Radiation Exposure Among Scrub Technologists and Nurse Circulators During Cardiac Catheterization: The Impact of Accessory Lead Shields

Abstract

Objectives: This study was performed to determine if the use of an accessory lead shield is associated with a reduction in radiation exposure among staff members during cardiac catheterization.

Background: Accessory lead shields that protect physicians from scatter radiation are standard in many catheterization laboratories, yet similar shielding for staff members is not commonplace.

Methods: Real-time radiation exposure data were prospectively collected among nurses and technologists during 764 consecutive catheterizations. The study had 2 phases: in phase I (n = 401), standard radiation protection measures were used, and in phase II (n = 363), standard radiation protection measures were combined with an accessory lead shield placed between the staff member and patient. Radiation exposure was reported as the effective dose normalized to dose-area product (E_DAP).

Results: Use of an accessory lead shield in phase II was associated with a 62.5% lower E_DAP per case among technologists (phase I: 2.4 [4.3] μSv/[mGy × cm²] × 10^-5; phase II: 0.9 [2.8] μSv/[mGy × cm²] × 10^-5; p < 0.001) and a 63.6% lower E_DAP per case among nurses (phase I: 1.1 [3.1] μSv/[mGy × cm²] × 10^-5; phase II: 0.4 [1.8] μSv/[mGy × cm²] × 10^-5; p < 0.001). By multivariate analysis, accessory shielding remained independently associated with a lower E_DAP among both technologists (34.2% reduction; 95% confidence interval: 20.1% to 45.8%; p < 0.001) and nurses (36.4% reduction; 95% confidence interval: 19.7% to 49.6%; p < 0.001).

Conclusions: The relatively simple approach of using accessory lead shields to protect staff members during cardiac catheterization was associated with a nearly two-thirds reduction in radiation exposure among nurses and technologists.

Keywords: cardiac catheterization; occupational hazard; radiation safety.