Occupational health hazards in the interventional laboratory: Time for a safer environment


  • Lloyd W. Klein MD, FSCAI, FACC,

    Corresponding author
    • Rush Medical College, 675 West North Avenue, Suite 202, Melrose Park, IL 60160
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  • Donald L. Miller MD, FACR, FSIR,

  • Stephen Balter PhD, FAAPM, FSIR, FACR,

  • Warren Laskey MD, FACC, FSCAI,

  • Neil Naito MD,

  • David Haines MD, FHRS,

  • Allan Ross MD, FACC,

  • Matthew A. Mauro MD, FSIR, FACR,

  • James A. Goldstein MD, FSCAI, FACC

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    • Dr. Goldstein discloses a financial relationship with a company working on radiation protection systems.

  • On behalf of the members of the Joint Inter-Society Task Force on Occupational Hazards in the Interventional Laboratory

    On Behalf of the following societies, which have formally endorsed this document, or are in the process of endorsement, & have representatives on the Joint Inter-Society Task Force on Occupational Hazards in the Interventional Laboratory: American Association of Physicists in Medicine; American College of Cardiology; American College of Radiology; Heart Rhythm Society; Society for Cardiovascular Angiography and Interventions; Society of Invasive Cardiovascular Professionals; Society of Interventional Radiology; Society of NeuroInterventional Surgery


Over the past 30 years, the advent of fluoroscopically guided interventional procedures has resulted in dramatic increments in both X-ray exposure and physical demands that predispose interventionists to distinct occupational health hazards. The hazards of accumulated radiation exposure have been known for years, but until recently the other potential risks have been ill-defined and under-appreciated. The physical stresses inherent in this career choice appear to be associated with a predilection to orthopedic injuries, attributable in great part to the cumulative adverse effects of bearing the weight and design of personal protective apparel worn to reduce radiation risk and to the poor ergonomic design of interventional suites. These occupational health concerns pertain to cardiologists, radiologists and surgeons working with fluoroscopy, pain management specialists performing nonvascular fluoroscopic procedures, and the many support personnel working in these environments.

This position paper is the work of representatives of the major societies of physicians who work in the interventional laboratory environment, and has been formally endorsed by all. In this paper, the available data delineating the prevalence of these occupational health risks is reviewed and ongoing epidemiological studies designed to further elucidate these risks are summarized. The main purpose is to publicly state speaking with a single voice that the interventional laboratory poses workplace hazards that must be acknowledged, better understood and mitigated to the greatest extent possible, and to advocate vigorously on behalf of efforts to reduce these hazards. Interventional physicians and their professional societies, working together with industry, should strive toward the ultimate zero radiation exposure work environment that would eliminate the need for personal protective apparel and prevent its orthopedic and ergonomic consequences. © 2008 Wiley-Liss, Inc.