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Interventional radiologists have a higher rate of chromosomal damage due to occupational radiation exposure: a dicentric chromosome assay

European Radiology volume 31, pages 8256–8263 (2021)Cite this article

Abstract

Objectives

There are growing concerns regarding radiation exposure in medical workers who perform interventional fluoroscopy procedures. Owing to the nature of certain interventional procedures, workers may be subjected to partial-body radiation exposure that is high enough to cause local damage. We aimed to investigate the level of radiation exposure in interventional radiologists in South Korea by performing cytogenetic biodosimetry, particularly focusing on partial-body exposure.

Methods

Interventional radiologists (n = 52) completed a questionnaire, providing information about their work history and practices. Blood samples were collected and processed for a dicentric chromosome assay. We determined Papworth’s U-value to assess the conformity of dicentrics with the Poisson distribution to estimate the partial-body exposures of the radiologists.

Results

Radiologists had a higher number of dicentrics than the normal population and industrial radiographers. Indeed, subjects with a U-value of > 1.96, an indicator of heterogeneous exposure, were observed more frequently; 4.67 ± 0.81% of their body was irradiated at an average dose of 4.64 ± 0.67 Gy. Logistic regression analysis revealed that the total duration of all interventional procedures per week was associated with partial-body exposure levels.

Conclusions

Our findings suggest that interventional radiologists had greater chromosomal damages than those in other occupational groups, and their partial-body exposure levels might be high enough to cause local damage. Use of special dosimeters to monitor partial-body exposure, as well as restricting the time and frequency of interventional procedures, could help reduce occupational radiation exposure.

Key Points

• Interventional radiologists had a higher number of dicentrics than the normal population and industrial radiographers.

• The level of partial-body exposure of interventional radiologists might be high enough to cause occupational local damage such as a skin cancer in fingers.

• Restricting the duration and frequency of interventional procedures might be helpful in reducing occupational radiation exposure.

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Abbreviations

DCA:

Dicentric chromosome analysis

NDT:

Non-destructive testing

References

  1. Miller DL (2008) Overview of contemporary interventional fluoroscopy procedures. Health Phys 95:638–644

    Article  CAS  Google Scholar 

  2. Miller DL, Balter S, Schueler BA, Wagner LK, Strauss KJ, Vano E (2010) Clinical radiation management for fluoroscopically guided interventional procedures. Radiology 257:321–332

    Article  Google Scholar 

  3. ICRP (2018) Occupational radiological protection in interventional procedures. ICRP Publication 139. Ann ICRP 47:1–118

    Google Scholar 

  4. Measurements NCoRPa (2010) Radiation dose management for fluoroscopically-guided interventional medical procedures. NCRP Report No 168. National Council on Radiation Protection and Measurements, Bethesda, Maryland

  5. Padovani R, Le Heron J, Cruz-Suarez R et al (2011) International project on individual monitoring and radiation exposure levels in interventional cardiology. Radiat Prot Dosimetry 144:437–441

    Article  CAS  Google Scholar 

  6. Zakeri F, Hirobe T (2010) A cytogenetic approach to the effects of low levels of ionizing radiations on occupationally exposed individuals. Eur J Radiol 73:191–195

    Article  Google Scholar 

  7. Wiper A, Katira R, Roberts DH (2005) Images in cardiology. Interventional cardiology: it’s a hairy business. Heart 91:1432

    Article  CAS  Google Scholar 

  8. Ciraj-Bjelac O, Rehani M, Minamoto A, Sim KH, Liew HB, Vano E (2012) Radiation-induced eye lens changes and risk for cataract in interventional cardiology. Cardiology 123:168–171

    Article  CAS  Google Scholar 

  9. Jacob S, Boveda S, Bar O et al (2013) Interventional cardiologists and risk of radiation-induced cataract: results of a French multicenter observational study. Int J Cardiol 167:1843–1847

    Article  Google Scholar 

  10. Roguin A, Goldstein J, Bar O, Goldstein JA (2013) Brain and neck tumors among physicians performing interventional procedures. Am J Cardiol 111:1368–1372

    Article  Google Scholar 

  11. Smilowitz NR, Balter S, Weisz G (2013) Occupational hazards of interventional cardiology. Cardiovasc Revasc Med 14:223–228

    Article  Google Scholar 

  12. Yoshinaga S, Mabuchi K, Sigurdson AJ, Doody MM, Ron E (2004) Cancer risks among radiologists and radiologic technologists: review of epidemiologic studies. Radiology 233:313–321

    Article  Google Scholar 

  13. ICRP (2000) Avoidance of radiation injuries from medical interventional procedures. ICRP Publication 85. Ann ICRP 30:1–67

    Google Scholar 

  14. Sanchez RM, Vano E, Fernandez JM et al (2012) Staff doses in interventional radiology: a national survey. J Vasc Interv Radiol 23:1496–1501

    Article  Google Scholar 

  15. Montoro A, Rodriguez P, Almonacid M et al (2005) Biological dosimetry in a group of radiologists by the analysis of dicentrics and translocations. Radiat Res 164:612–617

    Article  CAS  Google Scholar 

  16. Bera G, Gellie G, Jamet E, Entine F, Michel X (2018) Eye lens radiation exposure of workers during medical interventional procedures and surgery. Radiat Prot Dosimetry 182:323–328

    Article  Google Scholar 

  17. IAEA (2011) Cytogenetic dosimetry: applications in preparedness for and response to radiation emergencies. EPR-biodosimetry, IAEA, Vienna

    Google Scholar 

  18. Jang S, Lee JK, Cho M, Yang SS, Kim SH, Kim WT (2016) Consecutive results of blood cell count and retrospective biodosimetry: useful tools of health protection regulation for radiation workers. Occup Environ Med 73:694–700

    Article  Google Scholar 

  19. Xu XS, Zhang LA, Sun QF, Qin YC, Yu NL (2018) Estimation of the occupational exposure dose for medical diagnostic X-ray workers in Jiangsu, China, using a retrospective dosimetry method. J Radiat Res 59:141–148

    Article  Google Scholar 

  20. Salassidis K, Schmid E, Peter RU, Braselmann H, Bauchinger M (1994) Dicentric and translocation analysis for retrospective dose estimation in humans exposed to ionising radiation during the Chernobyl nuclear power plant accident. Mutat Res 311:39–48

    Article  CAS  Google Scholar 

  21. Ko S, Chung HH, Cho SB et al (2017) Occupational radiation exposure and its health effects on interventional medical workers: study protocol for a prospective cohort study. BMJ Open 7:e018333

    Article  Google Scholar 

  22. Seo S, Lim WY, Lee DN et al (2018) Assessing the health effects associated with occupational radiation exposure in Korean radiation workers: protocol for a prospective cohort study. BMJ Open 8:e017359

    Article  Google Scholar 

  23. Lee Y, Seo S, Jin YW, Jang S (2020) Assessment of working environment and personal dosimeter-wearing compliance of industrial radiographers based on chromosome aberration frequencies. J Radiol Prot 40:151–164

    Article  Google Scholar 

  24. Ainsbury EA, Lloyd DC (2010) Dose estimation software for radiation biodosimetry. Health Phys 98:290–295

    Article  CAS  Google Scholar 

  25. Lee Y, Jin YW, Wilkins RC, Jang S (2019) Validation of the dicentric chromosome assay for radiation biological dosimetry in South Korea. J Radiat Res 60:555–563

    Article  CAS  Google Scholar 

  26. Dolphin GW (1969) Biological dosimetry with particular reference to chromosome aberration analysis. A review of methodsHandling of Radiation Accidents (Proc Int Symp Vienna, 1969). IAEA, Vienna, pp 215–224

  27. Zakeri F, Hirobe T, Akbari Noghabi K (2010) Biological effects of low-dose ionizing radiation exposure on interventional cardiologists. Occup Med (Lond) 60:464–469

    Article  CAS  Google Scholar 

  28. Andreassi MG, Cioppa A, Botto N et al (2005) Somatic DNA damage in interventional cardiologists: a case-control study. FASEB J 19:998–999

    Article  CAS  Google Scholar 

  29. Foti C, Padovani R, Trianni A et al (2008) Staff dosimetry in interventional cardiology: survey on methods and level of exposure. Radiat Prot Dosimetry 129:100–103

    Article  CAS  Google Scholar 

  30. Hausler U, Czarwinski R, Brix G (2009) Radiation exposure of medical staff from interventional x-ray procedures: a multicentre study. Eur Radiol 19:2000–2008

    Article  Google Scholar 

  31. Jang S, Jin YW, Lee WJ (2020) Estimating occupational radiation exposure using cytogenetic dosimetry in an interventional radiologist with skin cancer: a case report. J Vasc Interv Radiol 31:1960–1963

    Article  Google Scholar 

  32. Miller DL, Vano E, Bartal G et al (2010) Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. Cardiovasc Intervent Radiol 33:230–239

    Article  Google Scholar 

  33. Bi J, Dai H, Feng J et al (2019) Rapid and high-throughput detection of peripheral blood chromosome aberrations in radiation workers. Dose Response 17:1559325819840852

    Article  Google Scholar 

  34. Romm H, Ainsbury E, Barnard S et al (2013) Automatic scoring of dicentric chromosomes as a tool in large scale radiation accidents. Mutat Res 756:174–183

    Article  CAS  Google Scholar 

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Acknowledgements

We are grateful to Ms. Su San Yang and Yang Hee Lee for their technical support during this study. We thank Dr. Ainsbury in Public Health England, UK, for kindly providing the Dose Estimate program.

Funding

This work was supported by the Korea Ministry of Health and Welfare and Center for Disease Control and Prevention (grant no. 2017E3600600) and the Nuclear Safety and Security Commission Republic of Korea (grant no. 1803014).

Author information

Authors and Affiliations

  1. Laboratory of Biological Dosimetry, National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea

    Younghyun Lee & Seongjae Jang

  2. Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea

    Won Jin Lee

  3. National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea

    Young Woo Jin

Authors
  1. Younghyun Lee
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  2. Won Jin Lee
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  4. Seongjae Jang
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Corresponding author

Correspondence to Seongjae Jang.

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Guarantor

The scientific guarantor of this publication is Seongjae Jang.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Comparison groups (normal population and industrial radiographers) have been previously reported in Jang et al (2016) and Lee et al (2020).

Jang S, Lee JK, Cho M, Yang SS, Kim SH, Kim WT (2016) Consecutive results of blood cell count and retrospective biodosimetry: useful tools of health protection regulation for radiation workers. Occup Environ Med 73:694-700

Lee Y, Seo S, Jin YW, Jang S (2020) Assessment of working environment and personal dosimeter-wearing compliance of industrial radiographers based on chromosome aberration frequencies. J Radiol Prot 40:151-164

The subjects were used to compare their chromosomal damages with those in interventional radiologists.

Methodology

• retrospective

• cross-sectional study

• multicenter study

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Lee, Y., Lee, W.J., Jin, Y.W. et al. Interventional radiologists have a higher rate of chromosomal damage due to occupational radiation exposure: a dicentric chromosome assay. Eur Radiol 31, 8256–8263 (2021). https://doi.org/10.1007/s00330-021-07883-0

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  • DOI: https://doi.org/10.1007/s00330-021-07883-0

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