Radiation Protection Practices Research Articles

Comparative Analysis of Multiple Comparison Tests for Radiation Exposure Subgroups Among Dental Workers At Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria

Post-hoc analysis is a crucial statistical technique employed to identify specific group differences following a significant ANOVA result. This study delves into the comparative analysis of three commonly used post-hoc tests - Tukey's HSD, LSD, and Scheffe's method - to determine significant differences in radiation exposure levels among dental workers at Usman Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Dental professionals are routinely exposed to ionizing radiation, primarily from X-ray machines. Excessive exposure can lead to various health risks, including cancer. Hence, accurate assessment and comparison of radiation exposure levels among different categories of dental workers are essential for effective radiation protection measures. In this study, the researchers calculated the critical values for each post-hoc test at a significance level of 0.05. The results indicated that the LSD method had the smallest critical value (0.674), followed by Tukey's HSD (1.304) and Scheffe's method (1.566). A lower critical value generally implies a higher sensitivity in detecting significant differences between groups. By conducting pairwise comparisons, the study found that the LSD method was the most effective in identifying statistically significant differences in radiation exposure levels among the dental workers. This suggests that the LSD method is a suitable choice for post-hoc analysis in this specific context. The findings of this study have significant implications for radiation protection practices in dental settings. By employing appropriate post-hoc analysis methods, healthcare institutions can accurately assess radiation exposure risks and implement targeted interventions to minimize exposure and protect the health of dental workers.

Development and validation of a questionnaire on radiation protection knowledge, attitudes, and practices among Moroccan dentists.

This study aimed to develop and evaluate the validity and reliability of dentists' radiation protection knowledge, attitudes, and practices (DRP-KAPs) questionnaire. This study was conducted using a stepwise approach. In the first step, items were generated to determine the relevant content and domains after a thorough literature review. In the second step, the content validity of the questionnaire was assessed by seven experts using face and content validity. The content validity index for relevance and clarity (I-CVI, S-CVI/Av, and S-CVI/UA) and the content validity ratio (CVR) were performed. Then, the questionnaire was pre-tested with 10 dentists for face validation. In the third step, reliability was assessed using internal consistency (Kuder-Richardson-20 (KR-20) and Cronbach's alpha) and test-retest (Kappa and intraclass correlation coefficient [ICC]) methods by filling out the questionnaire by 100 dentists practicing in the Rabat-Salé-Kénitra region, in Morocco. The finalized DRP-KAPs questionnaire contains 41 items covering knowledge, attitudes and practices (KAPs). The I-CVIs, S-CVI/UA and S-CVI/AV and CVR values of the 41 items were ≥0.86 for each item, ≥0.82, ≥0.97, and ≥0.71, respectively. With regard to internal consistency reliability, the KR-20 coefficients for the knowledge and practice domains were 0.70 and 0.68, respectively, and the Cronbach alpha for the attitude domain was 0.73. The DRP-KAPs questionnaire has good reliability with the ICC coefficients for attitude items ranging from 0.57 to 0.95 and Kappa coefficients for knowledge and practice items ranging from 0.64 to 1 and 0.77 to 1, respectively. The developed DRP-KAPs questionnaire was found to be a noteworthy tool for assessing radiation protection among dentists, with acceptable internal consistency, good ICC and Kappa coefficients, and good content validity indices.

Evaluation of radiation protection knowledge and practices among Moroccan operating room nurses

Evaluation of radiation protection knowledge and practices among Moroccan operating room nurses

Knowledge and practices of interventional radiology staff regarding radiation protection

Interventional radiology (IR) has become a widespread medical imaging technique, offering minimally invasive treatment options. However, IR procedures can expose patients and staff to substantial radiation risks, necessitating enhanced radiation protection practices. This study aimed to survey the knowledge and practices of interventional radiology staff regarding radiation protection. A cross-sectional study with a descriptive aim, based on a questionnaire was done. The study subjects were all healthcare personnel of all specialties having practiced in interventional radiology between 2019 and 2022 at the University Hospital Center of Rabat. The statistical processing was carried out using Microsoft Excel 2013® and the IBM SPSS Statistical program version 20 (IBM Inc. NY, USA). The results indicated that 59.4% of participants had not received any specific training in radiation protection, and 45% were unaware of the radiation-induced risks associated with interventional radiology procedures. Regarding safety practices, 75% of participants maintained a distance of at least 1 meter from the x-ray source, while only 6% used the lowest possible exposure settings. Concerning the use of radiation protection devices, 87.5% of participants wore a lead apron, 75% used a thyroid shield, 6.3% wore lead glasses, and 37.5% utilized suspended mobile screens, whereas 12.5% did not use any radiation protection devices. Additionally, 84% of participants wore their personal dosimeter, though not consistently. The knowledge and practices of most interventional radiology personnel are inadequate for effective radiation protection. Regular, ongoing training in radiation safety is essential to improve adherence to protection standards and enhance overall safety in clinical practice.

Theory of optimising radiation protection among diagnostic radiographers depicted as a model.

When radiation protection practices are suboptimal, it becomes necessary to take additional steps to optimise practices. Therefore, this study aimed to develop a model to facilitate radiation protection among diagnostic radiographers. The study was conducted in South Africa. A theory-generating design consisting of three steps was used to develop the model: (1) the central concept was identified, defined and classified; (2) relationship statements were created and (3) the model was developed, described and evaluated. The model was premised on the central concept of facilitating a transformative radiation protection environment and occurs in four phases: (1) relationship, (2) working, (3) termination and (4) independent phases. The radiography manager and radiographer enter the relationship phase of the model because of discord regarding radiation protection in their department and work together to optimise radiation protection. The model's purpose, assumptions, context, structure and process are described. A model to facilitate radiation protection among radiographers was conceptualised to optimise radiation protection. The model details the steps the radiography manager and radiographer take to co-create optimal radiation protection practices. Radiation protection compliance among radiographers is paramount to ethical radiography practice, and the model provides a guide to optimise radiation protection. In any radiography department where radiation protection may be lacking, the model provides a road map of possibilities for change. Ultimately, radiation protection compliance improves patient care and outcomes.

The influence of revised ordinance on radiation protection management in Japanese hospitals: device deployment and involvement of radiology technologists.

This study evaluates the impact of the 2021 revision of Japan's Ordinance on the Prevention of Ionizing Radiation Hazards on radiation protection practices, focusing on the deployment of radiation protection devices and the involvement of radiology technologists in Japanese hospitals. A two-phase web-based questionnaire survey was conducted among hospitals registered as training facilities with the Japanese Radiological Society. The survey included 53 questions covering facility information, radiation worker management, training, and working environment. The use of lens-specific dosimeters significantly increased post-revision (p = 0.005). Protective eyewear availability showed minor improvements, particularly in angiographic rooms (p = 0.019). The involvement of radiology technologists remained high in angiographic rooms but showed no significant changes in endoscopy and fluoroscopy rooms. Larger hospitals exhibited better compliance with protective measures, though gaps in resource allocation persisted. The ordinance revision led to significant improvements in dosimeter usage but only minor changes in protective eyewear deployment and technologist involvement.

A practitioners view on the ICRP review of the system of radiological protection - feedback from SRP 2023 workshop.

In 2018 the International Commission on Radiological Protection (ICRP) initiated a review and revision of the System of Radiological Protection which will lay the foundation for Radiation Protection standards, regulations, guidance and practice worldwide for the next 40 years. On the 25th April 2023 the Society for Radiological Protection ran a workshop at their Annual Conference presenting the current status and progress in the ICRP Review and Revision, along with inviting a number of panellist's across different areas of the profession and wider audience to share their thoughts. The outputs of the workshop are summarised in this paper showing the views from a variety of practitioners working across the radiation protection sectors on the key factors to be considered in the review.

Awareness, Knowledge, Attitude and Practice of Radiation Hazards and Radiation Protection among the Undergraduate Dental Students in C.S.M.S.S Dental College and Hospital, Chh. Sambhajinagar- A Questionnaire Based Cross-sectional Study

Awareness, Knowledge, Attitude and Practice of Radiation Hazards and Radiation Protection among the Undergraduate Dental Students in C.S.M.S.S Dental College and Hospital, Chh. Sambhajinagar- A Questionnaire Based Cross-sectional Study

Perspectives of the role of ICRP and the system of protection in meeting the United Nations sustainable development goals

Established in 2015 the United Nations (UN) sustainable development goals (SDGs) were agreed with the aim to balance the need to address social and ethical obligations such as ending poverty and other deprivations, while tackling climate change and the other planetary boundaries. In 2018 the International Commission on Radiological Protection (ICRP) initiated a review and revision of the System of Radiological Protection which will lay the foundation for Radiation Protection standards, regulations, guidance and practice worldwide for the next 40 years. Recognising the importance of the UN SDG's the ICRP has started to consider what the role of the revised system of protection should be in enabling delivery. On the 15 May 2024 the Society for Radiological Protection and World Nuclear Association ran a workshop exploring the intersection of the System of Radiological Protection and the SDG's. The outputs of the workshop are summarised in this paper showing the views from a variety of practitioners working across the radiation protection sectors on the key factors to be considered in the revision of the system of radiological protection to enable delivery of the UN SDG's.

Knowledge of occupational hazards and practice of occupational safety among diagnostic radiographers in university of port Harcourt teaching hospital, rivers state

Health workers particularly radiographers have continuously faced with various occupational hazards due to the occupational environment that is associated with unsafe working conditions and lack of protective equipment. This study aimed to explore knowledge of occupational hazards and practice of occupational safety among diagnostic radiographers in university of Port Harcourt teaching hospital, Rivers state. The study adopted descriptive cross-sectional study, a questionnaire was the instrument used to collect data from 226 radiographers. Data was analyzed using SPSS version 25.0. Results shows good knowledge occupational hazards (72.8%); and good practice of occupational safety (68.5%). Regarding safety practices, radiographers exhibited moderate radiation protection practices (71.2%), with most portraying good practices. No significant gender or age differences were found in practices. Experience did not affect practices significantly. Radiographers with specialized training displayed better practices. The study concluded that radiographers had appreciably high knowledge and moderate safety practices. The study recommended continuing education programs, monitoring of practices, adequate protective facilities, and enhanced curriculum on radiation safety are required to address knowledge and practice gaps among radiographers in Nigeria.

Radiation Protection Knowledge, Attitudes, and Practices Among Fluoroscopy-Utilizing Doctors at Misurata Medical Centre, Libya.

Radiation Protection Knowledge, Attitudes, and Practices Among Fluoroscopy-Utilizing Doctors at Misurata Medical Centre, Libya.

Knowledge and Practice of Diagnostic Reference Levels, Radiation Protection, and Safety among Dental Professionals and Dental Undergraduate Students in the United Arab Emirates: A Multicentric Study

Abstract Background: Dental radiographic examinations deliver low doses of radiation with low biological risks; however, low doses can lead to a cumulative risk. Diagnostic reference levels (DRLs) indicate typical practice in a country or region. Surveys to establish DRLs can help acquire dose information, and less attention to DRLs can have consequences for the patient and dental workers. This study aims to determine the knowledge and practice of DRLs, radiation protection, and safety among dental professionals and dental undergraduate students in the United Arab Emirates. Methods: A cross-sectional survey was distributed among dental students, general dental practitioners, dental faculty, and radiographers from dental universities in the United Arab Emirates. This study assessed the knowledge and practice of radiation safety of 221 participants. Results: Among the surveyed respondents, 58 (26.2%) had a good level of knowledge, 94 (42.50%) had an average level, and 69 (31.2%) had a poor level. 30.3% of the respondents were aware of the DRLs in dental radiography. Only 10 survivors were able to accurately mention the national DRL for intraoral adult radiography. The level of knowledge is significantly associated with age (P < 0.0001), year of experience (P < 0.0001), and professional development courses (P = 0.024). Almost half had an average level of practice, 30.8% a good level and 22.6% a low level. The level of practice is influenced by age (P = 0.001), qualification (P = 0.034), and experience (P = 0.022). Conclusions: Knowledge of DRLs, radiation protection, and safety is adequate among the sample surveyed. However, translation of this knowledge into practice is lacking, which warrants the need for further training and enhancement of dental health-care workers.

Radiographers’ attitudes toward the principles of patient radiation protection in the Souss Massa region of Morocco

Introduction: Radiographers play a vital role in patient radiation protection. Their training, supervision, and involvement in radiation protection programmes require greater attention from all stakeholders. Methods: This cross-sectional study was conducted between March and August 2023 to assess Radiographers’ attitudes toward the principles of patient radiation protection in the Souss Massa region of Morocco. An anonymous questionnaire containing 22 questions was sent to 80 radiographers practicing in the Sous Massa region. Results: 67.5% of the radiographers confirmed that they did not use a guide to radiological procedures. 85% of them confirmed that they had checked for the possibility of pregnancy each time a woman of childbearing age was involved in a conventional X-ray, compared with 97.5% who checked for the possibility of pregnancy in a CT scan. 97.5 % of our participants said that they automatically (without medical advice) repeated the X-ray examination if the image was not interpretable. 90% of radiographers said that they did not report parameters for dose estimation for each conventional X-ray examination, and 72.5% did not report data for dose estimation for CT-scan examinations. The results showed no association between gender and professional experience on the one hand and radiographers’ practices on the other. Nevertheless, there is an association between the workplace and certain radiographers’ practices, indicating the lack of a regional strategy aimed at standardizing procedures and radiation protection practices at the level of all radiology departments. Conclusion: It is vital to launch a patient dose management program in the Souss Massa region and campaigns to raise radiographers’ awareness of recommended patient radiation protection practices.

A multicentre survey of knowledge and implementation of radiation protection techniques in cardiac cath-lab medical personnel

BackgroundAwareness of radiation hazards and methods to reduce radiation dose is a sine qua non for all staff working in the cath-lab for their own safety and their patient’s safety.ResultsThere were large variations in the implementation of radiation protection techniques with overall inadequate radiation risk knowledge. Some members of the cath-lab team are at higher risk of radiation-induced side effects, including the fellows, nurses, technicians, and anaesthesiologists because they spent longer time in the cath-lab and/or their position in relation to the source of radiation. About 10% of the participants have reported different health problems potentially induced by radiation exposure.ConclusionsThere is lack of radiation risks knowledge with inadequate radiation protection practice among cath-lab team. Some members such as fellows, nurse, technicians, and cardiac anaesthesiologist are at higher risks. They represent the forgotten members of the Cath-Lab team.

3192: Evaluation of radiation protection knowledge and practices among radiotherapy professionals

3192: Evaluation of radiation protection knowledge and practices among radiotherapy professionals

Science-informed Policy Making for Protecting People and the Environment from Radiation.

The process to arrive at the radiation protection practices of today to protect workers, patients, and the public, including sensitive populations, has been a long and deliberative one. This paper presents an overview of the US Environmental Protection Agency's (US EPA) responsibility in protecting human health and the environment from unnecessary exposure to radiation. The origins of this responsibility can be traced back to early efforts, a century ago, to protect workers from x rays and radium. The system of radiation protection we employ today is robust and informed by the latest scientific consensus. It has helped reduce or eliminate unnecessary exposures to workers, patients, and the public while enabling the safe and beneficial uses of radiation and radioactive material in diverse areas such as energy, medicine, research, and space exploration. Periodic reviews and analyses of research on health effects of radiation by scientific bodies such as the National Academy of Sciences, National Council on Radiation Protection and Measurements, United Nations Scientific Committee on the Effects of Atomic Radiation, and the International Commission on Radiological Protection continue to inform radiation protection practices while new scientific information is gathered. As a public health agency, US EPA is keenly interested in research findings that can better elucidate the effects of exposure to low doses and low dose rates of radiation as applicable to protection of diverse populations from various sources of exposure. Professional organizations such as the Health Physics Society can provide radiation protection practitioners with continuing education programs on the state of the science and describe the key underpinnings of the system of radiological protection. Such efforts will help equip and prepare radiation protection professionals to more effectively communicate radiation health information with their stakeholders.

Radiation protection knowledge and practices among Moroccan dentists: A cross-sectional study

ObjectiveTo analyze the current status of knowledge and practices among the Moroccan dentists in the region of Rabat-Salé-Kenitra, towards radiation protection. MethodsThis is a cross-sectional study based on a questionnaire related to knowledge and practice regarding radiation protection of patients and dental staff from April to June 2022. The study sample included 325 dentists practicing in the Rabat-Salé-Kénitra region. The target population consisted of all dentists working in public, semi-public and private workplaces. Results96.6% of dentists were aware of radiation protection. However, nearly 35% were aware of ALARA (as low as reasonably achievable) principle and 73.9% thought that dental X-rays are harmful. 63.6%of subjects used digital image receptor. Only 16.7% of them used a film holder and more than 60% didn't follow the position and distance rule. The median knowledge score was 7 [5, 9], and there was a statistically significant difference according to dentist qualification (P ​= ​0.007), dental radiation protection continuous training (P ​< ​0.0001), age (P = ​0.007) and years of experience (P ​= ​0.039). The median practice score was 5 [4, 6] and there was a statically significance association according to workplace setting (P ​= ​0.001). There was a significant positive relationship between knowledge score and practice score (r ​= ​0.24, P<0.0001). Dentist qualification (OR 0.51, 95%CI: 0.27–0.94, P ​= ​0.03) and continuous training (OR 2.40, 95%CI: 1.47–3.93, P<0.0001) were significant predictors of knowledge, while workplace setting (OR 0.54, 95%CI: 0.32–0.93, P ​= ​0.027) and knowledge score (OR 1.24, 95%CI: 1.12–1.38, P<0.0001) were predictors of practices. ConclusionImproving dentists' knowledge of radiation protection measures and tools as well as dose reduction techniques could increase their safe practices in dental radiology.

Differing radiation exposure in scrub technicians and rotating staff in Cardiac catheterization laboratory: occupation matters

BackgroundRadiation exposure is a significant hazard associated with invasive Cardiology, with most studies based on primary operator exposure. This prospective, observational study aimed to find out over lead radiation exposure as effective dose acquired by non-physician staff comprising scrub technicians and rotating staff in the cath laboratory. Effective dose (ED) measured per procedure via Raysafe i2®dosimeter badges worn by both rotating staff and scrub technicians over lead aprons along with dose area product (DAP), fluoroscopy time (FT) and procedure time (PT) in minutes was collected prospectively over forty-six invasive Cardiology procedures.ResultsThis study shows that rotating staff acquire higher ED in comparison with their scrub technician colleagues in diagnostic, interventional and electrophysiology cases. However, a statistically significant difference in radiation exposure of both staff groups was demonstrated in diagnostic and interventional Cardiology procedures, with p values of 0.04 and 0.01, respectively.ConclusionsThese findings highlight occupational role and mobility around fluoroscopic sources as major factors in radiation exposure, which should be addressed within current radiation protection practices.

Establishment of local diagnostic reference levels for CT colonography at a tertiary hospital.

Diagnostic reference levels (DRLs) are an important metric in identifying abnormally high radiation doses in diagnostic examinations. National DRLs for CT colonography do not currently exist in South Africa, but there are efforts to collect data for a national DRL project. This study investigated radiation doses for CT colonography in adult patients at a large tertiary hospital in South Africa with the aim of setting local DRLs. Patient data from two CT scanners (Philips Ingenuity and Siemens Somatom go.Top) in the period March 2020 - March 2023 were obtained from the hospital's picture archiving and communication system (PACS) (n = 115). Analysis involved determining the median computed tomography dose index-volume (CTDIvol) and dose-length product (DLP) values. The findings were compared with DRLs established internationally. Ingenuity median CTDIvol was 20 mGy and DLP was 2169 mGy*cm; Somatom median CTDIvol was 6 mGy and DLP was 557 mGy*cm. Ingenuity exceeded the United Kingdom's (UK) recommended DRLs by 82% and 214%, respectively. Somatom median CTDIvol and DLP were 45% and 19% lower than UK NDRLs. Somatom's tin filter and other dose reduction features provided significant dose reduction. These data were used to set DRLs for CT colonography at the hospital; CTDIvol: 6 mGy and DLP: 557 mGy*cm. In addition to informing radiation protection practices at the level of the institution, the established local DRLs contribute towards implementing regional and national DRLs.

Evaluation of radiological capacity and usage in paediatric TB diagnosis: A mixed-method protocol of a comparative study in Mozambique, South Africa and Spain.

Tuberculosis remains one of the top ten causes of mortality globally. Children accounted for 12% of all TB cases and 18% of all TB deaths in 2022. Paediatric TB is difficult to diagnose with conventional laboratory tests, and chest radiographs remain crucial. However, in low-and middle-income countries with high TB burden, the capacity for radiological diagnosis of paediatric TB is rarely documented and data on the associated radiation exposure limited. A multicentre, mixed-methods study is proposed in three countries, Mozambique, South Africa and Spain. At the national level, official registry databases will be utilised to retrospectively compile an inventory of licensed imaging resources (mainly X-ray and Computed Tomography (CT) scan equipment) for the year 2021. At the selected health facility level, three descriptive cross-sectional standardised surveys will be conducted to assess radiology capacity, radiological imaging diagnostic use for paediatric TB diagnosis, and radiation protection optimization: a site survey, a clinician-targeted survey, and a radiology staff-targeted survey, respectively. At the patient level, potential dose optimisation will be assessed for children under 16 years of age who were diagnosed and treated for TB in selected sites in each country. For this component, a retrospective analysis of dosimetry will be performed on TB and radiology data routinely collected at the respective sites. National inventory data will be presented as the number of units per million people by modality, region and country. Descriptive analyses will be conducted on survey data, including the demographic, clinical and programmatic characteristics of children treated for TB who had imaging examinations (chest X-ray (CXR) and/or CT scan). Dose exposure analysis will be performed by children's age, gender and disease spectrum. As far as we know, this is the first multicentre and multi-national study to compare radiological capacity, radiation protection optimization and practices between high and low TB burden settings in the context of childhood TB management. The planned comparative analyses will inform policy-makers of existing radiological capacity and deficiencies, allowing better resource prioritisation. It will inform clinicians and radiologists on best practices and means to optimise the use of radiological technology in paediatric TB management.