Occupational health risks in interventional cardiology: expected inherent risk or preventable personal liability?

SEE PAGE 616 A lthough advances have been made in the diagnosis of and therapy for cardiovascular disease, this has not come without risks. This risk includes a 3-fold increase in patient medical radiation exposure over the past 25 years (1), with all imaging areas challenged to reduce patient dose (2). Although interventional cardiology contributes a small component to this increase, when a culture of radiation safety is practiced in the interventional suite, patient dose can be significantly reduced (3). Society efforts have focused on establishing a radiation safety program for all cardiac catheterization laboratories, in which dose reduction for the patient has had similarly beneficial effects on the operator and staff (4). As is often the case, unintended consequences may prove significant in the long term. Although invasive/interventional cardiology is appropriately focused on quality care/patient outcomes, the risks to the profession have received far less attention. This has resulted in the effects of radiation exposure and/ or the protective attire–induced orthopedic injuries being underestimated. These risks related to the fluoroscopy suite differ significantly from other disciplines in the medical profession. Career terminating orthopedic injuries, cataract formation, or life-altering cancers are subspecialty related (5–7). Although medical school lectures do not include