Doctors writing in the British Medical Journal say women working in healthcare are often exposed to X-rays and other imaging procedures and need better protection from ionising radiation to minimise their risk of developing breast cancer.
Ionizing radiation is a known human carcinogen, and breast tissue is very sensitive to radiation. Therefore, there is concern that frequent exposure to ionizing radiation during image-guided surgery may increase the risk of breast cancer in female healthcare workers.
During these procedures, personal protective equipment (PPE), such as lead aprons, is used to shield the body from harmful radiation. However, studies have shown that current radiation PPE does not provide adequate protection for breast tissue because it leaves exposed areas near the armpit called the upper outer quadrant and axilla — the most common sites for breast cancer to occur.
”Providing adequate PPE that covers the breasts may reduce radiation exposure and help prevent breast cancer in female healthcare workers,” write Isabel Pilkington and colleagues.
They acknowledged that measuring the risk of breast cancer from occupational exposure in women working in health care is challenging, but as the number of female trainees entering these professions increases, they said it was “important to take into account the available data and improve the provision of equipment to minimise this risk”.
They point to observational data showing that female orthopedists in the United States have an increased risk of breast cancer compared with the age-matched female population, while a small Finnish study found that radiologists, surgeons, and cardiologists had an expected incidence of breast cancer 1.7 times higher than female physicians who did not practice radiation therapy.
In a study using an artificial female torso to measure radiation exposure, scientists found that the upper outer quadrants were inadequately protected and there was no statistically significant reduction in dose when comparing standard PPE to a torso without PPE.
Occupational exposure to radiation has not been recognised as a risk factor for male breast cancer. However, the Ionising Radiation Regulations 2017 state that the radiation dose to all workers should be kept as low as reasonably practicable (ALARA). The authors argue that the most effective way to achieve this is to reduce exposure time, increase distance from radiation sources and provide effective personal protective equipment to all workers.
They note that additional protection, such as short sleeves and axillary wings worn under standard surgical gowns, can protect the upper outer quadrant of the breast, and argue that the 2023 European Society for Vascular Surgery Clinical Practice Guidelines on Radiation Safety already recommend that female operators consider using this additional protection.
”Providing adequate protection is a legal requirement for employers who have a duty of care to all workers exposed to radiation,” they wrote. “Women’s breasts appear to be particularly vulnerable, so it is important that employers invest in protective equipment to improve the safety of all employees.”
Pilkington, I. et al. (2023). Protecting female health workers from ionizing radiation in the workplace. BMJ. doi.org/10.1136/bmj-2023-075406.
Tags: axilla, breast cancer, cancer, carcinogens, healthcare, imaging, male breast cancer, orthopedics, personal protective equipment, PPE, radiation exposure, surgery, vascular disease
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Post time: Feb-07-2025
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