Sustainability in the cardiac cath lab.
Use of radiation for medical examinations and test is the largest man-made source of radiation exposure. Interventional procedures are only 2% of all radiological procedures, but contribute to about 20% of the total collective dose per head per year. On average, a left ventriculography and coronary angiography corresponds to a radiation exposure for the patient of about 300, a coronary stent to 1,000, a peripheral artery intervention to 1,500 to 2,500, and a cardiac radiofrequency ablation to 900-1,500 chest x-rays. Invasive cardiology procedures increased tenfold in the last ten years and growth in the field has been accompanied by concern for the safety of the staff. Interventional cardiologists have an exposure per-head per year two- to three times higher than that of radiologists, with an annual exposure equivalent to around 250 chest x-rays per head. A reduction of occupational doses by a factor of ten can be achieved simply by and intensive training program. The awareness of radiation effects may be suboptimal in the medical community. It is recommended by professional guidelines and reinforced by the European law that the responsibility of all physicians is to minimize the radiation injury hazard to their patients, to their professional staff and to themselves.
Picano
Eugenio
E
CNR, Institute of Clinical Physiology, Via Moruzzi, 1, Pisa 56124, Italy. picano@ifc.cnr.it
Santoro
Gennaro
G
Vano
Eliseo
E
D006328:Cardiac Catheterization / Q000009:adverse effects; D002309:Cardiology / Q000379:methods*; D017023:Coronary Angiography / Q000009:adverse effects; D005471:Fluoroscopy / Q000009:adverse effects; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008505:Medical Staff, Hospital; D016273:Occupational Exposure; D017410:Practice Guidelines as Topic; D011829:Radiation Dosage; D011834:Radiation Monitoring; D011835:Radiation Protection / Q000379:methods; D015641:Radiography, Interventional / Q000009:adverse effects*; D015635:Radionuclide Ventriculography / Q000009:adverse effects; D018084:Ultrasonography, Interventional; D000078329:Workforce