Radiation Cataract Risk in Interventional Cardiology Personnel

TLDR

The eye lens is highly radiosensitive, and interventional cardiologists and staff receive high cumulative X‑ray doses, yet the radiation risk to the lens remains uncertain. The study assessed cataract risk among interventional cardiology personnel following occupational radiation exposure. Dilated slit‑lamp examinations were conducted on cardiologists, staff, and controls, with exposure estimates derived from laboratory measurements and detailed questionnaires. Cardiologists had a 3.2‑fold higher risk of posterior subcapsular opacities (38% vs 12%) and 21% of nurses/technicians showed radiation‑associated lens changes, with median lens doses of 6.0 Sv for cardiologists and 1.5 Sv for staff, underscoring an urgent need for radiation protection education.

Abstract

The lens of the eye is one of the most radiosensitive tissues in the body, and exposure of the lens to ionizing radiation can cause cataract. Cumulative X-ray doses to the lenses of interventional cardiologists and associated staff can be high. The International Commission on Radiological Protection recently noted considerable uncertainty concerning radiation risk to the lens. This study evaluated risk of radiation cataract after occupational exposure in interventional cardiology personnel. Comprehensive dilated slit-lamp examinations were performed in interventional cardiologists, associated workers and controls. Radiation exposures were estimated using experimental data from catheterization laboratories and answers to detailed questionnaires. A total of 116 exposed and 93 similarly aged nonexposed individuals were examined. The relative risk of posterior subcapsular opacities in interventional cardiologists compared to unexposed controls was 3.2 (38% compared to 12%; P < 0.005). A total of 21% of nurses and technicians had radiation-associated posterior lens changes typically associated with ionizing radiation exposure. Cumulative median values of lens doses were estimated at 6.0 Sv for cardiologists and 1.5 Sv for associated medical personnel. A significantly elevated incidence of radiation-associated lens changes in interventional cardiology workers indicates there is an urgent need to educate these professionals in radiation protection to reduce the likelihood of cataract.