Survey: Orthopedic injuries plague half of operators

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Almost half of operators who responded to a survey on occupational health hazards in the cath lab reported they experienced at least one orthopedic injury, and more than one in 20 limited their case load because of radiation exposure.

The Society for Cardiovascular Angiography and Interventions (SCAI) released results of a survey it conducted of its members to assess the potential hazards practicing interventional cardiologists face on the job. Lead author Lloyd W. Klein, MD, of Advocate Illinois Medical Center in Chicago, and his colleagues noted that interventional procedures have become more complex and lengthy since SCAI sent out a similar survey a decade ago. At the same time, imaging safety features, shielding and practices have improved as well.

Nonetheless, operators and staff still need to wear protective lead aprons and potentially be exposed to ionizing radiation during cath lab procedures. The heavy apparel has contributed to problems such as back pain and hip, knee and ankle joint injuries. Radiation exposure has been associated with cataracts and cancers.

Klein et al sent out emails to the SCAI membership between late September and mid-October 2014 that included 18 questions. A total of 310 recipients responded. Recipients had on average been in their interventional practice for 16 years. They performed a mean 380 diagnostic and a mean 200 interventional cases a year, with coronary diagnostics being the most frequently performed procedure.

About 7 percent reported that they limited their personal caseload because of radiation exposure. When asked about radiation-related illnesses or injuries, 5.5 percent cited cataracts, 4.8 percent skin injuries and 4.8 percent hematologic or cancer-related diseases.

A total of 49.4 percent reported one or more orthopedic injury: 24.7 percent in the cervical spine; 34.4 percent in the lumbar spine; and 19.6 percent in the hip, knee or ankle joint. Almost one in 10 reported a health-related absence and one in three operators between the ages of 51 and 60 took an occupational health-related absence.

At the same time, 28.6 percent admitted that they never wore radiation badges and 18.5 percent occasionally didn’t wear badges. Older interventional cardiologists were more likely to skip wearing badges, both occasionally and routinely.   

“The significant number of operators in the present survey that do not routinely wear personal dosimetry badges likely reflects their concern that badges provide no direct radiation protection benefit, while at the same time, placing that individual ‘at-risk’ of being removed from the laboratory for high dosimetry readings,” they wrote.

Advances in imaging technologies and safety practices have helped to reduce the risk of radiation exposure to patients, Klein et al wrote, but cath labs have not made similar strides at reducing the orthopedic burden on operators. “[T]he present data demonstrate that the prevalence of orthopedic problems in interventionists today is higher than a decade ago; yet fewer operators are missing work, suggesting that we are working despite injuries.”

The study was published online March 24 in Catheterization and Cardiovascular Interventions.