Impact of post-licensure radiation safety training on catheterization laboratory radiation practices among interventional cardiologists in India: a nationwide survey

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Background Occupational radiation exposure remains a persistent and underestimated hazard in cardiac catheterization laboratories. This study evaluated the impact of post-licensure radiation safety training on adherence to radiation safety practices among interventional cardiologists. Methods A nationwide cross-sectional survey was conducted between May 2022 and August 2023 among 753 interventional cardiologists. Radiation safety knowledge and practice were assessed across five domains - dose awareness, time, distance, shielding, and collimation - and combined into a composite Radiation Safety Score (RSS; Maximum 100). Demographic and practice-related variables were analysed, and multivariable log-linear regression was used to identify independent predictors of higher RSS. A study-specific, novel Radiation Safety Score (RSS) was developed to assess adherence to radiation safety practices and as such, it was not externally validated or tested for reliability among other cohorts. Results Of the 753 respondents, 716 met the inclusion criteria. The median age was 44 years [IQR 37–52], and the mean catheterization laboratory experience was 11 ± 8.7 years. Two-thirds (66%) had attended at least one post-licensure radiation safety training program. The mean RSS was 56.5 ± 21.7, and only 16.3% achieved scores ≥ 75. Trained participants demonstrated significantly higher performance across all five radiation safety domains ( p < 0.001 for each). In multivariable analysis, post-licensure radiation safety training independently predicted higher RSS ( β = 0.216, p = 0.005), corresponding to a 24.1% higher adjusted score. Experience >10 years was also associated with superior RSS ( β = 0.267, p < 0.001). Conclusion Radiation safety practices among interventional cardiologists in India remain suboptimal. Participation in post-licensure radiation safety training is independently associated with better adherence across all major safety domains. Incorporating structured radiation safety training into cardiology conferences may help strengthen radiation safety culture and enhance long-term occupational protection.

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