Anselmino Matteo, Ballatore Andrea, Giaccardi Marzia, Agresta Alessia, Chieffo Enrico, Floris Roberto, Racheli Marco, Scaglione Marco, Casella Michela, Maines Massimiliano, Marini Massimiliano, De Ferrari Gaetano Maria, De Ponti Roberto, Del Greco Maurizio
Division of Cardiology, 'Città della Salute e della Scienza di Torino' Hospital, Department of Medical Sciences, University of Turin.
Cardiology and Electrophysiology Unit, Department of Medicine, 'Santa Maria Nuova' Hospital, Florence.
J Cardiovasc Med (Hagerstown). 2021 Oct 1;22(10):751-758. doi: 10.2459/JCM.0000000000001210.
Radiation use in medicine has significantly increased over the last decade, and cardiologists are among the specialists most responsible for X-ray exposure. The present study investigates a broad range of aspects, from specific European Union directives to general practical principles, related to radiation management among a national cohort of cardiologists.
A voluntary 31-question survey was run on the Italian Arrhythmology and Pacing Society (AIAC) website. From June 2019 to January 2020, 125 cardiologists, routinely performing interventional electrophysiology, participated in the survey. Eighty-seven (70.2%) participants are aware of the recent European Directive (Euratom 2013/59), although only 35 (28.2%) declare to have read the document in detail. Ninety-six (77.4%) participants register the dose delivered to the patient in each procedure, in 66.1% of the cases both as fluoroscopy time and dose area product. Years of exposition (P = 0.009) and working in centers performing pediatric procedures (P = 0.021) related to greater degree of X-ray equipment optimization. The majority of participants (72, 58.1%) did not recently attend radioprotection courses. The latter is related to increased awareness of techniques to reduce radiation exposure (96% vs. 81%, P = 0.022), registration of the delivered dose in each procedure (92% vs. 67%, P = 0.009), and X-ray equipment optimization (50% vs. 36%, P = 0.006).
Italian interventional cardiologists show an acceptable level of radiation awareness and knowledge of updated European directives. However, there is clear space for improvement. Comparison to other health professionals, both at national and international levels, is needed to pursue proper X-ray management and protect public health.
在过去十年中，医学领域的辐射使用显著增加，心脏病专家是X射线暴露责任最大的专科医生之一。本研究调查了与一组全国性心脏病专家的辐射管理相关的广泛方面，从欧盟的具体指令到一般实用原则。
在意大利心律失常与起搏协会（AIAC）网站上进行了一项自愿的31题调查。从2019年6月到2020年1月，125名常规进行介入性电生理学的心脏病专家参与了调查。87名（70.2%）参与者知晓最近的欧洲指令（2013/59号欧洲原子能指令），尽管只有35名（28.2%）宣称详细阅读过该文件。96名（77.4%）参与者记录每次手术中给予患者的剂量，66.1%的情况下同时记录透视时间和剂量面积乘积。工作年限（P = 0.009）以及在进行儿科手术的中心工作（P = 0.021）与更高程度的X射线设备优化相关。大多数参与者（72名，58.1%）最近没有参加辐射防护课程。后者与提高对减少辐射暴露技术的认识（96%对81%，P = 0.022）、每次手术中记录给予的剂量（92%对67%，P = 0.009）以及X射线设备优化（50%对36%，P = 0.006）相关。
意大利介入心脏病专家对辐射的认识以及对最新欧洲指令的了解处于可接受水平。然而，仍有明显的改进空间。需要与国家和国际层面的其他卫生专业人员进行比较，以实现适当的X射线管理并保护公众健康。
