Education In Radiation Protection Research Articles

A82 A SURVEY-BASED ASSESSMENT OF RADIATION PROTECTION ATTITUDES AND PRACTICES IN ADVANCED THERAPEUTIC ENDOSCOPY TRAINING CURRICULUMS

Abstract Background Fluoroscopy-assisted endoscopic procedures such as endoscopic retrograde cholangiopancreatography (ERCP) expose patients and physicians to the risks of ionizing radiation, including infertility, cataracts, skin hypersensitivity, hair loss and cancer. Radiation exposure from these procedures can have lasting adverse effects on the health and productivity of gastroenterologists. With attention to “as low as reasonably achievable” (ALARA) principles, recent efforts to minimize radiation use have emphasized the importance of formal radiation protection education, including during advanced therapeutic endoscopy (ATE) training. However, teaching of basic protective measures in radiation safety during ATE training remains often overlooked. Aims We aimed to learn how radiation safety training is delivered in ATE programs across Canada and the US. Identifying the existing training standards and knowledge will help us understand the current gaps in training curriculums and inform future curricular development. Methods Our study was reviewed by the Ottawa Health Science Network Research Ethics Board in September 2023. Surveys were designed and distributed with the REDCap software and sent to ATE trainees (current and recent graduates within the last 3 years) in Canada and Program Directors (PDs) of accredited ATE programs across Canada and the US. Results The survey was completed by 12 trainees and 4 PDs. These are preliminary results and further survey responses are being collected. The majority of trainees (75%) believed it would be very important for their program’s curriculum to include dedicated radiation safety teaching, but most trainees (83.3%) received no such training. Familiarity in optimizing modifiable fluoroscopy parameters to minimize radiation exposure (collimation, gain, magnification, frame rate modification or pulsed fluoroscopy) was variable among trainees (36.4%-81.8%). Seventy-five percent of trainees were unaware of the annual limit for radiation exposure and only 25% believed they were operating within a safe level. Most trainees (90.9%) felt they were given inadequate training to optimally reduce their risk of radiation exposure and 90.9% expressed a desire for further radiation safety training. Despite these findings, only 50% of PDs believed it would be beneficial to offer dedicated radiation safety training as part of their program’s curriculum. Among PDs, 75% did not feel their trainees had the knowledge required to reduce their risk of radiation exposure and all (100%) felt that dedicated training would be useful. Conclusions These findings indicate a need for more robust radiation safety training. Further studies are needed to understand the most effective way to deliver comprehensive radiation safety training to ATE trainees. Funding Agencies None

Current status of occupational radiation exposure and protection among medical interns and residents

Background: While individuals exposed to radiation in hospitals are typically registered as radiation workers, with regulated exposure levels, many interns and residents who are not registered as radiation workers are occupationally exposed to radiation. This study aimed to assess the current status and awareness of radiation exposure and related protective practices among interns and residents.Methods: An online survey was conducted nationwide from June 3 to June 16, 2023, engaging 262 interns and 799 residents. Descriptive analyses were conducted to summarize the status of occupational radiation exposure and radiation protection practices.Results: Approximately 6% of interns and 18% of residents reported receiving personal dosimeters, and 6% and 20%, respectively, were registered as radiation workers. In contrast, compliance with personal radiation protection equipment, such as lead aprons and thyroid shields, exceeded 85% during tasks involving radiation exposure. On average, interns spent 7 months (standard deviation [SD], 2.1) and residents 8.1 months (SD, 4.8) in main departments with potential radiation exposure. While overall safety performance showed improvement, the provision of personal dosimeters and radiation worker registration remained low (14.7%, 16.6%).Conclusion: Despite improvements in radiation protection education and the provision of personal protective equipment, the registration rate for radiation workers among interns and residents remains low. Ensuring these medical professionals are registered and managed as radiation workers is crucial for prioritizing their safety and well-being.

Questionnaire Survey of Radiation Protection Education in Hospitals

The present study aimed to investigate the current situation of radiation protection education for designated radiation workers in hospitals. A web-based questionnaire survey was conducted at 1,883 hospitals nationwide with 200 or more beds. Responses from 186 hospitals were included in the analysis. Seven hospitals (6.7%) regulated by the Act on the Regulation of Radioisotopes and six hospitals (7.4%) regulated by only the Ordinance on Prevention of Ionizing Radiation Hazards did not implement radiation protection education. In approximately 6% of the hospitals, designated radiation workers-including physicians, nurses, and radiological technologist-did not attend the education program. The education program attendance rate of physicians was lower than that of nurses. In more than 90% of the hospitals, the frequency of the periodical education program was once every year and lecture time spanned one or less than one hour. The topics of lecture in more than 90% of the hospitals were health effects of radiation and methods of radiation protection for occupational exposure. The radiological technologist was the instructor of the education program in approximately 70% of the hospitals. The implementation of radiation protection for designated radiation workers varied from hospital to hospital, and some hospitals did not comply with laws and regulations. Effective and efficient radiation protection education models should be implemented in hospitals.

TENORM radiation protection patterns for the sustainable health of workers

Background: Coal production in Indonesia continues to increase to meet national energy needs and export demand. Solid waste from the coal combustion process is estimated to increase significantly. One of the hazardous mining wastes is TENORM, but some TENORM is classified as production goods with economic value. The problem in this research is that the volume of waste containing TENORM is quite large, and the disposal, use, and recycling of TENORM has the potential to cause contamination for workers at the steam power plant and the surrounding environment. Objective: The purpose of this research is to obtain a design model for the protection of the environment and workers against TENORM radioactive waste from coal ash through an analysis of the social and economic perceptions of steam power plant workers regarding TENORM radiation and the effectiveness of TENORM radiation protection education to workers. Methods: A mixed method with a quantitative approach was applied. Data were gathered through field observation utilizing a questionnaire instrument that asked workers working at Steam Power Plant Units 1 – 7 a series of written questions. Results: Prior to Counseling, most Suralaya Steam Power Plant workers had shallow social and economic perceptions of TENORM radiation, with 88 percent unaware of its effects. The majority also paid between 100,000 and 500,000 IDR monthly in medical expenses. All respondents agreed that TENORM radiation safety counseling for Suralaya Steam Power Plant workers was utterly compelling, with acceptance of TENORM and WTP estimates following Counseling being the most important aspect. Conclusion: There was a significant relationship between the WTP variable after Counseling and the variables acceptance of TENORM protection (0.730), TENORM knowledge (0.627) before and after Counseling (after Counseling), and acceptance of TENORM protection (0.648), according to the pattern of protection for the SEM model.

The Effectiveness of Radiation Protection in Medical Field- A Short Review

The growing of X-ray imaging around the world has implication towards radiation protection of medical field. Higher usage in radiation commonly have been seen as a simple workload issue without future challenges. Unfortunately, due to improvement in technology and techniques, it caused the amount of X-ray procedures increase which requiring medical professionals in order to ensure patient who exposed to radiation has maintain their close physical contact. As many processes are complex, risk of severe occupational exposure become higher, thus necessary steps should be considered. It is important to ensure the lower effects of exposure are achievable. If the dosage limit for the lens of the eye is lowered in the near future, additional attention to eye protection may be required. There are many essential elements needed in ensuring medical field especially for X-ray imaging to be more proper and reasonably secured for example education and training in radiation protection.

Education and training in radiation protection in Europe: results from the EURAMED Rocc-n-Roll project survey

PurposeTo analyse the existing radiation protection (RP) education and training (E&T) capabilities in the European Union and identify associated needs, problems and challenges.MethodAn online survey was disseminated via the EURAMED Rocc-n-Roll consortium network and prominent medical societies in the field of radiological research. The survey sections analyse the RP E&T during undergraduate, residency/internship and continuous professional development; RP E&T problems and legal implementation. Differences were analysed by European geographic regions, profession, years of professional experience and main area of practice/research.ResultsThe majority of the 550 respondents indicated that RP topics are part of undergraduate curricula in all courses for their profession and country (55%); however, hands-on practical training is not included according to 30% of the respondents. The lack of E&T, practical aspects in current E&T, and mandatory continuing E&T were considered the major problems. The legal requirement that obtained higher implementation score was the inclusion of the practical aspects of medical radiological procedures on education (86%), and lower score was obtained for the inclusion of RP E&T on medical and dental school curriculums (61%).ConclusionsA heterogeneity in RP E&T during undergraduate, residency/internship and continuous professional development is evident across Europe. Differences were noted per area of practice/research, profession, and European geographic region. A large variation in RP E&T problem rating was also obtained.

A follow‐up questionnaire survey 2022 on radiation protection among 464 medical staff from 34 endoscopy–fluoroscopy departments in Japan

We surveyed and reported low protective equipment usage and insufficient knowledge among endoscopy-fluoroscopy departments in Japan in 2020. Two years later, we conducted a follow-up survey of doctors, nurses, and technologists in Japan. We conducted a questionnaire survey on radiation protection from May to June 2022. The participants were medical staff, including doctors, nurses, and radiological and endoscopy technicians in endoscopy-fluoroscopy departments. The questionnaire included 17 multiple-choice questions divided into three parts: background, equipment, and knowledge. We surveyed 464 subjects from 34 institutions. There were 267 doctors (58%), 153 nurses (33%), and 44 technologists (9%). The rate of wearing a lead apron was 98% in this study. The rates of wearing a thyroid collar, lead glasses, and radiation dosimeter were 27%, 35%, and 74%, respectively. The trend of the protective equipment rate was similar to that of our previous study; however, radiation dosimetry among doctors was still low at 58%. The percentage of subjects who knew the radiation exposure (REX) dose of each procedure was low at 18%. Seventy-six percent of the subjects attended lectures on radiation protection, and 73% knew about the three principles of radiation protection; however, the concept of diagnostic reference levels was not well known (18%). Approximately 60% of the subjects knew about the exposure dose increasing cancer mortality (63%) and the 5-year lens REX limit (56%). There was some improvement in radiation protection equipment or education, but relatively little compared to the 2020 survey of endoscopy departments.

Assessment of the awareness of radiation protection and related concepts among nursing staff mainly working in diagnostic imaging units, cath-labs and operation theatres in Sri Lanka: A survey-based study

IntroductionThis study was carried out to evaluate the awareness of radiation protection, radiation types, medical imaging equipment and radiation effects among nurses for the first time in Sri Lanka. Since nurses are involved as direct caregivers in diagnostic and therapeutic radiography and radiation treatment procedures, they need to have a good understanding of the areas mentioned above. MethodsA self-administered questionnaire was used to collect data from 391 nurses working in hospitals, clinics, and other healthcare settings. Forwarded questions gathered the participants' demographic details and assessed their awareness of radiation protection, medical imaging equipment, radiation type and radiation effects. The average score per awareness area for each demographic characteristic was calculated based on the responses. Additionally, the percentage of participants who scored above 50 and 75 was calculated for each awareness area. ResultsThe majority were female participants (81.1%) and possessed a diploma in nursing (66.0%) with 10.8 years of average work experience. 92.3%, 74.7%, 69.8% and 22.3% of the participants scored more than 50 marks for the questions related to radiation protection, medical imaging equipment, radiation type and radiation effects, respectively. The level of nursing education and prior training in radiation protection significantly influenced all awareness areas, whereas participants with a graduate qualification in nursing and with prior radiation protection training scored the highest average marks. ConclusionBased on the scores obtained, the Sri Lankan nurses have satisfactory awareness of the essential concepts related to radiation types, medical imaging equipment and radiation protection. However, there is a significant lacking of awareness of radiation effects. This can be attributed to the fact that most participants did not have any formal training in radiation protection. The results implicate that proper training in radiation protection can significantly influence awareness of radiation protection and related concepts. Therefore, it is a timely requirement to initiate short awareness programs and continuing education programs on radiation protection for nurses working in specialised radiation units. Implications for practiceThe study suggests the necessity of initiating continuous education programs for nursing staff radiation protection to overcome the awareness gaps.

Education and training in radiation protection in Europe: an analysis from the EURAMED rocc-n-roll project

BackgroundA Strengths, weaknesses, opportunities and threats analysis was performed to understand the status quo of education and training in radiation protection (RP) and to develop a coordinated European approach to RP training needs based on stakeholder consensus and existing activities in the field. Fourteen team members represented six European professional societies, one European voluntary organisation, two international healthcare organisations and five professions, namely: Medical Physicists; Nuclear Medicine Physicians; Radiologists; Radiation Oncologists and Radiographers. Four subgroups analysed the “Strengths”, “Weaknesses”, “Opportunities” and “Threats” related to E&T in RP developed under previous European Union (EU) programmes and on the Guidelines on Radiation Protection Education and Training of Medical Professionals in the EU.ResultsConsensus agreement identified four themes for strengths and opportunities, namely: (1) existing structures and training recommendations; (2) RP training needs assessment and education & training (E&T) model(s) development; (3) E&T dissemination, harmonisation, and accreditation; (4) financial supports. Weaknesses and Threats analysis identified two themes: (1) awareness and prioritisation at a national/global level and (2) awareness and prioritisation by healthcare professional groups and researchers.ConclusionsA lack of effective implementation of RP principles in daily practice was identified. EuRnR strategic planning needs to consider processes at European, national and local levels. Success is dependent upon efficient governance structures and expert leadership. Financial support is required to allow the stakeholder professional agencies to have sufficient resources to achieve a pan European radiation protection training network which is sustainable and accredited across multiple national domains.

Dental Undergraduates and Interns' Awareness, Attitudes, and Perception of Radiological Protection.

Medical ionizing radiation is widely used in hospitals, in particular dental clinics, and in medical research to facilitate the diagnosis and treatment of patients. The awareness, attitude, and perception of ionizing radiation exposure among dental undergraduate students and interns in radiological investigations and dental care clinics were investigated. A cross-sectional study was conducted; 17 questions were designed online using the software “QuestionPro,” which was licensed to the University of Imam Abdulrahman Bin Faisal. Participants included senior medical dental students from Imam Abdulrahman Bin Faisal University in their third to fifth years, as well as interns from King Fahad University Hospital and private dental care clinics. A total of 855 participants viewed, 360 started the questionnaire, and 258 (72%) completed it online. Overall, knowledge was lacking; 32% of respondents incorrectly believed that magnetic resonance imaging and ultrasound used ionizing radiation, while 38% were unsure. Dental X-rays were deemed harmful by 40% (n = 104) of respondents. According to 33% (n = 85) of participants, there is no radiation scatter during an X-ray or CT scan, while 30% (n = 76) are unsure. Respondents (44%; n = 104) were unaware of the radiation dose from a chest radiograph and (45%; n = 116) overestimated the radiation dose. The effects of ionizing radiation on healthy tissue are known to more than half of the participants (54%). According to 39% of respondents, digital radiography exposes them to less radiation than traditional radiography. In terms of radiation protection and hazard, 46% said personal monitoring badges should be always worn and 58% (n = 150) said lead aprons should be used on a regular basis. 63% of the subjects had received radiation protection education, such as formal lectures, tutorials, or workshops, while 37% (n = 95) had not. 53% of the respondents were not aware of the international recommendations from the International Commission on Radiological Protection. When asked if they would follow radiation protection protocols if they opened a private dental clinical practice in the future, 50% (n = 129) said they would.

Strengthening radiation protection education and training of health professionals: conclusions from an IAEA meeting

In March 2021 the International Atomic Energy Agency (IAEA) organised an online Technical Meeting on Developing Effective Methods for Radiation Protection Education and Training of Health Professionals with attendance of 230 participants representing 66 Member States and 24 international organizations, professional bodies and safety alliances. By means of a pre-meeting survey, presentations by experts, topical panel discussions and post-meeting feedback to the meeting summary, the meeting identified strengths, common weaknesses and possible solutions and actions for improving radiation protection education and training of health professionals. Available guidelines and resources for radiation protection training were also reviewed. The meeting discussion resulted in a strong consensus for the need of: (a) international guidance on education and training in radiation protection and safety for health professionals, (b) an international description of minimum standards of initial and ongoing competence and qualification in radiation protection for relevant professional groups, considering the available recommendations at international and regional levels. The proposed actions include provisions for train-the-trainer credentialing and facility training accreditation, balance betwee the online and face-to-face training, improved on-the job training, as well as improved inclusion in training programmes of aspects related to application of new technologies, ethical aspects, development of communication skills, and use of software tools for improving justification and optimisation. The need for making the ongoing training practical, applicable, and useful to the trainee was highlighted. The international consultation initiated by the IAEA was appreciated as a good approach to understand and promote coordination and collaboration at all levels, for best results in education and training in radiation protection of health professionals. Implementing such a holistic approach to education and training in radiation protection would contribute towards qualification and competence of health professionals needed to ensure application of high standards for quality and safety in medical uses of ionizing radiation.

Visualization of Scattered Radiation Distribution Using Virtual Reality Technology and Its Application to Radiation Protection Education

Visualization of Scattered Radiation Distribution Using Virtual Reality Technology and Its Application to Radiation Protection Education

Simulator training to minimize ionizing radiation exposure in the catheterization laboratory

Patients and operators are routinely exposed to high doses of ionizing radiation during catheterization procedures. This increased exposure to ionizing radiation is partially due to a lack of awareness to the effects of ionizing radiation, and lack of knowledge on the distribution and behaviour of scattered radiation. Our study aimed to evaluate the effectiveness of mentored simulation training (ST) in ionizing radiation protection during coronary angiography and to assess the transferability of acquired skills from virtual reality to the real world. Ten cardiology residents performed 5 consecutive real-life coronary angiographies in the catheterization laboratory before and after ST. Skill metrics measures concerned global procedure skill score and radiation procedure score. During virtual ST, fluoroscopic time ( P < 0.01) significantly decreased and global radioprotection score (3 ± 2.1 vs. 7 ± 3.9, P < 0.01) significantly improved. In real-life cases, procedure time was shorter ( P < 0.01), contrast amount lower ( P < 0.04) and the global procedure skill score were higher ( P = 0.001) after ST as compared to the control (before ST) group. Moreover, fluoroscopic time (5.4 ± 3.6 vs. 3.6 ± 2.7 min, P < 0.04), dose area product (2600 ± 25,000 vs. 1715 ± 2552 μGy.m 2 , P < 0.02) and air Kerma product (159 ± 219 vs. 116 ± 194 mGy, P = 0.05) were significantly lower after ST. In total, radioprotection score (2 ± 1.9 vs. 4 ± 1.9, P < 0.01) also improved after ST. In conclusion, simulator-based training in coronary angiography improved operator skills compared to traditional in catheterization laboratory mentor-based training including education in radiation protection. As a result of simulator training, the operator gains knowledge, which can then be applied in the catheterization laboratory in order to reduce radiation doses to the patient and to the operator.

OL83 - Custom-made education in radiation protection for health care workers

OL83 - Custom-made education in radiation protection for health care workers

Occupational radiation doses among nurses working in several medical departments in Saudi Arabia: a five-year national study

There has been an increase in the numbers of diagnostic and therapeutic procedures, which, in turn, has increased the occupational radiation doses delivered to healthcare practitioners. The aim of this study is to estimate a baseline for the occupational effective doses for five consecutive years (2016–2020) among nurses working in several medical departments in Saudi Arabia. A total of 3249 nurses were monitored from 2016 to 2020. Occupational effective doses were estimated using thermoluminescent dosimeters (TLD-100 chip) made of lithium fluoride (Li natural) LiF:Mg.Ti materials. An analysis of the dosimetry data revealed that the overall mean annual effective dose (MAED), range of the effective doses and the mean collective effective dose for nurses in selected departments during the study period were 0.85 mSv, 0.06–13.07 mSv and 46.51 man-mSv, respectively. The MAEDs for nurses were obtained from various departments, including the operating room (OR; 0.81 mSv), general X-ray (0.90 mSv), cardiac catheterization laboratory (cath-lab; 0.97 mSv), endoscopy (0.79 mSv), computed tomography (CT; 0.77 mSv), fluoroscopy (0.81 mSv), dentistry (0.92 mSv), angiography (0.91 mSv), nuclear medicine (1.01 mSv), urology (0.68 mSv), radiotherapy (0.67 mSv) and mammography (0.77 mSv). The MAED for cath-lab nurses was significantly higher than that for OR, CT and endoscopy nurses. The occupational doses among nurses in Saudi Arabia were below the recommended dose limit of 20 mSv. However, to further reduce the occupational dose, we recommend training and continuing education in radiation protection for nurses involved in radiological procedures.

Radiation protection education using virtual reality for the visualisation of scattered distributions during radiological examinations

When working in radiology and patient assistance in medical facilities, radiation workers need to understand how to properly protect themselves and others from scattered radiation. In this study, a visualisation method is examined to facilitate the understanding of the spread of scattered radiation in radiography, computerised tomography (CT), and angiography rooms, and the application of this system for radiation protection education is proposed. X-ray radiography, x-ray CT, and angiography rooms were constructed using the particle and heavy ion transport code system, and the scattered radiation distributions that occurred when a patient was irradiated with x-rays were simulated. The three-dimensional (3D) distribution of each moment was continuously displayed to create a four-dimensional (4D) distribution. Using the obtained data, a radiation protection education seminar was conducted that included exercises to allow the students to confirm the presence of scattered radiation from any direction. The effectiveness of the scattered radiation visualisation data was evaluated using an interview. The position of the assistant for conducting standing chest radiographs that experienced the least scattered radiation was determined to be at the side and foot side of the patient. As a result of an interview that was provided to the participants following the seminar, the effectiveness of this system for providing education about radiation protection was confirmed. The visualisation method allowed the students to better understand the behaviour of radiation and the sources of scattered radiation. The visualisation of 3D and 4D scattered radiation distributions in radiological examination rooms can intuitively enhance the understanding of the spread of invisible radiation and the appropriate methods of mitigating radiation exposure.

Development of scattered radiation distribution visualization system using WebAR

Radiation protection education is difficult for some radiological workers to taking because they are busy with medical work. In radiation protection, understanding the behaviour of scattered radiation is important for reducing exposure. Although applications that visualize the behaviour of scattered radiation using augmented reality or virtual reality have been developed, such applications are limited by the need to download the application and the performance of the device. We have developed a system that can be used in a web browser to visualize the behaviour of scattered radiation more easily. Monte Carlo method was used to simulate the behaviour of scattered radiation during radiography using a portable X-ray machine. An augmented reality (AR) system was developed using A-Frame, an open-source web framework, and AR.js, which adds the AR function. Finally, the behaviour of scattered radiation was observed using various devices. With AR, the behaviour of scattered radiation was visualized in three dimensions. The newly developed AR system can be used with web browsers to easily learn the behaviour of scattered rays without the need for special devices.

Factors Affecting Radiation Protection Behaviors among Emergency Room Nurses.

This study aimed to examine factors affecting radiation protection behaviors among emergency room nurses by assessing knowledge about radiation protection and attitude towards radiation protection, employing a cross-sectional design. Subjects were a convenience sample of 129 nurses working in the emergency rooms of three advanced general hospitals. Data were collected using self-report questionnaires and analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. There were significant relations between knowledge about radiation protection and attitude towards radiation protection (r = 0.34, p < 0.001), knowledge about radiation protection and radiation protection behaviors (r = 0.37, p < 0.001), and attitude towards radiation protection and radiation protection behaviors (r = 0.33, p < 0.001). The factors affecting radiation protection behaviors were radiation protection knowledge (β = 0.12, p = 0.045), attitude towards radiation protection (β = 0.17, p = 0.009), the experience of radiation protection education (β = 0.27, p < 0.001), and wearing of protective equipment (β = 0.29, p < 0.001). The governments, hospital administrators, and radiation protection agencies should strengthen their radiation defense environment to protect emergency room nurses from radiation. Research and development of radiation defense equipment and the medical examination of emergency room nurses should be carried out, radiation defense behavior protocols should be developed, radiation defense education opportunities should be provided, and the use of defense equipment should be encouraged.

The Importance of Radiation Protection Education and Training for Medical Professionals of All Specialties.

The article is part of the series of articles on radiation protection. You can find further articles in the special section of the CVIR issue. Lately, more advanced techniques have been introduced in medical imaging expanding the diagnostic and therapeutic applications of ionizing radiation. Among the various strategies that have been proposed for the management of radiation exposure, education and training seem to have a strong impact on radiation protection and dose reduction. However, according to several studies, medical professionals appear to lack knowledge on basic radiation protection aspects. Therefore, the establishment of an accreditation and certification system in radiation protection for all medical professionals employing ionizing radiation is considered as high priority. The purpose of this review article is to highlight the importance of education and training in radiation protection, provide recommendations for an effective educational program and propose an educational program structure for the different medical specialties.

A questionnaire survey on radiation protection among 282 medical staff from 26 endoscopy-fluoroscopy departments in Japan.

Background and aimsIt is essential for endoscopists, technologists, and nurses to understand radiation protection. However, protective equipment usage is still low, and there is little awareness of radiation protection in practice.MethodsWe conducted a questionnaire survey on radiation protection from January to February 2020. The participants were medical staff, including medical doctors, nurses, and radiological and endoscopy technician in endoscopy‐fluoroscopy departments. The questionnaire included 14 multiple‐choice questions divided among three parts: background, equipment, and knowledge.ResultsWe surveyed a total of 282 subjects from 26 institutions. There were 168 medical doctors (60%), 90 nurses (32%), and 24 technologists (9%). Although almost all staff members (99%) always wore a lead apron, only a few wore a thyroid collar (32%) and lead glasses (21%). The rate of wearing a radiation dosimeter was insufficient (69%), especially among doctors (52%). A few subjects knew the radiation exposure dose of each procedure (15%), and slightly over half had attended lectures on radiation protection (64%) and knew about the three principles of radiation protection (59%). Protection adherence did not differ by years of experience, knowledge of fluoroscopy, awareness of radiation exposure doses, or attendance at basic lectures on radiation protection. However, medical doctors who were aware of the radiation exposure dose of each procedure were significantly more likely to wear dosimeters than those who were not (p = 0.0008).ConclusionMedical staff in endoscopy departments in Japan do not have enough radiation protection equipment or education.