Ionising radiation – a cancer danger for cardiologists

Cardiologists exposed to radiation susceptible to tumors’, Jerusalem Post, By JUDY SIEGEL-ITZKOVICH02/15/2012  Israelis publish evidence of brain cancer as occupational hazard for certain medical specialists. Interventional cardiologists around the world have expressed concern over the findings of an Israeli colleague’s medical journal report suggesting aggressive brain cancer – especially on the left side of the head – may be an occupational hazard from their exposure to ionizing radiation.

Prof. Ariel Roguin, chief of interventional cardiology at Haifa’s
Rambam Medical Center, and colleagues presented new data on four
interventional cardiologists – all of them diagnosed with incurable
brain tumors of the left side – which due to the equipment they use
are exposed to the radiation source during procedures.

Roguin, who also teaches at the Technion’s Rappaport Faculty of
Medicine, told The Jerusalem Post on Tuesday that he wrote the article
to increase awareness of the possible risks of the profession. Other
cardiologists and radiologists, who are not interventional, are able
to sit in another room and do their work, but those who have to
function at the patient’s side in catheterization rooms must get close
to the ionizing radiation, he said.

The interventional specialist, he said, already wears heavy lead
protectors that cover the chest and thyroid glands below the neck to
minimize exposure and reduce the risk of cancer.

But the head and hands are not covered, and Roguin said he knows of no
one in the specialty who wears a lead helmet. They also have a special
card that monitors accumulated radiation exposure over time.

While hospitals usually check them, private clinics and hospitals may
be less careful, and the interventional specialists may ignore
warnings of overexposure because it would prevent them from working,
Roguin said.  The Rambam specialist, who said he performs 600 such
procedures a year, wrote the article in the latest issue of the
peer-reviewed journal EuroIntervention, along with the Carmel Medical
Center’s Dr. Jacob Goldstein and Dr. Olivier Bar of a cardiology
interventional imaging clinic in France.

They summarized the medical literature that included another two
interventional cardiologists and three interventional radiologists
with brain cancer for a total of nine documented cases since 1997. The
data was obtained from medical records and interviews with family
members or colleagues of the victims.

All the physicians who had the type of aggressive brain cancer called
gliomas were men who had been in the profession for decades, the
article said. There were no women, as there have been very few senior
female doctors in the profession, and only now have some joined the
ranks.

DNA damage is considered to be the main initiating event by which
radiation damage to cells results in slow development of this type of
cancer, said the Rambam cardiologist. Those performing the procedures
are likely to receive high radiation exposure in spite of
protection…..
Goldstein added: “Hospital workers exposed to low doses of ionizing
radiation had a higher frequency of early chromosomal changes than did
controls. Indeed, chromosomal aberrations in peripheral blood
lymphocytes have been used for many years to monitor human populations
exposed to potential carcinogens.”…..
“When measuring occupational doses from fluoroscopy- guided
interventional procedures, several studies calculated an increased
cancer risk caused by professional radiation exposure in modern
invasive cardiology practice.”….
http://www.jpost.com/Health/Article.aspx?id=257860

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