AMA Delegates Want Better Protection From Ionizing Radiation Exposure

Increasing concerns over clinicians’ risks of developing cancer or other health problems from ionizing radiation exposures on the job prompted members of the American Medical Association (AMA) House of Delegates at their interim meeting on Tuesday to urge that healthcare settings do more to protect workers.

Dosage exposures should also be more carefully measured, especially for women who may have higher risks, they said during the meeting, which was held in Orlando, Florida.

The delegates resolved to urge the AMA to “encourage public and private healthcare institutions to ensure more comprehensive coverage of different body types by providing PPE [personal protective equipment] that more completely protects employees of all genders and pregnancy statuses, such as lead and lead-free aprons with capped sleeves, axillary supplements, and maternity aprons.”

“As a radiation oncologist, I do not want to see my colleagues in my clinic with preventable cancers from their preventable exposure to radiation out of their selfless dedication to patient care,” said Kristina Novick, MD, speaking for the American Society of Clinical Oncology. She added that regulations vary across the country “by geography,” and that while radiation oncologists are especially concerned about exposures, “radiation safety should be taken seriously by every specialty.”

Laura Stone McGuire, MD, an alternate delegate for the Congress of Neurological Surgeons, noted that those in her specialty use radiation for multiple procedures, including spinal fusion, spinal cord stimulators, aneurysm coiling, mechanical thrombectomies, and more.

“Institution-standard lead aprons may not always offer the best available protection, especially when considering different body types and pregnancy status, as well as the interplay with the location of the radiation source relative to the surgeon for a given procedure,” she said.

The resolution also said standard lead and lead-free aprons “often leave the upper outer quadrant of the breast and axilla, common sites for breast cancer, exposed, and lead to increased vulnerability,” pointing to an increased risk of breast cancer among female surgeons, “particularly those frequently exposed to ionizing radiation during image-guided procedures.”

The resolution also noted that female orthopedic surgeons have a 2.9-fold to 3.9-fold increase in breast cancer prevalence compared with age-matched women, and female healthcare workers exposed to radiation have a 1.7-fold increase in breast cancer rates compared with their non-exposed counterparts.

A recent study using artificial female torsos revealed insufficient protection for the upper outer quadrant of the breast, the resolution said.

During Tuesday’s debate, several speakers said such advocacy was long overdue. They pointed to the need for the AMA, along with the American Association of Physicists in Medicine, the National Council on Radiation Protection and Measurements, and the American College of Radiology, to step up efforts to research the risks of ionizing radiation in healthcare practice and find better ways to optimize protection.

An amendment was also added that urges the AMA to work on a report that would be considered during their interim meeting next November.

Heidi Hullinger, MD, a delegate from the American Academy of Orthopaedic Surgeons, said she hopes that further study into the extent of risk would include “any type of data from all specialties within our house that talk about what groups are at risk … who is at risk within their populations, and from what procedures, and what complications [such as] cancer, cataracts, etc.”