Letter to the Clinical Editor

To the Editor:

I applaud the article by Dr. Morton J. Kern and other contributors entitled “Your Lead is Cracked? Radiation Safety Revisited,” (Clinical Editor’s Corner, Vol. 23, Issue 11 – November 2015) for calling attention to the failures that continue to exist in cath labs across the country in protecting interventional cardiologists and their teams from the health risks associated with chronic exposure to ionizing radiation.  

While it is evident that some hospitals, including those cited in the article, have made strides in implementing necessary protections regarding the monitoring of dosimeter badges, routinely checking the efficacy of lead aprons and collars, and retaining the right personnel to oversee radiation safety efforts in the cath lab, it is obvious that more needs to be done.

The Organization for Occupational Radiation Safety in Interventional Fluoroscopy (ORSIF) was launched in April 2015 to generate awareness of the growing issue of health hazards in the cath lab and protect the medical professionals who work in these labs. ORSIF advocates for all medical specialties that use interventional fluoroscopy, such as interventional cardiologists, and supports the type of safety measures the article references. Concern is growing as more and more interventionalists and cath lab workers become stricken with work-related health issues. Interventional cardiologists in particular have a radiation exposure rate documented to be two to ten times higher than that of diagnostic radiologists.¹

As a result of direct, chronic exposure to ionizing radiation, there is mounting evidence that shows a link to a series of significant stochastic health effects, including left-sided brain tumors (in interventional cardiologists, 86 percent of brain tumors occur on the left side of the head, which is closest to the radiation source in the cath lab), posterior subcapsular lens changes (a precursor to cataracts), skin cancers, thyroid disease, brain disease, cardiovascular changes and neuro-degenerative disease, among others. In addition, serious health risks, including high rates of musculoskeletal injuries, have resulted from wearing the heavy lead-lined personal protective equipment (PPE) that is standard protocol for cath lab staff.

Interventional cardiologists and their teams are already at risk for serious health issues simply from the life-saving work they do every day. Let’s not make their jobs any more difficult by being remiss in providing the most basic protections in the cath lab.

Sincerely,
Michael D. Seymour, MS, MPH, CIH
Director of Advocacy Programs
ORSIF

Reference

1. Picano E, Andreassi MG, Piccaluga E, Cremonesi A, Guagliumi G. Occupational risks of chronic low dose radiation exposure in cardiac catheterisation laboratory: The Italian Healthy Cath Lab Study. EMJ Int Cardiol. 2013; 1: 50-58. Available online at https://emjreviews.com/therapeutic-area/interventional-cardiology/occupational-risks-chronic-low-dose-radiation-exposure-cardiac-catheterisation-laboratory-italian-healthy-cath-lab-study/. Accessed December 17, 2015.