Authors

Research Center for Science and Technology in Medicine, Tehran University of Medical Sciences, Tehran, Iran

Abstract

BACKGROUND: Medical radiation workers are potentially at a risk of unwanted ionizing radiation
exposures. This study assessed the radiation protection knowledge, attitude, and practice (RP‑KAP)
of health‑care workers who are occupationally exposed to radiation regarding protecting themselves
from radiation.
MATERIALS AND METHODS: This study was cross‑sectional in design and was carried out in 16
hospitals affiliated to the Tehran University of Medical Sciences between May and September 2014.
Total health‑care workers who were occupationally exposed to radiation comprising 670 individuals
were included in the study based on census sampling method. In total, 413 individuals consented
to complete an anonymous 32‑item questionnaire comprising single best choice questions with a
numerical value assigned to each correct answer. Each set of RP‑KAP questions was scored and
categorized as poor, medium, and good. The effect of independent variables for prediction of RP‑KAP
was explored using linear regression analyses.
RESULTS: A significant number of participants had poor RP‑knowledge (78.9%), RP‑attitude (70.7%),
and RP‑practice (32.4%). Based on linear regression analyses, it was found that field of study (β = 0.1,
P = 0.001), marital status (β = −0.14, P = 0.01), and level of education (β = 0.2, P < 0.001) were the
predictors of higher RP‑knowledge. In‑service RP‑training (β = 0.1, P = 0.04) was associated with
an increased RP‑attitude. Being a woman (β = 0.2, P < 0.001) and longer years of experience with
radiation (β = 0.2, P < 0.001) were significantly related to better practice.
CONCLUSION: In‑service training with appropriate qualified and up‑to‑date materials based on
radiation workers’ educational needs and approved protocols and guidelines is recommended.

Keywords

1. Niu SH. Safe work information note series. Radiation Protection of
Workers. Geneva, Switzerland. International Labour Organization
(ILO); 2011.
2. Herrmann TL, Fauber TL, Gill J, Hoffman C, Orth DK,
Peterson PA, et al. Best practices in digital radiography. Radiol
Technol 2012;84:83‑9.
3. Briggs‑Kamara MA, Okoye PC, Omubo‑Pepple VB. Radiation
safety awareness among patients and radiographers in three
hospitals in Port Harcourt. Am J Sci Ind Res 2013;4:83‑8.
4. Lautin EM, Novick MK, Jean‑Baptiste R. Tailored CT: Primum
non nocere. Br J Radiol 2008;81:442‑3.
5. Stewart F, Akleyev A, Hauer‑Jensen M, Hendry J, Kleiman N,
Macvittie T, et al. ICRP publication 118: ICRP statement on tissue
reactions and early and late effects of radiation in normal tissues
and organs‑threshold doses for tissue reactions in a radiation
protection context. Ann ICRP 2012;41:1‑322.
6. Popanda O, Marquardt JU, Chang‑Claude J, Schmezer P. Genetic
variation in normal tissue toxicity induced by ionizing radiation.
Mutat Res 2009;667:58‑69.
7. The 2007 recommendations of the international commission on
radiological protection: ICRP publication 103. Ann ICRP 2007;
37:1‑332.
8. Little MP. Ionising radiation in the workplace. BMJ 2015;351:h5405.
9. Kruszewski M, Wojewódzka M, Iwanenko T, Collins AR, Szumiel
I. Application of the comet assay for monitoring DNA damage in
workers exposed to chronic low‑dose irradiation. II. Base damage.
Mutat Res 1998;416:37‑57.
10. World Health Organization. Global Initiative on Radiation Safety
in Healthcare Settings: Technical Meeting Report. Geneva: World
Health Organization. 2008. p. 4.
11. Yurt A, Çavuşoğlu B, Günay T. Evaluation of awareness
on radiation protection and knowledge about radiological
examinations in healthcare professionals who use ionized
radiation at work. Mol Imaging Radionucl Ther 2014;23:48.
12. Rahman N, Dhakam S, Shafqut A, Qadir S, Tipoo FA. Knowledge
and practice of radiation safety among invasive cardiologists.
J Pak Med Assoc 2008;58:119‑22.
13. Eze CU, Abonyi LC, Njoku J, Irurhe NK, Olowu O. Assessment
of radiation protection practices among radiographers in Lagos,
Nigeria. Niger Med J 2013;54:386‑91.
14. Tavakoli MR, Seilanian Toosi F, Saadatjou SA. Knowledge of
medical students on hazards of ionizing radiation. J Med Educ
2003;3:3‑6.
15. Salih S, Zeidan ZA, Alzalabani A, Albadrani MS, Yousef M.
Awareness and knowledge towards ionizing radiation hazard
among medical students, interns and residents in Al‑Madinah
Al‑Munawarah, KSA. Life Sci J 2014;11:6‑10.
16. Teferi S, Admassie D, Ewnetu Y. An Assessment of final‑year
medical students and interns awareness of radiation exposure
to common diagnostic imaging procedures. Adv Radiol 2014;
2014: 1‑7.
17. Mutyabule TK, Whaites EJ. Survey of radiography and radiation
protection in general dental practice in Uganda. Dentomaxillofac
Radiol 2002;31:164‑9.
18. World Education Services. International Grade Conversion Guide
for Higher Education; 2013. Available from: http://www.wes.
org/gradeconversionguide. [Last cited on 2016 Jan 04].
19. Islami Parkoohi P, Jalli R, Danaei M, Khajavian S, Askarian M.
Medical students’ knowledge of indications for imaging modalities
and cost analysis of incorrect requests, Shiraz, Iran 2011‑2012. Iran
J Med Sci 2014;39:293‑7.
20. Bonassi S, Forni A, Bigatti P, Canevarollo N, De Ferrari M,
Lando C, et al. Chromosome aberrations in hospital workers:
Evidence from surveillance studies in Italy (1963‑1993). Am J Ind
Med 1997;31:353‑60.
21. Limacher MC, Douglas PS, Germano G, Laskey WK, Lindsay
BD, McKetty MH, et al. ACC expert consensus document.
Radiation safety in the practice of cardiology. American College
of Cardiology. J Am Coll Cardiol 1998;31:892‑913.
22. Flôr R, Gelbcke F. Radiation protection and the attitude of nursing
staff in a cardiac catheterization laboratory. Texto & Contexto
Enferm agem 2013;2:416‑22.
23. Anim‑Sampong S, Opoku SY, Addo P, Botwe BO. Nurses
knowledge of ionizing radiation and radiation protection during
mobile radiodiagnostic examinations. Educ Res 2015;6:39‑49.
24. Amis ES Jr., Butler PF, Applegate KE, Birnbaum SB, Brateman LF,
Hevezi JM, et al. American College of radiology white paper on
radiation dose in medicine. J Am Coll Radiol 2007;4:272‑84.
25. Paolicchi F, Miniati F, Bastiani L, Faggioni L, Ciaramella A,
Creonti I, et al. Assessment of radiation protection awareness and
knowledge about radiological examination doses among Italian
radiographers. Insights Imaging 2016;7(2):233‑42.
26. Rassin M, Granat P, Berger M, Silner D. Attitude and knowledge
of physicians and nurses about ionizing radiation. J Radiol Nurs
2005;24:26‑30.
27. Enabulele JE, Igbinedion BO. An assessment of dental students’
knowledge of radiation protection and practice. J Educ Ethics
Dent 2013;3:54‑9.
28. Slechta AM, Reagan JT. An examination of factors related to
radiation protection practices. Radiol Technol 2008;79:297‑305.
29. Shah AS, Begum N, Nasreen S, Khan A. Assessment of radiation
protection awareness levels in medical radiation science
technologists – A pilot survey. J Postgrad Med Inst 2007;21:169‑72.
30. Ali M. Regulatory Requirements for Medical Teletherapy
Facilities. No. DNSRP‑RED‑4(111)/99, January 2000. Directorate
of Nuclear Safety and Radiation Protection (Pakistan Nuclear
Regulatory Board); 2000. Available from: http://www.pnra.org/
medical%20therapy.pdf. [Last cited on 2016 Jan 04].
31. Dianati M, Zaheri A, Talari HR, Deris F, Rezaei S. Intensive Care
Nurses’ Knowledge of Radiation Safety and Their Behaviors
Towards Portable Radiological Examinations. Nurs Midwifery
Stud 2014;3:e23354.
32. Soye JA, Paterson A. A survey of awareness of radiation dose
among health professionals in Northern Ireland. Br J Radiol
2008;81:725‑9.
33. Mihai LT, Milu C, Voicu B, Enachescu D. Ionizing
radiation – Understanding and acceptance. Health Phys
2005;89:375‑82.
34. Reagan JT, Slechta AM. Factors related to radiation safety practices
in California. Radiol Technol 2010;81:538‑47.