Coronary Artery Disease

Risk for radiation-induced cataract for staff in interventional cardiology: Is there reason for concern?†‡

  1. Olivera Ciraj-Bjelac PhD1,
  2. Madan M. Rehani PhD2,*,
  3. Kui Hian Sim MBBS, FRACP3,
  4. Houng Bang Liew MBBS, FRCP3,
  5. Eliseo Vano PhD4,
  6. Norman J. Kleiman PhD5

Article first published online: 14 JUN 2010

DOI: 10.1002/ccd.22670

Issue

Catheterization and Cardiovascular Interventions

Catheterization and Cardiovascular Interventions

Volume 76, Issue 6, pages 826–834, 15 November 2010

Additional Information

How to Cite

Ciraj-Bjelac, O., Rehani, M. M., Sim, K. H., Liew, H. B., Vano, E. and Kleiman, N. J. (2010), Risk for radiation-induced cataract for staff in interventional cardiology: Is there reason for concern?. Cathet. Cardiovasc. Intervent., 76: 826–834. doi: 10.1002/ccd.22670

Author Information

  1. 1

    Vinca Institute of Nuclear Sciences, Belgrade, Serbia

  2. 2

    International Atomic Energy Agency, Vienna, Austria

  3. 3

    Department of Cardiology, Sarawak General Hospital, Kuching, Malaysia

  4. 4

    Radiology Department, Complutense University, Madrid, Spain

  5. 5

    Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York

*International Atomic Energy Agency, P. O. Box 100, Vienna, Austria

  1. †

    This work was performed during the annual conference of the National Heart Association of Malaysia on 17–19 April, 2009.

  2. ‡

    Conflict of interest: Nothing to report.

Publication History

  1. Issue published online: 19 NOV 2010
  2. Article first published online: 14 JUN 2010
  3. Accepted manuscript online: 14 JUN 2010 12:00AM EST
  4. Manuscript Accepted: 19 MAY 2010
  5. Manuscript Received: 7 APR 2010

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Keywords:

  • cardiac catheterization;
  • fluoroscopy;
  • occupational exposure;
  • posterior subcapsular cataract (psc);
  • lens opacity

Abstract

Objectives: To examine the prevalence of radiation-associated lens opacities among interventional cardiologists and nurses and correlate with occupational radiation exposure. Background: Interventional cardiology personnel are exposed to relatively high levels of X-rays and based on recent findings of radiation-associated lens opacities in other cohorts, they may be at risk for cataract without use of ocular radiation protection. Methods: Eyes of interventional cardiologists, nurses, and age- and sex-matched unexposed controls were screened by dilated slit lamp examination and posterior lens changes graded using a modified Merriam-Focht technique. Individual cumulative lens X-ray exposure was calculated from responses to a questionnaire and personal interview. Results: The prevalence of radiation-associated posterior lens opacities was 52% (29/56, 95% CI: 35–73) for interventional cardiologists, 45% (5/11, 95% CI: 15–100) for nurses, and 9% (2/22, 95% CI: 1–33) for controls. Relative risks of lens opacity was 5.7 (95% CI: 1.5–22) for interventional cardiologists and 5.0 (95% CI: 1.2–21) for nurses. Estimated cumulative ocular doses ranged from 0.01 to 43 Gy with mean and median values of 3.4 and 1.0 Gy, respectively. A strong dose–response relationship was found between occupational exposure and the prevalence of radiation-associated posterior lens changes. Conclusions: These findings demonstrate a dose dependent increased risk of posterior lens opacities for interventional cardiologists and nurses when radiation protection tools are not used. While study of a larger cohort is needed to confirm these findings, the results suggest ocular radio-protection should be utilized. © 2010 Wiley-Liss, Inc.

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