Hematological Parameters and Occupational Ionizing Radiation Exposure in Interventional Healthcare Workers: A Longitudinal Matched Case-Control Study

Background/Objectives: The rising volume of fluoroscopy-guided interventions poses an occupational safety challenge for healthcare workers (HCWs) exposed to chronic low-dose ionizing radiation (LDR), which carries stochastic risks of bone marrow suppression and radiation-induced cytopenias. Real-world longitudinal evidence validating the efficacy of modern protection standards on specific peripheral hematological parameters remains limited. This study aims to evaluate the peripheral hemogram profiles of interventional HCWs exposed to LDR, compared to those of a non-exposed control cohort, from baseline (T0) to follow-up (T1). Methods: A longitudinal matched case-control study evaluated the complete blood count with differential leukograms of 136 interventional HCWs exposed to LDR compared to those of 272 matched non-exposed controls from baseline (T0) to follow-up (T1), stratifying by role, seniority, and cumulative ionizing radiation dose. Results: The mean annual radiation dose was 0.22 mSv, and the mean cumulative radiation dose was 4.11 mSv. Hemogram indicators showed no significant differences between cases and controls at T0 and T1 (p > 0.05). Stratification by length of service (<10 vs. >10 years), and radiation dose (<3 vs. ≥3 mSv) demonstrated no significant variations in erythrocyte, leukocyte, or platelet counts. Regression analysis confirmed no association between hematological parameters and job seniority or radiation dose. All radiation doses remained below mandatory limits. Conclusions: The findings provide objective evidence of the effectiveness of current safety measures countering radiation-induced hematotoxicity in hospital settings. Longitudinal tracking confirms the absence of adverse hematological shifts, suggesting that structured training and strict personal protective equipment (PPE) use mitigate hematotoxicity risks among interventional staff exposed to ionizing radiation in healthcare settings. Safety protocols should maintain strict PPE compliance and safety training. Occupational health policy needs to prioritize continuous dosimetry monitoring, as routine hematological screening may not show early low-dose exposure effects.