Interventional cardiologists are exposed to the most radiation among medical personnel using X-rays. In a previous survey conducted by the European Association of Percutaneous Coronary Interventions (EAPCI) Women’s committee, both men and women in cardiology consider radiation exposure and the associated risks are the main perceived causes preventing female doctors from having a career in interventional cardiology. Moreover the possibility of pregnancy in young female doctors is often provided as a reason for directors of catheterization laboratories to not choose young women for an interventional cardiology position or for women in medicine to not choose this career path.
The EAPCI Women’s committee proposed a new web survey to European catheterization laboratories in order to assess currently adopted radiation protection measures and practices, in general and during pregnancy, as well as to derive gender ratio of directors, medical and paramedical personnel.
This survey was provided to 1065 catheterization laboratory directors and was completed by 326 institutions (30.6 %) in 18 countries. Radioprotective measures were adequate and appropriate in all catheterization laboratories. Among the responding centers, 29.7% (n = 97) had radiological equipment older than 10 years. Two-thirds of doctors were wearing at least two dosimeters. A larger proportion of active vs passive dosimeters were found in high procedure volume (> 700 PCI/year) catheterization laboratories (difference 35.5%, p < 0.01). Personal dose exposure to radiation was reported monthly in 39% of the cases and medical follow-up was scheduled once or twice per year in 80% of the centers.
Concerning the gender ratio, there were 353 female interventional cardiologists out of a total of 1952 (18%) and in more than one third of all catheterization laboratories there were no women among the interventional cardiologists. Female cardiologists held the role of cathlab director in 8% of the centers (25/326) and among 599 fellows, women accounted for the 24.5% (n = 147, p < 0.01 vs male fellows).
The possibility of pregnancy for young female doctors represented a deterrent for a fellowship or a permanent position according to 8% of catheterization laboratories directors. Specific radioprotection measures need to be adopted for pregnant women who wish to continue working ensuring radiation safety for themselves and the fetuses, according to European directives. However, local policies are heterogeneous between countries and within the same country.
Despite women constitute 60% of medical students worldwide, women in cardiology represent less than 20% of the total and especially interventional cardiology remains largely a male specialty.
The evolution of radiation protection strategies, the adoption of modern equipment reducing radiation exposure and the improvement of radioprotection standards for all personnel and pregnant women could help reduce the sex-disparity in interventional cardiology.
Original Article: EuroIntervention. 2019 Mar 19. pii: EIJ-D-18-01044.
Author: Lorena Casadonte, Cardiology Update