Thursday, April 24, 2014

RADIATION RISK. THE PROBLEM INTERVENTIONIST FACE. BRAIN TUMOURS.

It is obvious that Interventional cardiologist deals alot with radiation. All our techniques uses Xrays to help us track what we do and also document our results. Xrays are indispensable to our work. Some of us literally spend hours in the cath lab, next to big Xray machines. Do these pose a danger?
Well we have known for years that interventional cardiologist face cancer problems, back problems, thyroid problem and some blood disease.

Well, at the ongoing SOLACI ( Societad Latinoamericana de Cardiologia interventionista ) 2014 meeting at Beunos Aires, Dr Ariel Roguin ( Rambam Medical Center, Haifa, Israel ), reported on his updates. He had written an earlier paper in 212 on the number of brain tumours in interventionists. Since then, he has received numerous more reports from colleagues on this issue. He now has a series of 36 cases of brain cancers. 86% were on the left side ( the side of the image intensifier for right handers ). 50% of the brain tumours were glioblastoma multiforme, 14% were meningiomas and 7% were astrocytomas.
In this cohort there were 28 interventional cardiologist, 2 electrophysiologists, and 6 interventional radiologist. Some have been doing interventions for 25 years. The annual radiation dose of this cohort was about 20-30 mSv annually.
Well 86 cases is a lot, but I am not sure what the national average is for countries where these interventionist come from. Are these cases in excess of the national average?
I had suffered an avascular necrosis of my left hip ( the side of the image intensifier ) and had atotal left hip replacement done in 2009.

This report is to highlight the fact that radiation is a necessary evil for us, and we should take precaution. Beside gowning with all those heavy lead shield and gowns, we should also take some training perhaps, in radiation education. We surely hope for the day, when everyone is aware, an the incidence. Maybe one day we will be wearing total body suits and also a head gear against radiation.

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