Assessment of Radiation Protection Measures in Radiology Departments of Hospitals in Kogi (Case Study of Kogi State)

Assessment of Radiation Protection Measures in Radiology Departments of Hospitals in Kogi (Case Study of Kogi State)

CHAPTER ONE

OBJECTIVES OF STUDY

MAIN OBJECTIVE

To evaluate radiation protection practices in radiology departments of hospitals in Kogi State.

SPECIFIC OBJECTIVES

To ascertain the availability of radiation protection devices in the departments.
To assess the availability of personnel monitoring devices in the departments
To assess the causes of repeat exposures

CHAPTER TWO

LITERATURE REVIEW

Radiation protection, sometimes known as radiological protection, is defined as the protection of people and the environment from the harmful effects of ionizing radiation, which includes both particle radiation and high energy electromagnetic radiation.

According to Pan American Health organization (PAHO), Radiation protection sometimes known as radiological protection is the science of protecting people and the environment from the harmful effects of radiation and it includes the occupational radiation workers, which is the protection of work people (radiographers)⁵.

Marian school of radiology reported that for the adequate protection of student radiographers, a student is expected to exercise sound radiation protection at all times. At no time should a student participate in a procedure that exhibits unsaved radiation practices. The student has a full responsibility having the film badge on him in the hospital and at school for laboratory cases. Although 30mRem is an extremely small reading, any student who receives this amount or more during any given month should be counseled⁶.

WHO report on the basis of radiation protection stated the factors that can be used to minimize radiation doses to patients and staff. This includes limitation of field size of interest, use of fast film screen combination whenever appropriate, optimal film processing, use of gonad shield when appropriate, compression of obese patients, performance of quality assurance test, etc. It stated that, provided protection measures are implemented, the risk of potential radiation induced damage is minimized⁷.

Per wilkam et al, protested the proposal by International Council of Radiation protection (ICRP) that doses below a certain level ought to be excluded from radiation protection without regard to the number of persons exposed. He stated that the fact that possible effects of exposure to ionizing radiation cannot be detected is not relevant as substantial effects might be present without being detectable. He proposed a possible solution stating that regulating small risk is to make sure that the expected value of harm remains small and if instead we want to apply an exclusion levels for risk, the level ought to depend on the number of people exposed⁸.

According to “Veterans Affairs Palo Alto Health Care System”Transparent upper body shields are usually suspended from the ceiling and protect the upper torso, face and neck. The shield is contoured so that it can be positioned between the irradiated patient anatomy and the operator.

Flat panel mobile shields and when used must be placed between personnel and the sources of radiation (i.e., the irradiated area of the patient and the x-ray tube). Mobile shields are recommended for the operator and for ancillary personnel who must be in the room but who are not performing patient-side-work. X-ray attenuating surgical gloves help to reduce the risk of radiation dermatitis in physician’s hands from exposure to scattered radiation⁹.

Lead aprons are used in medical facilities to protect workers and patients from unnecessary radiation exposure from diagnostic radiology procedures. A lead apron is a protective garment which is designed to shield the body from harmful radiation, usually in the context of medical imaging. Both patients and medical personnel utilize lead aprons, which are customized for a wide range of usages. As is the case with many protective garments, it is important to remember that a lead apron is only effective when it is worn properly, matched with the appropriate radiation energy and is used in a safe and regularly inspected environment. Protective aprons of at least 0.25 mm leadequivalent shall be worn in the fluoroscopy room by each person, except the patient, whose body is likely to be exposed to 5mR/hr or more.”

CHAPTER THREE

RESEARCH METHODOLOGY

RESEARCH DESIGN:

The research was intended to assess the radiation protection measures in radiology departments of hospitals in Kogi State. The research is a non-experimental study.

TARGET POPULATION:

The population of this study included all the radiographers working in hospitals in Kogi State. The Hospitals include; Federal Medical Centre (FMC) Lokoja, Kogi State specialist Hospital, Lokoja, Kogi State Diagnostic Hospital, Anyigba, Grimad Hospital Anyigba, Maria Goretti Hospital Anyigba. The number of radiographers for this study was 19 in all. Their distribution was as follows: 11 Radiographers in FMC Lokoja, 3 Radiographers in Kogi State Specialist Hospital, 3 Radiographers in Kogi State Diagnostic Hospital, 1 Radiographer in Grimad Hospital and 1 Radiographer Maria Goretti Hospital, Anygba.

CHAPTER FOUR

RESULTS

DATA PRESENTATION AND ANALYSIS

Data were presented using frequency/percentage tables.

CHAPTER FIVE

DISCUSSION, SUMMARY OF FINDINGS, RECOMMENDATIONS AND CONCLUSION

DISCUSSION

The protection of both staff and patients from the effect of radiation must remain the watchword of any radiology department. Therefore, it is highly recommended that every necessary radiation protection device is available in a radiology department. Ascertaining the availability radiation protection devices, it was made known from the responses that these devises like the lead aprons, lead gloves beam diaphragms, are very much available in Kogi State hospitals and 78% of Radiographers use the lead aprons (i.e. giving the protective devices to the patient assistants). This is in concordance with Ukoha et’ al, 2007, who noted the availability of radiation protection devices in the hospitals in Enugu metropolis included in her study.

However from this study, most of the departments lack gonad shield and this goes in line with the finding of Christian et al, which states “that there is a general non-availability of gonad shield in the government hospitals in Enugu”. This calls for quick attention to address the issue of unavailability of gonad shields in the hospitals. WHO also saw to the need to use gonad shield appropriately so that the risk of potential radiation induced damage is minimized⁷.

RECOMMENDATIONS

A regulatory body should be set up to monitor the trend of radiation protection measures adopted in Kogi State hospitals
Hospital management should ensure that the radiation protection practices are up to standard and well recognized.
Quality assurance test should be made compulsory and conducted routinely.

CONCLUSION

The research was conducted using survey method. The result showed that there is poor radiation protection practice in Kogi State.

The recommendations above should go a long way towards improving radiation protection practices in Radiology departments of Hospitals in Kogi State.

LIMITATIONS OF STUDY

Small number of Radiographers in Kogi State

Limiting this research to Kogi State alone due to financial constrain.

AREA OF FURTHER STUDY

Comparative assessment of Radiation Protection practices in radiology departments of hospitals in Kogi and Benue State.

REFERENCES

European commission for radiation protection. 88 recommendations for the implementation of title vii of the European basic safety standard (BSS), June 1997. http://europa.eu.int/comm/environment/radprot/publication.
European commission (EC). Radiation protection 125: Low dose ionizing radiation and risk of cancer. Office for official publication of the EC, Luxembourg, 2001.http://europa.eu.int/comm/environment/radprot/publications.
National council on Radiation protection and measurement, NCRP report No. 160. Ionizing radiation exposure of the population of the United States, March 23, 2009, pg 142-146.
Obuchowski N. A. “Ten criteria for effective screening: Their application to multislice CT screening for pulmonary and colorectal cancer, American Journal of Roentgnology, June 2001, Vol. 176, pg 1357-1362.
Pan American Health organization (PAHO) “Radiation as a carcinogenic agent” Vol. 10, March 2003.
maricansprinceton.edu. “Radiation protection practices for student radiographers”. Received on January 11, 2013.
Muro Leonie. Basic Radiation protection; how to achieve ALARA: working tips and guidelines; Switzerland WHO publication 2004, pg 8-10.
Wilka per. “Trival risks and the new radiation protection system”; Journal of radiological protection, March 2004, Vol. 24. No.1, pg9-10
Veterans Affairs palo alto health care system; “Radiation protection guidance for Hospital staff”, December 2010, Reviewed August 23, 2012, Vol.8, pg 18.
Golding S. J., Practical Radiation protection in health care, Newyork, Oxford University press, 2002.
Osborn S. B., “Radiological protection for medical exposure to ionizing radiation safety guide”; International atomic energy, Vienna, August 2010.
Woodhead Dennis, “Protection of environment from the effects of ionizing radiation”; Journal of radiological protection. September 2002, Vol.22 No.2, pg. 231.
Hand book of Radiation protection; Selection criteria and radiation protection for dental radiography, Faculty of General dental practitioners, Royal College of surgeons of England, London. April 1998.