Abstract
BACKGROUND: With the rise of structural heart interventions (SHIs), interventional echocardiographers (IEs) face significant radiation exposure in catheterization laboratories. However, US-specific radiation safety practices remain understudied. This study aims to address radiation safety practices and concerns among US IEs, focusing on occupational risks and sex-specific challenges. METHODS: A 21-item online survey was conducted from March to June 2025, targeting US IEs through a multifaceted recruitment strategy. It assessed demographics, SHI frequency, radiation monitoring, shielding practices, and reproductive health concerns. Descriptive statistics summarized responses, with sex-specific analyses for female IEs. RESULTS: Of 69 respondents (64% [n = 44] men, 36% [n = 25] women), 88% (n = 61) worked in tertiary care settings and 46% (n = 32) guided SHIs several times weekly. Key gaps were identified, including 18% (n = 17) not using dosimeters, 64% (n = 44) never receiving exposure notifications, and 80% (n = 55) lacking awareness of their personal annual radiation dose. In addition, 30% (n = 21) had no radiation safety training, and 75% (n = 52) reported insufficient radiation protection in their catheterization laboratory. Reproductive health concerns affected 71% (n = 49) of IEs. Among female IEs, 56% (n = 14) reported an influence on pregnancy planning, 32% (n = 8) noted career concerns owing to maternity, and 63% of those who had had a pregnancy (n = 12/19) performed SHIs during pregnancy, with 7% taking no additional precautions. CONCLUSIONS: US IEs face critical radiation safety gaps, including inadequate monitoring, training, and shielding, with pronounced reproductive and career concerns among female IEs. Tailored protocols, enhanced shielding, and pregnancy-specific precautions are urgently needed to ensure the safety and well-being of IEs.