WASHINGTON—A survey conducted by the Society for Cardiovascular Angiography and Interventions (SCAI) highlights ongoing radiation and orthopedic hazards faced by interventional cardiologists and cardiac catheterization laboratory ("cath lab" or CCL) staff. The survey revealed that despite technological advancements, significant risks often remain unaddressed despite advances in protective equipment.
"Occupational Health Hazards in the Cardiac Catheterization Laboratory: Results of the 2023 SCAI Survey" highlights alarming trends in radiation exposure and orthopedic injuries for interventional cardiologists and staff. The survey was published in JSCAI with a call to action by SCAI Leadership.
"This study confirms what many of us in the field have long suspected—occupational hazards in the cath lab remain unacceptable and are largely unchanged over the past two decades," said SCAI President James B. Hermiller, MD, MSCAI . "We must act now to implement stronger protections for interventional cardiologists and cath lab staff to ensure their long-term health and safety. Addressing these risks is not just about protecting today's workforce but also about ensuring the sustainability of our profession."
The survey, conducted by SCAI's Professional Well-Being Committee, compared data from 2014 to 2023 and found that although technological advancements in the field have been made, the risks associated with working in the CCL remain unacceptably high. Over 60% of respondents reported experiencing orthopedic injuries, and 6% reported being diagnosed with cancer, far exceeding normal rates and underscoring the urgent need for improved safety measures.
"This data provides an undeniable call to action. The results showed that the preponderance of cancers and other types of radiation injury, such as cataracts, was threefold higher than what is observed in the general population," said coauthor Allison Dupont, MD, FSCAI , chair of SCAI's Professional Well-Being Committee. "Hospitals and healthcare systems need to prioritize investments in advanced protective equipment and safer work environments. We know that new technologies exist that could significantly reduce radiation exposure and orthopedic strain, but we need institutional commitment to make these solutions accessible."
Among the study's key findings:
- Persistent orthopedic injuries: Nearly 60% of respondents reported orthopedic injuries due to wearing lead aprons for hours, with spine injuries being the most common. Such aprons can weigh over 10 pounds. Chronic pain related to these injuries remains a leading cause of career limitations and early retirement among interventional cardiologists.
- Radiation exposure concerns: Despite the availability of protective equipment, usage remains inconsistent. Many respondents cited high costs and administrative barriers as obstacles to adopting newer radiation protection technologies. Additionally, 17% of respondents admitted to limiting their time in the cath lab to reduce their radiation exposure, a significant increase from previous surveys.
- Concerns for female interventionalists: The survey highlighted the specific needs of female interventional cardiologists, particularly regarding pregnancy and radiation exposure. Among female respondents, 28% reported being discouraged from working in the cath lab due to pregnancy, while 71% expressed a desire to step away during pregnancy, highlighting the need for more flexible policies and better workplace accommodations.
In addition to highlighting existing concerns, the study proposes concrete steps to mitigate these hazards, including the adoption of new shielding technologies, reducing reliance on heavy lead aprons, and expanding formal radiation safety education. The survey also found that despite the availability of various radiation mitigation tools, many are underutilized due to cost concerns and a lack of administrative support, underscoring the need for systemic change.
"We cannot afford to ignore these findings," said coauthor Islam Abudayyeh, MD, FSCAI, co-chair of SCAI's Professional Well-Being Committee. "At a time when recruitment and retention in interventional cardiology are already challenging, we must ensure that our work environments are not only cutting-edge in terms of patient care but also safe and sustainable for providers."
Hermiller called upon hospitals, healthcare administrators, and policymakers to address these critical issues by investing in safer work environments and fostering a culture that prioritizes the well-being of CCL professionals. The Society also plans to use these findings to advocate for legal changes that would promote safer working conditions and increased institutional accountability.
DOI: https://doi.org/10.1016/j.jscai.2024.102493
