Abbreviations:ALARA (as low as reasonably achievable), FGI (fluoroscopically guided intervention), Hp(10) (personal dose equivalent), ICRP (International Commission on Radiological Protection), NRC (Nuclear Regulatory Commission), NRCP (National Council on Radiation Protection and Measurements)
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
- Consensus methods: characteristics and guidelines for use.Am J Public Health. 1984; 74: 979-983
- The appropriateness of use of coronary artery bypass graft surgery in New York State.JAMA. 1993; 269: 753-760
ACR. Proceedings of the ACR/FDA Workshop on Fluoroscopy.”Strategies for Improvement in Performance, Radiation Safety and Control.” October 16–17, 1992. Dulles Hyatt Hotel, Washington, DC: American College of Radiology, Merrifield, VA, 1993.
- Ionizing radiation exposure of the population of the United States. NCRP Report No. 160.National Council on Radiation Protection and Measurements, Bethesda, MD2009
- Preconception and prenatal radiation exposure: health effects and protective guidance. Recommendations of the National Council on Radiation Protection and Measurements. NCRP Report No. 174.National Council on Radiation Protection and Measurements, Bethesda, MD2013
- Effects of ionizing radiation. UNSCEAR 2006 report to the general assembly with scientific annexes. Volume 1. United Nations Scientific Committee on the Effects of Atomic Radiation, New York2008
- Exposed medical staff: challenges, available tools, and opportunities for improvement.Health physics. 2014; 106: 217-224
- Overview of contemporary interventional fluoroscopy procedures.Health physics. 2008; 95: 638-644
- Occupational radiation doses to operators performing cardiac catheterization procedures.Health physics. 2008; 94: 211-227
- Radiation dose management for fluoroscopically guided interventional medical procedures. NCRP Report No. 168.National Council on Radiation Protection and Measurements, Bethesda, MD2010
- Occupational radiation doses to operators performing fluoroscopically-guided procedures.Health physics. 2012; 103: 80-99
- The information system on occupational exposure in medicine, industry and research (ISEMIR): interventional cardiology. TECDOC 1735.International Atomic Energy Agency, Vienna2014
- International project on individual monitoring and radiation exposure levels in interventional cardiology.Radiat Prot Dosim. 2011; 144: 437-441
- Proposition: a pregnant resident physician should be excused from training rotations such as angiography and nuclear medicine because of the potential exposure of the fetus.Med Phys. 1999; 26: 2517-2519
- Time for radiation safety program guidelines for pregnant trainees and vascular surgeons.Journal of vascular surgery. 2012; 55 (e2): 862-868
- Physicians’ perceptions of teratogenic risk associated with radiography and CT during early pregnancy.AJR American journal of roentgenology. 2004; 182: 1107-1109
- Counseling patients exposed to ionizing radiation during pregnancy.Rev Panam Salud Publica. 2006; 20: 198-204
- Saving lives and changing family histories: appropriate counseling of pregnant women and men and women of reproductive age, concerning the risk of diagnostic radiation exposures during and before pregnancy.Am J Obstet Gynecol. 2009; 200: 4-24
- Pregnancy during residency: a literature review.Academic medicine : journal of the Association of American Medical Colleges. 2003; 78: 418-428
- American Association for Women R, Association of Program Directors in R. Proposed program guidelines for pregnant radiology residents: a project supported by the American Association for Women Radiologists and the Association of Program Directors in Radiology.Academic radiology. 2006; 13: 391-401
- Ionizing radiations in pregnancy and teratogenesis. A review of literature.Reproductive Toxicology. 2005; 20: 323-329
ICRP. Pregnancy and medical radiation. International Commission on Radiological Protection. ICRP Publication 84. Ann of the ICRP 2000; 30:1-43.
- Radiation management for interventions using fluoroscopic or computed tomographic guidance during pregnancy: a joint guideline of the Society of Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe with Endorsement by the Canadian Interventional Radiology Association.Journal of vascular and interventional radiology : JVIR. 2012; 23: 19-32
- Guidelines for Patient Radiation Dose Management.Journal of Vascular and Interventional Radiology. 2009; 20: S263-S273
- Council Directive 2013/59/Euratom of 5 December 2013 laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation, and repealing Directives 89/618/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/Euratom and 2003/122/Euratom.Off J Eur Commun. 2013; L13: 1-73
ICRP. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP 2007; 37:1-332.
ICRP. Biological effects after prenatal irradiation (embryo and fetus). ICRP Publication 90. Annals of the ICRP 2003; 33:1-206.
ACR. ACR practice guideline for imaging pregnant or potentially pregnant adolescents and women with ionizing radiation. In: Practice Guidelines and Technical Standards. Reston, VA: American College of Radiology, 2008.
- Imaging in pregnant patients: examination appropriateness.Radiographics. 2010; 30 (discussion 30-3): 1215-1229
- Medical radiation and pregnancy.Health Phys. 2008; 95: 551-553
- Radiation exposure and pregnancy: when should we be concerned?.Radiographics. 2007; 27 (discussion 17-8): 909-917
- Health of children born to medical radiographers.Occupational and environmental medicine. 1996; 53: 73-79
- Childhood cancer in the offspring born in 1921-1984 to US radiologic technologists.Br J Cancer. 2008; 99: 545-550
- Limitation of exposure to ionizing radiation. NCRP Report No. 116.National Council on Radiation Protection and Measurements, Bethesda, MD1993
ICRP. Statement on tissue reactions. ICRP ref 4825-3093-1464. 2011. Available at: http://www.icrp.org/page.asp?id=123. Accessed October 30, 2014.
- Standards for protection against radiation. 10 CFR Part 20.U.S. Nuclear Regulatory Commission, Washington, DC2007
- Radiation safety considerations for diagnostic radiology personnel.Radiographics. 1999; 19: 1037-1055
- Radiation exposure and pregnancy.Journal of vascular surgery. 2011; 53: 28S-34S
- Radiation protection and safety of radiation sources: International basic safety standards. Interim edition. General Safety Requirements.Vienna: International Atomic Energy Agency. 2011
- Radiation protection guidance to federal agencies for occupational exposure, 52 FR 2822.U.S. Environmental Protection Agency, Washington, DC1987
- Standards for protection against radiation. Dose equivalent to an embryo/fetus. 10 CFR Part 20.1208.U.S. Nuclear Regulatory Commission, Washington, DC1998
- G4441.1-6. Evaluation and control of radiation dose to the embryo/fetus. Guide for use with Title 10, Code of Federal Regulations, Part 835, Occupational Radiation Protection.U.S. Department of Energy, Washington, DC1999
- SCAI consensus document on occupational radiation exposure to the pregnant cardiologist and technical personnel.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. 2011; 77: 232-241
- Regulatory Guide 8.13–Instruction concerning prenatal radiation exposure, rev. 3.U.S. Nuclear Regulatory Commission, 1999
- Pregnant workers. A physician’s guide to assessing safe employment.The Western journal of medicine. 1998; 168: 86-92
- The pregnant health care worker--an evidence-based approach to job assignment and reassignment.AAOHN J. 2008; 56: 329-333
- Written policies are necessary for pregnant radiology workers.ACR Bull. 1992; 48: 21-24
- Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology.Journal of vascular and interventional radiology : JVIR. 2010; 21: 607-615
- Recommendations for occupational radiation protection in interventional cardiology.Catheter Cardiovasc Interv. 2013; 82: 29-42
- Personal monitoring of pregnant staff in diagnostic radiology.J Radiol Prot. 1993; 13: 259-265
- Isodose curves in a phantom due to diagnostic quality X-radiation.Health physics. 1977; 33: 359-367
- Radiation and the pregnant nurse.Cath Lab Digest. 2002; : 10
- Anticipation of radiation dose to the conceptus from occupational exposure of pregnant staff during fluoroscopically guided electrophysiological procedures.J Cardiovasc Electrophysiol. 2005; 16: 773-780
- Standards for protection against radiation. Subpart F. Surveys and Monitoring. 10 CFR 20.1501 General.U.S. Nuclear Regulatory Commission, Washington, D.C.2000
- [Pregnancy and medical irradiation; summary and conclusions from the International Commission on Radiological Protection, Publication 84].Nederlands tijdschrift voor geneeskunde. 2002; 146: 299-303
- Software for the estimation of foetal radiation dose to patients and staff in diagnostic radiology.J Radiol Prot. 2003; 23: 183-194
- Equivalent dose to the fetus from occupational exposure of pregnant staff in diagnostic radiology.The British journal of radiology. 2001; 74: 629-637
- Minimising radiation exposure to physicians performing fluoroscopically guided cardiac catheterisation procedures: a review.Radiation protection dosimetry. 2009; 133: 227-233
- Fetal radiation dose calculations. ANSI/HPS N13.54.Health Physics Society, McLean, VA2008: 1-79
- Radiation safety program for the cardiac catheterization laboratory.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. 2011; 77: 546-556
- Comparison of indirect radiation dose estimates with directly measured radiation dose for patients and operators during complex endovascular procedures.J Vasc Surg. 2011; 53: 885-894
- Staff radiation doses in interventional cardiology: correlation with patient exposure.Pediatr Cardiol. 2009; 30: 409-413
- Influence of patient thickness and operation modes on occupational and patient radiation doses in interventional cardiology.Radiat Prot Dosimetry. 2006; 118: 325-330
- Correlation of patient and staff doses in interventional cardiology.Radiat Prot Dosim. 2005; 117: 26-29
- Clinical radiation management for fluoroscopically guided interventional procedures.Radiology. 2010; 257: 321-332
- A summary of recommendations for occupational radiation protection in interventional cardiology.Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions. 2013; 81: 562-567
ICRP. Avoidance of radiation injuries from medical interventional procedures. ICRP Publication 85. Annals of the ICRP 2000; 30:7-67.
- Management of patient skin dose in fluoroscopically guided interventional procedures.Journal of vascular and interventional radiology : JVIR. 2000; 11: 25-33
- Minimizing radiation-induced skin injury in interventional radiology procedures.Radiology. 2002; 225: 329-336
IAEA. 10 Pearls: Radiation protection of patients in fluoroscopy.: International Atomic Energy Agency, Radiation Protection of Patients, 2013.
ImageGently. Interventional radiology–step lightly resources.: The Alliance for Radiation Safety in Pediatric Imaging, 2014. Available at: http://www.imagegently.org/Procedures/InterventionalRadiology/ImageSafelyResources.aspx. Accessed October 30, 2014.
- Efforts to optimize radiation protection in interventional fluoroscopy.Health Phys. 2013; 105: 435-444
ICRP. Radiological protection in fluoroscopically guided procedures performed outside the imaging department. ICRP Publication 117. Ann ICRP 2010; 40:1-102.
ICRP. Radiological protection in cardiology. ICRP Publication 120. Ann ICRP 2013; 42:1-125.
- Occupational health hazards in the interventional laboratory: time for a safer environment.Journal of vascular and interventional radiology : JVIR. 2009; 20: S278-S283
- Prevalence and risk factors for cervical and lumbar spondylosis in interventional electrophysiologists.J Cardiovasc Electrophysiol. 2011; 22: 957-960
- Reducing occupational exposure from fluoroscopy.J Am Coll Radiol. 2007; 4: 335-337
- Evaluation of the transmitted exposure through lead equivalent aprons used in a radiology department, including the contribution from backscatter.Med Phys. 2003; 30: 1033-1038
- Use of personal monitors to estimate effective dose equivalent and effective dose to workers for external exposure to low-LET radiation. NCRP report no. 122.National Council on Radiation Protection and Measurements, Bethesda, MD1995
- Pregnancy and women radiologists.Radiology. 1982; 145: 559-562
- EDE for exposure with protective aprons.Health physics. 1989; 56: 568-569
- Occupational health hazards in the interventional laboratory: progress report of the multispecialty occupational health group.J Vasc Interv Radiol. 2010; 21: 1338-1341
- Why don’t female medical students choose diagnostic radiology? A review of the current literature.J Am Coll Radiol. 2004; 1: 583-590
- Survey results: a decade of change in professional life in cardiology: a 2008 report of the ACC women in cardiology council.Journal of the American College of Cardiology. 2008; 52: 2215-2226
Buls N., Covens P., Nieboer K., et al. Dealing with pregnancy in radiology: a thin line between science, social and regulatory aspects. JBR-BTR : organe de la Societe royale belge de radiologie 2009; 92:271-9.
USDOL. OSHA Injury and illness prevention programs. White paper. Washington, DC: U.S. Department of Labor, 2012.
USNRC. Notices, instructions and reports to workers: Inspection and investigation. Instructions to workers. 10 CFR Part 19.12. Washington, DC, 1995.
- ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training.Circulation. 2005; 111: 511-532
- ICRP Publication 113. Education and training in radiological protection for diagnostic and interventional procedures.Annals of the ICRP. 2009; 39: 7-68
- Survival probability of human conceptions from fertilization to term.International journal of fertility. 1990; 35 (9-80, 1-94): 75
- Incidence of early loss of pregnancy.The New England journal of medicine. 1988; 319: 189-194
- Radiation safety among cardiology fellows.Am J Cardiol. 2010; 106: 125-128
- Reduction of the radiation dose received by interventional cardiologists following training in radiation protection.Radiat Prot Dosim. 2013; 155: 119-121
- Modifying fluoroscopic views reduces operator radiation exposure during coronary angioplasty.Journal of the American College of Cardiology. 1994; 24: 1660-1663
- Data analysis on patient exposures in cardiac angiography.Radiation protection dosimetry. 1995; 57: 475-480
- Radiation and pregnancy. Putting the risks in proportion.Am J Nurs. 1986; 86: 260-265
- The effect of embryonic and fetal exposure to x-ray, microwaves, and ultrasound: counseling the pregnant and nonpregnant patient about these risks.Semin Oncol. 1989; 16: 347-368
- Protection of pregnant patients during diagnostic medical exposures to ionising radiation. Advice from the Health Protection Agency, the Royal College of Radiologists and the College of Radiographers. RCE-9.Health Protection Agency, The Royal College of Radiologists and the College of Radiographers, Oxfordshire: UK2009
- The all-or-none phenomenon revisited.Birth defects research Part A, Clinical and molecular teratology. 2012; 94: 664-669
- Guidelines for diagnostic imaging during pregnancy. ACOG Committee Opinion No. 299. American College of Obstetricians and Gynecologists.Obstet Gynecol. 2004; 104: 647-651
- Surveillance, Epidemiology, and End Results Cancer Statistics Review, 1975-2002.National Cancer Institute, 2005
The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.
None of the authors have identified a conflict of interest.