Occupational Health Risks in Cardiac Catheterization Laboratory Workers

• Published in: Circulation. Cardiovascular interventions Vol. 9; no. 4; p. e003273
• Main Authors: Andreassi, Maria Grazia, Piccaluga, Emanuela, Guagliumi, Giulio, Del Greco, Maurizio, Gaita, Fiorenzo, Picano, Eugenio
• Format: Journal Article
• Language: English
• Published: United States American Heart Association, Inc 01.04.2016
• Subjects: Adult; Allied Health Personnel; Cardiac Catheterization - adverse effects; Case-Control Studies; Cataract - etiology; Coronary Angiography - adverse effects; Female; Fluoroscopy; Health Status; Humans; Hypercholesterolemia - etiology; Hypertension - etiology; Job Description; Male; Middle Aged; Musculoskeletal Diseases - etiology; Occupational Exposure - adverse effects; Occupational Exposure - prevention & control; Occupational Health; Occupational Injuries - diagnosis; Occupational Injuries - etiology; Occupational Injuries - prevention & control; Operating Rooms - manpower; Radiation Dosage; Radiation Exposure - adverse effects; Radiation Exposure - prevention & control; Radiation Injuries - diagnosis; Radiation Injuries - etiology; Radiation Injuries - prevention & control; Radiography, Interventional - adverse effects; Risk Factors; Skin Diseases - etiology; Surveys and Questionnaires; Time Factors; radiation risk; cataract; cardiac catheterization; safety; cancer; fluoroscopy; ionizing radiation
• ISSN: 1941-7640; 1941-7632
• DOI: 10.1161/CIRCINTERVENTIONS.115.003273

BACKGROUND—Orthopedic strain and radiation exposure are recognized risk factors in personnel staff performing fluoroscopically guided cardiovascular procedures. However, the potential occupational health effects are still unclear. The purpose of this study was to examine the prevalence of health problems among personnel staff working in interventional cardiology/cardiac electrophysiology and correlate them with the length of occupational radiation exposure. METHODS AND RESULTS—We used a self-administered questionnaire to collect demographic information, work-related information, lifestyle-confounding factors, all current medications, and health status. A total number of 746 questionnaires were properly filled comprising 466 exposed staff (281 males; 44±9 years) and 280 unexposed subjects (179 males; 43±7years). Exposed personnel included 218 interventional cardiologists and electrophysiologists (168 males; 46±9 years); 191 nurses (76 males; 42±7 years), and 57 technicians (37 males; 40±12 years) working for a median of 10 years (quartiles5–24 years). Skin lesions (P=0.002), orthopedic illness (P<0.001), cataract (P=0.003), hypertension (P=0.02), and hypercholesterolemia (P<0.001) were all significantly higher in exposed versus nonexposed group, with a clear gradient unfavorable for physicians over technicians and nurses and for longer history of work (>16 years). In highly exposed physicians, adjusted odds ratio ranged from 1.7 for hypertension (95% confidence interval1–3; P=0.05), 2.9 for hypercholesterolemia (95% confidence interval1–5; P=0.004), 4.5 for cancer (95% confidence interval0.9–25; P=0.06), to 9 for cataract (95% confidence interval2–41; P=0.004). CONCLUSIONS—Health problems are more frequently observed in workers performing fluoroscopically guided cardiovascular procedures than in unexposed controls, raising the need to spread the culture of safety in the cath laboratory.