The Society for Cardiovascular Angiography and Interventions (SCAI) is pushing the Environmental Protection Agency (EPA) to broaden its guidance on radiation protection to better address staff- and operator-related issues.

In a June 3 letter, SCAI President Theodore A. Bass, MD, recommended that a revision of the report “Radiation Protection Guidance for Diagnostic and Interventional X-Ray Procedures” give greater consideration to radiation exposure to staff and operators as well as occupational injuries that may arise with shielding equipment. The letter included comments from James A. Goldstein, MD, of the Beaumont Heart Center in Royal Oak, Mich., who noted that the rise in fluoroscopically guided interventional procedures has increased occupational radiation exposure and orthopedic injuries.

Daily radiation exposure over a career has been associated with an increase in the incidence of cancers and cataracts, according to Goldstein. In addition, protective gear such as heavy lead aprons during procedures may have an accumulative effect on the spine. Women of childbearing age also may be concerned about radiation exposure to the fetus.

“Given the growing body of evidence that occupational risks threaten the long term personal health (and potentially career spans), clearly there is need for a safer workplace environment,” Goldstein commented. He recommended changes in equipment that reduce operator radiation exposure and orthopedic complications without interfering with workflow, and operator training to minimize radiation and orthopedic risks.

“[W]e encourage the EPA to focus more on the risks to operators and staff that are involved in these procedures,” wrote Bass, who also is chief of the cardiology division and medical director of the cardiovascular center at the University of Florida-Shands Jacksonville. “Their radiation safety and the orthopedic injuries that are related need to be considered more thoroughly by the EPA.”