{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T17:10:36Z","timestamp":1768410636190,"version":"3.49.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T00:00:00Z","timestamp":1707436800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T00:00:00Z","timestamp":1707436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Catheter laboratories are high-radiation exposure environments, especially during X-ray procedures like percutaneous transluminal coronary angioplasty and electrophysiological studies. Radiation exposure poses risks of stochastic (e.g., cancer) and deterministic (e.g., skin changes) effects. This study assessed radiation safety and health practices in a cardiac catheterization unit to optimize radiation safety. A cross-sectional study in Cairo University Hospital (March\u2013September 2019) evaluated 700 patients and healthcare workers. Real-time radiation measurements, educational lectures, and radiation protection measures were implemented in three phases. Data on radiation exposure, procedures, and compliance were collected and analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The total procedure time and fluoroscopy time per cardiologist did not significantly differ between phases, but there was a statistically significant reduction in the mean total cumulative radiation doses between Phase I and Phase III for cardiologists (<jats:italic>P<\/jats:italic>\u2009=\u20090.013). Among nurses and technicians, there was no significant difference in radiation doses between the two phases. Significant correlations were found between operators' radiation doses, procedure time, and fluoroscopy time. Patients' radiation doses decreased significantly from Phase I to Phase III, with correlations between dose, procedure time, and gender. Compliance with radiation protection measures was suboptimal.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Compliance with radiation safety standards in the cardiac catheterization unit at the Cairo University Hospital needs improvement. The study highlights the importance of adhering to radiation safety principles and optimizing protective measures to reduce radiation exposure for both patients and healthcare personnel. Despite low compliance, significant reductions in radiation doses were achieved with increased awareness and adherence to specific protection measures. Future efforts should focus on enhancing radiation safety protocols and organ-specific radiation impact assessments.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s43044-024-00449-7","type":"journal-article","created":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T08:02:17Z","timestamp":1707465737000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Assessing and improving radiation safety in cardiac catheterization: a study from Cairo University Hospital"],"prefix":"10.1186","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2171-6860","authenticated-orcid":false,"given":"Muhammad","family":"Ghallab","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdy","family":"Abdelhamid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Nassar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim S.","family":"Mostafa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dina H.","family":"Salama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wael","family":"Elnaggar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaban","family":"Alramlawy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zakaria","family":"Alagha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salma","family":"Abdelmoteleb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Assem","family":"Hashad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,9]]},"reference":[{"key":"449_CR1","doi-asserted-by":"crossref","unstructured":"Amro A (2010) What practicing cardiologists need to know about radiation exposure in Cath Lab?. J Saudi Heart Assoc 22(3):153\u20134","DOI":"10.1016\/j.jsha.2010.04.003"},{"issue":"2","key":"449_CR2","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1017\/S1047951122000543","volume":"33","author":"A McKeiver","year":"2023","unstructured":"McKeiver A, Marshall J, Churchill P, Bittel D, O\u2019Brien JE, Kaine S, Bingler M (2023) Sustained radiation reduction following initial quality improvement intervention in a paediatric cardiac catheterisation laboratory. Cardiol Young 33(2):221\u2013226","journal-title":"Cardiol Young"},{"issue":"6","key":"449_CR3","doi-asserted-by":"publisher","first-page":"1882","DOI":"10.3390\/ijerph6061882","volume":"6","author":"I Foffa","year":"2009","unstructured":"Foffa I, Cresci M, Andreassi MG (2009) Health risk and biological effects of cardiac ionising imaging: from epidemiology to genes. Int J Environ Res Public Health 6(6):1882\u20131893","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"449_CR4","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.jvir.2010.12.016","volume":"22","author":"DA Marichal","year":"2011","unstructured":"Marichal DA, Anwar T, Kirsch D, Clements J, Carlson L, Savage C et al (2011) Comparison of a suspended radiation protection system versus standard lead apron for radiation exposure of a simulated interventionalist. J Vasc Interv Radiol JVIR 22(4):437\u2013442","journal-title":"J Vasc Interv Radiol JVIR"},{"issue":"1","key":"449_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1667\/RR0763.1","volume":"168","author":"DL Preston","year":"2007","unstructured":"Preston DL, Ron E, Tokuoka S, Funamoto S, Nishi N, Soda M et al (2007) Solid cancer incidence in atomic bomb survivors: 1958\u20131998. Radiat Res 168(1):1\u201364","journal-title":"Radiat Res"},{"issue":"1","key":"449_CR6","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1186\/1471-2407-12-157","volume":"12","author":"E Picano","year":"2012","unstructured":"Picano E, Vano E, Domenici L, Bottai M, Thierry-Chef I (2012) Cancer and non-cancer brain and eye effects of chronic low-dose ionizing radiation exposure. BMC Cancer 12(1):157","journal-title":"BMC Cancer"},{"issue":"1\u20132","key":"449_CR7","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1093\/rpd\/ncu285","volume":"164","author":"S Mundigl","year":"2015","unstructured":"Mundigl S (2015) Modernisation and consolidation of the European radiation protection legislation: the new euratom basic safety standards directive. Radiat Prot Dosim 164(1\u20132):9\u201312","journal-title":"Radiat Prot Dosim"},{"issue":"2","key":"449_CR8","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1148\/radiol.2542082312","volume":"254","author":"S Balter","year":"2010","unstructured":"Balter S, Hopewell JW, Miller DL, Wagner LK, Zelefsky MJ (2010) Fluoroscopically guided interventional procedures: a review of radiation effects on patients\u2019 skin and hair. Radiology 254(2):326\u2013341","journal-title":"Radiology"},{"key":"449_CR9","unstructured":"Brilakis ES, Patel VG (2012) What you can't see can hurt you! J Invasive Cardiol 24(9):421"},{"key":"449_CR10","doi-asserted-by":"crossref","unstructured":"Christopoulos G, Papayannis AC, Alomar M, Kotsia A, Michael TT, Rangan BV et al (2014) Effect of a real-time radiation monitoring device on operator radiation exposure during cardiac catheterization. Circ Cardiovasc Interv 7(6):744\u201350","DOI":"10.1161\/CIRCINTERVENTIONS.114.001974"},{"issue":"3","key":"449_CR11","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1097\/01.HP.0000290614.76386.35","volume":"94","author":"KP Kim","year":"2008","unstructured":"Kim KP, Miller DL, Balter S, Kleinerman RA, Linet MS, Kwon D et al (2008) Occupational radiation doses to operators performing cardiac catheterization procedures. Health Phys Radiat Saf J 94(3):211\u2013227","journal-title":"Health Phys Radiat Saf J"},{"key":"449_CR12","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.carrev.2021.05.017","volume":"36","author":"SR Dixon","year":"2022","unstructured":"Dixon SR, Rabah M, Emerson S, Schultz C, Madder RD (2022) A novel catheterization laboratory radiation shielding system: results of pre-clinical testing. Cardiovasc Revasc Med 36:51\u201355","journal-title":"Cardiovasc Revasc Med"},{"key":"449_CR13","doi-asserted-by":"crossref","unstructured":"McCutcheon K, Vanhaverbeke M, Pauwels R, Dabin J, Schoonjans W, Bennett J et al (2020) Efficacy of MAVIG X-ray protective drapes in reducing operator radiation dose in the cardiac catheterization laboratory. Circ Cardiovasc Interv 13(11)","DOI":"10.1161\/CIRCINTERVENTIONS.120.009627"},{"issue":"4","key":"449_CR14","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1002\/ccd.30396","volume":"100","author":"S Shekhar","year":"2022","unstructured":"Shekhar S, Ajay A, Agrawal A, Kumar A, Kaur M, Isogai T et al (2022) Radiation reduction in a modern catheterization laboratory: a single-center experience. Catheter Cardiovasc Interv 100(4):575\u2013584","journal-title":"Catheter Cardiovasc Interv"},{"key":"449_CR15","doi-asserted-by":"crossref","unstructured":"Douglas PS, Carr JJ, Cerqueira MD, Cummings JE, Gerber TC, Mukherjee D et al (2012) Developing an action plan for patient radiation safety in adult cardiovascular medicine. Circ Cardiovasc Imaging 5(3):400\u201314","DOI":"10.1161\/HCI.0b013e318252e9d9"},{"key":"449_CR16","doi-asserted-by":"crossref","unstructured":"Wilson\u2010Stewart K, Shanahan M, Fontanarosa D, Davidson R (2018) Occupational radiation exposure to nursing staff during cardiovascular fluoroscopic procedures: a review of the literature. J Appl Clin Med Phys 19","DOI":"10.1002\/acm2.12461"},{"key":"449_CR17","doi-asserted-by":"crossref","unstructured":"ICRP (2006) The optimisation of radiological protection: broadening the process. Ann ICRP 36(3):69\u201387","DOI":"10.1016\/j.icrp.2006.09.007"},{"key":"449_CR18","first-page":"470","volume-title":"The ORAMED project: optimisation of radiation protection for medical staff","author":"F Vanhavere","year":"2009","unstructured":"Vanhavere F, Carinou E, Gualdrini G, Clairand I, Merce MS, Ginjaume M (2009) The ORAMED project: optimisation of radiation protection for medical staff. Springer, Berlin, pp 470\u2013473"},{"key":"449_CR19","doi-asserted-by":"crossref","unstructured":"Li X, Samei E, Segars WP, Sturgeon GM, Colsher JG, Toncheva G et al (2010) Patient-specific radiation dose and cancer risk estimation in CT: part I. Development and validation of a Monte Carlo program. Med Phys 38(1):397\u2013407","DOI":"10.1118\/1.3515839"},{"issue":"3","key":"449_CR20","first-page":"447","volume":"17","author":"MM Abuzaid","year":"2019","unstructured":"Abuzaid MM, Elshami W, Shawki M, Salama D (2019) Assessment of compliance to radiation safety and protection at the radiology department. Int J Radiat Res 17(3):447\u2013454","journal-title":"Int J Radiat Res"}],"container-title":["The Egyptian Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-024-00449-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43044-024-00449-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-024-00449-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T08:02:24Z","timestamp":1707465744000},"score":1,"resource":{"primary":{"URL":"https:\/\/tehj.springeropen.com\/articles\/10.1186\/s43044-024-00449-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,9]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["449"],"URL":"https:\/\/doi.org\/10.1186\/s43044-024-00449-7","relation":{},"ISSN":["2090-911X"],"issn-type":[{"value":"2090-911X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,9]]},"assertion":[{"value":"26 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Institutional Review Boards of the \u201cResearch Ethics Committee of the Faculty of Medicine at Cairo University\u201d reviewed and approved the protocol on January 15, 2019. Informed written consent to participate in the study was provided by all the participants in the study including the operators, nurses, technicians, and patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None to report.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"17"}}