Invited commentary: Collar Badge Lens Dose Equivalent Values among United States Physicians Performing Fluoroscopically Guided Interventional Procedures

Abstract

In the recently published article entitled “Collar badge lens dose equivalent values among United States physicians performing fluoroscopically guided interventional procedures,” a retrospective observational study on occupational radiation exposure to the eye from fluoroscopic procedures, Borrego et al (1) have added important information to our knowledge base and seek to provide thoughtful reassurance. However, some aspects of this subject remain disturbing. The realities of our workplaces are as follows: (i) wearing radiation detection badges is mandatory, but some interventionalists wear these incorrectly or do not wear them at all; (ii) the leaded eye protections that many interventionalists wear are variable in efficacy; (iii) the regulations on allowable radiation dose limits to the eye have not been updated for 4 decades despite evidence that they are 7.5 times too high; (iv) strong animal and human data show that individuals respond to radiation with widely variable biological responses with no precise thresholds; and (v) although effective measures to decrease dose to the operator are readily available, there are no regulations mandating their use, the use is inconsistent, and even when used, these measures are often quickly abandoned if they impede technical success in a difficult case (2).