any concern about radiation exposure as an interventionalist?

[Sing56]

Hey guys, new to the forum. Like cards and particularly interventional cardiology versus EP, however I am concerned about the occupational radiation exposure. THis article suggests that cardiologists are particularly at risk: http://radiology.rsnajnls.org/cgi/content/full/235/2/709-a

Does anyone else know anything about the occupational risks or if the current shielding measures taken by most in the field is sufficient to prevent an additional cancer risk?

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[dragonfly99]

I don't think anybody really knows the long term effects, if any. I don't think there has been any solid evidence of increased cancer risks among interventional cardiologists. I'd think that ortho docs would be at risk as well, since they use the fluoro a lot.

Another concern is risk of damage to reproductive tissues (i.e sperm and eggs) and/or a developing fetus. Female nurses in the cath lab wear little radiation badges which track their level of exposure to radiation.

 

[Sing56]

True there aren't any well-done case control trials done looking at the carcinogenic effect on interventional cardiologists; however there is the (relatively) recent finding that interventionalists are much more likely to develop premature cataracts due to the exposure. This begs the question: if interventionalists are getting such high exposure to the head, what else is being affected?

Further while ortho docs and trauma guys do use fluoro also, they don't use it continuously like interventional cards and rads guys do so their exposure is much less.

Has/Does this concern anyone else?

 

[cocojambo]

Cardiologists are at a certain amount of occupational exposure risk due to the nature of their job. However, there is a new type of Radiation therapy being deployed out there, here's a useful paragraph from Mesothelioma

"Systemic Radiation (Intensity-Modulated Radiation Therapy (IMRT))

Intensity-Modulated Radiation Therapy (IMRT) is a fairly new & sophisticated type of radiation therapy where Computer-controlled x-ray accelerators spread precise radiation doses to malignant tumor masses. The pattern of how radiation is delivered is determined using highly-tailored computing applications to perform optimization and treatment simulation. The dose of radiation is made same as the 3-D shape of the tumor by modifying the radiation beam’s intensity. The dose of radiation is increased near solid tumor masses while it is decreased near non-malignant tissues. This customized form of radiation is done to ensure the malignant tissues get destroyed while preserving the nearby non-malignant & healthy tissues. Because the doses of radiation are modified according to how tumorous the tissues are, this type of radiotherapy is better than the conventional type & results in better tumor targeting, less side effects and improved treatment results."
Source: http://www.themesotheliomalibrary.com/radiation-therapy.html

 

[DrIM]

What about Nuclear Cardiologists and Cardiac CT Cardiologists?

 

[dragonfly99]

I'm not sure what you mean by "cardiac CT cardiologists". Do you mean cardiologists who know how to read cardiac CT's? Reading these doesn't really expose you to extra radiation. I mean, it's not different than a radiologist reading an abdominal CT (or cardiac CT, as I'm sure they will and/or are trying to get a piece of the cardiac CT-reading pie).

As far as nuclear cardiology goes, those studies are also usually read off in a room somewhere with little computer monitors. I'm not sure the cardiologist is very close by when the nuclear imaging agents are being given for a nuclear cardiac study, and he/she isn't the one who does the injecting of the nuclear contrast agent as far as I know, so I don't think there's much risk of exposure.