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Radiation risk to healthcare workers from diagnostic and interventional imaging procedures

Authors
Reza Fazel, MD, MSc
Andrew J Einstein, MD, PhD, FACC, FAHA
Section Editors
Donald Cutlip, MD
Stephan Windecker, MD
N A Mark Estes, III, MD
Deputy Editor
Gordon M Saperia, MD, FACC

INTRODUCTION

In addition to the patient, health care workers are exposed to significant amounts of radiation during cardiovascular imaging procedures. With advancing technology, the realm of procedures being performed percutaneously is steadily expanding. The increased anatomic and technical complexity of these procedures often requires longer fluoroscopy and image capture time and leads to greater radiation exposure to the patient and interventional laboratory staff [1]. In addition, these procedures are exposing new groups of health care workers, including echocardiographers and anesthesiology and operating room staff, to radiation exposure from fluoroscopic imaging while assisting with these procedures. It is imperative that health care workers involved in these procedures be aware of the radiation exposure and are provided with the tools necessary to protect and monitor themselves [2].

This topic will present radiation risks related to occupational exposure in diagnostic and interventional imaging suites, the role of dosimetry, and tools for minimizing radiation exposure to health care workers. Other related topics, including discussions of radiation injury and radiation exposure in cardiovascular imaging, are presented separately. (See "Biology and clinical features of radiation injury in adults" and "Radiation-related risks of imaging studies" and "Radiation dose and risk of malignancy from cardiovascular imaging".)

RADIATION RISK

Exposure to ionizing radiation can lead to tissue reactions (formerly known as deterministic effects) or stochastic effects (a stochastic effect represents an outcome for which the probability of occurrence, rather than severity, is determined by the dose). An example is radiation-induced carcinogenesis. (See "Radiation dose and risk of malignancy from cardiovascular imaging".)

When standard radiation protection tools are used in the cardiovascular interventional lab, doses to the operator and staff do not typically approach thresholds of tissue reactions and the principle risks to consider are the stochastic risks of induced cataract formation and cancer [3].

Cataracts — The lens of the eye is one of the most radiosensitive tissues in the body [4,5]. In spite of the well documented history of radiation-induced cataract, there is still considerable uncertainty surrounding the relationship between dose and radiation cataract development [6]. Studies of exposed human subjects suggest that there is no clear threshold dose for cataract formation. It also appears that the latency period is inversely related to the exposure dose.

                

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Literature review current through: Nov 2016. | This topic last updated: Tue Jun 14 00:00:00 GMT 2016.
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