Occupational hazards associated with fluoroscopy-guided settings continue to be prevalent and have unique impacts on women, trainees, and supporting staff.

Current reliance on traditional, nonergonomic radiation protection contributes to significant musculoskeletal injuries, harming individual careers and straining health systems, while barriers remain to adopting improved protective technologies.

At the 2025 Society for Cardiovascular Angiography & Interventions Scientific Sessions in Washington, DC, a multidisciplinary Think Tank brought together professional societies, advocacy groups, and industry partners to address these issues.

Discussions focused on the dual hazards of ionizing radiation and orthopedic injury, and the document outlines actionable steps to advance wider adoption of enhanced radiation protection and imaging technologies to achieve ALARA+ (as low and as light as reasonably achievable).

All authors: Arash Salavitabar, MD, FSCAI; Amit N. Vora, MD, MPH, FSCAI; Dorothea Altschul, MD; J. Fritz Angle, MD; Chelsea Ballinger, RT(R); Andrew Bojanowski, PA-C; Anna E. Bortnick, MD, PhD, MSc, FSCAI; Kyle Bugg, MBA, RT(R); Emily Carpenter, MSN-Ed, RN, CV-BC; Robert E. Foster, MD, FSCAI; Joanna Ghobrial, MD, MS; Matthew Glogoza, MD; Atul Gupta, MD; James B. Hermiller, MD, MSCAI; A. Kyle Jones, PhD; Summer L. Kaplan, MD, MS; Steven J. Kraus, MD; Omar Khalique, MD, FSCAI; Andrea Klein, MD; Nick Morse, MBA; Preethi Ramchand, MD; David G. Rizik, MD, MSCAI; Lucy M. Safi, DO, FSCAI; Cheryl C. Schultz, MS; Kamala P. Tamirisa, MD; R. Jay Widmer, MD, PhD, FSCAI; Kristi Wilson, RT(R) CV; Jonathan X. Fang, MBBS, FSCAI; Arnold H. Seto, MD, MPA, FSCAI, Summit Co-Chair; and Robert F. Riley, MD, MS, FSCAI, Summit Chair.