Occupational Radiation Risk Stratification and Protection in Fluoroscopy-Guided Surgeons and Interventionalists: A Multispecialty Structured Narrative Review

At a glance

Type of study

Narrative review

Who was studied

Orthopedic surgeons, Vascular surgeons, Other surgeons, Interventional cardiologists, Interventional radiologists

Size

n = 16 studies

Where

United States, Italy, Japan, Ireland, South Korea

Topics

Personal protective equipmentCancer riskBreast cancerEye lens and cataractsThyroidDosimetry and monitoringSafety culture and compliance

Summary based on

the full text

What it found

• Lead aprons reduced operator exposure by about 90% at 0.25 mm and 99% at 0.5 mm; thyroid collars reduced neck dose 60-70%; lead glasses reduced eye dose 2.5-4.5-fold.

  Key figures: ~90% (0.25 mm), ~99% (0.5 mm); 60-70%; 2.5-4.5-fold

• Unshielded operator doses averaged 0.08-0.11 mSv per procedure at the chest and 0.04-0.05 mSv at the eye.

  Key figures: 0.08-0.11 mSv chest; 0.04-0.05 mSv eye per procedure

• Apron and thyroid collar compliance was high, but lead glasses were inconsistently used, often because they interfere with surgical loupes.

  Key figures: 90-99% compliance for aprons and collars

• Limited epidemiologic data: one Italian study found 29% cancer incidence in exposed orthopedic surgeons versus 4% in controls; US data showed 2.9-fold higher breast cancer rate in female orthopedic surgeons.

  Key figures: 29% vs 4%; 2.9-fold

• Biological Effects of Ionizing Radiation (BEIR) VII-based modeling projected lifetime attributable risk of all solid cancers for male surgeons of about 1 in 48; a relative risk of 3.2 was reported for posterior lens opacities.

  Key figures: 2079 per million (≈1 in 48); relative risk (RR) 3.2 (p < 0.005)

Limits to keep in mind

Narrative review of only 16 heterogeneous studies without meta-analysis; cancer evidence is sparse and largely modeled from BEIR VII and atomic bomb data that may not apply to chronic low-dose exposure, and nurses and technologists were not covered.

Related research summaries

• Radiation in the Orthopedic Operating Room: What We Know, What We Do, and What Needs Attention (2025, Narrative review)
• Radiation Exposure, Training, and Safety in Cardiology (2024, Narrative review)
• SCAI Multi-Society Position Statement on Occupational Health Hazards (2020, Guideline or consensus statement)
• Occupational Risks of Chronic Low Dose Radiation Exposure in Cardiac Catheterisation Laboratory (2013, Narrative review)
• SCAI/ASE/HRS/SIR/SVS Expert Consensus Statement on Enhanced Radiation Protection: Time for Mandatory and Urgent Action (2026, Guideline or consensus statement)