RESOURCES

RESOURCES

1]

R. Fazel, et al., Approaches to Enhancing Radiation Safety in Cardiovascular Imaging: A Scientific Statement from the American Heart Association. Circulation. 2014;130:1730-48.

2]

Center for Devices and Radiological Health & U.S. Food and Drug Administration,Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging (February 2010).

3]

A. Roguin, et al, Brain and Neck Tumors among Physicians Performing Interventional Procedures. 111 American Journal of Cardiology 9: 1368-72 (May 2013).

4]

E. Picano, et al, Occupational Risks of Chronic Low Dose Radiation Exposure in Cardiac Catheterisation Laboratory: The Italian Healthy Cath Lab Study, European Medical Journal International,50-58 (2013).

5]

NRCP Report No. 117, Implementation of the Principle of As Low As Reasonably Achievable (ALARA) for Medical and Dental Personnel, December 31, 1990.

6]

U.S. Environmental Protection Agency Office of Radiation Protection Programs Home Page, Health Effects. http://www.epa.gov/rpdweb00/understand/health_effects.html
(Accessed on November 10, 2014).

7]

LW Klein, et al., Occupational Health Hazards in the Interventional Laboratory: Time for a Safer Environment. J Vasc Interv Radiol. 2009;20:147-153.

8]

GM Allen, Genetic susceptibility to radiogenic cancer in humans, Health Physics, 95:677-686 (2009); Steven Simon, Radiation-Exposed Populations: Who, Why and How to Study, Health Physics, 106(2) 182-195 (2014).

9]

National Research Council, Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII – Phase 2 (2006).

10]

U.S. Environmental Protection Agency, Radiation Protection,
http://www.epa.gov/rpdweb00/understand/health_effects.html (Accessed on November 10, 2014). Non-stochastic or deterministic health effects, the second EPA category, results from acute, high-dose exposure to ionizing radiation. The severity of these effects is dose-dependent and includes symptoms of “radiation poisoning” such as nausea, vomiting, weakness, alopecia, premature aging, cellular damage, skin changes, and death.

11]

U.S. Environmental Protection Agency Office of Radiation Protection Programs Home Page; Health Effects.

12]

National Research Council, Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII – Phase 2 (2006).

13]

S. Zhonghua, et al. Radiation-Induced Noncancer Risks in Interventional Cardiology: Optomisation of Procedures and Staff and Patient Dose Reduction, BioMed Research International (2013).

14]

MG Andreassi, The Biological Effects of Diagnostic Cardiac Imaging on Chronically Exposed Physicians: The Importance of Being Non-Ionizing, 2 Cardiovascular Ultrasound, 25 (November 22, 2004).

15]

E. Picano, et al, Occupational Risks of Chronic Low Dose Radiation Exposure in Cardiac Catheterisation Laboratory: The Italian Healthy Cath Lab Study, European Medical Journal International,50-58(2013).

16]

A. Roguin, et al. Brain and neck tumors among physicians performing interventional procedures. 111 American Journal of Cardiology 9: 1368-72 (May 2013).

17]

S. Yoshinaga, et al., Nonmelanoma skin cancer in relation to ionizing radiation exposure among U.S. radiologic technologists. Int J Cancer. 2005;115:828-34.

18]

E. Vano, et al. Radiation-associated lens opacities in catheterization personnel: results of a survey and direct assessments. 24 Journal of Vascular Interventional Radiology 2:197-204(2013).

19]

E. Ron, E, Brenner, Non-malignant thyroid diseases after a wide range of radiation exposures. Radiation Research, 174:877-888 (2010).

20]

R. Rola, Indicators of hippocampal neurogenesis are altered by 56Fe-particle irradiation in a dose-dependent manner. Radiation Research, 162:442-6 (2004).

21]

E. Picano, Cancer and non-cancer brain and eye effects of chronic low-dose ionizing radiation exposure, BMC Cancer, 12:157 (2012).

22]

A. Budorf, Effects of occupational exposure on the reproductive system: core evidence and practical implications, Occupational Medicine 56: 516-520 (2006).

23]

National Council on Radiation Protection (NCRP) Report No. 168. Radiation dose management for fluoroscopically guided interventional procedures. July 2010.

24]

U.S. EPA. Federal Guidance Report No. 14. Radiation protection guidance for diagnostic and interventional X-ray procedures. November 2014.

25]

A. Roguin, et al. Brain and neck tumors among physicians performing interventional procedures. 111 American Journal of Cardiology 9: 1368-72 (May 2013).

26]

DL Preston, et al, Tumors of the nervous system and pituitary gland associated with atomic bomb radiation exposure, Journal of National Cancer Institute, 94: 1555-1556 (2002).

27]

D. Marazzitti, Cognitive, psychological and psychiatric effects of ionizing radiation exposure, Current Medical Chemistry, 19:1864-1869 (2012).

28]

F. Lazarini, et al, Cellular and behavioral effects of cranial irradiation of the subventricular zone in adult mice, PLOS One 4: 7017 (2009).

29]

D. Miller, et al., Occupational Radiation Protection in Interventional Radiology: A Joint Guideline of the Cardiovascular and Interventional Radiology Society of Europe and Society of Interventional Radiology, Cardiovascular and Interventional Society of Europe & the Society of Interventional Radiology (2010).

30]

L Renaud, et al., A 5-year follow-up of the radiation exposure to in-room personnel during cardiac catheterization, Health Physics, 62:10-15 (1992).

31]

National Eye Institute, Facts about Cataracts,
https://nei.nih.gov/health/cataract/cataract_facts
(Accessed on July 21, 2014).

32]

E Vano, et al. Radiation cataract risk in interventional cardiology personnel. 170 Radiation Research 4: 490-495 (2010); GR Merrian, Experimental radiation cataracts –its clinical relevance, Buff. N.Y. Acad. Med. 59: 372-392.

33]

S. Jacob, et al. Ionizing radiation as a risk factor for cataract: What about low-dose effects? J Clinic Experiment Opthalmol. 2011;S1:005.

34]

E. Vano, et al. Radiation-associated lens opacities in catheterization personnel: results of a survey and direct assessments. 24 Journal of Vascular Interventional Radiology 2:197-204(2013).

35]

IAEA, Radiation and cataracts,
https://rpop.iaea.org/RPOP/RPoP/Content/News/radiation-and-cataract.htm (Accessed on July 21, 2014).

36]

E Vano, et al., Radiation cataract risk in interventional cardiology personnel. 170 Radiation Research 4: 490-495 (2010).

37]

E. Ron, R. Brenner, Non-malignant thyroid diseases after a wide range of radiation exposures. Radiation Research, 174:877-888 (2010).

38]

G. Latini, Reproductive effects of low to moderate medical radiation exposure, Current Medical Chemistry, 19:6171-6177 (2012).

39]

A. Budorf, Effects of occupational exposure on the reproductive system: core evidence and practical implications, Occupational Medicine 56: 516-520 (2006).

40]

P. Best, et al, SCAI Consensus Document on Occupational Radiation Exposure to the Pregnant Cardiologist and Technical Personnel, 77 Catheterization and Cardiovascular Interventions, 232-241 (2011).

41]

National Council on Radiation Protection (NCRP) Report No. 168. Radiation dose management for fluoroscopically guided interventional procedures. July 2010.

42]

E. Picano, et al, Occupational Risks of Chronic Low Dose Radiation Exposure in Cardiac Catheterisation Laboratory: The Italian Healthy Cath Lab Study, European Medical Journal International, 50 (2013).

43]

U.S. Environmental Protection Agency, Radiation Protection Basics (Jul. 6, 2012),
http://www.epa.gov/rpdweb00/understand/protection_basics.html
(Accessed on November 10, 2014)

44]

OSHA’s long-established hierarchy of controls demonstrates a clear preference for source reduction and implementation of engineering/administrative controls designed to shield the exposed individual from the hazardous chemical over the use of personal protective equipment.

45]

LW Klein, et al. Occupational Health Hazards in the Interventional Laboratory: Time for a Safer Environment, 20 Vasc Interv Radiol 147, 147 (2009).

46]

G. Dehmer et al., Occupational Hazards for Interventional Cardiologists, The Society for Cardiovascular Angiography and Interventions, 68 Catheterization and Cardiovascular Interventions 974, 975 (2006).

47]

NCRP Report No. 168. Radiation dose management for fluoroscopically guided interventional procedures. July 2010.

48]

LW Klein, et al. Occupational Health Hazards in the Interventional Laboratory: Time for a Safer Environment, 20 Vasc Interv Radiol 147, 147 (2009).

49]

LW Klein, et al., Occupational Health Hazards in the Interventional Laboratory: Time for a Safer Environment. J Vasc Interv Radiol. 2009;20:147-153.

50]

D. Miller, et al. Occupational Health Hazards in the Interventional Lab: Progress Report of the Multi-specialty Occupational Hazard Group, Journal of Vascular Interventional Radiology, 21:1338-1341 (2010).

51]

Id. Specifically, the guidelines state that “New data from exposed human populations suggest that lens opacities (cataracts) occur at doses far lower than those previously believed to cause cataracts.” This document was published prior to the ICRP implementing its new, lower exposure limit for lens of an eye, which the ICRP revised in 2011.

52]

ICRP, Publication 118 Statement on Tissue Reactions, 41 Ann ICRP 1 (2012).

53]

Radiation dose limits recommended by international entities and countries are originally listed in the milliSievert unit of measurement, not rems. These dose limit quantities have been converted to rems for the purposes of this paper.

54]

ICRP, Publication 103 The 2007 Recommendations of the International Commission on Radiological Protection, 37 Ann. ICRP 1 (2007).

55]

Center for Devices and Radiological Health & U.S. Food and Drug Administration, Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging (February 2010).

56]

U.S. Environmental Protection Agency, Radiation Protection Guidance for Diagnostic and Interventional X-Ray Procedures, Federal Guidance Report No. 14 – Draft Proposal (2012).

57]

SCAI Comments on U.S. Environmental Protection Agency Radiation Safety Document for Cath Labs, June 03, 2013.

58]

A. Duran, et al., A summary of recommendations for occupational radiation protection in interventional cardiology. Catheter Cardiovasc Interv. 2013;81:562-7.

59]

NCRP Report No. 168. Radiation dose management for fluoroscopically guided interventional procedures. July 2010

60]

National Council on Radiation Protection (NRCP). Current Program. CC 1: Radiation Protection Guidance for the United States.
http://www.ncrponline.org/Current_Prog/CC_1.html  (Accessed on January 14, 2015.)

61]

NRCP Report No. 117, Implementation of the Principle of As Low As Reasonably Achievable (ALARA) for Medical and Dental Personnel, December 31, 1990.

62]

LW Klein, et al., The Catheterization Laboratory and Interventional Vascular Suite of the Future: Anticipating Innovations in Design and Function. Catheter Cardiovasc Interv. 2011;15:447-55.

63]

RF Riley, et al, Trends in Coronary Revascularization in the United States from 2001 to 2009: Recent Declines in Percutaneous Coronary Intervention Volumes. Circ Cardiovasc Qual Outcomes. 2011;4:193-197,

64]

MJ Mack, et al., Outcomes Following Transcatheter Aortic Valve Replacement in the United States. JAMA. 2013;310:2069-2077.

65]

DC Levin, et al. Endovascular Repair vs. Open Surgical Repair of Abdominal Aortic Aneurysms: Comparative Utilization Trends from 2001- to 2006. J Am Coll Radiol. 2006;6:506-9.

66]

PP Goodney, et al. National Trends in Lower Extremity Bypass Surgery, Endovascular Interventions, and Major Amputations. J Vasc Surg. 2009;50:54-60.

67]

NCRP Report No. 168. Radiation dose management for fluoroscopically guided interventional procedures. July 2010.

68]

LW Klein, J Maroney. Optimizing Operator Protection by Proper Radiation Shield Positioning in the Interventional Cardiology Suite. JACC Cardiovasc Interv. 2011;4:1140-1.

69]

U.S. EPA. Federal Guidance Report No. 14. Radiation protection guidance for diagnostic and interventional X-ray procedures. November 2014.

70]

American Society of Radiologic Technologists, Occupational Radiation Safety (Jun. 2013), http://www.asrt.org/docs/default-source/publications/occupational_radiation_safety.pptx?sfvrsn=4  (Accessed on Jul 18, 2014)

71]

Weisz et al, Safety and Feasibility of Robotic Percutaneous Coronary Intervention, 61 J. Am. C. Cardiology 15 (2013)

72]

E. Stephen Amis, Jr et al, American College of Radiology White Paper on Radiation Dose in Medicine, 4 Journal of the American College of Radiology, 272, 273 (2007).

73]

National Research Council, Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII – Phase 2 (2006).

74]

U.S. Environmental Protection Agency, Radiation Protection,
http://www.epa.gov/rpdweb00/understand/health_effects.html

75]

Pancholy SB, Joshi P, Shah S, et al. Randomized evaluation of vascular entry site and radiation exposure: the REVERE trial. J Am Coll Cardiol Intv. 2015;Epub ahead of print.

76]

Mahmud E, et al. Invasive Cardiologists Are Exposed to Greater Left Sided Cranial Radiation: The BRAIN Study (Brain Radiation Exposure and Attenuation During Invasive Cardiology Procedures). J Am Coll Cardiol Intv. 2015;8(9):1197-1206. doi:10.1016/j.jcin.2015.03.027