Women Face Higher Scatter Radiation Concerns: Here’s What You Need to Know!

Throughout my over 7 years as an interventional cardiologist, which involves practicing, teaching, and performing procedures, I’ve seen attitudes shift considerably regarding fluoroscopic radiation exposure. Though my fellowship training addressed this issue, a deeper understanding took years to evolve. Aside from the lead shields and protective gear already in use, radiation was considered a fatalistic problem we couldn’t do much about. 

Over time, however, the increasing awareness of scatter radiation’s health effects, the debilitating physical costs of a career involving heavy lead apparel, and new, more effective technological solutions have begun to change perspectives. We’re now on the brink of a revolution in reducing radiation exposure for medical staff, and it’s time to capitalize on the new ideas among physicians, staff, and the institutions supporting them.

The Evolving Landscape of Radiation Protection

Ionizing radiation has been used in healthcare settings since the late 1890s, serving both as an imaging tool and as a treatment. While its effectiveness as a healing aid seems nearly miraculous, the health risks associated with medical radiation became apparent early on: breast, brain, and other cancers, cataracts, cognitive decline, thyroid disease, and the specific concern of women contemplating pregnancy: profound congenital disabilities. These dangers, however, predominantly affect healthcare workers rather than patients, whose exposures are generally short-term. The real hazards of medical radiation are faced by physicians, nurses, technicians, and other staff who dedicate their careers to working with it. 

Lead’s ability to block radiation was discovered early on, and when incorporated into shielding panels and special apparel, the protection it provides was considered adequate for nearly a century. Likewise, the subsequent development of image intensifiers, lower power fluoroscope settings, and digital fluoroscopy helped increase safety and improve image quality. 

Over the decades, however, the use of radiation in healthcare has increased, leading to higher exposure in both frequency and duration, especially since catheter-based interventional cardiology took off in the 1960s. It has become clear that traditional lead protection is no longer sufficient or satisfactory, and new solutions are needed. 

The Unique Concerns of Female Medical Staff

Those who choose careers in radiation medicine know they’ll receive more exposure than those who do not work with radiation. The biggest questions are how much and whether it will be enough to cause injury over time. If pregnant, however, a woman in the catheterization lab must confront the fear of an additional potential risk: exposure to her developing fetus. 

This anxiety over radiation’s potential to cause serious birth defects is tenacious and difficult to dispel. As a result, some female medical students prefer to avoid the risk and choose another specialty instead. Ironically, due to anatomical differences, men present during cardiac interventions are exposed to more gonadal radiation than women. This eye-catching fact is likely to increase awareness of the need for better solutions. 

The modern reality is that while a pregnant cath lab worker inevitably receives some radiation, standard lead aprons can completely protect her unborn child. To ease their concerns, regulations indicate that pregnant staff wear a dosimetry badge over the abdomen, under lead,  during procedures, and check it afterward. It should read zero exposure. 

The prenatal radiation risk that many women fear most is a stubborn relic of the past, and as this understanding spreads, the fears inevitably subside. This is why radiation protection education, social media campaigns, and other outreach programs are so important for female medical students and women already working in the field. Once the myths have been largely dispelled, I believe that formerly reluctant women will pursue interventional cardiology as a field for the same reasons I did: it’s a fascinating and richly rewarding field. Eventually, their talent, skill, and contributions to patient care will prove indispensable.

Advanced Technologies and Institutional Efforts

To address the shortcomings of traditional radiation protection, interventional cardiology and other branches of radiation medicine are ready for technological and procedural solutions. This also presents an opportunity to reduce or eliminate the costs associated with treating staff radiation injuries and the much more common orthopedic problems. These can include herniated spinal discs, chronic pain in the back, shoulders, and neck, joint pain in the hips, knees, and ankles, fatigue, and postural strain leading to musculoskeletal problems. Fortunately, new approaches to radiation safety are beginning to make a 100% scatter-free radiation cath lab a realistic goal for the future.

One of the most intriguing recent innovations is Radiaction Medical’s Dynamic Smart Shield. It attaches to a fluoroscope’s C-arm and deploys robotically at the touch of a button to block radiation at the source — the X-ray emitter. The system’s convenience, unobtrusiveness, and ease of use are particularly attractive because we’ve seen that radiation protection systems lacking those qualities just don’t get used regularly. It also integrates seamlessly with the lab’s workflow, enhancing the speed and efficiency of ever-proliferating fluoroscopic procedures. 

Traditional lead apparel and shields can reduce the radiation that is already scattering about the lab. Radiaction’s approach is entirely different. By blocking X-rays before they enter the room, the device protects everyone present, reducing cath lab scatter radiation. This allows the use of much lighter protective gear without sacrificing safety, and Radiaction offers this lighter alternative as an adjunct to the dynamic smart shield system. Of course, eliminating the risk altogether will require further innovation and possibly a suite of different devices and refined interventional procedures. 

Until then, cost-averse healthcare institutions are filling in the gaps where possible. One tactic growing in use is dosimetry badges for cath lab staff. Standard badges are federally mandated now to help staff avoid exceeding yearly limits, but new real-time badges are becoming more popular as well. These lightweight, wearable badges track daily radiation exposure and can alert caregivers nearing their limit. In these cases, staff should exit the cath lab for the day. Some, however, will prioritize patient care over their own safety and continue working despite a danger warning, though this could be rendered impossible by some future technological or procedural fix. 

Because we are still in the early stages of the radiation reduction revolution, most cath labs continue to rely solely on traditional shields and apparel for protection. Educating caregivers and institutions about the health and cost-saving benefits of new technologies will help increase their adoption and should be a top priority. 

My institution, Vanderbilt University Medical Center, has been actively investing in modern radiation protection and staff education. We also employ radiation physicists to advise staff and serve as safety officers, ensuring that best practices are consistently followed. This type of institutional advocacy is growing across the medical community, driven by the need for better protective solutions and the recognition that the current costs and long-term health consequences are simply too high to bear.

Awareness of the brightening future for cath lab safety has been spreading day by day. We’ve now reached a point where modern understanding, the latest technologies, and a new willingness to invest in radiation safety are beginning to converge. It’s both exciting and rewarding to help it along and see it unfold.

Block Radiation At The Source

Scatter radiation poses a significant occupational hazard for professionals working in catheterization labs. To address this critical issue, the Radiaction Dynamic Smart Shield represents a revolutionary advancement in radiation protection. This innovative system is designed for ease of use and offers comprehensive protection for all medical staff throughout the room, ensuring safety without interrupting workflow or compromising patient access. Embracing such a solution is essential for protecting the well-being of healthcare teams while maintaining high standards of patient care.