HRS Press Release

WASHINGTON D.C., August 5, 2026 — The ALARA+ (“As Low And As Light As Reasonably Achievable”) Coalition, comprised of nine leading medical societies, today released a suite of resources to help hospital leadership and decisionmakers implement enhanced radiation and occupational safety guidelines for clinicians and staff working in the fluoroscopy laboratory, often called “cath labs” or “angio suites.”

In response to a growing occupational health crisis, the core principle of ALARA+ is to move beyond reducing harm by building safety into the workplace, equipment, and standards of care for all cath lab team members. The new implementation toolkits translate recently published ALARA+ guidelines into practical steps to protect cath lab team members from both occupational radiation exposure and orthopedic injuries related to protective equipment.

Available at www.ALARA-PLUS.org the four ALARA+ toolkits include:

• A Radiation Safety Foundations Toolkit, providing education on the fundamentals of occupational radiation exposure and orthopedic risk in fluoroscopy laboratories, the evidence base behind the ALARA+ framework, and dosimetry and monitoring best practices for the full cath lab team.
• An ERPD Implementation Toolkit, offering an overview of available enhanced radiation protection device technologies (ERPD), clinical evidence, and practical guidance on evaluation, implementation, and workflow integration.
• An Economic & Business Toolkit, featuring a return-on-investment framework, funding and phased-implementation pathways, and talking points to help hospital administrators and cath lab directors build the financial case for enhanced radiation protection; and
• An Advocacy Toolkit, including model policy language, a summary of the gap between current U.S. occupational dose limits and international standards, and resources members can use to advocate for modernized radiation safety regulations and safer labs within their institutions.

The ALARA+ resources build on the Summit on Radiation and Orthopedic Risks in Fluoroscopic Laboratories and a 2026 a multisociety expert consensus statement. They call on healthcare institutions, manufacturers, regulators, and professional societies to share responsibility for occupational safety in fluoroscopy laboratories; adopt ERPDs; modernize federal and state radiation safety regulations; measure and report radiation safety performance; design safer fluoroscopy laboratories; and expand education, training, and research.

“Clinicians should not have to sacrifice their health, or their careers, to care for their patients,” said Sana M. Al-Khatib, MD, MHS, FHRS, CCDS, President of the Heart Rhythm Society. “The ALARA+ framework reflects a simple but overdue idea: that protecting the people who deliver lifesaving cardiac care is just as important as protecting the patients they treat. We’re proud to join our partner societies in giving hospitals and clinicians the practical tools they need to make cath labs and EP labs safer.”

According to a 2023 SCAI Survey on Occupational Health Hazards in the Cardiac Catheterization Laboratory, nearly 60 percent of respondents reported orthopedic injuries attributable to protective lead, and roughly one in five reported reducing their caseload or taking medical leave due to injury or radiation concerns. Among women respondents, 28 percent reported being discouraged from working in the cath lab because of pregnancy or considering pregnancy—a barrier that deters women from entering fluoroscopy-based specialties at all and deepens shortages in a workforce already too thin to meet growing demand for lifesaving procedures.

The toolkits are endorsed by the Society for Cardiovascular Angiography & Interventions (SCAI), American College of Cardiology (ACC), Alliance for Cardiovascular Professionals (ACVP), American Society of Echocardiography (ASE), Heart Rhythm Society (HRS), Society of Interventional Radiology (SIR), Society of NeuroInterventional Surgery (SNIS), Society of Vascular and Interventional Neurology (SVIN), and the Society for Vascular Surgery (SVS).

About the Heart Rhythm Society

The Heart Rhythm Society (HRS) is a 501(c)(3) international nonprofit organization and the preeminent leader in science, education, and advocacy for cardiac arrhythmia professionals and patients. HRS continues to be the primary information resource on heart rhythm disorders with a mission to improve the care of patients by promoting research, education, and optimal health care policies and standards, and a mission to eliminate death and suffering due to heart rhythm disorders. Incorporated in 1979 and based in Washington, D.C., it has a membership of more than 9,700 heart rhythm professionals in more than 100+ countries around the world. For more information, visit www.HRSonline.org.