<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2183-8453</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Saúde Ocupacional online]]></journal-title>
<abbrev-journal-title><![CDATA[RPSO]]></abbrev-journal-title>
<issn>2183-8453</issn>
<publisher>
<publisher-name><![CDATA[Ajeogene Serviços Médicos Lda]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2183-84532025000100712</article-id>
<article-id pub-id-type="doi">10.31252/rpso.01.05.2025</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[CATARATA SUBCAPSULAR POSTERIOR EM ANESTESIOLOGISTA COM EXPOSIÇÃO OCUPACIONAL A RADIAÇÃO IONIZANTE]]></article-title>
<article-title xml:lang="en"><![CDATA[POSTERIOR SUBCAPSULAR CATARACT IN AN ANESTHESIOLOGIST WITH OCCUPATIONAL EXPOSURE TO IONIZING RADIATION]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Duarte]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mendanha]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pina]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
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</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
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</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Miranda]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidade do Porto Instituto de Ciências Biomédicas Abel Salazar ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Unidade Local de Saúde de Saúde de Matosinhos  ]]></institution>
<addr-line><![CDATA[Póvoa de Varzim ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,Unidade Local de Saúde de Saúde de Matosinhos  ]]></institution>
<addr-line><![CDATA[Matosinhos ]]></addr-line>
</aff>
<aff id="Af4">
<institution><![CDATA[,Unidade Local de Saúde de Matosinhos. Assistente Hospitalar de Medicina do Trabalho ]]></institution>
<addr-line><![CDATA[Leça da Palmeira ]]></addr-line>
</aff>
<aff id="Af5">
<institution><![CDATA[,Unidade Local de Saúde de Santo António  ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>01</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>01</month>
<year>2025</year>
</pub-date>
<volume>19</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2183-84532025000100712&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2183-84532025000100712&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2183-84532025000100712&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  Introdução A radiação ionizante desempenha um papel indispensável na prática médica moderna, sendo amplamente utilizada, mas pode causar dois tipos principais de efeitos sobre a saúde humana: determinísticos e estocásticos. Estes resultam de danos extensivos em células e tecidos, alterações aleatórias no ácido desoxirribonucleico celular, podendo resultar em mutações genéticas. A catarata rádica tem sido classificada como um efeito determinístico, caraterizado pela opacificação progressiva do cristalino do olho. O cristalino é uma estrutura avascular, composta por células epiteliais altamente organizadas que não possuem capacidade de regeneração. A formação da catarata induzida pela radiação ionizante depende de fatores como a dose total acumulada, o padrão de exposição e a sensibilidade individual. O tempo de latência entre a exposição e o surgimento clínico da catarata varia entre cinco e quinze anos, dependendo da dose e da frequência da exposição.  Descrição do caso clínico Trata-se de um caso de um médico especialista em anestesiologia, sexo masculino, 48 anos. Apresentava, no exame periódico de medicina do trabalho, queixas de visão turva e dificuldade em ambientes com pouca luz, com um ano de evolução; alteração da visão do olho direito, com "imagens onduladas com duração entre 5 e 15 minutos". Trabalhava desde há 23 anos com exposição a radiação ionizante. Referia não ter, nem nunca ter utilizado, óculos plumbíferos. A avaliação por oftalmologia revelou opacidades subcapsulares posteriores no olho direito, com diminuição da acuidade visual desse lado, apenas &#8220;conta dedos&#8221;. Foi submetido a cirurgia de facoemulsificação com implante de lente intraocular e apresentou melhoria significativa na acuidade visual do olho direito. Foi participada a catarata como Doença Profissional e solicitada nova avaliação de riscos do posto de trabalho, tendo sido proposta a aquisição de óculos plumbíferos e a implementação de dosimetria do cristalino. Recomendou-se ministrar (in)formação a todos os trabalhadores.  Discussão/conclusão A catarata induzida pela radiação ionizante representa um risco ocupacional significativo e amplamente reconhecido entre profissionais de saúde expostos. Este efeito resulta da exposição cumulativa no cristalino, mesmo em doses inferiores aos limites anteriormente estabelecidos. A adesão ao uso de Equipamentos de Proteção Individual, especialmente no que respeita aos óculos plumbíferos, permanece inconsistente entre os profissionais de saúde, sendo o risco de desenvolver catarata até três vezes superior entre os trabalhadores expostos. Além dos dispositivos físicos, a implementação de práticas operacionais otimizadas desempenha um papel crítico na redução da dose ocupacional. Um programa de vigilância adequado da saúde dos trabalhadores expostos a radiação ionizante, com identificação precoce de danos ao cristalino, e a sua orientação, permite reduzir o absentismo, melhorar a capacidade de trabalho e a qualidade de vida dos trabalhadores.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction Ionizing radiation plays an indispensable role in modern medical practice and is widely used, but it can cause two main types of effects on human health: deterministic and stochastic. They result from extensive damage to cells and tissues, random changes in cellular deoxyribonucleic acid, and can result in genetic mutations. Radiation-induced cataract has been classified as a deterministic effect, characterized by the progressive opacification of the lens of the eye. The lens is an avascular structure composed of highly organized epithelial cells that have no capacity for regeneration. The formation of cataract induced by ionizing radiation depends on factors such as the total accumulated dose, the exposure pattern and individual sensitivity. The latency between exposure and the clinical appearance of cataract varies between five and fifteen years, depending on the dose and frequency of exposure.  Description of the clinical case A 48-year-old male specialist in anesthesiology. During his periodic occupational health examination, he complained of blurred vision and difficulty in low-light environments, which had been present for one year; vision impairment in his right eye, with "wavy images lasting between 5 and 15 minutes". He had been working for 23 years and was exposed to ionizing radiation. He reported not having, and never having used, lead glasses. An ophthalmology evaluation revealed posterior subcapsular opacities in his right eye, with decreased visual acuity on this side, only "counting fingers". He underwent phacoemulsification surgery with intraocular lens implantation and showed significant improvement in the visual acuity of his right eye. The cataract was reported as an Occupational Disease and a new risk assessment of the workplace was requested. The purchase of lead glasses and the implementation of lens dosimetry were proposed. It was recommended that training be provided to all workers.  Discussion/Conclusion Cataract induced by ionizing radiation represents a significant and widely recognized occupational risk among exposed healthcare professionals. This effect results from cumulative exposure to the lens, even at doses below previously established limits. Adherence to the use of Personal Protective Equipment, especially regarding lead glasses, remains inconsistent among healthcare professionals. The risk of developing cataract has been found to be up to three times higher among exposed workers. In addition to physical devices, the implementation of optimized operational practices plays a critical role in reducing occupational dose. A proper health surveillance program for workers exposed to ionizing radiation, with early identification of lens damage and its management, allows to reduce absenteeism, improve work capacity and quality of life of workers.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Radiação ionizante]]></kwd>
<kwd lng="pt"><![CDATA[Catara rádica]]></kwd>
<kwd lng="pt"><![CDATA[Medicina do Trabalho]]></kwd>
<kwd lng="pt"><![CDATA[Segurança no Trabalho]]></kwd>
<kwd lng="pt"><![CDATA[Proteção radiológica.]]></kwd>
<kwd lng="en"><![CDATA[Ionizing radiation]]></kwd>
<kwd lng="en"><![CDATA[Radiation cataract]]></kwd>
<kwd lng="en"><![CDATA[Occupational medicine]]></kwd>
<kwd lng="en"><![CDATA[Safety at work]]></kwd>
<kwd lng="en"><![CDATA[Radiological protection.]]></kwd>
</kwd-group>
</article-meta>
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