ABC | Volume 112, Nº4, April 2019

Original Article Barbosa et al Prevalence of lens opacity Arq Bras Cardiol. 2019; 112(4):392-399 distribution of scattered radiation. The use of mobile radiation shields, including suspended radiation protection and lead shields placed laterally to the fluoroscopy table, are relevant strategies to reduce individual radiation doses, and should be used regardless of gantry angulations. The adoption of angiography device in cardiovascular procedures in terms of radiologic protection was summarized in a recent study that describes all adjustments necessary to minimize the radiation doses delivered to patients and professionals. 32 Although the use of protective lead glasses was recognized as important protective devices by radiation-exposed volunteers, the reason for their low frequency of use, according to them was mainly their “weight” and “difficult adjustment to the face”. Thus, ergonomic improvements should be made to encourage the use of protective lead glasses on a routine basis. Evidence of early occurrence of lens opacity has been discussed in the scientific community; however, the fact that participants have received a radiation dose lower than the occupational threshold (mean of 5 years, 20 mSy/year) can be attributed to the fact that they did not use personal protective apparatus regularly. 18 Despite the consistent findings of our study, some limitations should be noted. There are some uncertainties regarding the use of personal and collective protective devices that cannot be measured, since these data were obtained by interview. Nevertheless, despite the uncertainties of dose estimates using a radiation dosimeter, an effective control of the doses enables the correlation of dose and tissue damage. In our study, this correlation could not be evaluated since information on individual occupation dose were not available. Conclusions In the present study, we detected early occurrence of lens opacity in Brazilian interventional cardiologists, who attended the annual congress of the SOLACI/SBHCI. The questionnaire administered by interview allowed us to obtain information about the current use of radiation protective devices and to detect the need for strategies that reinforce the importance of fostering a culture of radiologic protection among professionals exposed to radiation. Acknowledgment To all those present at the SOLACI and SBC 2016 congresses who agreed to participate voluntarily. Author contributions Conception and design of the research: Barbosa AHP, Medeiros RB; acquisition of data: Barbosa AHP, Medeiros RB, Corpa AMR, Higa FS, Souza MT, Barbosa PL, Moreira AC; analysis and interpretation of the data: Barbosa AHP, Medeiros RB, Corpa AMR, Higa FS; statistical analysis: Barbosa AHP; obtaining funding: Barbosa AHP, Lemke VMG, Cantarelli MJC; writing of the manuscript: Barbosa AHP, Medeiros RB, Corpa AMR, Cantarelli MJC; critical revision of the manuscript for intellectual content: Barbosa AHP, Medeiros RB, Quadros AS, Cantarelli MJC. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This study was approved by the Ethics Committee of the Unifesp/EPM under the protocol number 1.550.372. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 1. Picano E, Vañó E. The radiation issue in cardiology: The time for action is now. Cardiovasc Ultrasound. 2011 Nov 21;9:35. 2. Klein LW, Miller DL, Balter S, Laskey W, Haines D, Norbash A, et al. Occupational health hazards in the interventional laboratory: time for a safer environment. Radiology 2009;250(2):538-44. 3. Hamada N, Fujimichi Y. Classification of radiation effects for dose limitation purposes: history, current situation and future prospects. J Radiat Res. 2014;55(4):629-40. 4. Hendry JH. Radiation biology and radiation protection. Ann ICRP. 2012;41(3-4):64-71. 5. Klein BE, Klein R, Linton KL, Franke T. Diagnostic x-ray exposure and lens opacities: the Beaver Dam Eye Study. Am J Public Health. 1993;83(4):588-90. 6. Cucinotta FA, Manuel FK, Jones J, Iszard G, Murrey J, Djojonegro B, et al. Space radiation and cataracts in astronauts. Radiat Res. 2001;156(6):811. 7. Rastegar N, Eckart P, MertzM. Radiation-induced cataract in astronauts and cosmonauts. Graefes Arch Clin Exp Ophthalmol. 2002;240(7):543-7. 8. Chodick C, Bekiroglu N, Hauptmann M Alexander BH, Freedman DM, Doody MM, et al. Risk of cataract after exposure to low doses of ionizing radiation: a 20-year prospective cohort study among US radiologic technologists. Am. J. Epidemiol. 2008;168(6):620-31. 9. Hall P, Granath F, Lundell M, Olsson K, Holm LE. Lenticular opacities in individuals exposed to ionizing radiation in infancy. Radiat Res. 1999;152(2):190-5. 10. Nakashima E, Nerisihi K, Minamoto A. A reanalysis of atomic-bomb cataract data, 2000-2002: a threshold analysis. Health Phys. 2006;90(2):154-60. References 397