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Cataract risk in US radiologic technologists assisting with fluoroscopically guided interventional procedures: a retrospective cohort study
  1. Raquel Velazquez-Kronen1,2,
  2. David Borrego1,
  3. Ethel S Gilbert1,
  4. Donald L Miller3,
  5. Kirsten B Moysich4,
  6. Jo L Freudenheim2,
  7. Jean Wactawski-Wende2,
  8. Elizabeth K Cahoon1,
  9. Mark P Little1,
  10. Amy E Millen2,
  11. Stephen Balter5,
  12. Bruce H Alexander6,
  13. Steven L Simon1,
  14. Martha S Linet1,
  15. Cari M Kitahara1
  1. 1 Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Rockville, Maryland, USA
  2. 2 Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
  3. 3 Office of In Vitro Diagnostics and Radiological Health, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland, USA
  4. 4 Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, USA
  5. 5 Departments of Radiology and Medicine, Columbia University, New York, New York, USA
  6. 6 Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
  1. Correspondence to Dr Cari M Kitahara, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda MD 20892, USA; kitaharac{at}


Objectives To assess radiation exposure-related work history and risk of cataract and cataract surgery among radiologic technologists assisting with fluoroscopically guided interventional procedures (FGIP).

Methods This retrospective study included 35 751 radiologic technologists who reported being cataract-free at baseline (1994–1998) and completed a follow-up questionnaire (2013–2014). Frequencies of assisting with 21 types of FGIP and use of radiation protection equipment during five time periods (before 1970, 1970–1979, 1980–1989, 1990–1999, 2000–2009) were derived from an additional self-administered questionnaire in 2013–2014. Multivariable-adjusted relative risks (RRs) for self-reported cataract diagnosis and cataract surgery were estimated according to FGIP work history.

Results During follow-up, 9372 technologists reported incident physician-diagnosed cataract; 4278 of incident cases reported undergoing cataract surgery. Technologists who ever assisted with FGIP had increased risk for cataract compared with those who never assisted with FGIP (RR: 1.18, 95% CI 1.11 to 1.25). Risk increased with increasing cumulative number of FGIP; the RR for technologists who assisted with >5000 FGIP compared with those who never assisted was 1.38 (95% CI 1.24 to 1.53; p trend <0.001). These associations were more pronounced for FGIP when technologists were located ≤3 feet (≤0.9 m) from the patient compared with >3 feet (>0.9 m) (RRs for >5000 at ≤3 feet vs never FGIP were 1.48, 95% CI 1.27 to 1.74 and 1.15, 95% CI 0.98 to 1.35, respectively; pdifference=0.04). Similar risks, although not statistically significant, were observed for cataract surgery.

Conclusion Technologists who reported assisting with FGIP, particularly high-volume FGIP within 3 feet of the patient, had increased risk of incident cataract. Additional investigation should evaluate estimated dose response and medically validated cataract type.

  • retrospective exposure assessment
  • cataract
  • cataract surgery
  • fluoroscopy
  • occupational exposure

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  • Contributors RV-K, DB, ESG, KM, JLF, JW-W, MSL and CMK conceived and designed the study, and produced an analytical plan. RV-K, MSL and CMK were responsible for acquisition and processing of data. RV-K was responsible for data analysis and drafted the manuscript. ESG verified the analytic methods. RV-K, DB, ESG, MSL and CMK interpreted the results. All authors reviewed the manuscript and provided intellectual input. CMK is the principal investigator and the guarantor of the study.

  • Funding This work was supported by the Intramural Research Program of the National Cancer Institute, National Institutes of Health. RVK was previously supported by the National Cancer Institute (NCI) Interdisciplinary Training Grant in Cancer Epidemiology R25CA113951.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.