Moriña David, Grellier James, Carnicer Adela, Pernot Eileen, Ryckx Nick, Cardis Elisabeth
ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. Universitat Pompeu Fabra (UPF), Barcelona, Spain. CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Program (CERP), Catalan Institute of Oncology (ICO)-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain. Grups de Recerca d'Àfrica i Amèrica Llatines (GRAAL)-Unitat de Bioestadística, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain.
J Radiol Prot. 2016 Sep;36(3):561-578. doi: 10.1088/0952-4746/36/3/561. Epub 2016 Jul 27.
Those working in interventional cardiology and related medical procedures are potentially subject to considerable exposure to x-rays. Two types of tissue of particular concern that may receive considerable doses during such procedures are the lens of the eye and the brain. Ocular radiation exposure results in lens changes that, with time, may progress to partial or total lens opacification (cataracts). In the early stages, such opacities do not result in visual disability; the severity of such changes tends to increase progressively with dose and time until vision is impaired and cataract surgery is required. Scattered radiation doses to the eye lens of an interventional cardiologist in typical working conditions can exceed 34 μGy min in high-dose fluoroscopy modes and 3 μGy per image during image acquisition (instantaneous rate values) when radiation protection tools are not used. A causal relation between exposure to ionising radiation and increased risk of brain and central nervous system tumours has been shown in a number of studies. Although absorbed doses to the brain in interventional cardiology procedures are lower than those to the eye lens by a factor between 3.40 and 8.08 according to our simulations, doses to both tissues are among the highest occupational radiation doses documented for medical staff whose work involves exposures to x-rays. We present InterCardioRisk, a tool featuring an easy-to-use web interface that provides a general estimation of both cumulated absorbed doses experienced by medical staff exposed in the interventional cardiology setting and their estimated associated health risks. The tool is available at http://intercardiorisk.creal.cat.
从事介入心脏病学及相关医疗程序的人员可能会大量接触X射线。在此类程序中,特别值得关注的两种可能接受大量辐射剂量的组织是眼睛晶状体和大脑。眼部辐射暴露会导致晶状体发生变化,随着时间推移,可能会发展为部分或完全晶状体混浊(白内障)。在早期阶段,这种混浊不会导致视力残疾;此类变化的严重程度往往会随着剂量和时间的增加而逐渐加重,直到视力受损并需要进行白内障手术。在典型工作条件下,若不使用辐射防护工具,介入心脏病学家眼睛晶状体所接受的散射辐射剂量在高剂量荧光透视模式下可能超过34μGy/分钟,在图像采集期间(瞬时速率值)每张图像为3μGy。多项研究表明,电离辐射暴露与脑和中枢神经系统肿瘤风险增加之间存在因果关系。根据我们的模拟,尽管介入心脏病学程序中大脑所吸收的剂量比眼睛晶状体低3.40至8.08倍,但这两种组织所接受的剂量均属于记录在案的从事涉及X射线暴露工作的医务人员最高职业辐射剂量之列。我们展示了InterCardioRisk,这是一个具有易于使用的网络界面的工具,可对介入心脏病学环境中暴露的医务人员所经历的累积吸收剂量及其估计的相关健康风险进行总体估算。该工具可在http://intercardiorisk.creal.cat获取。