OR12-2 | In-Practice Measurement of Radiation Exposure and Protection for (assumed) Pregnant Cardiologists Performing Cardiac Catheterization and Electrophysiology Procedures

Concern about fetus radiation exposure during pregnancy remains a barrier for women considering a career in invasive cardiology. While fetus exposure is expected to be low, there is a lack of real-world data to inform career decisions. The purpose of this work was to measure the influence of radio-protective garment thickness on abdominal exposure for physicians working in a diverse invasive cardiology practice. In this single-site study, exposure monitors were placed at the left shoulder (n=1) and abdomen (n=4) of cardiologists (n=32) and advanced fellows (n=10) performing cardiac ablation, pacemaker implant, catheterization, and structural heart procedures. Both female (n=11) and male (n=31) physicians participated and wore the monitors during their clinical routine. Standard radiation practices were followed, including routine use of upper and lower body shields. The monitors at the abdomen, worn outside the standard radio-protective apron, were covered by Pb-equivalent material of thickness 0, 0.25, 0.35, and 0.5 mm. The radiation exposure measured over a 6 month period was extrapolated to a 40 week pregnancy term. Exposure at the abdomen and outside of the radio-protective garment was 2.2x higher than at the left shoulder. Median (95th %) exposure at the abdomen and behind the protective material was 5.2 (23), 0.53 (2.0), 0.35 (1.3), and 0.22 (0.83) mGy for material thickness 0, 0.25, 0.35, and 0.5 mm, respectively. Radioprotective material thicknesses ≥0.25 mm would ensure that fetus dose remains below 5 mSv as required by U.S. regulations and 0.5 mm material would ensure dose below 1 mSv as required by European standards. The following variables did not affect exposure: physician sex and height, clinical role, and clinical specialty. This work supports that cardiologists can perform invasive procedures throughout pregnancy without exceeding fetus dose limits. Importantly, use of a 0.5 mm Pb-equivalent radio-protective garment would mitigate fetus dose to levels which are below that from natural sources. The findings demonstrate that standard radiation protection equipment provides appropriate protection for all cardiologists performing invasive procedures.