SCAI consensus document on occupational radiation exposure to the pregnant cardiologist and technical personnel

Abstract

Concerns regarding radiation exposure and its effects during pregnancy are often quoted as an important barrier preventing many women from pursuing a career in Interventional Cardiology. Finding the true risk of radiation exposure from performing cardiac catheterization procedures can be challenging and guidelines for pregnancy exposure have been inadequate. The Women in Innovations group of Cardiologists with endorsement of the Society for Cardiovascular Angiography and Interventions aim to provide guidance in this publication by describing the risk of radiation exposure to pregnant physicians and cardiac catheterization personnel, to educate on appropriate radiation monitoring and to encourage mechanisms to reduce radiation exposure. Current data do not suggest a significant increased risk to the fetus of pregnant women in the cardiac catheterization laboratory and thus do not justify precluding pregnant physicians from performing procedures in the cardiac catheterization laboratory. However, radiation exposure among pregnant physicians should be properly monitored and adequate radiation safety measures are still warranted. V C 2011 Wiley-Liss, Inc.

A Zero‐Fluoroscopy Approach to Cavotricuspid Isthmus Catheter Ablation: Comparative Analysis of Two Electroanatomical Mapping Systems

“…Once the decision has been made to use a navigation system to reduce fluoroscopy time, the next step is just a question of learning and confidence . The zero‐fluoroscopy approach using electroanatomical systems would offer more advantages than the minimal fluoroscopy approach: an almost complete absence of radiation, reduction in spinal injuries because no protective clothing is required, and greater safety for pregnant staff …”

SCAI multi‐society position statement on occupational health hazards of the catheterization laboratory: Shifting the paradigm for Healthcare Workers' Protection

“…Renewed attention has focused on the occupational health hazards posed by working in the fluoroscopic laboratory . Accumulated occupational radiation exposure is associated with health risks to physicians, nurses, and technologists working in this environment.…”

“…Radiation exposure is inherent to procedural performance in the fluoroscopic laboratory. Exposure to ionizing radiation imposes health risks to both patients and operators, resulting in an increased likelihood of numerous illnesses and diseases . The association with posterior subcapsular cataracts is well documented .…”

“…These methods and concepts have been well described previously . Recently, publications from the Society of Cardiovascular Angiography and Interventions, The Heart Rhythm Society, and the American College of Cardiology/multi‐society consensus document articulate detailed procedural systems and processes, as well as practical approaches, to assist cardiac catheterization laboratories in establishing optimal radiation safety program.…”

Radiological protection for pregnant women at a large academic medical Cancer Center

“…In the United States, Nuclear Regulatory Commission (NRC) requires that if worker activities are such that an individual could receive more than 1 mSv (annual effective dose), the occupational radiation protection program is required to have a fetal assessment program [20]. Such a program typically includes training, historical dose assessments, counseling, monitoring, worker practice modifications when appropriate, and ongoing monthly and end-of declaration of pregnancy review.…”