Cardiac catheterization staff may have increased cancer risk.

A non-negligible lifetime attributable risk of cancer from cumulative professional exposure of cardiac catheterization staff was reported in a recent study. Occupational doses of radiation from fluoroscopy-guided intervention procedures are the highest ones registered among medical staff using x-rays.

This study evaluated the order of magnitude of cancer risk caused by professional radiation exposure in modern invasive cardiology practice. The study used the thermoluminescent dosimeter readings of 26 workers on a cardiovascular catherization unit. Their lifetime attributable risk of cancer was estimated using the approach of Biological Effects of Ionizing Radiation 2006 Report VII. It found that of the 26 workers with 2006 exposure greater than 2 mSv, 15 of them had worked at least 10 (up to 24) consecutive years. Of these 15 subjects, the median individual effective dose was 46 mSv. The median risk of (fatal and nonfatal) cancer was 1 in 192. The authors concluded that because of the length of the procedures, the cumulative exposure to radiation is considerable.

The National Cancer Institute has launched, in connection with five medical societies, a larger, long-term study to determine whether healthcare practitioners such as radiologists and cardiologists who are involved in fluoroscopy-guided procedures have a higher risk of cancer. The study will compare cancer-related deaths between physicians regularly involved in radiation procedures and those who are not involved in such procedures to determine whether increasing use of these new imaging technologies is associated with an elevated cancer risk.

Venneri, L., Rossi F., Botto, N., Andreassi, M. G., Salcone, N., Emad A., et al. (2009). Cancer risk from professional exposure in staff working in cardiac catheterization laboratory: Insights from the National Research Council's Biological Effects of Ionizing Radiation VII Report. American Heart Journal, 157(1), 118-124.

Contributing Editor Deborah McBride, RN, MSN, CPON [R], is a nurse at the Kaiser Permanente Oakland Medical Center and a faculty member at Samuel Merritt University in Oakland, CA.