A critical analysis of personal radiation protection in the catheterization laboratory: A systematic review

Abstract

Background / Purpose

Over the last decade, there has been a growing body of evidence on the adverse health effects of occupational exposure to ionizing radiation from fluoroscopically guided procedures, including left-sided brain tumors, skin cancer, posterior subcapsular lens changes, and thyroid disease. It is assumed that traditional radiation protection equipment provides adequate protection from exposure to scattered radiation. However, a growing body of evidence casts doubt on whether cath lab personnel exposed to ionizing radiation are being adequately protected.

Methods

A systematic literature review was used to identify, select, and critically appraise research to determine the efficacy of personal protection equipment currently worn in the catheterization lab. The literature reviewed was collected from the following databases: CINAHL, PubMed, Science Direct, and Medline. The search was limited to full-text and scholarly journals published between 2013 and 2023 in the English language. Articles were selected for inclusion based on relevance. The literature search for this systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines.

Results

The recurring theme in this literature review is that the orientation of the body to the source of radiation scatter appears to be critical and significantly reduces the effectiveness of personal radiation protection equipment in the cath lab.

Conclusion

The orientation of personnel who perform fluoroscopically guided procedures towards the source of scatter exposes them significantly to radiation. Traditional personal radiation protection aprons and equipment frequently provide inadequate shielding in the cath lab environment. Considering the increasing evidence highlighting the occupational risks associated with fluoroscopy, it is crucial to reassess personal radiation protection to ensure the safety and well-being of interventional teams responsible for life and limb saving procedures.