ABC | Volume 112, Nº4, April 2019

Original Article Prevalence of Lens Opacity in Interventional Cardiologists and Professional Working in the Hemodynamics in Brazil Adriano Henrique Pereira Barbosa, 1 Regina Bitelli Medeiros, 1 A driana Maria Rodrigues Corpa, 1 Fabiana Shinzato Higa, 1 Marco Túlio de Souza, 1 P atrícia Lopes Barbosa, 1 A ntônio Carlos Moreira, 1 Alexandre Shaan de Quadros, 2 Viviana de Mello Guzzo Lemke, 2 M arcelo José de Carvalho Cantarelli 2 Escola Paulista de Medicina – Universidade Federal de São Paulo, 1 São Paulo, SP – Brazil Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista, 2 São Paulo, SP – Brazil Mailing Address: Adriano Henrique Pereira Barbosa • Rua Doutor Bacelar, 719 Apto 104. Postal Code 04026-001, Vila Clementino, São Paulo, SP – Brazil E-mail: barbosa-ah@uol.com.br , ahpbarb@cardiol.br Manuscript received February 26, 2018, revised manuscript July 29, 2018, accepted August 15, 2018 DOI: 10.5935/abc.20190028 Abstract Background: Posterior subcapsular cataract is a tissue reaction commonly found among professionals exposed to ionizing radiation. Objective: To assess the prevalence of cataract in professionals working in hemodynamics in Brazil. Methods: Professionals exposed to ionizing radiation (group 1, G1) underwent slit lamp examination with a biomicroscope for lens examination and compared with non-exposed subjects (group 2, G2). Ophthalmologic findings were described and classified by opacity degree and localization using the Lens Opacities Classification System III. Both groups answered a questionnaire on work and health conditions to investigate the presence of risk factors for cataract. The level of significance was set at 5% (p < 0.05). Results: A total of 112 volunteers of G1, mean age of 44.95 (±10.23) years, and 88 volunteers of G2, mean age of 48.07 (±12.18) yearswere evaluated; 75.2%of G1 and85.2%of G2were physicians. Statistical analysis betweenG1 andG2 showed a prevalence of posterior subcapsular cataract of 13% and 2% in G1 and G2, respectively (0.0081). Considering physicians only, 38% of G1 and 15% of G2 had cataract, with the prevalence of posterior subcapsular cataract of 13% and 3%, respectively (p = 0.0176). Among non-physicians, no difference was found in the prevalence of cataract (by types). Conclusions: Cataract was more prevalent in professionals exposed to ionizing radiation, with posterior subcapsular cataract the most frequent finding. (Arq Bras Cardiol. 2019; 112(4):392-399) Keywords: Cataract/surgery;Radiation,Ionizing;Cardiologists;Hemodynamics;OccupationalRisks;Radiation,Protection. Introduction In the last years, due to considerable increase in the complexity of diagnostic and therapeutic procedures in cardiology, radiology and interventional neurology, health professionals have been increasingly exposed to ionizing radiation. This has been particularly seen in some areas, including interventional cardiology. 1 With the development of new therapeutic devices and adjuvant therapy, cardiologists have been involved in even more complex and longer procedures, requiring longer exposure to ionizing radiation. 2 Routine, continuous exposure to radiation may cause deleterious effects on human body by direct or indirect effect on the cells, causing physiological and/or functional damage to the organs. For any radiation dosage, there is the risk of neoplasm and cell death, with a direct relationship between the dose and the risk. 3,4 The lens is one of the most sensitive tissues to ionizing radiation. Studies have suggested a significant risk of changes in the lens in populations exposed to low radiation doses. These populations include patients undergoing computed tomography, 5 astronauts, 6,7 radiologic technologists, 8 patients undergoing radiotherapy, 9 atomic bombing survivors, 10,11 and Chernobyl survivors. 12,13 The most common change in the lens reported in these studies was lens opacity classified as posterior subcapsular cataract (PSC). 14 Considering health professionals, studies have shown higher prevalence of this type of cataract among individuals working in interventional radiology. 15-18 In 2011, the International Commission for Radiological Protection (ICRP) revised radiation threshold levels that may cause lens damage, and reduced the occupational dose limits, aiming to reduce the incidence of cataract induced by radiation among health professionals. 19 During last years, interventional cardiology has exponentially increased in Brazil; however, so far, there is no data available on the prevalence of lens opacity among exposed professionals. Therefore, the aim of the present study was to evaluate the prevalence of cataract in interventional cardiologists (ICs) and professionals working in hemodynamics and possible factors that could minimize the risk. 392