Clark BC, Sumihara K, McCarter R, et al. Getting to zero: impact of electroanatomical mapping on fluoroscopy use in pediatric catheter ablation. J Interv Card Electrophysiol. 2016 Aug;46(2):183-9.

Over the past several years, alternative imaging techniques including electroanatomic mapping systems such as CARTO®3 (C3) have been developed to improve anatomic resolution and potentially limit radiation exposure in electrophysiology (EP) procedures. We retrospectively examined the effect of the introduction of C3 on patient radiation exposure during EP studies and ablation procedures at a children’s hospital.

Burdorf A, Figà-Talamanca I, Jensen T, et al. Effects of occupational exposure on the reproductive system: core evidence and practical implications. Occup Med (London). 2006 Dec;56(8):516-520.

The main aims of this accompanying article are to present a summary of the core findings in the three reviews, to discuss important constraints in the interpretation of these results and then derive practical implications for research and practice in occupational health. The evidence on occupational risk factors for adverse effects on the reproductive system is consistent for a limited number of risk factors, most notably exposure to lead, glycol ethers, organic solvents, pesticides and ionizing radiation. It remains difficult to arrive at sound conclusions on the level of exposure and the specific chemicals within the groups of glycol ethers, organic solvents and pesticides that are associated with an increased risk.

Best PJM, Skelding KA, Mehran R, et al. SCAI consensus document on occupational radiation exposure to the pregnant cardiologist and technical personnel. Catheter Cardiovasc Interv. 2011 Feb 1;77(2):232-241.

The Women in Innovations group of Cardiologists with endorsement of the Society for Cardiovascular Angiography and Interventions aim to provide guidance in this publication by describing the risk of radiation exposure to pregnant physicians and cardiac catheterization personnel, to educate on appropriate radiation monitoring and to encourage mechanisms to reduce radiation exposure. Current data do not suggest a significant increased risk to the fetus of pregnant women in the cardiac catheterization laboratory and thus do not justify precluding pregnant physicians from performing procedures in the cardiac catheterization laboratory. However, radiation exposure among pregnant physicians should be properly monitored and adequate radiation safety measures are still warranted.

Andreassi MG, Venneri L, Picano E. The biological effects of diagnostic cardiac imaging on chronically exposed physicians: The importance of being non-ionizing. Prog Biophys Mol Bio. Jan-Apr 2007;91(1-3):399-410.

This paper reviewed the available information on occupational risk of the cardiologists who perform, every day, cardiac imaging procedures. At the moment, there are noconsistent evidence that exposure to medical ultrasound is capable of inducing genetic effects, and representing a serious health hazard for clinical staff. In contrast, exposure to ionizing radiation mayresult in adverse health effect on clinical cardiologists. Although the current risk estimates are clouded by approximations and extrapolations, most data from cytogenetic studies have reported a detrimental effect on somatic DNA of professionally exposed personnel to chronic low doses of ionizing radiation. Since interventional cardiologists and electro-physiologists have the highest radiation exposure among health professionals, a major awareness is crucial for improving occupational protection. Furthermore, the use of a biological dosimeter could be a reliable tool for the risk quantification on an individual basis.

Alejo L, Koren C, Corredoira E, et al. Eye lens dose correlations with personal dose equivalent and patient exposure in paediatric interventional cardiology performed with a fluoroscopic biplane system. Phys Med. 2017 Apr;36:81-90.

To analyse the correlations between the eye lens dose estimates performed with dosimeters placed next to the eyes of paediatric interventional cardiologists working with a biplane system, the personal dose equivalent measured on the thorax and the patient dose.

Aldoss O, Patel S, Harris K, Divekar A. The lateral plane delivers higher dose than the frontal plane in biplane cardiac catheterization systems. Pediatr Cardiol. 2015 Jun;36(5):912-7.

The objective of the study is to compare radiation dose between the frontal and lateral planes in a biplane cardiac catheterization laboratory. Tube angulation progressively increases patient and operator radiation dose in single-plane cardiac catheterization laboratories. This retrospective study captured biplane radiation dose in a pediatric cardiac catheterization laboratory between April 2010 and January 2014.