The OrthoVest is a personal protective device in use at several facilities and is currently undergoing testing in the cardiac electrophysiology (EP) lab at the University of Chicago and in the cardiac catheterization lab at Keele University in the United Kingdom. The device offers an elegant and effective solution for the epidemic of back pain and injury caused by wearing lead aprons.
Wearing a lead apron during interventional and EP procedures can often cause neck pain, back pain, fatigue, and orthopedic disability. However, a new option that is worn under a lead apron is now available. The OrthoVest is a backpack-like apparatus that is worn under a lead apron, transferring the entire weight of the lead apron to the hips in upright and bent over standing positions. The OrthoVest protects the neck, shoulders, and spinal column like an exoskeleton without restricting movement, and can be used by every employee who needs to wear a lead apron to perform their job.
The Scourge of the CV Profession
Lead aprons place considerable pressure on the neck, shoulders, and spinal column. Wearing a lead apron for hours while standing and maintaining awkward positions frequently has detrimental consequences. For decades, literature has demonstrated the alarming prevalence of orthopedic injury, neck pain, back pain, and fatigue among invasive cardiologists. The most recent publications illustrate a causational relationship between these problems and wearing lead aprons.
In 1997, Ross et al found in the American Journal of Cardiology that “Cardiologists reported more neck and back pain, more subsequent time lost from work, and a higher incidence of cervical disc herniations, as well as multiple level disc disease.”1 They write that “Interventionalist’s disc disease is a confirmed entity” and that this is “possibly a consequence of lead apron use.”1
In 2000, Pelz reported in the American Journal of Neuroradiology that “Cardiologists who wore lead aprons had a significantly higher incidence of skeletal complaints and more days missed from work because of back pain than did individuals of the control groups.”2 The author estimates that “Wearing a 15-pound lead apron can place pressures of up to 300 pounds per square inch of intravertebral disks.”2
Additionally, a 2011 publication in the Journal of Cardiovascular Electrophysiology established that the same problems faced by interventional cardiologists are faced by electrophysiologists.3 “There is a significant increased prevalence of cervical spondylosis among interventional electrophysiologists. Programs to improve ergonomics and minimize time spent wearing lead are needed.”3
A March 2015 article in the American Journal of Cardiology establishes that the incidence of musculoskeletal pain is considerably higher among technicians and nurses.4 “Musculoskeletal pain varied significantly by job description, with the highest incidence reported by technicians (62%) and nurses (60%) followed by attending physicians (44%) and trainees (19%; P<0.001).”4
The damage caused by lead apron use extends beyond the healthcare provider as well, because it can reduce the workload of electrophysiologists and force early retirement. This may create access to care challenges and force hospitals to rely on locum providers in the short term and require them to recruit new physicians earlier than they otherwise would.
The OrthoVest Solution
The OrthoVest is a semi-rigid exoskeleton that attaches to a belt. Because it is worn under the lead apron, it transfers all of its weight to the hips, bypassing the spinal column, neck, and shoulders. This may help avoid and halt the damage caused by bearing the weight of a lead apron. The OrthoVest also creates an air gap between the lead apron and the healthcare professional wearing it. This may help reduce sweating, improve respiratory function, and ultimately reduce the fatigue associated with wearing a lead apron. The OrthoVest can be used by every healthcare provider who is required to wear a lead apron for their job.
About the OrthoVest
For additional information about the OrthoVest, please visit MyOrthoVest.com.
1 Ross AM, Segal J, Borenstein D, Jenkins E, Cho S. Prevalence of spinal disc disease among interventional cardiologists. Am J Cardiol. 1997;79:68-70.
2 Pelz D. Low back pain, lead aprons, and the angiographer. AJNR Am J Neuroradiol. 2000;21(7):1364.
3 Birnie D, Healey JS, Krahn AD, et al. Prevalence and risk factors for cervical and lumbar spondylosis in interventional electrophysiologists. J Cardiovasc Electrophysiol. 2011;22(9):957-960.
4 Orme N, Rihal CS, Gulati R, et al. Occupational health hazards of working in the interventional laboratory: a multisite case control study of physicians and allied staff. J Am Coll Cardiol. 2015;65(8):820-826.