Prevalence of Cataractous Changes in the Eyes and Chronic Inflammatory Changes in the Hands Among Spine Surgeons.

Abstract

Background: The impact of radiation exposure on cataracts and hand skin cancer in orthopaedic and spine surgeons remains understudied. This study aimed to investigate the prevalence of cataracts and chronic hand inflammation in orthopaedic and spine surgeons and to assess their association with radiation exposure.

Methods: A cross-sectional analysis was conducted on orthopaedic and spine surgeons attending the 38th Annual Meeting of the Neurospinal Society of Japan or the 31st Annual Meeting of the Japanese Society for the Study of Low Back Pain. Cataractous changes were categorized into none, lens micro-opacity, or cataracts and were detailed alongside the prevalence of chronic hand inflammation, which included longitudinal melanonychia and hand eczema. Participants were divided into quartiles according to hand-exposure opportunities in the operating and fluoroscopy rooms in 2022. Prevalence ratios and 95% confidence intervals (CIs) of chronic hand inflammation in the upper quartiles relative to the first quartile were calculated using modified Poisson regression adjusted for potential confounders.

Results: The median work experience of the 162 participants was 23 years, and the median number of hand-exposure opportunities was 70 (interquartile range [IQR], 20 to 123) in the operating room and 20 (IQR, 0 to 60) in the fluoroscopy room. The prevalence of cataracts was 20% (32 participants), and the prevalence of cataractous changes, including lens micro-opacity, was 40% (64 participants). Chronic hand inflammation was present in 62 participants (38%), of whom 52 had longitudinal melanonychia and 23 had hand eczema. The adjusted prevalence ratios of chronic hand inflammation relative to the lowest quartile of hand-exposure opportunities in the operating room were 0.91 (0.50, 1.66) for quartile 2, 0.72 (0.41, 1.25) for quartile 3, and 1.56 (0.97, 2.50) for quartile 4. For fluoroscopy room exposure, the adjusted prevalence ratios were 2.31 (1.16, 4.58) for quartile 2, 2.03 (1.00, 4.09) for quartile 3, and 2.94 (1.51, 5.75) for quartile 4.

Conclusions: This study highlighted substantial cataractous and chronic hand inflammatory changes in spine surgeons, indicating indirect and direct radiation exposure effects. Therefore, radiation safety and protective measures must be emphasized. Comparative studies with other populations and longitudinal observations are required to better understand the effects of radiation on health.

Level of evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.