Radiation exposure risk for various personnel in the catheterization laboratory: A systematic review and...

Radiation exposure is a well-recognized occupational hazard for catheterization lab personnel. However, the extent of exposure disparities among different staff roles remains unclear. Existing research primarily focuses on primary operators, leaving a gap in understanding radiation risks for ancillary staff. This study aims to evaluate how staff positioning and shielding affect radiation exposure, focusing on disparities between primary operators and ancillary staff during fluoroscopy-guided cardiovascular procedures.

After a systematic search across five databases on November 20, 2023, we included studies reporting radiation data for coronary angiographies, structural heart interventions, electrophysiological procedures, or endovascular aorta interventions, with at least one ancillary staff member in prespecified positions. Radiation exposures were compared relative to the primary operator using the Ratio of Means (ROM) during meta-analysis. Risk of Bias was assessed using RoB-2 or ROBINS-E. The review protocol was registered as CRD42023484491.

Our meta-analysis, based on 8116 measurements from 3091 procedures across 23 studies, suggests that personnel at the patient's head without shielding may experience higher radiation exposure than primary operators (ROM 1.77, 95% CI: 0.75-4.18), although this difference didn't reach statistical significance. Shielded workers at the head or in secondary/assistant positions received significantly lower radiation than primary operators (ROM 0.26, 95% CI: 0.12-0.57; ROM 0.33, 95% CI: 0.25-0.43).

Our results suggest a potential disparity in radiation exposure among catheterization laboratory personnel, with unshielded workers at the patient's head tending to receive the highest levels of exposure. Dedicated shielding solutions and attention to all personnel are imperative.