# Increasing Awareness and Reducing Occupational Hazards in the Cardiac Catheterization and Electrophysiology Laboratories: Working to Eliminate Lead and Complications of Radiation in Cardiovascular Team Study

## TL;DR

This study examines health risks faced by workers in cardiac catheterization labs and finds that educational interventions can help reduce injuries and radiation exposure risks.

## Contribution

The study evaluates an educational intervention's effectiveness in mitigating occupational hazards in cardiac catheterization labs.

## Key findings

- Educational interventions increased adoption of ergonomic techniques among 75.9% of participants.
- Lead-apron use and limited knowledge of mitigation strategies were significant risk factors for musculoskeletal injury.
- Women with prior pregnancies reported challenges adjusting workload and reducing hours to manage discomfort.

## Abstract

Increasing procedural volumes in the electrophysiology and cardiac catheterization laboratories (EP/CCLs) expose physicians, staff, and nurses to hazards from ionizing radiation and prolonged lead-apron use.

To characterize the adverse health outcomes among contemporary EP/CCL workers and to evaluate an educational intervention to mitigate risk.

Two surveys were distributed 3 months apart to the American College of Cardiology chapters and assessed injuries and ailments, perceived risk awareness, and knowledge of potential interventions to mitigate harm. The initial survey was paired with a video on ergonomic strategies to prevent musculoskeletal (MSK) injury, radiation safety principles, and best practices for pregnant workers. Univariable logistic regression models were used to assess associations between each baseline variable separately and health outcomes related to occupational hazards.

Of the 306 initial respondents, 70% were 31 to 60 years old, and 43% were women. Thirty-six percent were interventional cardiologists, 30% were nonphysician cardiovascular team members, 64% had >10 years' EP/CCL experience, and 43% wore lead >8 hours/day. Risk factors for MSK pain/injury included age ≥50 (adjusted OR [aOR]: 2.19; 95% CI: 1.15 to 4.16; P = 0.02), lead-apron use >4 hours/day (aOR: 2.39; 95% CI: 1.31-4.39; P = 0.05), and limited knowledge of mitigation strategies (aOR: 4.62; 95% CI: 1.62-11.45; P = 0.003). Among women with prior pregnancy, 41.5% reported worsening MSK discomfort due to occupational duties; 52.1% lacked opportunities to adjust procedural load; and 76% could not reduce work hours. On follow-up, 75.9% reported adopting ergonomic techniques from the video.

Occupational hazards remain prevalent in the modern EP/CCL. Focused educational interventions may help to reduce injuries and risks.