21 Jul Patient Body Mass Index (BMI) and Physician Radiation Dose
Here is an insightful study that brings up questions about how the upward trend in obesity in the general population may adversely affect physician health. Specifically during coronary angiography procedures, elevated patient BMI was associated with considerably increased radiation dose exposure for physicians.
More mass = more scatter!
Limit your fluoro time, take a step back, and use your shields!
Patient Body Mass Index and Physician Radiation Dose During Coronary Angiography
Consistent with the increasing prevalence of obesity in the general population, obesity has become more prevalent among patients undergoing cardiac catheterization. This study evaluated the association between patient body mass index (BMI) and physician radiation dose during coronary angiography.
Methods and Results:
Real-time radiation exposure data were collected during consecutive coronary angiography procedures. Patient radiation dose was estimated using dose area product. Physician radiation dose in each case was recorded by a dosimeter worn by the physician and is reported as the personal dose equivalent (Hp10). Patient BMI was categorized as <25.0, 25.0 to 29.9, 30.0 to 34.9, 35.0 to 39.9, and ≥40. Among 1119 coronary angiography procedures, significant increases in dose area product and physician radiation dose were observed across increasing patient BMI categories (P<0.001). Compared with a BMI <25, a patient BMI ≥40 was associated with a 2.1-fold increase in patient radiation dose (dose area product, 91.8 [59.6–149.2] versus 44.5 [25.7–70.3] Gy×cm2; P<0.001) and a 7.0-fold increase in physician radiation dose (1.4 [0.2–7.1] versus 0.2 [0.0–2.9] μSv; P<0.001). By multiple regression analysis, patient BMI remained independently associated with physician radiation dose (dose increase, 5.2% per unit increase in BMI; 95% CI, 3.0%–7.5%; P<0.0001).
Among coronary angiography procedures, increasing patient BMI was associated with a significant increase in physician radiation dose. Additional studies are needed to determine whether patient obesity might have adverse effects on physicians, in the form of increased radiation doses during coronary angiography.
WHAT IS KNOWN
- Consistent with the increasing prevalence of obesity in the general population, obesity has become more prevalent among patients undergoing cardiac catheterization.
- Increasing patient body mass index results in higher patient radiation doses during coronary angiography.
- The greatest source of physician radiation exposure during cardiac catheterization comes from scatter radiation emitted from the patient, which itself is proportional to patient radiation dose.
WHAT THE STUDY ADDS
- Among patients undergoing coronary angiography, increasing patient body mass index was observed to be associated with a significant increase in physician radiation dose.
- Whereas prior studies have documented the adverse health consequences of obesity on the patient, additional studies are needed to determine whether patient obesity may have adverse health effects on physicians as well, in the form of increased radiation doses during coronary angiography.