title: Occupational Health Risks in Cardiac Catheterization Laboratory Workers.
abstract: 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.
  
  
  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 (quartiles: 5-24 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 interval: 1-3; P=0.05), 2.9 for hypercholesterolemia (95% confidence interval: 1-5; P=0.004), 4.5 for cancer (95% confidence interval: 0.9-25; P=0.06), to 9 for cataract (95% confidence interval: 2-41; 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.
authors.affiliation: From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.). mariagrazia.andreassi@ifc.cnr.it.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Andreassi
authors.affiliation: From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.).
authors.forename: Emanuela
authors.initials: E
authors.lastname: Piccaluga
authors.affiliation: From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.).
authors.forename: Giulio
authors.initials: G
authors.lastname: Guagliumi
authors.affiliation: From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.).
authors.forename: Maurizio
authors.initials: M
authors.lastname: Del Greco
authors.affiliation: From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.).
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.affiliation: From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.).
authors.forename: Eugenio
authors.initials: E
authors.lastname: Picano
mesh_terms: D000328:Adult; D000488:Allied Health Personnel; D006328:Cardiac Catheterization / Q000009:adverse effects*; D016022:Case-Control Studies; D002386:Cataract / Q000209:etiology; D017023:Coronary Angiography / Q000009:adverse effects; D005260:Female; D005471:Fluoroscopy; D006304:Health Status; D006801:Humans; D006937:Hypercholesterolemia / Q000209:etiology; D006973:Hypertension / Q000209:etiology; D007587:Job Description; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000517:prevention & control; D016272:Occupational Health; D060051:Occupational Injuries / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D009873:Operating Rooms; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000009:adverse effects* / Q000517:prevention & control; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D015641:Radiography, Interventional / Q000009:adverse effects; D012307:Risk Factors; D012871:Skin Diseases / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D000078329:Workforce
keywords: cancer; cardiac catheterization; cataract; fluoroscopy; ionizing radiation; radiation risk; safety