Risk for radiation-induced cataract for staff in interventional cardiology: is there reason for concern?
OBJECTIVE
To examine the prevalence of radiation-associated lens opacities among interventional cardiologists and nurses and correlate with occupational radiation exposure.


BACKGROUND
Interventional cardiology personnel are exposed to relatively high levels of X-rays and based on recent findings of radiation-associated lens opacities in other cohorts, they may be at risk for cataract without use of ocular radiation protection.


METHODS
Eyes of interventional cardiologists, nurses, and age- and sex-matched unexposed controls were screened by dilated slit lamp examination and posterior lens changes graded using a modified Merriam-Focht technique. Individual cumulative lens X-ray exposure was calculated from responses to a questionnaire and personal interview.


RESULTS
The prevalence of radiation-associated posterior lens opacities was 52% (29/56, 95% CI: 35-73) for interventional cardiologists, 45% (5/11, 95% CI: 15-100) for nurses, and 9% (2/22, 95% CI: 1-33) for controls. Relative risks of lens opacity was 5.7 (95% CI: 1.5-22) for interventional cardiologists and 5.0 (95% CI: 1.2-21) for nurses. Estimated cumulative ocular doses ranged from 0.01 to 43 Gy with mean and median values of 3.4 and 1.0 Gy, respectively. A strong dose-response relationship was found between occupational exposure and the prevalence of radiation-associated posterior lens changes.


CONCLUSIONS
These findings demonstrate a dose dependent increased risk of posterior lens opacities for interventional cardiologists and nurses when radiation protection tools are not used. While study of a larger cohort is needed to confirm these findings, the results suggest ocular radio-protection should be utilized.
Ciraj-Bjelac
Olivera
O
Vinca Institute of Nuclear Sciences, Belgrade, Serbia.
Rehani
Madan M
MM
Sim
Kui Hian
KH
Liew
Houng Bang
HB
Vano
Eliseo
E
Kleiman
Norman J
NJ
D000328:Adult; D002309:Cardiology / Q000379:methods*; D016022:Case-Control Studies; D002386:Cataract / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D003941:Diagnostic Techniques, Ophthalmological; D004307:Dose-Response Relationship, Radiation; D005135:Eye Protective Devices; D005260:Female; D006801:Humans; D007908:Lens, Crystalline / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D016017:Odds Ratio; D015995:Prevalence; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D011835:Radiation Protection / Q000295:instrumentation; D015641:Radiography, Interventional / Q000009:adverse effects* / Q000451:nursing; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors