Six medical societies have endorsed a call for healthcare organizations to strengthen radiation protection in fluoroscopy laboratories, where clinicians and other staff can face repeated exposure to ionizing radiation and physical strain from heavy protective equipment.
Published in JSCAI, the Journal of Vascular and Interventional Radiology, and JACC: Cardiovascular Interventions, the expert consensus statement urges hospitals, manufacturers, regulators, and professional societies to adopt enhanced radiation protection devices, update safety standards, and improve occupational exposure monitoring. The Society for Cardiovascular Angiography and Interventions led the statement, which the American College of Cardiology, American Society of Echocardiography, Heart Rhythm Society, Society of Interventional Radiology, and Society for Vascular Surgery endorsed.
Engineering controls could reduce exposure
Fluoroscopy laboratories use X-ray imaging to guide minimally invasive procedures. Although established safety practices follow the “as low as reasonably achievable,” or ALARA, principle, the statement’s authors argue that available technologies have changed what organizations should consider reasonably achievable.
Enhanced radiation protection devices use engineering controls rather than relying primarily on personal protective equipment. The statement cites evidence that these systems can reduce radiation exposure to operators and staff by as much as 99 percent compared with standard protection practices, depending on the device and procedure configuration.
The guidance also addresses orthopedic injuries associated with prolonged use of lead aprons. A 2023 SCAI survey cited in the statement found that nearly 60 percent of participating interventional cardiologists reported orthopedic injuries, while 17 percent said they had limited their time in the catheterization laboratory to reduce radiation exposure. The survey findings reflect the participating cardiologists rather than all fluoroscopy laboratory personnel.
Operational priorities for fluoroscopy labs
The statement recommends using real-time dosimetry and standardized quality metrics to measure radiation safety performance. It also calls for healthcare organizations to incorporate enhanced protection into imaging equipment and procedure-room design, rather than treating radiation safety primarily as an individual responsibility managed through wearable lead.
For managers responsible for fluoroscopy or interventional imaging environments, the recommendations point to several operational areas for review, including exposure data, shielding practices, equipment needs, and facility plans. Managers can also examine whether employees receive training on dosimetry, equipment positioning, and exposure reporting, and whether radiation safety specialists participate in purchasing and renovation decisions.
The publication is an expert consensus statement rather than a report of findings from a new clinical trial, and it does not establish a new regulation. Instead, it combines existing evidence and expert recommendations to press healthcare organizations and policymakers toward broader adoption of enhanced protections. Its authors argue that radiation safety programs should evolve as safer technologies become available, with responsibility shared across institutions, equipment manufacturers, regulators, and professional organizations.
This article was created with the assistance of Generative AI and has undergone editorial review before publishing.
