Radiation Safety Knowledge and Practices Among Urology Residents and Fellows: Results of a Nationwide Survey

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Reliance upon fluoroscopy within urology is increasing, with urologists key in determining radiation exposure to patients, themselves, and other healthcare personnel. However, education in occupational radiation safety is nonstandardized, often lacking. Consequently, residents and practicing urologists risk overexposure. We assessed occupational radiation safety attitudes and practices of training urologists. A confidential, anonymous, internet-based survey on workplace radiation safety practices was distributed to residents and fellows via program directors identified from the American College of Graduate Medical Education and the American Osteopathic Association. Items explored included sources of education on occupational radiation exposure, knowledge of occupational dose limits, exposure frequency, and protective item utilization. Investigators were blinded to responses. Overall, 165 trainees responded, almost all of whom reported at least weekly workplace radiation exposure. Compliance with body and thyroid shields was high at 99% and 73%, respectively. Almost no one used lead-lined glasses and gloves; three-quarters cited lack of availability. The principle of keeping radiation doses As Low As Reasonably Achievable (ALARA) was widely practiced (88%). However, 70% of respondents never used dosimeters, while 56% never had one issued. Only 53% felt adequately trained in radiation safety; this number was 30% among those pregnant during training. Fewer than half (46%) correctly identified the maximum acceptable annual physician exposure. Departmental education in radiation safety improved knowledge, protective practices, monitoring, and satisfaction with education in radiation exposure. Our findings show that protective equipment usage and occupational radiation monitoring for the training urologist are insufficient. Despite frequent exposure, resident education in radiation safety was found lacking. Efforts should be made to address these deficiencies on a local and national level.