- List of articles used in this meta-analysis with their geographic distribution, study design, participant characteristics, and outcomes.
Study | Study design | Country | Participants (occupational category) | Age (years) | Duration of occupational work | Lens scoring system | Outcomes (lens area assessed) | Radiation dose | ||
---|---|---|---|---|---|---|---|---|---|---|
n | Exposed | Non-exposed | ||||||||
Andreassi et al44 | Cohort | Italy | 746 | 466 (218 ICs and electrophysiologists, 191 nurses, and 57 technicians) | 280 | 35-53 | 5-24 years | ND | Cataract | Median lifetime effective dose physicians: 21 mSv nurses: 7 mSv |
Auvinen et al33 | Cohort | Finland | 37 | 21 (14 radiologists, 2 interventional radiologists, 3 cardiologists, and 2 surgeons) | 16 (physicians excluding radiologists and cardiologists) | 45-74 | At least 15 years | LOCS II | Posterior subcapsular, cortical change, nuclear opalescence, nuclear color, nuclear opacities | Mean cumulative radiation dose based on dosimeter readings: 111 mSv |
Barbosa et al34 | Cross-sectional | Brazil | 200 | 112 ICs and healthcare workers in cardiac hemodynamics: nurse, physician, technician, or technologist | 88 (cardiologists not exposed to radiation) | 36-66 | 62% of the professionals: <20 years of work, and 31% presented between 5-10 years of work. | LOCS III | Posterior subcapsular, lens opacities, cortical cataract | ND |
Ciraj-Bjelac et al18 | Cohort | Austria | 89 | 56 ICs and 11 nurses working in interventional cardiology | 22 age- and gender-matched unexposed healthcare staff | 25-64 | 1-33 | MF scoring system | Posterior lens changes | 0.01-43 Gy |
Ciraj-Bjelac et al17 | Cohort | Austria | 86 | 52 healthcare workers in interventional cardiology | 34 age- and gender-matched unexposed healthcare staff | 19-67 | 1-20 | MF scoring system | Posterior lens changes | Cumulative dose: 0.026-21 Sv |
Domienik-Andrzejewska et al45 | Cohort | Poland | 147 | 69 (interventional cardiologists) | 78 physicians, scientific/administrative staff, and nurses | 37-68 | 5-36 years | LOCS III | Nuclear opalescence, nuclear color, cortical opacities, posterior subcapsular opacities | ICs: 224 mSv (left eye)85 mSv (right eye) |
Jacob et al36 | Cross-sectional | France | 205 | 106 ICs | 99 non-medical workers | >40 | ND | LOCS III | Any lens opacities, nuclear opacities, cortical opacities, posterior subcapsular opacities | ND |
Karatasakis et al46 | Cross-sectional | USA | 117 | 99 ICs and cath-lab staff | 18 participants (industry, research staff, and others) | 36-60 | ND | MF scale | Any lens opacities, cortical and posterior subcapsular lens changes, Frank opacities | Cumulative radiation dose to the lens: 0.1-22.5 Gy (Mean: 4.5) |
Matsubara et al40 | Cohort | Thailand | 85 | Cardiac catheterization laboratories staff: 7 ICs, 41 nurses, and technologists | 37 age- and gender-matched volunteers | 19-59 | 0.4-35 years | MF scale | Posterior lens opacities | Cumulative radiation dose to the lens: 0.03-8.5 Sv |
Milacic et al47 | Cohort | Serbia | 3240 | 1560 health workers | 1680 health workers | 28-52 | 6-26 years | ND | Cataract | Equivalent doses 0.5-8 μSv/h |
Rajabi et al48 | Cohort | Iran | 95 | 81 interventional cardiology members (44 ICs and 37 technicians) | 14 nurses not working in interventional sites | 26-54 | At least 4 years | LOCS III | Cataract | At least 1 mSv for at least 4 years |
Scheidemann-Wesp et al49 | Cohort | Germany | 61 | 17 ICs | 18 physicians | 37-75 | 8-50 years | LOCS III | Nuclear opacity, cortical opacity | ND |
Vano et al19 | Cohort | Colombia and Uruguay | 209 | 58 interventional cardiologists and 58 nurses and technicians | 93 unexposed non-healthcare workers of similar age | 20-69 | 1-40 | MF scale | Posterior subcapsular lens opacities | Cumulative lens dose range: 0.1-27 Sv |
Vano et al50 | Cohort | Argentina, Colombia, and Uruguay | 145 | 54 ICs and 69 nurses and technicians | 91 non-medical professionals | 20-66 | 4-25 | MF scale | Posterior subcapsular lens changes | Cumulative eye dose range: 0.1-18.9 Sv |
Yuan et al51 | Cross-sectional | Taiwan | 1866 | 733 cardiologists performing cardiac catheterization | 988 cardiologists not performing cardiac catheterization | 35-50 | ND | ND | Cataract | ND |
ICs: interventional cardiologists, ND: not defined, mSv: millisievert, LOCS II: Lens Opacities Classification System, version II, LOCS III: The Lens Opacities Classification System III, Gy: the gray, Sv: stroke volume, cath-lab: catheterization laboratory, MF: Modified Merriam-Focht, μSv/h: micro-Sieverts/hour