Risk of cataract among interventional cardiologists and catheterization lab staff: A systematic review and meta‐analysis

Elmaraezy, Ahmed; Morra, Mostafa Ebraheem; Mohammed, Abdelrhman Tarek; Al-Habaa, Ahmed; Elgebaly, Ahmed; Ghazy, Ahmed; Khalil, Adham M.; Huy, Nguyen Tien; Hirayama, Kenji

doi:10.1002/ccd.27114

Cited by 93 publications

(74 citation statements)

References 41 publications

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“…The harmful effects of ionizing radiation include skin and eye damage, as well as certain forms of cancer consequent to the interaction of radiation with cellular DNA. [1][2][3][4][5] Although advances in technology and fine-tuning of radiation safety protocols over the past decades have reduced radiation doses in patients and operators, 2 the catheterization laboratory continues to be a significant source of radiation. 7 Implementing our LRP, as well as stressing the importance of reducing radiation exposure to our operators, resulted in significant reductions in DAP and AK in our cardiac catheterization laboratory, without increasing procedural complications, fluoroscopy time, or the volume of contrast media used during the procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Radiation exposure can result in long-term health effects, including skin and eye damage, and may cause certain forms of cancer by interacting with and altering cellular DNA. [1][2][3][4][5] The deleterious effects of ionizing radiation on human tissue can be categorized into 2 types: deterministic and stochastic. 6,7 Deterministic effects are characterized by a predictable dose-related increase in severity, which can be evaluated by means of air kerma (kinetic energy released per unit mass, AK), or radiation dose, measurements.…”

mentioning

confidence: 99%

“…9 In recent years, radiation exposure during cardiac catheterization procedures has attracted increasing attention among interventional cardiologists, who have a strong interest in reducing radiation doses during such procedures. 2,5,7,10 Our objective was to investigate whether fine-tuning radiation safety protocols could reduce radiation doses without compromising the effectiveness of catheterization procedures in patients.…”

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confidence: 99%

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Effective Reduction of Radiation Exposure during Cardiac Catheterization

Gutiérrez-Barrios¹,

Camacho-Galán²,

Medina-Camacho³

et al. 2019

Texas Heart Institute Journal

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Exposure to ionizing radiation during cardiac catheterization can have harmful consequences for patients and for the medical staff involved in the procedures. Minimizing radiation doses during the procedures is essential. We investigated whether fine-tuning the radiation protocol reduces radiation doses in the cardiac catheterization laboratory. In January 2016, we implemented a new protocol with reduced radiation doses in the Hospital de Jerez catheterization laboratory. We analyzed 170 consecutive coronary interventional procedures (85 of which were performed after the new protocol was implemented) and the personal dosimeters of the interventional cardiologists who performed the procedures. Overall, the low-radiation protocol reduced air kerma (dose of radiation) by 44.9% (95% CI, 18.4%–70.8%; P=0.001). The dose-area product decreased by 61% (95% CI, 30.2%–90.1%; P <0.001) during percutaneous coronary interventions. We also found that the annual deep (79%, P=0.026) and shallow (62.2%, P=0.035) radiation doses to which primary operators were exposed decreased significantly under the low-radiation protocol. These dose reductions were achieved without increasing the volume of contrast media, fluoroscopy time, or rates of procedural complications, and without reducing the productivity of the laboratory. Optimizing the radiation safety protocol effectively reduced radiation exposure in patients and operators during cardiac catheterization procedures.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Effective Reduction of Radiation Exposure during Cardiac Catheterization

Gutiérrez-Barrios¹,

Camacho-Galán²,

Medina-Camacho³

et al. 2019

Texas Heart Institute Journal

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“…Potential visual disability and morbidity resulting from radiation cataract, or its treatment, is greatly underappreciated due to the prolonged latency period of cataract formation after radiation exposure. Evidence from recent epidemiologic studies has shown detectable lens changes with estimated cumulative occupational exposures lower than previously considered dose thresholds and suggests that there is no dose–response threshold. Radiogenic lens changes are pathognomonic in the posterior subcapsular area and may cause more visual impairments than more anteriorly located cataracts, even when minor, due to their location on the visual axis.…”

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confidence: 97%

X‐ray canary in the cath lab: Posterior cataracts

Ahmad

Gilchrist

2018

Cathet Cardio Intervent

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Cataract formation in the posterior subcapsular region of the lens is a lesion highly specific to both high-dose acute radiation exposure and chronic low-dose exposure. Low-dose radiation may not manifest lens changes for several decades after initial exposure. Cardiac catheterization team members need to be educated on, and protected from, this form of radiation injury as its long latency period between exposure and physical damage may acutely reduce the sense of hazard amongst healthcare radiation workers.

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“…Changes in the genome increase the risk for cancer [2,3]. It has been documented that radiation causes a 3-fold increase in risk of lens opacities (cataract) in interventional cardiologists, compared to people who are not exposed to medical radiation at work [4]. This risk increases already at low doses.…”

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confidence: 99%

A quality project for radiation reduction in the cath lab

Ceuninck

Muyldermans²,

Walle

et al. 2018

Acta Cardiologica

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The radiation exposure in the cath lab of patients, cardiologists, and nurses was measured during three consecutive periods of 8 weeks. The first 8 weeks the baseline radiation exposure was obtained. In the second period standard incidences for coronarography and frame rate were changed, without compromising the image quality of the examination. In the third period, a pelvic shield covered the lower part of the patient. This pilot quality project demonstrates that further significant reduction in radiation exposure of 37% is possible for patients. A significant reduction in radiation exposure of 53 and 62% was obtained among cardiologists and nurses working in the cath lab, even with the already diminished radiation exposure over the last years by better equipment and general radioprotection measures.

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Risk of cataract among interventional cardiologists and catheterization lab staff: A systematic review and meta‐analysis

Abstract: Interventional cardiologists are at high risk of developing radiation-induced cataract; therefore, protective measures with high safety rates should be implied. © 2017 Wiley Periodicals, Inc.

Cited by 93 publications

References 41 publications

Effective Reduction of Radiation Exposure during Cardiac Catheterization

Effective Reduction of Radiation Exposure during Cardiac Catheterization

X‐ray canary in the cath lab: Posterior cataracts

A quality project for radiation reduction in the cath lab

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