title: InterCardioRisk: a novel online tool for estimating doses of ionising radiation to occupationally-exposed medical staff and their associated health risks.
abstract: Those working in interventional cardiology and related medical procedures are potentially subject to considerable exposure to x-rays. Two types of tissue of particular concern that may receive considerable doses during such procedures are the lens of the eye and the brain. Ocular radiation exposure results in lens changes that, with time, may progress to partial or total lens opacification (cataracts). In the early stages, such opacities do not result in visual disability; the severity of such changes tends to increase progressively with dose and time until vision is impaired and cataract surgery is required. Scattered radiation doses to the eye lens of an interventional cardiologist in typical working conditions can exceed 34 μGy min-1in high-dose fluoroscopy modes and 3 μGy per image during image acquisition (instantaneous rate values) when radiation protection tools are not used. A causal relation between exposure to ionising radiation and increased risk of brain and central nervous system tumours has been shown in a number of studies. Although absorbed doses to the brain in interventional cardiology procedures are lower than those to the eye lens by a factor between 3.40 and 8.08 according to our simulations, doses to both tissues are among the highest occupational radiation doses documented for medical staff whose work involves exposures to x-rays. We present InterCardioRisk, a tool featuring an easy-to-use web interface that provides a general estimation of both cumulated absorbed doses experienced by medical staff exposed in the interventional cardiology setting and their estimated associated health risks. The tool is available at http://intercardiorisk.creal.cat.
authors.affiliation: ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. Universitat Pompeu Fabra (UPF), Barcelona, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Program (CERP), Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. Grups de Recerca d'Àfrica i Amèrica Llatines (GRAAL)-Unitat de Bioestadística, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Moriña
authors.forename: James
authors.initials: J
authors.lastname: Grellier
authors.forename: Adela
authors.initials: A
authors.lastname: Carnicer
authors.forename: Eileen
authors.initials: E
authors.lastname: Pernot
authors.forename: Nick
authors.initials: N
authors.lastname: Ryckx
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Cardis
mesh_terms: D001921:Brain / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000209:etiology; D002309:Cardiology; D006801:Humans; D020407:Internet; D007908:Lens, Crystalline / Q000528:radiation effects*; D009010:Monte Carlo Method; D009381:Neoplasms, Radiation-Induced / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000517:prevention & control*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D011839:Radiation, Ionizing; D018570:Risk Assessment; D012542:Scattering, Radiation; D014584:User-Computer Interface