ISEMIR-IC: Interventional Cardiology

ISEMIR-IC is an international database, a tool for interventional cardiology (IC) facilities to use in their implementation of optimization of occupational radiation protection. It has been developed through the activities of the Working Group on Occupational Radiation Protection in Interventional Cardiology (WGIC) as part of the Information System on Occupational Exposure in Medicine, Industry and Research (ISEMIR) project.

» What is ISEMIR-IC? 

ISEMIR is Information System on Occupational Exposure in Medicine, Industry and Research. ISEMIR-IC is a tool for radiation protection optimization in IC facilities. ISEMIR-IC is developed as a web-based tool for data collection and analysis of occupational doses for individuals in IC, and for the use of this information to improve occupational radiation protection. It assists IC facilities in benchmarking their arrangements in radiation protection and safety, and hence in promoting of, implementation of optimization of occupational radiation protection.

The ISEMIR-IC database was developed in stages:

  • Stage 1. Data entry on doses, workload, radiation protection training and radiation protection practice for IC personnel in an IC facility;
  • Stage 2. Statistical analysis, benchmarking and reporting tools, and improved data entry.

Each IC facility needs one person, typically their radiation protection officer, radiation safety officer or medical physicist, to become their registered Facility Coordinator (FC).
The success of the ISEMIR-IC database is dependent on IC facilities registering and contributing their occupational dose and other data for each calendar year.

» What are the objectives of ISEMIR-IC? 

  • to facilitate the implementation of ALARA practices and effective exposure management
  • to provide efficient collection, maintenance of data on occupational exposure and radiation practices
  • to allow IC facilities to benchmark their own facility and individual radiographers’ performances against global or regional data
  • to define follow-up actions to address identified gaps and disseminate lessons learnt.

» How was ISEMIR-IC developed? 

The ISEMIR project was initiated by the IAEA in January 2009 to focus on very specific topical areas where occupational radiation protection for the workers is not trivial, and where there are still pending issues and gaps.

The ISEMIR is coordinated by the IAEA assisted by an Advisory Group with representatives of international organisations such as UNSCEAR, EC, NEA/OECD as well as the five main world regions. The Advisory Group initially identified two specific areas in radiation use, where non-trivial occupational exposures occur, interventional cardiology and industrial radiography.

For each of these two topical areas a working group was set up with experts covering the respective area in a comprehensive way with respect to professions, type of radiation usages, geographical regions and other factors.

» What was the role of the ISEMIR Working Group on Interventional Cardiology? 

ISEMIR Working Group on Interventional Cardiology’s (WGIC) main task was to draw an overview picture of the situation concerning occupational exposures and radiation protection of staff in IC all over the world, to identify both good practices and shortcomings, and hence define actions to be implemented for assisting each of regulatory bodies, medical physicists, medical staff, technicians and nurses, dosimetry service providers and X ray machine suppliers, in improving occupational radiation protection.

As part of its actions, WGIC performed a worldwide survey of occupational radiation protection in IC. Responses were received from 45 chief interventional cardiologists of IC facilities, 201 responses from individual interventional cardiologists, and from 81 regulatory bodies. The data collected were able to demonstrate:

  • a clear need for worldwide improved optimization of occupational radiation protection in IC
  • an ability to compare doses for specific occupational roles and conditions, and to assess the impact of radiation protection actions, and to follow dose trends.

Read more about the survey in IAEA TECDOC 1735.

As a result, WGIC has proposed to the Advisory Group and IAEA to set up an international database to be used by end-users as a tool for optimization of occupational radiation protection.

» Why is ISEMIR-IC focused on interventional cardiology? 

In the last three decades, the use of image guided interventional procedures in cardiology has increased significantly, bringing great benefit to millions of patients around the world. As technology improves, the medical capabilities of these procedures continue to expand, adding further to the armamentarium for diagnosis and treatment of patients with cardiac problems.

All of these procedures require health professionals (including interventional cardiologists, electrophysiologists, nurses and medical radiation technologists) to be present in the room alongside the patient when radiation is being used, which may result in occupational exposure.

While it has been long known that there is significant potential for health professionals in attendance during interventional cardiology to receive non-trivial occupational exposures, reported details have been typically limited to a few specific interventional cardiology facilities and situations. A more global perspective has been lacking, as is the availability of a systematic means for improving occupational radiation protection in interventional cardiology facilities throughout the world.

» How do I benefit from participation in ISEMIR-IC? 

The participation is free of charge and many parts of the data entry are voluntary in order to make it accessible to all interested parties. Each participating IC facility should provide annual information about facility, including the annual number of procedures performed, number of catheterization laboratories, the X ray equipment used, typical patient doses for given procedures, X ray equipment performance data (dose rates), data on the personal dosimetry provider, and individual personnel working in the facility.

As an outcome of the data entry, IC facility can reviewed its assessment of the effectiveness of the optimization of radiation protection. The metric is determined by occupational dose per procedure. The international database supports three broad types of analyses - occupational doses per procedure as a function of personnel and facility attributes; benchmarking; and trends with time.

A registered IC facility user is able to perform statistical analyses of occupational effective dose per procedure, eye dose per procedure and hand dose per procedure, based on combinations (one or more) of the individuals’ personal attributes and facility attributes.
IC facilities are able to benchmark their own facility and individual personnel performances against global or regional data and identify areas for improvement and corrective actions that should lead to an improvement in radiation protection.

» How do I register for using ISEMIR IC? 

  • Register with NUCLEUS 
  • Confirm the email link received after your registration
  • Once your IAEA Nucleus account is activated, return to ISEMIR 
  • Select ISEMIR-IC

If you are already registered with Nucleus, simply sign in using your existing user name and password. For more information, please read the User Guide. 

» How do I know that my data are kept confidential? 

Individuals and facilities are anonymised in the database. IAEA cannot and does not reveal the identity of the relevant facility, and all submitted personal or company data are considered to be confidential and will not be shared.