Occupational Pelvic and Chest-Level Radiation Exposure Among Interventional Echocardiographers During Percutaneous Structural Heart Interventions

At a glance

Type of study

Original research, Dosimetry measurement study

Who was studied

Other physicians, Mixed lab staff

Size

n = 230 procedures

Where

United States

Topics

Pregnancy and reproductive healthDosimetry and monitoringRoom shielding and protective devicesPersonal protective equipmentWomen in the fieldWorkforce and careersMusculoskeletal injury and ergonomics

Summary based on

the full text

What it found

• Under-lead pelvic dose was undetectable in nearly all procedures. The modeled fetal dose over a full pregnancy was far below the International Commission on Radiological Protection (ICRP) 1 mSv limit.

  Key figures: 0 μSv in 98.7% of cases; ∼2.3 μSv estimated for full pregnancy

• Half-shield-only use was independently associated with higher chest-level dose than adjustable full or combination shielding. This was the largest effect in the model.

  Key figures: adjusted fold change 3.78; 95% confidence interval (CI): 1.51-9.44; P = 0.005

• Chest-level dose to interventional echocardiographers rose from left atrial appendage occlusion (LAAO) to mitral to tricuspid interventions.

  Key figures: median 9.0 μSv (IQR: 3.2-21.0) LAAO, 18.0 μSv (7.5-43.5) TMVI, 36.0 μSv (16-116) TTVI; P < 0.001

• Head-of-bed positioning was independently associated with about twofold higher chest-level dose. The estimate rests on few cases.

  Key figures: adjusted fold change 2.17; 95% CI: 1.06-4.43; P = 0.035, n = 17

• Interventional echocardiographers received much higher chest-level doses than sonographers during the same procedures.

  Key figures: 10- to 50-fold higher; P < 0.001

Limits to keep in mind

Single-center observational study using one upper-arm dosimeter site, with no eye, thyroid or hand dosimetry, two fluoroscopy systems, few head-of-bed cases (n = 17) and no correction for multiple comparisons. The fetal dose is a modeled estimate from a suprapubic under-lead dosimeter, not a measured fetal dose.

Related research summaries

• SCAI Multi-Society Position Statement on Occupational Health Hazards (2020, Guideline or consensus statement)
• Radiation Realities: Radiation Safety Practices and Awareness Among Interventional Echocardiographers in the United States (2025, Cross-sectional survey)
• Occupational Health Hazards in the Cardiac Catheterization Laboratory: Results of the 2023 SCAI Survey (2025, Cross-sectional survey)
• Radiation Exposure, Training, and Safety in Cardiology (2024, Narrative review)
• Occupational Protection in Interventional Radiology. A Joint Guideline of the Cardiovascular and Interventional Radiological Society of Europe and the Society of Interventional Radiology (2026, Guideline or consensus statement)