Should future interventional neuroradiologists be screened for mutations that impair radiation-induced DNA repair?
In our current medical practice, an increasing number of specialists now have access to radiology technical platforms in order to perform imaging-guided procedures. Although knowledge about the current guidelines and radiation protection devices is a pre-requisite for the use of radiation, the preventive measures are often more or less strictly followed, leading to chronic daily exposure to significant doses of radiation and large accumulated lifetime exposures. Aortic intervention, electrophysiology, and neuro intervention in particular can result in large doses to the operators. Interventionalists might try to rationalize their dismissal of the exposure risks with various excuses: they don't know where they left their badges (even though, guiltily, they would readily admit it is good practice to always wear them), the estimated short duration of the procedure, significant muscular strain and spasm caused by the heaviness of lead aprons, decreased dexterity with lead gloves, or discomfort in wearing lead protective glasses. But their dismissive attitude is most likely due to the inherent inability to feel threatened by something they cannot see or feel, a commitment to the patient at all cost, and a culture of bravado that reinforces their behavior.
1 Techna Research Institute, University Health Network, Toronto, Canada.
Kieran
K
Murphy
2 Trinity College, University of Dublin, Dublin, Ireland.
Adam
A
Thakore
3 University of Toronto, Toronto, Canada.
Marie Constance
MC
Lacasse
4 Royal College of Surgeons in Ireland, Dublin, Ireland.
Danyal Z
DZ
Khan
D004260:DNA Repair / Q000528:radiation effects*; D019983:Guideline Adherence; D006801:Humans; D008403:Mass Screening; D009154:Mutation; D059906:Neuroimaging; D016273:Occupational Exposure / Q000009:adverse effects* / Q000517:prevention & control*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection; D015641:Radiography, Interventional; D011874:Radiometry; D013997:Time Factors
Radiation injury; cancer risk; genetic screening