Occupational Health Risks in Cardiac Catheterization Laboratory Workers

被引:213
作者
Andreassi, Maria Grazia [1 ]
Piccaluga, Emanuela [2 ]
Guagliumi, Giulio [3 ]
Del Greco, Maurizio [4 ]
Gaita, Fiorenzo [5 ]
Picano, Eugenio [1 ]
机构
[1] CNR, Inst Clin Physiol, Via Moruzzi 1, I-56124 Pisa, Italy
[2] Niguarda Ca Granda Hosp Milan, Cardiovasc Dept, Milan, Italy
[3] Papa Giovanni XXIII Hosp, Cardiovasc Dept, Bergamo, Italy
[4] Santa Chiara Hosp, Dept Cardiol, Trento, Trento, Italy
[5] Univ Turin, Dept Med Sci, Div Cardiol, Turin, Italy
关键词
cancer; cardiac catheterization; cataract; fluoroscopy; ionizing radiation; radiation risk; safety; ATOMIC-BOMB SURVIVORS; IONIZING-RADIATION EXPOSURE; INTERVENTIONAL CARDIOLOGISTS; INVASIVE CARDIOLOGISTS; MORTALITY RISKS; STAFF WORKING; HAZARDS; CANCER; ATHEROSCLEROSIS; BRAIN;
D O I
10.1161/CIRCINTERVENTIONS.115.003273
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Orthopedic strain and radiation exposure are recognized risk factors in personnel staff performing fluoroscopically guided cardiovascular procedures. However, the potential occupational health effects are still unclear. The purpose of this study was to examine the prevalence of health problems among personnel staff working in interventional cardiology/cardiac electrophysiology and correlate them with the length of occupational radiation exposure. Methods and Results-We used a self-administered questionnaire to collect demographic information, work-related information, lifestyle-confounding factors, all current medications, and health status. A total number of 746 questionnaires were properly filled comprising 466 exposed staff (281 males; 449 years) and 280 unexposed subjects (179 males; 43 +/- 7years). Exposed personnel included 218 interventional cardiologists and electrophysiologists (168 males; 46 +/- 9 years); 191 nurses (76 males; 42 +/- 7 years), and 57 technicians (37 males; 40 +/- 12 years) working for a median of 10 years (quartiles: 5-24 years). Skin lesions (P=0.002), orthopedic illness (P<0.001), cataract (P=0.003), hypertension (P=0.02), and hypercholesterolemia (P<0.001) were all significantly higher in exposed versus nonexposed group, with a clear gradient unfavorable for physicians over technicians and nurses and for longer history of work (>16 years). In highly exposed physicians, adjusted odds ratio ranged from 1.7 for hypertension (95% confidence interval: 1-3; P=0.05), 2.9 for hypercholesterolemia (95% confidence interval: 1-5; P=0.004), 4.5 for cancer (95% confidence interval: 0.9-25; P=0.06), to 9 for cataract (95% confidence interval: 2-41; P=0.004). Conclusions-Health problems are more frequently observed in workers performing fluoroscopically guided cardiovascular procedures than in unexposed controls, raising the need to spread the culture of safety in the cath laboratory.
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页数:8
相关论文
共 37 条
[1]   Subclinical Carotid Atherosclerosis and Early Vascular Aging From Long-Term Low-Dose Ionizing Radiation Exposure A Genetic, Telomere, and Vascular Ultrasound Study in Cardiac Catheterization Laboratory Staff [J].
Andreassi, Maria Grazia ;
Piccaluga, Emanuela ;
Gargani, Luna ;
Sabatino, Laura ;
Borghini, Andrea ;
Faita, Francesco ;
Bruno, Rosa Maria ;
Padovani, Renato ;
Guagliumi, Giulio ;
Picano, Eugenio .
JACC-CARDIOVASCULAR INTERVENTIONS, 2015, 8 (04) :616-627
[2]   Somatic DNA damage in interventional cardiologists: a case control study [J].
Andreassi, MG ;
Cioppa, A ;
Botto, N ;
Joksic, G ;
Manfredi, S ;
Federici, C ;
Ostojic, M ;
Rubino, P ;
Picano, E .
FASEB JOURNAL, 2005, 19 (03) :998-+
[3]   Ionizing radiation and atherosclerosis: Current knowledge and future challenges [J].
Borghini, Andrea ;
Gianicolo, Emilio Antonio Luca ;
Picano, Eugenio ;
Andreassi, Maria Grazia .
ATHEROSCLEROSIS, 2013, 230 (01) :40-47
[4]   DOSE RECONSTRUCTION FOR THE MILLION WORKER STUDY: STATUS AND GUIDELINES [J].
Bouville, Andre ;
Toohey, Richard E. ;
Boice, John D., Jr. ;
Beck, Harold L. ;
Dauer, Larry T. ;
Eckerman, Keith F. ;
Hagemeyer, Derek ;
Leggett, Richard W. ;
Mumma, Michael T. ;
Napier, Bruce ;
Pryor, Kathy H. ;
Rosenstein, Marvin ;
Schauer, David A. ;
Sherbini, Sami ;
Stram, Daniel O. ;
Thompson, James L. ;
Till, John E. ;
Yoder, Craig ;
Zeitlin, Cary .
HEALTH PHYSICS, 2015, 108 (02) :206-220
[5]   Occupational Health Risks in Interventional Cardiology Expected Inherent Risk or Preventable Personal Liability? [J].
Chambers, Charles E. .
JACC-Cardiovascular Interventions, 2015, 8 (04) :628-630
[6]   Occupational hazards for interventional cardiologists [J].
Dehmer, Gregory J. ;
Goldstein, James ;
Naito, Neil ;
Miller, Donald L. ;
Haines, David ;
Kleinerman, Ruth .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2006, 68 (06) :974-976
[7]   Psychophysiologic responses of invasive cardiologists in an academic catheterization laboratory [J].
Detling, N ;
Smith, A ;
Nishimura, R ;
Keller, S ;
Martinez, M ;
Young, W ;
Holmes, D .
AMERICAN HEART JOURNAL, 2006, 151 (02) :522-528
[8]   Approaches to Enhancing Radiation Safety in Cardiovascular Imaging A Scientific Statement From the American Heart Association [J].
Fazel, Reza ;
Gerber, Thomas C. ;
Balter, Stephen ;
Brenner, David J. ;
Carr, J. Jeffrey ;
Cerqueira, Manuel D. ;
Chen, Jersey ;
Einstein, Andrew J. ;
Krumholz, Harlan M. ;
Mahesh, Mahadevappa ;
McCollough, Cynthia H. ;
Min, James K. ;
Morin, Richard L. ;
Nallamothu, Brahmajee K. ;
Nasir, Khurram ;
Redberg, Rita F. ;
Shaw, Leslee J. .
CIRCULATION, 2014, 130 (19) :1730-1748
[9]  
Filkelstein MM, 1998, CAN J CARDIOL, V14, P1385
[10]   Occupational hazards of interventional cardiologists: Prevalence of orthopedic health problems in contemporary practice [J].
Goldstein, JA ;
Baiter, S ;
Cowley, M ;
Hodgson, J ;
Klein, LW .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2004, 63 (04) :407-411