Risk for radiation-induced cataract for staff in interventional cardiology: Is there reason for concern?

• Published in: Catheterization and cardiovascular interventions 2010-11, Vol.76 (6), p.826-834
• Main Authors: Ciraj-Bjelac, Olivera, Rehani, Madan M., Sim, Kui Hian, Liew, Houng Bang, Vano, Eliseo, Kleiman, Norman J.
• Format: Article
• Language: English
• Subjects: Adult; cardiac catheterization; Cardiology - methods; Case-Control Studies; Cataract - diagnosis; Cataract - epidemiology; Cataract - etiology; Cataract - prevention & control; Diagnostic Techniques, Ophthalmological; Dose-Response Relationship, Radiation; Eye Protective Devices; Female; fluoroscopy; Humans; lens opacity; Lens, Crystalline - radiation effects; Male; Middle Aged; Occupational Exposure; Odds Ratio; posterior subcapsular cataract (psc); Prevalence; Radiation Dosage; Radiation Injuries - diagnosis; Radiation Injuries - epidemiology; Radiation Injuries - etiology; Radiation Injuries - prevention & control; Radiation Protection - instrumentation; Radiography, Interventional - adverse effects; Radiography, Interventional - nursing; Risk Assessment; Risk Factors; Surveys and Questionnaires; Time Factors
• ISSN: 1522-1946; 1522-726X; 1522-726X
• DOI: 10.1002/ccd.22670

Objectives: To examine the prevalence of radiation‐associated lens opacities among interventional cardiologists and nurses and correlate with occupational radiation exposure. Background: Interventional cardiology personnel are exposed to relatively high levels of X‐rays and based on recent findings of radiation‐associated lens opacities in other cohorts, they may be at risk for cataract without use of ocular radiation protection. Methods: Eyes of interventional cardiologists, nurses, and age‐ and sex‐matched unexposed controls were screened by dilated slit lamp examination and posterior lens changes graded using a modified Merriam‐Focht technique. Individual cumulative lens X‐ray exposure was calculated from responses to a questionnaire and personal interview. Results: The prevalence of radiation‐associated posterior lens opacities was 52% (29/56, 95% CI: 35–73) for interventional cardiologists, 45% (5/11, 95% CI: 15–100) for nurses, and 9% (2/22, 95% CI: 1–33) for controls. Relative risks of lens opacity was 5.7 (95% CI: 1.5–22) for interventional cardiologists and 5.0 (95% CI: 1.2–21) for nurses. Estimated cumulative ocular doses ranged from 0.01 to 43 Gy with mean and median values of 3.4 and 1.0 Gy, respectively. A strong dose–response relationship was found between occupational exposure and the prevalence of radiation‐associated posterior lens changes. Conclusions: These findings demonstrate a dose dependent increased risk of posterior lens opacities for interventional cardiologists and nurses when radiation protection tools are not used. While study of a larger cohort is needed to confirm these findings, the results suggest ocular radio‐protection should be utilized. © 2010 Wiley‐Liss, Inc.