From the CNR Institute of Clinical Physiology, Pisa, Italy (M.G.A., E. Picano); Cardiovascular Department, Niguarda Ca' Granda Hospital Milan, Milano Italy (E. Piccaluga); Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (G.G.); Department of Cardiology, S. Chiara Hospital, Trento, Italy (M.D.G.); and Division of Cardiology, Department of Medical Science, University of Turin, Torino, Italy (F.G.).
Circ Cardiovasc Interv. 2016 Apr;9(4):e003273. doi: 10.1161/CIRCINTERVENTIONS.115.003273.
Orthopedic strain and radiation exposure are recognized risk factors in personnel staff performing fluoroscopically guided cardiovascular procedures. However, the potential occupational health effects are still unclear. The purpose of this study was to examine the prevalence of health problems among personnel staff working in interventional cardiology/cardiac electrophysiology and correlate them with the length of occupational radiation exposure.
We used a self-administered questionnaire to collect demographic information, work-related information, lifestyle-confounding factors, all current medications, and health status. A total number of 746 questionnaires were properly filled comprising 466 exposed staff (281 males; 44±9 years) and 280 unexposed subjects (179 males; 43±7years). Exposed personnel included 218 interventional cardiologists and electrophysiologists (168 males; 46±9 years); 191 nurses (76 males; 42±7 years), and 57 technicians (37 males; 40±12 years) working for a median of 10 years (quartiles: 5-24 years). Skin lesions (P=0.002), orthopedic illness (P<0.001), cataract (P=0.003), hypertension (P=0.02), and hypercholesterolemia (P<0.001) were all significantly higher in exposed versus nonexposed group, with a clear gradient unfavorable for physicians over technicians and nurses and for longer history of work (>16 years). In highly exposed physicians, adjusted odds ratio ranged from 1.7 for hypertension (95% confidence interval: 1-3; P=0.05), 2.9 for hypercholesterolemia (95% confidence interval: 1-5; P=0.004), 4.5 for cancer (95% confidence interval: 0.9-25; P=0.06), to 9 for cataract (95% confidence interval: 2-41; P=0.004).
Health problems are more frequently observed in workers performing fluoroscopically guided cardiovascular procedures than in unexposed controls, raising the need to spread the culture of safety in the cath laboratory.
在进行透视引导心血管手术的人员中，骨科劳损和辐射暴露被认为是危险因素。然而，潜在的职业健康影响尚不清楚。本研究的目的是检查介入心脏病学/心脏电生理学工作人员的健康问题发生率，并将其与职业辐射暴露时间进行相关性分析。
我们使用自我管理问卷收集人口统计学信息、工作相关信息、生活方式混杂因素、所有当前药物和健康状况。共有 746 份问卷被正确填写，其中包括 466 名暴露于射线的工作人员（281 名男性；44±9 岁）和 280 名非暴露于射线的对照组（179 名男性；43±7 岁）。暴露于射线的人员包括 218 名介入心脏病专家和电生理学家（168 名男性；46±9 岁）、191 名护士（76 名男性；42±7 岁）和 57 名技术员（37 名男性；40±12 岁），中位数工作时间为 10 年（四分位间距：5-24 年）。皮肤损伤（P=0.002）、骨科疾病（P<0.001）、白内障（P=0.003）、高血压（P=0.02）和高胆固醇血症（P<0.001）在暴露组中均显著高于非暴露组，并且对医生（高于技术员和护士）和更长的工作史（>16 年）不利。在高度暴露的医生中，调整后的优势比（odds ratio）范围为 1.7（高血压；95%置信区间：1-3；P=0.05）、2.9（高胆固醇血症；95%置信区间：1-5；P=0.004）、4.5（癌症；95%置信区间：0.9-25；P=0.06）和 9（白内障；95%置信区间：2-41；P=0.004）。
在进行透视引导心血管手术的人员中，健康问题比未暴露于射线的对照组更为常见，这表明需要在导管室中传播安全文化。
