Occupational radiation exposure to the head is higher for scrub nurses than cardiologists during cardiac angiography

Aims: This study aimed to compare the head dose of a cardiologist to scrub and scout nurses during cardiac angiography. 

Design: A correlational longitudinal quantitative design was used to examine the relationship between the variable of occupational dose to the medical operator when compared with the dose to the scrub and scout nurses. 

Methods: A quantitative analysis was performed on data collected during coronary angiograms (N = 612) for one cardiologist and 22 nurses performing either the scrub or scout role between May 2015 and February 2017. Analysis was based on log-transformed dose levels and reported as geometric means and associated 95% confidence intervals. 

Results: It was found that scrub nurses received on average 41% more head dose than the cardiologist during diagnostic procedures and 52% higher doses during interventional cases. Conclusion: Nurses working in fluoroscopic cardiovascular procedures should be provided with appropriate training and protective equipment, notably lead skull caps, to minimize their occupational radiation exposure. Impact: There is a notable lack of research evaluating the occupational head and eye exposure to nurses involved in fluoroscopic procedures. This study found that during diagnostic coronary angiograms, the scrub nurses received 41% more occupational head dose than the cardiologist and 52% higher head doses during interventional cases. Radial access resulted in higher doses to scrub nurses than femoral artery access. It is advisable that staff wear protective lead glasses and skull caps and use appropriately positioned ceiling mounted lead shields to minimize the risk of adverse effects of occupational exposure to ionizing radiation.