WASHINGTON—Healthcare professionals performing minimally invasive procedures in fluoroscopy laboratories, often called "cath labs," should no longer have to accept preventable radiation exposure and orthopedic injuries as part of their jobs, according to an expert consensus statement released today that is endorsed by six leading medical societies.
Published today in JSCAI , the Journal of Vascular and Interventional Radiology (JVIR), and JACC: Cardiovascular Interventions, "SCAI/ASE/HRS/SIR/SVS Expert Consensus Statement on Enhanced Radiation Protection: Time for Mandatory and Urgent Action" calls for hospitals, manufacturers, regulators, and professional societies to immediately adopt enhanced radiation protection technologies, modernize radiation safety standards, and strengthen monitoring and reporting practices to better protect the healthcare teams working in fluoroscopy laboratories.
Given the availability of safer technologies, the authors say broader implementation of enhanced radiation protection devices (ERPDs) is both an ethical responsibility and a necessary evolution of ALARA ("As Low As Reasonably Achievable"), the longstanding radiation safety standard that exposures should be kept "as low as reasonably achievable."
"For decades, we accepted occupational radiation exposure and the physical burden of heavy protective equipment as unavoidable realities of working in a fluoroscopy laboratory," said David G. Rizik, MD, MSCAI , chair of the writing group. "That is no longer acceptable. Technologies available today can greatly reduce radiation exposure while also addressing the orthopedic injuries associated with traditional lead protection. The question is no longer whether these solutions exist. It is whether we are willing to make protecting healthcare workers the priority it deserves. This consensus makes clear that the time for implementation is now."
ERPDs reduce radiation exposure through engineering controls rather than relying primarily on personal protective equipment. The consensus statement cites evidence that ERPDs can reduce operator and staff radiation exposure by up to 99 percent.
The statement cited a 2023 SCAI survey of interventional cardiologists , which found that nearly 60 percent reported orthopedic injuries and 17 percent reported limiting their time in the cath lab to reduce radiation exposure. Among women respondents, 28 percent reported being discouraged from working in the cath lab because of pregnancy or considering pregnancy, while 71 percent wanted the option to step away from the cath lab during pregnancy.
"Every clinician and staff member who leaves the fluoroscopy laboratory because of preventable injury or chronic occupational disease represents a loss of expertise that patients depend on, in addition to the immense pain and loss experienced by the clinician and their loved ones," said James B. Hermiller, MD, MSCAI , cochair of the writing group. "Demand for minimally invasive procedures continues to grow, and the duration and complexity of these procedures are increasing. Maintaining a healthy, experienced workforce will be essential to ensuring patients continue to have access to the lifesaving care these teams provide."
The statement calls for healthcare organizations and policymakers to:
