Table 2.
Evaluation of the risks or prevalence rates of cataract in health personnel exposed to Ionizing Radiation as reported in the studies included in this review.
| Author year | Activity performed | Evaluation of the risk of cataract | Signif. |
| Chodick, 2008 | Radiologic Technologists (exposed to low IR doses) | For workers in the highest exposure category (estimated lens dose, mean, 60 mGy) vs lowest (mean, 5 mGy): adjusted hazard ratio (HR) of cataract= 1.18 (95% CI 0.99-1.40); self-report of >3 x-rays to the face/neck: HR of cataract= 1.25 (95% CI 1.06- 1.47); ERR/Gy = 1.9 (CI 95% -0.69-4.65) |
+/- |
| Milacic, 2009 | Health Workers exposed to IR (mainly radiologic technicians and IR exposed physicians) | Significant difference (χ2=65.92;p<0.01) of cataract prevalence between exposed vs unexposed, estimated relative risk=4.6 (CI not reported) | + |
| Ciraj-Bjelac, 2010 | Interventional cardiology staff (IC and nurses) | PSC prevalence= 52% (95% CI: 35–73) for IC; 45% (95% CI 15–100) for nurses; 9% (95% CI 1–33) for controls RR= 5.7 (95% CI 1.5–22) for IC; 5.0 (95% CI 1.2–21) for nurses. Estimated cumulative ocular doses= 0.01 up to 43 Gy, mean 3.4 Strong dose–response relationship found. |
+ |
| Vano, 2010 | Interventional cardiology staff (IC, nurses, technicians) | Prevalence of PSC in IC vs not exposed= 38% vs 12% (p < 0.005); RR =3.2 (CI 95% 1.7 - 6.1); RR in nurses and technicians (prevalence of PSC= 21%) vs not exposed= 1.7 (0.8–3.7). Cumulative median values of lens doses estimated: 6.0 Sv for IC; 1.5 Sv for nurses and technicians |
+ |
| Yuan, 2010 | IC | Prevalence exposed vs. unexposed: 1.2% vs. 0.8%, X2 test not significant | - |
| Mrena, 2011 | IR exposed physicians (Radiologists, IC, others) | Any type of lens opacity: adjusted OR = 3.87 CI 95% (0.82 - 18.3) cortical or posterior opacity excluding nuclear opacities: adjusted OR = 1.28 CI 95% (0.08 - 19.38) | - |
| Ciraj-Bjelac, 2012 | Interventional cardiology staff (IC, nurses and technicians) | Prevalence of PSC in IC=53%, in nurses and technicians =45%. RR vs unexposed= 2.6 (95% CI 1.2–5.4) for IC; =2.2 (95% CI 0.98–4.9) for nurses and technicians |
+ |
| Jacob, 2013 | IC | PSC prevalence= 17% in IC vs 5% in unexposed (p = 0.006); OR = 3.9 (CI 95% 1.3–11.4). Risk increased with duration of activity, no clear relationship with workload observed. For IC regular users of protective glasses: OR= 2.2 (95% CI 0.4–12.8) |
+ |
| Vano, 2013 | Interventional cardiology staff (IC and IR exposed paramedicals) | Estimated cumulative eye dose (Gy ± SD and range): for IC with opacities 8.3 ± 5.4 (0.7-18.9) compared to 3.0 ± 2.9 (0.1-9.7) for those without opacities; for paramedicals with opacities 2.7 ± 2.0 (0.6-6.3) compared to 1.8 ± 1.9 (0.1-6.8) for those without opacities | + |
| Auvinen 2015 |
IC | PSC PR in IC vs unexposed= 2.3% (CI 95% 0.29 - 19.9) PSC ERR per 10 mSv= −0.09 (95% CI (−0.51-0.35) |
- |
| Bitarafan Rajabi, 2015 | Interventional cardiology staff (IC and technicians) | Lens opacity incidence in IC staff vs nurses (not exposed)= 79% (95% CI, 69.9-88.1%) vs. 7.1% (95% CI, 2.3-22.6%); attributable risk of 91.0% (95% CI, 40.0-98.6%); increased % of relative risk= 11.06% (95% CI 1.67-73.37%) |
+ |
| Negrone, 2016 | Health Workers with different working tasks and differnet levels of IR exposure | Highly exposed health workers showed increased cataract prevalence: χ2 = 13.7; p = 0.0001), as well as nurses: χ2 = 14.3 (p = 0.0002) vs other categories; no significantly increased prevalence for workers engaged as physicians and for radiologic technologists | +/- |
| Bernier, 2017 | Radiologic technologists (engaged in nuclear medicine procedures) | Significantly increased cataract risk: Hazard Ratio (HR): =1.08 (95% CI 1.03-1.14) for performance of nuclear medicine (NM) procedures at least once vs never; = 1.07 (95% CI 1.01-1.12) for diagnostic NM procedures; = 1.10 (95% CI 1.04-1.17) for therapeutic NM procedures; = 1.30 (95% CI 1.08-1.58) for diagnostic NM procedures in the 1980s vs. 2000s; = 1.11 (95% CI 1.01-1.23) for therapeutic NM procedures in the 1970s vs early 2000s |
+ |
| Matsubara, 2017 | Interventional cardiology staff (IC, nurses and technicians) | Prevalence of PSC in IC=28.6%; in nurses & technicians= 19.5%; Increased risk vs. unexposed group: IC 10.6 (CI 95% 1.1 - 101.4); 7.2 (CI 95% 0.9–55.0) for nurses & technicians |
+ |
| Barbosa, 2018 | Interventional cardiology staff (IC, nurses and technicians) | Significantly increased PSC prevalence in IR exposed vs unexposed: 13% vs 3% | + |
| Coppeta, 2018 | Health Workers classified at high exposure | Lenticular opacity: prevalence = 10.5% in the whole group (95% CI), = 14.3 (4.9-34.6; CI 95%) for comulative dose 10-30mSv/year; =17.8 (CI 95%; 7.8-35.6) for >30mSv/year | + |
| Little, 2018 | Radiologic Technologists | Hazard Ratio (HR) for cataract history compared to subjects with comulative dose at the lens < 10.0mGy: 20-49.9mGy = 1.11 (1.0;1.23) | + |
| Domienik-Andrzejewska, 2019 | IC | Adjusted OR = 1.47 (CI 95% 0.6-3.6) Average cumulative dose: left eye= 224 mSv; right eye= 85 mSv. PSC= 7% in IC vs 6% in unexposed. Considering also other opacities type: adjusted OR for any opacity in IC vs unexposed= 1.47 (95% CI 0.62-3.59); no evidence for increased opacity risk with increasing dose. |
- |
| Scheidemann-Wesp, 2019 | Physicians performing fluoroscopy-guided interventional procedures (IC, interventional neuroradiologists and interventional radiologists) | Lens Opacities in IC vs not exposed = 59% vs 28% (difference not significant at the X2 test), mainly in the nuclear region. Results not reported for other interventional physicians | - |
| Velazquez-Kronen, 2019 | Radiologic Technologists | RR vs who never worked in Interventional Fluoroscopy: <1000 procedures = 1.1 (CI 95% 1.0-1.2); 1000-<3000 procedures = 1.2 (CI 95% 1.1-1.4); 3000-<5000 procedures = 1.2 (CI 95% 1.0-1.5); >5000 = 1.3 (CI 95% 1.2-1.5) | + |
| Little, 2020 | Radiologic Technologists | Cumulative occupational IR exposure associated with self-reported cataract: EAR per 104 persons-year Gy= 94.2 (CI 95% 46.7-142.9). No association considering reporting of cataract surgery: EAR per 104 persons-year Gy= 13 (95% CI <0-57. p=0.55) Elevated additive risk observed for estimated occupational lens IR exposure <100mGy (p=0.004), no dose–response relationship |
+ |
Legend: EAR= excess additive risk; ERR: excessive relative risk; IC: interventional cardiologists; OR: Odds Ratio; PSC: posterior subcapsular cataract; PR: prevalence ratio; RR: relative risk