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Well established is that during fluoroscopy assisted interventions, depending on factors such as patient obesity, procedural complexity and fluoroscopy time, medical practitioners are subjected to relatively high radiation exposure.¹

The current standards and practices are based on the premise that any radiation dose may result in unfavorable health effects.²'³ The risks for radiation-induced diseases are associated with uncertainties regarding biological effects and individual sensitivity.⁴'⁵ Being exposed to harmful radiation may cause diseases such as: anxiety/depression⁶, cancer⁷ and cognitive impairments.⁸'⁹

Alarmingly, over 50% of OR staff do not feel adequately protected from the scatter radiation.¹⁰ However, the risk for developing radiation-induced diseases is still an ongoing debate among experts.¹¹


+ anxiety/depression⁶

+ tumors/cancer⁷

+ cognitive impairments⁸'⁹


+ back/neck pain from using heavy and uncomfortable radiation protection devices.¹²

A study on brain tumors occurring in medical practitioners with exposure to ionizing radiation documented 85% left sided malignancy.

Data available for 35 of 45 cases on the side of the brain involved. The malignancy was left-sided in 30 (85%), midline in one, and right-sided in four cases. This accumulation of left-sided versus right-sided tumors could be due to the operator's routine working position in which the left side of the head is closest to the scatter radiation coming from the patient.⁷

1. Vano E. Occupational radiation protection of health workers in imaging. Radiation Prot Dosimetry. 2015 Apr;164(1-2):126-9. doi: 10.1093/rpd/ncu354.
2. ICRP, 2018. Occupational radiological protection in interventional procedures. ICRP Publication 139. Ann. ICRP 47(2).
3. Miller, D.L., et al., Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. Cardiovascular Interventional Radiology, 2010. 33(2): p. 230-9.
4. Lee, W. H., Nguyen, P. K., Fleischmann, D., & Wu, J. C. (2016). DNA damage-associated biomarkers in studying individual sensitivity to low-dose radiation from cardiovascular imaging. European heart journal, 37(40), 3075-3080.
5. Brenner, D. J., Doll, R., Goodhead, D. T., Hall, E. J., Land, C. E., Little, J. B., ... & Zaider, M. (2003). Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proceedings of the National Academy of Sciences, 100(24), 13761-13766
6. Andreassi MG., Piccaluga E., Guagliumi G., et al. Occupational health risks in cardiac catheterization laboratory workers. Circ Cardiovasc Interv. 2016;9:e003273.
7. Roguin A., Bartal G. Radiation and your brain. Endovascular Today, 2016, 15,63-65.
8. Andreassi, M. G., Cioppa, A., Botto, N., Joksic, G., Manfredi, S., Federici, C., ... & Picano, E. (2005). Somatic DNA damage in interventional cardiologists: a
case-control study. The FASEB Journal, 19(8), 998-999.
9. El-Sayed, T., Patel, A. S., Cho, J. S., Kelly, J. A., Ludwinski, F. E., Saha, P., ... & Gill, J. (2017). Radiation-induced DNA damage in operators performing endovascular
aortic repair. Circulation, 136(25), 2406-2416.
10. O’Sullivan N., Naughton A., McKevitt K., Boyle E., Egan B., Tierney S., Intra-Operative Radiation Safety; Who does what? Who knows what? Department of Vascular Surgery, Tallaght University Hospital, Dublin 24, Ireland.
11. Roguin, A., & Nolan, J. (2021). Radiation protection in the cardiac catheterisation lab: best practice. Heart, 107(1), 76-82.
12. 1. Bjersgård A., En studie på strålskyddskläder, dess användning och användarnas rörelsemönster med ett ergonomiskt perspektiv. Centre for Health Technology Halland (HCH), Halmstad University, Sweden, 2015