Radiation Realities: Radiation Safety Practices and Awareness Among Interventional Echocardiographers in the United States.

BACKGROUND

With the rise of structural heart interventions (SHIs), interventional echocardiographers (IEs) face significant radiation exposure in catheterization laboratories. However, US-specific radiation safety practices remain understudied. This study aims to address radiation safety practices and concerns among US IEs, focusing on occupational risks and sex-specific challenges.

METHODS

A 21-item online survey was conducted from March to June 2025, targeting US IEs through a multifaceted recruitment strategy. It assessed demographics, SHI frequency, radiation monitoring, shielding practices, and reproductive health concerns. Descriptive statistics summarized responses, with sex-specific analyses for female IEs.

RESULTS

Of 69 respondents (64% [n = 44] men, 36% [n = 25] women), 88% (n = 61) worked in tertiary care settings and 46% (n = 32) guided SHIs several times weekly. Key gaps were identified, including 18% (n = 17) not using dosimeters, 64% (n = 44) never receiving exposure notifications, and 80% (n = 55) lacking awareness of their personal annual radiation dose. In addition, 30% (n = 21) had no radiation safety training, and 75% (n = 52) reported insufficient radiation protection in their catheterization laboratory. Reproductive health concerns affected 71% (n = 49) of IEs. Among female IEs, 56% (n = 14) reported an influence on pregnancy planning, 32% (n = 8) noted career concerns owing to maternity, and 63% of those who had had a pregnancy (n = 12/19) performed SHIs during pregnancy, with 7% taking no additional precautions.

CONCLUSIONS

US IEs face critical radiation safety gaps, including inadequate monitoring, training, and shielding, with pronounced reproductive and career concerns among female IEs. Tailored protocols, enhanced shielding, and pregnancy-specific precautions are urgently needed to ensure the safety and well-being of IEs.