduced eye exposures using shields are not fully corroborated by clinical studies using the same shielding, with one study documenting high clinical eye doses and recommending protective eyewear in addition to the suspended shield [20][21][22][23][27][28][29]. A feasibility study of an earlier prototype of the suspended personal radiation protection system using phantoms showed 16 -78 fold decreases in exposure to various body areas compared to a lead apron due to thicker lead and greater surface area covered [30].…”

Effective Use of Radiation Shields to Minimize Operator Dose During Invasive Cardiology Procedures

“…To help minimize radiation dose, all persons working in interventional x-ray rooms are required to wear lead-equivalent radiation protection garments. Although these garments are effective at stopping radiation, a person's arms, head, and neck (without protective collar) are generally unprotected (5)(6)(7)(8).…”

Eye Lens Exposure to Radiation in Interventional Suites: Caution Is Warranted

“…These are among the highest occupational radiation doses documented by medical staff who use x-rays (2)(3)(4).…”