Increasing Awareness and Reducing Occupational Hazards in the Cardiac Catheterization and Electrophysiology Laboratories: Working to Eliminate Lead and Complications of Radiation in Cardiovascular Team Study.

BACKGROUND

Increasing procedural volumes in the electrophysiology and cardiac catheterization laboratories (EP/CCLs) expose physicians, staff, and nurses to hazards from ionizing radiation and prolonged lead-apron use.

OBJECTIVES

To characterize the adverse health outcomes among contemporary EP/CCL workers and to evaluate an educational intervention to mitigate risk.

METHODS

Two surveys were distributed 3 months apart to the American College of Cardiology chapters and assessed injuries and ailments, perceived risk awareness, and knowledge of potential interventions to mitigate harm. The initial survey was paired with a video on ergonomic strategies to prevent musculoskeletal (MSK) injury, radiation safety principles, and best practices for pregnant workers. Univariable logistic regression models were used to assess associations between each baseline variable separately and health outcomes related to occupational hazards.

RESULTS

Of the 306 initial respondents, 70% were 31 to 60 years old, and 43% were women. Thirty-six percent were interventional cardiologists, 30% were nonphysician cardiovascular team members, 64% had >10 years' EP/CCL experience, and 43% wore lead >8 hours/day. Risk factors for MSK pain/injury included age ≥50 (adjusted OR [aOR]: 2.19; 95% CI: 1.15 to 4.16; P = 0.02), lead-apron use >4 hours/day (aOR: 2.39; 95% CI: 1.31-4.39; P = 0.05), and limited knowledge of mitigation strategies (aOR: 4.62; 95% CI: 1.62-11.45; P = 0.003). Among women with prior pregnancy, 41.5% reported worsening MSK discomfort due to occupational duties; 52.1% lacked opportunities to adjust procedural load; and 76% could not reduce work hours. On follow-up, 75.9% reported adopting ergonomic techniques from the video.

CONCLUSIONS

Occupational hazards remain prevalent in the modern EP/CCL. Focused educational interventions may help to reduce injuries and risks.