Radiation exposure to cardiologists: how it could be reduced

Interventional cardiologists are at greater risk from radiation exposure as a result of the procedures they undertake than most other medical specialists. Thus, any measures that may help to reduce radiation exposure are most welcome It is well known that occupational doses of radiation in interventional procedures guided by fluoroscopy are the highest doses registered among medical staff using x rays.1,2 Interventional cardiologists represent the most important group of medical specialists involved in such practices. Scatter radiation levels in the vicinity of the patient may be quite high under normal working conditions.1 If protection tools and good operational measures are not used, and if several complex procedures are undertaken per day, radiation lesions of the eyes may result after several years of work, particularly when the equipment used is not designed for interventional practices.1,3 Interventional x ray systems specifically designed for interventional cardiology should be a “sine qua non” condition for safety. Recently, the International Electrotechnical Commission has produced a new standard relating to the safety of x ray systems to be used in interventional practice.4 Several aspects of radiation safety in the practice of cardiology have been addressed by the American College of Cardiology (ACC) in a consensus document endorsed by the North American Society of Pacing and Electrophysiology, the Society for Cardiac Angiography and Interventions, and the American Society of Nuclear Cardiology.5 The European Commission has addressed the importance of training in radiological protection (RP), publishing a guideline with specific recommendations for accreditation of training programmes for interventional procedures.6 This guideline suggests specific learning objectives and 20–30 hours of training for interventional cardiologists. Recently, a pilot course was held in Luxembourg at the National Institute of Cardiac Surgery and Interventional Cardiology to give accreditation in RP to the interventional cardiologists …