Occupational radiation exposure and crystalline lens density in perioperative nurses: a short communication

Zahra Masumi; Masoud Bagheri; Reza Feizi; Ehsan Khodamoradi

doi:10.1186/s12912-026-04780-z

Occupational radiation exposure and crystalline lens density in perioperative nurses: a short communication

BMC Nurs. 2026 May 19;25(1):611. doi: 10.1186/s12912-026-04780-z.

Authors

Zahra Masumi¹, Masoud Bagheri², Reza Feizi³, Ehsan Khodamoradi⁴

Affiliations

¹ Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
² Clinical Research Development Center, Imam Khomeini, Mohammad Kermanshahi, and Farabi Hospitals, Imam Khomeini, Kermanshah University of Medical Sciences, Kermanshah, Iran.
³ Department of Operating Room Technology, School of Paramedical Sciences, Arak University of Medical Sciences, Arak, Iran.
⁴ Department of Radiology and Nuclear Medicine, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran. ehkh.2000@gmail.com.

Abstract

Background: The rising use of C-arm fluoroscopy in operating rooms raises occupational safety concerns for perioperative nurses. They may face scattered ionizing radiation despite not being classified as radiation workers. This study compared posterior Crystalline Lens Density a key indicator of radiation-induced cataract among perioperative nurses working with C-arm fluoroscopy, interventional radiology staff, and a non-exposed control group to determine whether intermittent occupational exposure is associated with measurable lens changes.

Methods: In this Cross-sectional comparative study, 150 participants (50 perioperative nurses with C-arm exposure, 50 non-exposed or staff, and 50 interventional radiology personnel) underwent standardized ophthalmic examination. Pentacam Nucleus Staging quantified posterior lens density; the worse eye was analyzed. Groups were compared using chi-square tests and ANCOVA with Bonferroni correction.

Results: Interventional radiology personnel exhibited significantly higher crystalline lens density (8.99 ± 1.50) compared with both perioperative nurses (8.40 ± 0.69; mean difference: 0.53, p = 0.001) and the control group (8.20 ± 0.27; mean difference: 0.70, p < 0.001). No significant difference was observed between perioperative nurses and controls (mean difference: 0.17, p = 0.539). The frequency of posterior subcapsular opacities (6.1% vs. 3.0% vs. 2.0%, p = 0.001), PNS grade ≥ 1 (17.1% vs. 8.0% vs. 3.9%, p = 0.002), and overall cataract prevalence (19.5% vs. 6.0% vs. 4.0%, p = 0.001) were all significantly higher in the interventional radiology group, with no significant differences between perioperative nurses and controls.

Conclusion: Perioperative nurses showed no significant difference compared with unexposed controls. These findings suggest that intermittent C-arm exposure under typical distancing conditions poses minimal measurable risk. Specifically, such exposure does not appear to increase radiation-related lens changes.

Trial registration: Clinical trial number not applicable.

Keywords: C-arm fluoroscopy; Crystalline lens density; Eye lens safety; Occupational radiation exposure; Perioperative nursing.