Women urged to overcome radiation fears, consider a career in interventional cardiology
Health concerns associated with radiation exposure and the physical toll of wearing radiation protection garments has caused many women to think twice about entering the field of interventional cardiology. In fact, this is often cited as a major reason only 8% of interventional cardiology fellows are women.
To combat the fears about radiation exposure in the cath lab, the Society for Cardiovascular Angiography and Interventions (SCAI) Women in Innovations (WIN) program, a professional development and networking group for women in interventional cardiology, recently launched a social media campaign to try and change perceptions. The group created a series of graphics and sample social media posts its members can push to their own personal pages the explain there are ways to reduce exposure and remain safe in the cath lab.
"The underrepresentation of women in interventional cardiology is a significant concern. We believe that by dispelling the fears and misconceptions surrounding radiation exposure, we can empower more females cardiologists to pursue this rewarding subspecialty," explained Nadia Sutton, MD, MPH, FSCAI, chair of the SCAI WIN Committee and assistant professor and director of interventional cardiology research in the Division of Cardiovascular Medicine, Vanderbilt University Medical Center, in an SCAI statement.
SCAI WIN said the key to minimizing the effects of ionizing radiation among cath lab staff lies in balancing measures to reduce the exposure dose and ensuring adequate image quality needed for diagnosis and treatment. In essence, radiation exposure should be kept As Low As Reasonably Achievable (ALARA). SCAI created a short social media video reel to highlight these points.
The biggest radiation concern of younger women in interventional cardiology is exposure to doses that can harm their future reproductive health or a developing fetus. Scatter radiation from X-ray angiography imaging systems used in cath labs impacts all staff in the room, but it is usually the interventional cardiologist who is closest to the X-ray source.
The SCAI video notes that there is no scientific evidence that radiation doses less than 100 milliSieverts (mSv) are damaging to a fetus. However, to be sure there are no risks, the U.S. Nuclear Regulatory Commission set a dose limit of 5 mSv for women who are pregnant. Internationally, the SCAI video said the dose is set even lower at 1 mSv.
The video cites one study measuring the exposure dose from scatter radiation for a pregnant interventional cardiologist wearing a radiation badge under her lead. It was less than 0.3 mSv during the gestation period.
A screen shot from the SCAI WIN radiation dose safety campaign video aimed at recruiting more women into interventional cardiology, It shows numerous interventional cardiologists who worked while pregnant and had healthy children. This is one of the big concerns among women when thinking aboit entering interventional cardiology and is a contributor of why women only make up 8% of interventional residents.
Radiation safety recommendation in the cath lab
Following ALARA guidelines, the WIN campaign calls for operators to first and foremost wear their protective garments. These include not only the leaded apron, but also leaded thyroid shield, shoulder pads and leaded glasses.
When performing a procedure, dose can be lowered fro angiography systems by lowering frame rates, using fluoro-save, collimation and reducing the distance from the image intensifier and the patient. The group also advocates for avoiding magnification where possible and using of disposable radiation protection drapes.
If you become pregnant, the video also says to talk with your radiation safety officer for early information. Recommendations include wearing a second dosimeter and not wearing a second set of lead, because the weight will cause back issues. SCAI also suggested discussing the pregnancy and with the cath lab manager and colleagues about what can be done for additional radiation shielding in the lab.
The campaign reminds operators about the fundamentals of radiation safety, including spending less time near the X-ray source, putting more distance between the staff member and the X-ray source and the use of shielding to block scatter radiation.
SCAI Women in Innovations (WIN)
The mission of the SCAI WIN program is to empower women in interventional cardiology, nurturing their leadership skills, professional development opportunities, education, collaboration, and research by and on behalf of women in interventional cardiology and their patients.
The program leads educational initiatives supporting its mission, the SCAI-WIN CHIP fellowship, collaboration with other societies, and campaigns to improve the representation of women in interventional cardiology.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com