ISSN: 0975-8585
Research Journal of Pharmaceutical, Biological and Chemical
Sciences
A Study On Knowledge & Awareness Of Work Safety Amongst
Employees Working In Radiology Department In A Tertiary Care
Hospital.
Sarika P Kate1*, Arun P Chepte2, Sandeep V Pakhale3, YS Sachdeva4, and
Rahul Kunkulol5.
1Associate Professor, Department of Anatomy, Dr.BVPRMC, Loni,Maharashtra-413736, India.
2Associate Professor, Department of Anatomy, Dr.BVPRMC, Loni,Maharashtra-413736, India.
3Professor & Head, Department of Anatomy, Dr.BVPRMC, Loni,Maharashtra-413736, India.
4Professor & Head, Department of Radiology, Dr.BVPRMC, Loni,Maharashtra-413736, India.
5Professor & Head, Department of Pharmacology, Dr.BVPRMC, Loni,Maharashtra-413736, India.
ABSTRACT
The radiation exposure is one of major risk factor for hospitals which not only affects employees
but also to patients and their relatives. The risk of cancer is increasing because of increase in tomograhic
examinations in recent era.Various studies had shown that the knowledge &awareness level of health
workers towards radiation safety is very less so every year about 90% healthcare workers are exposed to
radiation. The purpose of this study was to assess the level of Knowledge and awareness regarding
radiation safety among radiology technicians& allied healthworkers. In this cross sectional study the
technologists & allied healthworkers and residents, fellows of the Department of Radiology are included
in the study.The prevalidated questionnaire used was obtained from a literature knowledge study
obtained from AERB guidelines and other Radiological society guidelines. The questionnaire was
comprised of 2 sections.First section includes demographic characteristics like Gender, Age,
Qualification,Work experience.Second section comprises of 20 questions based on knowledge, awareness
& good practices. A prevalidated Questionnaire will be given to radiology technicians and allied
healthworkers in google form format and from their responses data analysis is done. The Questionnaire
includes open as well as closed ended questions. A well informed valid consent will be obtained from
participants. The mean score of correct answers was 10.93 out of 20 (50 %).90.32% of the employees
were male (n=56), and 9.67% of the workers were female (n=6). 53 % Individuals taking part in the study
were between 18 to 27 yrs old,29 % between 28 to 37 years old and 17 % between 38 to 57 yrs old.63 %
have less than 5 yrs experience while 4.8 % have more than 25 yrs of experience.Considering their
educational backgrounds, it was detected that 40.3% had an associate’s degree (n=25), 24.19% had a high
school diploma (n=15), 12.9% had a bachelor’s degree (n=8) and 6.45% had a master’s degree (n=4). The
results of this survey show knowledge deficit among all radiology workers, including residents, fellows
and technologists.Staff radiologists should impart knowledge & updates in the fields to technicians,
residents, fellows regularly as well provide expert counselling on risk and dose issues.
Keywords: Radiation dose, Radiation risk, Technologists, Cancer risk, Questionnaire
https://doi.org/10.33887/rjpbcs/2023.14.1.17
*Corresponding author
January – February 2023 RJPBCS 14(1) Page No. 112
ISSN: 0975-8585
INTRODUCTION
Radiation safety can be defined as the protection of people and the environment against ionizing
radiation beams [1, 2]. Medical personnel should have adequate information about the issue to protect
both themselves and patients from harmful effects of radiation. Most of the mistakes made result from a
lack of measures and knowledge. Accordingly, employees working with radiation should be given training
on radiation, and then, they should be regularly updating their knowledge [3, 4]. Training to these
personnel should be directly be given by a health physician or training content should be examined by
him/her. There should be detailed training regarding special work responsibilities.
Hospitals are medical institutions that contain lots of risk factors. One of these risks is exposure
to radiation. This matters to employees, patients, and their relatives. Previous studies had shown that the
number of tomographic examinations have increased in recent years and that will increase risk of cancer.
Recent studies also show that low dose radiation applications used for diagnosis may influence human
health negatively.
Various studies shown that the knowledge level of health workers are insufficient in terms of
radiation safety so about 88 to 90% healthcare workers exposed to radiation every year.so we need to
know in our setup the knowledge & awareness of radiology technicians & allied healthworkers about
radiation safety and to overcome this what will be the measures to minimize the radiation risk to
employees as well as patients.The purpose of this study was to assess the level of awareness regarding
radiation safety among radiology technicians.
MATERIAL AND METHODS
Data Collection is done from the Radiology technicians & allied healthworkers of tertiary care
hospital in Maharashtra.
Sample Size
62 (Includes male & female)
Inclusion Criteria
The technologists & allied healthworkers and residents, fellows of the Department of Radiology
are included in the study.
The prevalidated questionnaire used was obtained from a literature knowledge study obtained
from AERB guidelines and other Radiological society guidelines. The questionnaire was comprised of 2
sections. First section includes demographic characteristics like Gender, Age, Qualification, Work
experience. Second section comprises of 20 questions based on knowledge, Awareness & good practices.
A prevalidated Questionnaire will be given to radiology technicians and allied healthworkers in google
form format and from their responses data analysis is done. The Questionnaire includes open as well as
closed ended questions. A well informed valid consent will be obtained from participants.
Data Analysis
The study will be carried out on radiology technicians & allied health workers,residents and
fellows employed in a Radiology Department of a private Trust Hospital. Employees were given a survey
obtained from a literature review, a Questionnaire on Radiation awareness by Society of Radiology, and
other related resources. The results will be then analyzed with frequency and proportion.The
questionnaire includes socio-demographic characteristics of participants ,knowledge about awareness of
radiation safety will be checked. It will be prepared from a literature knowledge study carried out by
different Society of Radiology,AERB Guidelines. The questionnaire will be comprised of radiation safety
(general expressions), to determine radiation awareness of radiation personnel . All steps of our study
were designed according to the ALARA principle, Declaration of Helsinki, BARC & AERB guidelines.Data
obtained in the study, was transferred into Statistical Package for the Social Sciences (IBM SPSS Statistics)
19.0 software and analyzed. In the analysis of the data, frequency& proportion were used.
January – February 2023 RJPBCS 14(1) Page No. 113
ISSN: 0975-8585
RESULTS
90.32% of the employees were male (n=56), and 9.67% of the workers were female (n=6). 53 %
Individuals taking part in the study were between 18 to 27 yrs old,29 % between 28 to 37 years old and
17 % between 38 to 57 yrs old. 63 % have less than 5 yrs experience while 4.8 % have more than 25 yrs
of experience. Considering their educational backgrounds, it was detected that 40.3% had an associate’s
degree (n=25), 24.19% had a high school diploma (n=15), 12.9% had a bachelor’s degree (n=8) and 6.45%
had a master’s degree (n=4).
Table 1: Demographic profile
Age 18-27 33 53.22 %
28-37 18 29.03 %
38-47 8 12.9 %
48-57 3 4.8 %
Gender Male 56 90.32 %
Female 6 9.67 %
Term of service Below 5 yrs 39 62.90 %
6-10 yrs 8 12.90 %
11-15yrs 4 6.45 %
16-20 yrs 6 9.67 %
21-25yrs 2 3.22 %
25 yrs & more 3 4.83 %
Educational High school 15 24.19 %
background
Associate degree 25 40.32 %
Bachelor’s degree 8 12.90 %
Master’s degree 4 6.45 %
Table 2: Results of questionnaire on radiation knowledge level
Question Correct answer n %
1. Average natural background radiation is in 2-3mSv 20 32.25
the range
2.Approximate effective dose received by a 0.02mSv 16 25.8
patient in a single-view chest X-ray is
3.Approximate effective dose received by a 1-5mSv 30 48.38
patient in a Abdominal X-ray is
4.Do not use grids for- Paediatric patient 48 77.419
5. Dosage from two-view unilateral 10–20 times the 18 29.03
mammogram is single-view chest X-ray
6. Which of the following has no radiation MRI 56 90.322
risks:
7. Please select which one of the following is Children 42 67.74
most sensitive to radiation:
8.Approximate estimated risks of fatal cancer Very low: 1 in 100,000 to 24 38.7
from CT head 1 in 10,000
9.Collimator use do the following except Increase scatter 26 41.93
radiation
10. Following are basic 3 factors for radiation Exposure rate 26 41.93
protection except
11. ------------period of exposure to radiation Decrease, decrease 18 29.03
to ----------- the dose received from source.
12.----------------distance from source to Increase, Decrease 35 56.45
------------exposure rate.
13. Radiation dose would be reduced by more 90% 22 35.48
than ----% by using lead aprons
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14. Shielding adequacy should be checked 2 years 14 22.58
atleast once in ------
15.Which is false about TLD Badge- TLD protects us from 32 51.61
radiation
16. Which is good practice about wearing TLD with Cassette 49 79.03
TLD-
17. Which is good practice about wearing TLD TLD below lead apron 41 66.12
18. Where to store TLD badge when not in Office room 56 90.322
use
19. What is low dose protocol for patient High Kv & Low mA 52 83.87
safety
20. Mobile Xray machine should be operated 2m 35 56.45
from a distance of -------m of length
Chart Title
60
50
Axis Title
40
30
20
10
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Question No.
Question Correct Incorrect
Figure 1: The right and wrong answers to each question shown in figure.
10.93 out of 20was the mean score of correct answers which is 50 %. These scores ranges from 5
to 17 out of 20 correct answers.
The percentage of the employees who answered more than half of the questions correctly was
found to be 64.51% (n=40). It was detected that 40% of ones who scored 50% & more were between the
ages of 18–27, ones with an associate’s degree (75%).It is observed from the study that more experienced
personnel having more knowledge and awareness about radiation safety.Less experienced personnel
should be given training on regular basis.
DISCUSSION
Our study results indicate overall average knowledge on radiation dose and risk among
technologists,radiology residents, fellows of the Department of Radiology. Our study results reflect a
knowledge deficit among radiology workers. Nearly half of our study group scored less than 50 % on
questions of radiation dose and risks. The study group is not homogeneous. One of the most frequently
performed radiology examination is chest X-ray and nearly half of the participants did not know about the
dosage from a single view chest X-ray. This is not different from prior publications [1, 2].
The overestimation as well as underestimation of cancer risk due to knowledge deficit in
routinely performed examinations should be taken seriously to avoid repeated as well as unwarranted
examinations which is causing significant radiation hazard and is of major public health concern.
More than 90 % of technologists correctly identified the absence of radiation risk in MRI and 40%
correctly identified radiation risk in the paediatric population. This is in strong contrast to prior studies
among physicians reporting variably poor knowledge. There are some limitations to the study. It is a
single tertiary care institutional study. Before coming to any action the sample size also should be taken
January – February 2023 RJPBCS 14(1) Page No. 115
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into account. Comprehensive radiation knowledge cannot be compared with the questions based on
radiation dose & cancer risk. Many of our participants opined that many questions based on numeric
were not practicable as exact numerical value will be difficult to memorize. But as radiology workers,
they should have deeper and more accurate knowledge on radiation dose and cancer risks and this should
be imparted from the beginning of radiology training. Few provisions made in questionnaire as they were
interrelated and one can easily deduce the answers from other questions as well the questions based on
effective dose and cancer risk have a wide range of variable answers. As the survey was performed online
with a few days time given, there might be the search of answers from various resources which will not
give the real idea of status of knowledge. There might be the chances that the real knowledge is much less
than evaluated.so it is very important to take knowledge about radiation dose and risk more seriously [5,
6].
We are trying to enforce many of the recommendations which includes improving medical
physics training during residency, including radiation safety topics in exit examinations, regular
in-service training for technologists on hazards of radiation & radiation safety,advanced training of senior
technologist so they can give periodic training to other staff [3]. Periodic continuous medical educational
(CME) activities are recommended among radiology workers [4] and we are working to make this
mandatory for all, including the staff radiologists irrespective of subspecialties to attend CME to keep
them updated on radiation risks & dosage. This will be very useful in future for reducing the cancer risk
due to overuse of imaging technolog. Inclusion of patient’s total radiation exposure and radiation dosages
in the imaging report and in the radiology request forms will create more awareness not only in
physicians but also in patients and eventually reduce the inadvertent use of imaging technology [7, 8].
Although the questionnaire was not an all-inclusive one and not an ideal way of knowledge
assessment with numerous limitations as already Discussed, knowledge deficit was observed on
Radiation dose levels and Cancer risk due to different imaging modalities. As technologists are first
contact persons with patients and relatives they should be adequately trained so as to answer common
questions and give satisfactory explanation.The next level of contact is the speciality residents and fellows,
who are often called upon to advise colleagues in other departmental faculties & residents and patients
about dose and safety concerns.Senior Staff radiologists is the key person not only for acquiring the
knowledge but also for imparting the knowledge of radiation safety and updates in the field to the juniors
at regular intervals so they can provide expert advice whenever required.
CONCLUSION
The results of this survey demonstrate a knowledge deficit among all radiology staffs , including
residents, fellows and technologists. Overall there is significant casual attitude regarding use of dosage
and cancer risk from common radiological examinations. Inaccuracy is seen even at estimation of the
dosage of commonly performed chest X-rays.
ACKNOWLEDGEMENT
The authors thank Dr. Jayant Deshpande & Dr. Anup Kharde for their help during the study.
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