Radiation Exposure to Women Radiation Oncologists During Pregnancy: Results of a North American Survey

Jacqui Tan, MD
OncoLink Assistant Editor
Last Modified: November 3, 1999

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Presenter: Rachel Rabinovitch
Affiliation: University of Colorado Health Sciences Center

Background:
Although safeguards exist to limit radiation exposure during pregnancy, female radiation oncologists remain at risk of occupational exposure. The incidence, cause, and outcomes of this are not well defined.

Materials and Methods:

  • 293 of 865 female ASTRO members (95% physicians) in the United States and Canada responded to a survey about their pregnancy history, radiation exposure during pregnancy, and fetal outcomes.
Results:
  • 182 women carried 383 pregnancies during their training and post-graduate employment.
  • 21% of respondents reported radiation exposures in 25% of pregnancies.
  • Incidents occurred from 1967 to 1998; 53% occurred after January, 1990. 43% occurred during residency or fellowship training.
  • 98% of events involved low dose rate brachytherapy.
  • In only 1 event did the reported dose exceed NRCP-recommended limits.
  • In 45% of incidents involving residents or fellows, women reported pressure to perform as a trainee as a contributing factor. 36% of women did not realize they were pregnant at the time. Other factors cited were "acceptable dose", inadequate radiation safety education or supervision, own carelessness, and lack of staff coverage.
  • Pregnancy outcomes did not significantly vary from expected rates of spontaneous abortion, congenital abnormality, or stillbirth. Eight pregnancies were electively terminated, which did represent a significant increase (0.0029). To date, none of the children exposed in utero have developed a pediatric malignancy.
Clinical/Scientific Implications:
  • Although occupational radiation exposure during pregnancy did not correlate with an increased rate of spontaneous abortion, congenital anomaly, or stillbirth, it certainly might have impacted a woman's decision to electively terminate their pregnancy.
  • The responsibility to avoid these exposures should be shared by departments, in ensuring a safe work environment, and female physicians, in more careful monitoring of when they might be in the earliest weeks of pregnancy.

ASTRO coverage is sponsored, in part, by Varian Medical Systems, Inc.


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