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Spotlight on Physical Stressors in the Cath Lab
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The issue of occupational hazards in the cath lab is an important one. Radiation during interventional procedures has long been a concern, and a number of recent efforts have been made to reduce radiation exposure in the cath lab and met with modest success.
In this issue, the Feature focuses on another physical stressor for cath lab workers: orthopedic injuries, mainly those of the back, neck, hip and knee. Many interventional cardiologists I know who have been performing procedures for several years report some degree of orthopedic problems. The coupling of wearing heavy lead aprons and standing in sometimes uncomfortable or awkward positions that are necessary in the cath lab, whether gaining vascular access or straining to see a monitor, can make life painful, literally, and shorten otherwise productive careers.
Cardiology Today’s Intervention interviewed leading experts about the current state of orthopedic issues in the cath lab and current efforts to limit these injuries. It is important to think about strategies that can reduce radiation exposure without increasing risk for orthopedic injuries. One approach has been to wear less lead, but that can raise concerns about radiation exposure. There is a need for more ergonomic analyses in the cath lab to examine the extent of orthopedic issues and how to protect against them. We should also study whether exercise may play a preventive role. Charanjit S. Rihal, MD, chair of the division of cardiovascular diseases at Mayo Clinic, Rochester, Minnesota, once told me that he does targeted exercises twice a day to strengthen his back and core muscles for his work in the cath lab.
“Developing good musculoskeletal health and radiation safety techniques early in an interventionalist’s career will serve them well. It is never too late, however. Attention to correct posture, neck position, core strengthening and stability, stretching (particularly hip joints), and knowing how to turn and bend will help prevent orthopedic problems that interventionalists are at risk for. A variety of techniques are available, including Pilates, yoga, physiotherapy, etc. This is something we should be teaching, along with radiation safety, during training,” Rihal told Cardiology Today’s Intervention.
What is your experience with occupational hazards in the cath lab? Let us know by emailing the editors at cardiology@healio.com.
– Deepak L. Bhatt, MD, MPH
Chief Medical Editor
Cardiology Today’s Intervention