Radiation Exposure Among Scrub Technologists and Nurse Circulators During Cardiac Catheterization: The Impact of Accessory Lead Shields

JACC Cardiovasc Interv. 2018 Jan 22;11(2):206-212. doi: 10.1016/j.jcin.2017.07.026. Epub 2017 Nov 1.

Abstract

Objectives: This study was performed to determine if the use of an accessory lead shield is associated with a reduction in radiation exposure among staff members during cardiac catheterization.

Background: Accessory lead shields that protect physicians from scatter radiation are standard in many catheterization laboratories, yet similar shielding for staff members is not commonplace.

Methods: Real-time radiation exposure data were prospectively collected among nurses and technologists during 764 consecutive catheterizations. The study had 2 phases: in phase I (n = 401), standard radiation protection measures were used, and in phase II (n = 363), standard radiation protection measures were combined with an accessory lead shield placed between the staff member and patient. Radiation exposure was reported as the effective dose normalized to dose-area product (EDAP).

Results: Use of an accessory lead shield in phase II was associated with a 62.5% lower EDAP per case among technologists (phase I: 2.4 [4.3] μSv/[mGy × cm2] × 10-5; phase II: 0.9 [2.8] μSv/[mGy × cm2] × 10-5; p < 0.001) and a 63.6% lower EDAP per case among nurses (phase I: 1.1 [3.1] μSv/[mGy × cm2] × 10-5; phase II: 0.4 [1.8] μSv/[mGy × cm2] × 10-5; p < 0.001). By multivariate analysis, accessory shielding remained independently associated with a lower EDAP among both technologists (34.2% reduction; 95% confidence interval: 20.1% to 45.8%; p < 0.001) and nurses (36.4% reduction; 95% confidence interval: 19.7% to 49.6%; p < 0.001).

Conclusions: The relatively simple approach of using accessory lead shields to protect staff members during cardiac catheterization was associated with a nearly two-thirds reduction in radiation exposure among nurses and technologists.

Keywords: cardiac catheterization; occupational hazard; radiation safety.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cardiac Catheterization* / adverse effects
  • Equipment Design
  • Female
  • Humans
  • Lead*
  • Male
  • Middle Aged
  • Nursing Staff, Hospital*
  • Occupational Exposure / adverse effects
  • Occupational Exposure / prevention & control*
  • Occupational Health*
  • Operating Room Nursing*
  • Operating Room Technicians*
  • Operating Rooms
  • Prospective Studies
  • Protective Factors
  • Radiation Dosage
  • Radiation Exposure / adverse effects
  • Radiation Exposure / prevention & control*
  • Radiation Monitoring
  • Radiation Protection / instrumentation*
  • Radiography, Interventional* / adverse effects
  • Risk Assessment
  • Risk Factors
  • Scattering, Radiation
  • Time Factors

Substances

  • Lead