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Radiography (London, England : 1995) May 2022Radiation protection is multifarious, and consequently, a radiographers' application of radiation protection is multifaceted. Studies have shown varying radiation...
INTRODUCTION
Radiation protection is multifarious, and consequently, a radiographers' application of radiation protection is multifaceted. Studies have shown varying radiation protection practices among radiographers. The first quantitative phase of this explanatory, sequential mixed-method study used the theory of planned behaviour to explore South African radiographers' radiation protection behaviour. Overall, South African radiographers' attitudes to radiation protection, subjective norm, perceived behavioural control, and radiation protection intention was high. This second phase of the study aimed to explore the reasons for South African radiographers' radiation protection practices.
METHODS
This study used an exploratory and descriptive qualitative approach. Data was collected through 13 in-depth semi-structured telephone interviews. Thematic analysis was used in order to uncover original phenomena. Data saturation was achieved and the study adhered to trustworthiness and ethical measures.
RESULTS
Thematic analysis identified two themes. The participants had the appropriate radiation protection knowledge, but radiation protection compliance remained a personal choice. Impediments such as feeling rushed during imaging of trauma and challenging patients, patients knowledge of radiation protection, resources, imaging referrals, inadequate training when transitioning from analogue to digital radiography and managerial support contributed to radiation protection compliance. Strategies such as further education, research and a change in mindset were suggested to further foster radiation protection compliance.
CONCLUSION
Even though participants' knowledge of radiation protection aligned with the legislated guidelines, limited internalising of the knowledge resulted in compliance being a personal choice. Participants reflected on their insouciant attitude and observed a similar attitude in their radiographer colleagues. Patient and work-related impediments were identified to contribute to radiation protection compliance. Strategies to further foster compliance were suggested.
IMPLICATIONS FOR PRACTICE
Understanding the reasons for radiographers' choice in radiation protection will allow the development of strategies that foster optimum application of radiation protection practises. Developing a radiation protection culture that enhances personal compliance supported by education and evidence should be considered.
Topics: Allied Health Personnel; Humans; Qualitative Research; Radiation Protection; Radiographic Image Enhancement; South Africa
PubMed: 34991938
DOI: 10.1016/j.radi.2021.12.008 -
International Journal of Environmental... Jun 2021This study aimed to examine factors affecting radiation protection behaviors among emergency room nurses by assessing knowledge about radiation protection and attitude...
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 -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, < 0.001), knowledge about radiation protection and radiation protection behaviors (r = 0.37, < 0.001), and attitude towards radiation protection and radiation protection behaviors (r = 0.33, < 0.001). The factors affecting radiation protection behaviors were radiation protection knowledge (β = 0.12, = 0.045), attitude towards radiation protection (β = 0.17, = 0.009), the experience of radiation protection education (β = 0.27, < 0.001), and wearing of protective equipment (β = 0.29, < 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.
Topics: Attitude of Health Personnel; Cross-Sectional Studies; Emergency Service, Hospital; Health Knowledge, Attitudes, Practice; Humans; Nurses; Nursing Staff, Hospital; Radiation Protection; Surveys and Questionnaires
PubMed: 34207672
DOI: 10.3390/ijerph18126238 -
Dento Maxillo Facial Radiology Sep 2021This review aimed to present studies that prospectively investigated biological effects in patients following diagnostic dentomaxillofacial radiology (DMFR). (Review)
Review
OBJECTIVES
This review aimed to present studies that prospectively investigated biological effects in patients following diagnostic dentomaxillofacial radiology (DMFR).
METHODS
Literature was systematically searched to retrieve all studies assessing radiobiological effects of using X-ray imaging in the dentomaxillofacial area, with reference to radiobiological outcomes for other imaging modalities and fields.
RESULTS
There is a lot of variability in the reported radiobiological assessment methods and radiation dose measures, making comparisons of radiobiological studies challenging. Most radiological DMFR studies are focusing on genotoxicity and cytotoxicity, data for 2D dentomaxillofacial radiographs, albeit with some methodological weakness biasing the results. For CBCT, available evidence is limited and few studies include comparative data on both adults and children.
CONCLUSIONS
In the future, one will have to strive towards patient-specific measures by considering age, gender and other individual radiation sensitivity-related factors. Ultimately, future radioprotection strategies should build further on the concept of personalized medicine, with patient-specific optimization of the imaging protocol, based on radiobiological variables.
Topics: Adult; Bias; Child; Humans; Radiation Protection; Radiology
PubMed: 33989056
DOI: 10.1259/dmfr.20210153 -
European Journal of Nuclear Medicine... May 2024In the rapidly evolving field of nuclear medicine, the paramount importance of radiation protection, safety, and quality systems cannot be overstated. This document... (Review)
Review
BACKGROUND
In the rapidly evolving field of nuclear medicine, the paramount importance of radiation protection, safety, and quality systems cannot be overstated. This document provides a comprehensive analysis of the intricate regulatory frameworks and guidelines, meticulously crafted and updated by national and international regulatory bodies to ensure the utmost safety and efficiency in the practice of nuclear medicine.
METHODS
We explore the dynamic nature of these regulations, emphasizing their adaptability in accommodating technological advancements and the integration of nuclear medicine with other medical and scientific disciplines.
RESULTS
Audits, both internal and external, are spotlighted for their pivotal role in assessing and ensuring compliance with established standards, promoting a culture of continuous improvement and excellence. We delve into the significant contributions of entities like the International Atomic Energy Agency (IAEA) and relevant professional societies in offering universally applicable guidelines that amalgamate the latest in scientific research, ethical considerations, and practical applicability.
CONCLUSIONS
The document underscores the essence of international collaborations in pooling expertise, resources, and insights, fostering a global community of practice where knowledge and innovations are shared. Readers will gain an in-depth understanding of the practical applications, challenges, and opportunities presented by these regulatory frameworks and audit processes. The ultimate goal is to inspire and inform ongoing efforts to enhance safety, quality, and effectiveness in nuclear medicine globally.
Topics: Nuclear Medicine; Radiation Protection; Humans; Quality Control; Safety
PubMed: 38319322
DOI: 10.1007/s00259-024-06633-w -
Health Physics Mar 2023Worldwide, radiographers' radiation protection practices vary. In South Africa, evidence of diagnostic radiographers' suboptimal radiation protection practices has been...
Worldwide, radiographers' radiation protection practices vary. In South Africa, evidence of diagnostic radiographers' suboptimal radiation protection practices has been reported, but the reasons for these practices and suggestions to improve practices were lacking. Therefore, this study explored radiation protection among South African diagnostic radiographers. This study used an explanatory, sequential, mixed-method approach. Data were collected in three phases. Phase I, the quantitative phase, used an online questionnaire and respondents from Phase I interested in participating in Phase II, the qualitative phase, were interviewed, yielding 13 in-depth semi-structured telephone interviews. In Phase III, eight radiography managers co-constructed change strategies to optimize radiation protection in South Africa in two focus group interviews. Radiation protection was suboptimal despite diagnostic radiographers having a good attitude, subjective norm and perceived behavioral control toward radiation protection and optimal radiation protection knowledge. Varying attitudes to radiation protection, lack of resources, and support from radiography management and healthcare teams contributed to suboptimal radiation protection practices. Radiography managers suggested increasing radiation protection awareness, ameliorating the diminished stature of the radiographer in the healthcare team, and increasing the availability of optimal quality resources. South African diagnostic radiographers' radiation protection knowledge was optimal, but the implementation of radiation protection varied and was influenced by multiple factors. A radiation protection culture supported by management is advocated to optimize radiation protection. However, ultimately radiation protection practices are incumbent on the individual radiographers' choice to practice radiation protection.
Topics: South Africa; Radiation Protection; Radiography; Attitude of Health Personnel; Surveys and Questionnaires
PubMed: 36719936
DOI: 10.1097/HP.0000000000001655 -
Physica Medica : PM : An International... Mar 2023To evaluate the effectiveness of currently available radioprotective (RP) devices in reducing the dose to interventional cardiology staff, especially to the eye lens and...
PURPOSE
To evaluate the effectiveness of currently available radioprotective (RP) devices in reducing the dose to interventional cardiology staff, especially to the eye lens and brain.
METHODS
The performances of five RP devices (masks, caps, patient drapes, staff lead and lead-free aprons and Zero-Gravity (ZG) suspended radiation protection system) were assessed by means of Monte Carlo (MC) simulations. A geometry representative of an interventional cardiology setup was modelled and several configurations, including beam projections and staff distance from the source, were investigated. In addition, measurements on phantoms were performed for masks and drapes.
RESULTS
An average dose reduction of 65% and 25% to the eyes and the brain respectively was obtained for the masks by MC simulations but a strong influence of the design was observed. The cap effectiveness for the brain ranges on average between 13% and 37%. Nevertheless, it was shown that only some upper parts of the brain were protected. There was no significant difference between the effectiveness of lead and lead-free aprons. Of all the devices, the ZG system offered the highest protection to the brain and eye lens and a protection level comparable to the apron for the organs normally covered.
CONCLUSION
All investigated devices showed potential for dose reduction to specific organs. However, for masks, caps and drapes, it strongly depends on the design, exposure conditions and staff position. Therefore, for a clinical use, it is recommended to evaluate their effectiveness in the planned conditions of use.
Topics: Humans; Radiation Protection; Radiometry; Radiation Dosage; Radiation Exposure; Cardiology; Occupational Exposure; Radiology, Interventional; Lens, Crystalline
PubMed: 36780792
DOI: 10.1016/j.ejmp.2023.102543 -
Health Physics Feb 2023177 Lu therapy as part of theranostic treatment for cancer is expanding but it can be a challenge for sites with limited radiation protection staff to implement the...
IMPORTANCE
177 Lu therapy as part of theranostic treatment for cancer is expanding but it can be a challenge for sites with limited radiation protection staff to implement the radiation safety program required for therapeutic nuclear medicine.
OBJECTIVE
To increase the adoption of 177 Lu therapy, especially in smaller centers and clinics, by providing a collection of radiation safety best practices and operational experience. To provide a resource for radiation safety officers supporting the implementation of a 177 Lu therapy program.
METHODS
A panel of 11 radiation safety professionals representing sites across Canada and the United States with experience delivering 177 Lu therapy was assembled and discussed their responses to a list of questions focused on the following radiation safety topics: facility layout and design; radiation safety program; and drug management and patient care.
RESULTS
A comprehensive set of best practice guidelines for clinical radiation safety during 177 Lu therapy has been developed based on the collective operational experience of a group of radiation safety professionals. Significant findings included that 177 Lu therapy is often safely administered in unshielded rooms, that staff radiation exposure associated with 177 Lu therapy is minimal relative to other nuclear medicine programs, and that some relatively simple preparation in advance including papering of common surfaces and planning for incontinence can effectively control contamination during therapy.
CONCLUSION
The guidance contained in this paper will assist radiation safety professionals in the implementation of safe, effective 177 Lu therapy programs, even at smaller sites with limited to no experience in therapeutic nuclear medicine.
Topics: Humans; Radioisotopes; Radiation Protection; Lutetium; Nuclear Medicine
PubMed: 36508552
DOI: 10.1097/HP.0000000000001644 -
PloS One 2022Multiple studies show orthopedic health problems for medical staff due to wearing radiation protection aprons. The aim of this study was to evaluate the weight pressure...
OBJECTIVES
Multiple studies show orthopedic health problems for medical staff due to wearing radiation protection aprons. The aim of this study was to evaluate the weight pressure on the shoulder as a marker of physical strain caused by different radiation-protection devices.
METHODS
For the weight pressure measurement, a pressure sensor (OMD-30-SE-100N, OptoForce, Budapest, Hungary) placed on the left and right shoulder was used. Wearing different radiation protection systems the force measurement system was used to quantify the weight pressure. Measurements were acquired in still standing position and during various movements.
RESULTS
A mean significant decreasing weight pressure on the shoulder between 74% and 84% (p<0.001) was measured, when the free-hanging radiation protection system was used in comparison to one-piece and two-piece radiation protection aprons and coats. Using two-piece radiation protection aprons, the weight pressure was significantly lower than that of one-piece radiation protection coats. If a belt was used for the one-piece radiation protection coat, the weight pressure on the shoulder was reduced by 32.5% (p = 0.003). For a two-piece radiation protection apron and a one-piece radiation protection coat (with and without belt) a significant different weight pressure distribution between the right and left shoulder could be measured.
CONCLUSIONS
The free-hanging radiation protection system showed a significant lower weight pressure in comparison to the other radiation protection devices. Apart from this, use of a two-piece radiation protection apron or addition of a belt to a radiation protection coat proved to be further effective options to reduce weight pressure.
Topics: Humans; Hungary; Medical Staff; Occupational Exposure; Protective Clothing; Radiation Dosage; Radiation Protection; Radiology, Interventional
PubMed: 35862403
DOI: 10.1371/journal.pone.0271664 -
Physica Medica : PM : An International... Jun 2020This work investigates the patient eye lens dose and x-ray scatter to the operator expected for a proposed hybrid Angio-MR concept. Two geometries were simulated for...
This work investigates the patient eye lens dose and x-ray scatter to the operator expected for a proposed hybrid Angio-MR concept. Two geometries were simulated for comparative assessment: a standard C-arm device for neuro-angiography applications and an innovative hybrid Angio-MR system concept, proposed by Siemens Healthineers. The latter concept is based on an over-couch x-ray tube and a detector inside an MRI system, with the aim of allowing combined, simultaneous MRI and x-ray imaging for procedures such as neurovascular interventions (including x-ray fluoroscopy and angiography imaging, 3D imaging, diffusion, and perfusion). To calculate the scattered radiation dose to the physician, Monte Carlo simulations were performed. Dose estimates of simplified models of the brain and eyes of both the patient and the physician and of the physician's torso and legs have been calculated. A number of parameters were varied in the simulation including x-ray spectrum, field of view (FOV), x-ray tube angulation, presence of shielding material and position of the physician. Additionally, 3D dose distributions were calculated in the vertical and horizontal planes in both setups. The patient eye lens dose was also calculated using a detailed voxel phantom and measured by means of thermoluminescent dosimeters (TLDs) to obtain a more accurate estimate. Assuming the same number of x-rays and the same size of the irradiated area on the patient's head, the results show a significant decrease in the scattered radiation to the physician for the Angio-MR system, while large increases, depending on setup, are expected to patient eye lens dose.
Topics: Angiography; Health Personnel; Humans; Lens, Crystalline; Magnetic Resonance Imaging; Occupational Exposure; Radiation Protection
PubMed: 32473413
DOI: 10.1016/j.ejmp.2020.04.028 -
Journal of Korean Medical Science Feb 2016International Commission on Radiological Protection (ICRP), an independent international organization established in 1925, develops, maintains, and elaborates... (Review)
Review
International Commission on Radiological Protection (ICRP), an independent international organization established in 1925, develops, maintains, and elaborates radiological protection standards, legislation, and guidelines. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) provides scientific evidence. World Health Organization (WHO) and International Atomic Energy Agency (IAEA) utilise the ICRP recommendations to implement radiation protection in practice. Finally, radiation protection agencies in each country adopt the policies, and adapt them to each situation. In Korea, Nuclear Safety and Security Commission is the governmental body for nuclear safety regulation and Korea Institute of Nuclear Safety is a public organization for technical support and R&D in nuclear safety and radiation protection.
Topics: History, 20th Century; Humans; International Agencies; Radiation Injuries; Radiation Protection; Radiation, Ionizing
PubMed: 26908987
DOI: 10.3346/jkms.2016.31.S1.S4