Medical societies call for more stringent radiation protection measures
Numerous medical societies are calling for improved radiation safety standards in procedures that utilize fluoroscopy.
The concept of ALARA, or “as low as reasonably achievable,” was introduced in 1977. The goal is to minimize the amount of radiation patients are exposed to during various imaging exams and procedures. Now, nine medical societies, including the Society of Interventional Radiology (SIR), are calling for updated safety standards that reach beyond patients and take into account the occupational hazards healthcare workers face when using fluoroscopy.
Enter ALARA+, a revised version of the previous initiative that prioritizes safety more broadly.
“We have a responsibility to protect both our patients and our teams," SIR President Robert A. Lookstein, MD, said in a statement March 24. "Embracing ALARA+ principles means constantly optimizing our techniques, technology and awareness to minimize exposure while maintaining the highest quality care. A culture of radiation safety is not optional—it is a professional obligation and a defining standard of excellence in interventional radiology.”
The “as light as reasonably achievable” refers to the protective lead aprons staff assisting in fluoroscopic procedures must wear. There are ample data detailing the musculoskeletal harms of wearing heavy protective lead for long durations of time for years on end. For example, a recent occupational health hazards survey from the Society for Cardiovascular Angiography and Interventions (SCAI) revealed that around two-thirds of interventional cardiologists deal with musculoskeletal pain related to protective equipment worn during procedures.
The aim of ALARA+ is to explore alternative radiation protection measures that would reduce the reliance on lead coverings. Besides SIR and SCAI, other IR-related groups involved in the initiative include the Society of NeuroInterventional Surgery (SNIS), Society of Vascular and Interventional Neurology (SVIN) and the Society for Vascular Surgery (SVS).
Some of the actions the medical societies are calling for include:
Adopting modern radiation protection alternatives, including suspended, freestanding or table-mounted shielding systems that reduce exposure without requiring clinicians to wear heavy protective garments.
Expanding real-time dose monitoring to enable clinicians to receive immediate feedback. This would allow them to make adjustments as necessary during procedures.
Bolstering radiation safety education for physicians, trainees, nurses and technologists.
Continuing technological innovation to protect all cath lab clinicians.
Supporting regulatory and accreditation standards that promote safer fluoroscopy laboratory environments.
"ALARA+ represents a shift from accepting risk to expecting better," said SCAI President and interventional cardiologist Srihari S. Naidu, MD. "Fluoroscopy-guided procedures save lives every day by allowing minimally invasive treatment for heart disease, vascular disease and stroke. The clinicians and teams delivering that care deserve laboratories that protect them just as thoughtfully as we protect our patients.
Read more here. Several heart care groups also are part of the effort, including the American College of Cardiology (ACC), Alliance for Cardiovascular Professionals (ACVP), American Society of Echocardiography (ASE) and the Heart Rhythm Society (HRS).
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.