title: Mortality in U.S. Physicians Likely to Perform Fluoroscopy-guided Interventional Procedures Compared with Psychiatrists, 1979 to 2008.
abstract: Purpose To compare total and cause-specific mortality rates between physicians likely to have performed fluoroscopy-guided interventional (FGI) procedures (referred to as FGI MDs) and psychiatrists to determine if any differences are consistent with known radiation risks. Materials and Methods Mortality risks were compared in nationwide cohorts of 45 634 FGI MDs and 64 401 psychiatrists. Cause of death was ascertained from the National Death Index. Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for FGI MDs versus psychiatrists, with adjustment (via stratification) for year of birth and attained age. Results During follow-up (1979-2008), 3506 FGI MDs (86 women) and 7814 psychiatrists (507 women) died. Compared with psychiatrists, FGI MDs had lower total (men: RR, 0.80 [95% CI: 0.77, 0.83]; women: RR, 0.80 [95% CI: 0.63, 1.00]) and cancer (men: RR, 0.92 [95% CI: 0.85, 0.99]; women: RR, 0.83 [95% CI: 0.58, 1.18]) mortality. Mortality because of specific types of cancer, total and specific types of circulatory diseases, and other causes were not elevated in FGI MDs compared with psychiatrists. On the basis of small numbers, leukemia mortality was elevated among male FGI MDs who graduated from medical school before 1940 (RR, 3.86; 95% CI: 1.21, 12.3). Conclusion Overall, total deaths and deaths from specific causes were not elevated in FGI MDs compared with psychiatrists. These findings require confirmation in large cohort studies with individual doses, detailed work histories, and extended follow-up of the subjects to substantially older median age at exit.©RSNA, 2017 Online supplemental material is available for this article.
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
authors.forename: Cari M
authors.initials: CM
authors.lastname: Kitahara
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
authors.forename: Estelle
authors.initials: E
authors.lastname: Ntowe
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Kleinerman
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
authors.forename: Ethel S
authors.initials: ES
authors.lastname: Gilbert
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
authors.forename: Neal
authors.initials: N
authors.lastname: Naito
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Lipner
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Miller
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
authors.forename: Amy
authors.initials: A
authors.lastname: Berrington de Gonzalez
authors.affiliation: From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NCI Shady Grove, 9609 Medical Center Dr, Room 7E452, Bethesda, MD 20892-9778 (M.S.L., C.M.K., E.N., R.A.K., E.S.G., A.B.d.G.); Retired, U.S. Navy, Washington, DC (N.N.); American Board of Internal Medicine, Philadelphia, Pa (R.S.L.); and Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Md (D.L.M.). Members of the Multi-Specialty Occupational Health Group are listed at the end.
mesh_terms: D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends*; D009381:Neoplasms, Radiation-Induced / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D010820:Physicians; D011570:Psychiatry; D000069079:Radiation Exposure / Q000009:adverse effects*; D015641:Radiography, Interventional; D012307:Risk Factors; D014481:United States / Q000453:epidemiology