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SCAI/ASE/HRS/SIR/SVS Expert Consensus Statement on Enhanced Radiation Protection
David G. RizikNadia R. SuttonAlexandra J. LanskyMirvat AlasnagGabriel BartalMary Beth BradyMegan CoylewrightJames A. GoldsteinScott M. FirestoneAndrew M. GoldsweigDean J. KereiakesMelissa KirkwoodRyan D. MadderRoxana MehranWilliam J. NicholsonGraciano PauloSunil V. RaoKenneth RosenfieldCheryl C. SchultzKamala P. TamirisaKristin A. TuozzoPoonam VelagapudiAmit N. VoraCelina M. YongJames B. Hermiller
Why the study?
Health care professionals in fluoroscopic laboratories face significant occupational hazards from radiation exposure and orthopedic injuries, and adoption of enhanced radiation protection technology has been slow due to costs and outdated regulations.
Should enhanced radiation protection devices be mandatorily implemented for health care professionals in fluoroscopic laboratories?
Key Points
- Multisociety guidance calls for mandatory implementation of enhanced radiation protection devices, aiming to reduce severe occupational hazards among staff.
- Expert consensus statement outlines institutional and legal duties to mitigate ionizing radiation exposure and prevent orthopedic injuries from heavy aprons.
- Highlights the urgent need for updated exposure regulations and standardized radiation safety protocols across states without endorsing any specific device.
Structured PICO
Should enhanced radiation protection devices be mandatorily implemented for health care professionals in fluoroscopic laboratories?
P
Population
Health care professionals in fluoroscopic laboratories
I
Intervention
Enhanced radiation protection devices (ERPDs)
O
Outcome
Protection from radiation and orthopedic injuries
This multisociety expert consensus statement advocates for the mandatory implementation of enhanced radiation protection devices to mitigate occupational hazards in fluoroscopy laboratories.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Radiation exposure, and the physical burden of avoiding that exposure, poses substantial and quantifiable occupational risks to all members of the fluoroscopy laboratory team, including the development of fatal cancers and disabling spine and musculoskeletal conditions. These risks persist despite traditional radiation safety practices and, in part, result from their limitations. Today, these risks can be mitigated through improved education, adherence to established safety principles, and the implementation of effective enhanced protection technologies. Enhanced radiation protection devices have been shown to reduce operator and staff radiation exposure by up to 99% compared with standard practices. These commercially available protective devices now define the contemporary standard for compliance with ALARA, the federal regulatory framework for occupational radiation protection.”
“Every clinician and staff member who leaves the fluoroscopy laboratory because of preventable injury or chronic occupational disease represents a loss of expertise that patients depend on, in addition to the immense pain and loss experienced by the clinician and their loved ones. Demand for minimally invasive procedures continues to grow, and the duration and complexity of these procedures are increasing. Maintaining a healthy, experienced workforce will be essential to ensuring patients continue to have access to the lifesaving care these teams provide.”
“For decades, we accepted occupational radiation exposure and the physical burden of heavy protective equipment as unavoidable realities of working in a fluoroscopy laboratory. That is no longer acceptable. Technologies available today can greatly reduce radiation exposure while also addressing the orthopedic injuries associated with traditional lead protection. The question is no longer whether these solutions exist. It is whether we are willing to make protecting healthcare workers the priority it deserves. This consensus makes clear that the time for implementation is now.”
Implication
Clinicians must adopt enhanced radiation protection devices in fluoroscopy labs; extends prior safety guidance by mandating updated regulatory exposure thresholds.
Abstract
Health care professionals in fluoroscopic laboratories face significant occupational hazards, including cancer, cataracts, and reproductive concerns due to prolonged exposure to iodizing radiation, and orthopedic injuries stemming from long-term use of heavy aprons as protection from radiation. Despite substantial advancements in radiation protection technology, adoption of these advancements has been slow, hindered by the high upfront costs of implementation and the lag in revising institutional and regulatory radiation exposure thresholds to reflect the capabilities of contemporary enhanced radiation protection devices (ERPDs). This multisociety statement, endorsed by the Society for Cardiovascular Angiography & Interventions, American College of Cardiology, the American Society of Echocardiography, the Heart Rhythm Society, the Society of Interventional Radiology, and the Society for Vascular Surgery, calls for mandatory implementation of ERPDs to meet as low as reasonably achievable standards. This expert consensus statement outlines the ethical and legal responsibilities of government, fluoroscopy laboratory manufacturers, and health care institutions to protect all health care professionals from avoidable workplace hazards and the urgent need to implement ERPDs. The document does not promote or recommend any single ERPD system, and the choice of protection technology is left to department preference. It also addresses the importance of training, monitoring, and continuous research to optimize radiation safety practices. The document advocates for updated regulations and standardized practices across states to ensure comprehensive protection for all fluoroscopy laboratory personnel.
Coverage & sources
Journal, society, and media accounts. Useful signal, not independent expert judgment.
Discussion
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Cite This Study
Rizik et al. (2026) conducted a review in Occupational hazards from ionizing radiation. Enhanced radiation protection devices (ERPDs) was evaluated. This multisociety expert consensus statement calls for the mandatory implementation of enhanced radiation protection devices to protect health care professionals from avoidable workplace hazards.