Frequent use of lead aprons to protect clinicians in the interventional lab and radiology departments from radiation exposure may be associated with increased musculoskeletal pain, according to a study published Feb. 23 in the Journal of the American College of Cardiology (JACC).

The study, led by Nicholas M. Orme, MD, Division of Cardiovascular Disease, Mayo Clinic, Rochester, MN, sought to determine the prevalence of work-related medical conditions associated with clinicians working in interventional laboratories, as compared with employees outside of the lab. Researchers recorded results from 1,543 electronic surveys completed by Mayo Clinic employees in interventional cardiology or interventional radiology labs (1,042 participants), with the control group being those who indicated they were not involved with radiation procedures.

The electronic survey results showed that interventional clinicians reported experiencing work-related pain more often than the control group, specifically musculoskeletal pain (55 percent). Technicians (62 percent) and nurses (60 percent) reported the highest incidences of work-related musculoskeletal pain, closely followed by attending physicians (44 percent). Interestingly, researchers found that employees involved in radiation procedures who reported work-related pain were more likely to be female (71 percent), spent more time exposed to radiation, and wore a lead apron approximately four hours per week. The survey did not show a difference between interventional clinicians and the control group in their reported history of cancer, cataracts, hypothyroidism or nephrolithiasis.

The authors of the study note that “more attention and effort needs to be directed toward improving the physical stresses that interventional lab employees endure. For all employees, continued efforts at limiting procedure times and regular ergonomic evaluations with associated training are advisable. Non-physician employees also may benefit from periodic rotation out of the interventional lab suite.”

“Most of the focus of safety procedures and policies in interventional laboratories have been directed to the patient and the physicians performing the procedure, with good reason, but not necessarily geared toward to the supportive personnel who are integral to these procedures,” said Valentin Fuster, MD, PhD, MACC, editor-in-chief of JACC. “In creating hospital standards and policies for cardiac catheterization labs, we need to be equally focused on the physical toll to these allied health professionals.”

In an accompanying editorial comment, James A. Goldstein, MD, FACC, remarked that “recent industry innovations in radiation equipment now facilitate quality imaging with less dose and provide online exposure monitoring … Fortunately, there is now a growing technology portfolio that provides optimism for a healthier work environment. Technologies now available include ceiling-suspended individual lead aprons, shielded gloves [and] scrub caps for cranial protection and vascular robotic technology.”

Keywords: Attention, Cardiac Catheterization, Cardiology, Cardiovascular Diseases, Cataract, Control Groups, Data Collection, Ergonomics, Hypothyroidism, Incidence, Musculoskeletal Pain, Neoplasms, Nephrolithiasis, Occupational Health, Pain, Prevalence, Radiology, Interventional, Research Personnel, Robotics, Rotation, Workplace

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