Knowledge, attitude and practice of nuclear medicine staff towards radiation protection

Document Type : Original Article


1 Mazandaran University of Medical Sciences, Sari, Iran

2 Department of Medical Physics, Semnan University of Medical Sciences, Semnan, Iran

3 Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran

4 Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

5 Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

6 Deputy of Research and Technology, Semnan University of Medical Sciences, Semnan, Iran

7 Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran

8 Department of Medical Physics and Radiology, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran


Introduction: Ionizing radiation in medical imaging is one of the dominant sources of exposure, and correct knowledge of radiation protection, affects staff safety behaviors during procedures. This study aimed to assess the radiation protection Knowledge, Attitude and Practice (KAP) amongst nuclear medicine centers' staff in Iran.
Methods: To evaluate the level of radiation protection KAP, a validated questionnaire was distributed between 243 participants considering demographic characteristics in different geographical regions in Iran from 2014 to 2015.
Results:There were statistically significant differences in the level of nuclear medicine staff KAP radiation protection with gender (p<0.05), practice age KAP level and radiation protection (p<0.05) among nuclear medicine staff with different working regions and healthcare market. There is no significant connection between educational age and KAP level of radiation protection of nuclear medicine department staff (p>0.05).
Conclusion: Our findings have shown that radiation protection KAP level of nuclear medicine staff was inadequate in some regions. This might be due to the lack of continuous training and absence of adequate safety knowledge about ionizing radiation. It seems that awareness about radiation protection rules and regulations, along with continuous training and preparations has a direct effect on radiation practice leading to enhanced KAP of staff in nuclear medicine centers.


Main Subjects

  1. World Health Organization. Global initiative on radiation safety in health care settings. Geneva: WHO Headquarters;  2008.
  2. Migliore L, Coppedè F. Genetic and environmental factors in cancer and neurodegenerative diseases. Mutat Res. 2002 Dec;512(2-3):135-53.
  3. Mettler Jr FA, Guiberteau MJ. Essentials of nuclear medicine imaging. Philadelphia, PA: Elsevier Health Sciences; 2011.
  4. Hendel RC, Corbett JR, Cullom SJ, DePuey EG, Garcia EV, Bateman TM. The value and practice of attenuation correction for myocardial perfusion SPECT imaging: a joint position statement from the American Society of Nuclear Cardiology and the Society of Nuclear Medicine. J Nucl Cardiol. 2002 Jan-Feb;9(1):135-43.
  5. Figley MM, Margulis AR. The impact of new imaging technology on health care, research, and teaching: an international symposium. AJR Am J Roentgenol. 1987 Dec;149(6):1111-26.
  6. Heller GV, Links J, Bateman TM, Ziffer JA, Ficaro E, Cohen MC, Hendel RC. American Society of Nuclear Cardiology and Society of Nuclear Medicine joint position statement: attenuation correction of myocardial perfusion SPECT scintigraphy. J Nucl Cardiol. 2004 Mar-Apr;11(2):229-30.
  7. Picano E. Sustainability of medical imaging. BMJ. 2004 Mar 6;328(7439):578-80.
  8. Muhogora WE, Ahmed NA, Almosabihi A, Alsuwaidi JS, Beganovic A, Ciraj-Bjelac O, Kabuya FK, Krisanachinda A, Milakovic M, Mukwada G, Ramanandraibe MJ, Rehani MM, Rouzitalab J, Shandorf C. Patient doses in radiographic examinations in 12 countries in Asia, Africa, and Eastern Europe: initial results from IAEA projects. AJR Am J Roentgenol. 2008 Jun;190(6):1453-61.
  9. Picano E. Informed consent and communication of risk from radiological and nuclear medicine examinations: how to escape from a communication inferno. BMJ. 2004 Oct 9;329(7470):849-51.
  10. Correia MJ, Hellies A, Andreassi MG, Ghelarducci B, Picano E. Lack of radiological awareness among physicians working in a tertiary-care cardiological centre. Int J Cardiol. 2005 Sep 1;103(3):307-11.
  11. Brown N, Jones L. Knowledge of medical imaging radiation dose and risk among doctors. J Med Imaging Radiat Oncol. 2013 Feb;57(1):8-14.
  12. Thomas KE, Parnell-Parmley JE, Haidar S, Moineddin R, Charkot E, BenDavid G, Krajewski C. Assessment of radiation dose awareness among pediatricians. Pediatr Radiol. 2006 Aug;36(8):823-32.
  13. Osko J, Golnik N, Pliszczynski T. Cases of post-accident contamination with iodine 131I, registered in the Institute of Atomic Energy POLATOM in Swierk, Poland. Radiat Prot Dosimetry. 2011 Mar;144(1-4):560-3.
  14. Baechler S, Stritt N, Bochud FO. Individual monitoring of internal exposure for nuclear medicine workers in Switzerland. Radiat Prot Dosimetry. 2011 Mar;144(1-4):464-7.
  15. Kerekes A, Kocsy G, Pellet S. Individual monitoring for internal exposure of workers: regulation and practice in Hungary. Radiat Prot Dosimetry. 2007;125(1-4):33-6.
  16. Chen S, Yu L, Jiang C, Zhao Y, Sun D, Li S, Liao G, Chen Y, Fu Q, Tao Q, Ye D, Hu P, Khawli LA, Taylor CR, Epstein AL, Ju DW. Pivotal study of iodine-131-labeled chimeric tumor necrosis treatment radioimmunotherapy in patients with advanced lung cancer. J Clin Oncol. 2005 Mar 1;23(7):1538-47.
  17. Armpilia CI, Dale RG, Coles IP, Jones B, Antipas V. The determination of radiobiologically optimized half-lives for radionuclides used in permanent brachytherapy implants. Int J Radiat Oncol Biol Phys. 2003 Feb 1;55(2):378-85.
  18. Marhas KK, Goswami JN, Davis AM. Short-lived nuclides in hibonite grains from Murchison: evidence for solar system evolution. Science. 2002 Dec 13;298(5601):2182-5.
  19. Lopez MA, van Dijk JW, Castellani CM, Currivan L, Falk R, Olko P, Wernli C. Individual monitoring for internal exposures in Europe: conclusions of an EURADOS action. Radiat Prot Dosimetry. 2006;118(2):176-81.
  20. Hamada N, Fujimichi Y. Classification of radiation effects for dose limitation purposes: history, current situation and future prospects. J Radiat Res. 2014 Jul;55(4):629-40.
  21. Kovoor P, Ricciardello M, Collins L, Uther JB, Ross DL. Risk to patients from radiation associated with radiofrequency ablation for supraventricular tachycardia. Circulation. 1998 Oct 13;98(15):1534-40.
  22. Tien HC, Tremblay LN, Rizoli SB, Gelberg J, Spencer F, Caldwell C, Brenneman FD. Radiation exposure from diagnostic imaging in severely injured trauma patients. J Trauma. 2007 Jan;62(1):151-6.
  23. Loose R, Wucherer M. Occupational exposure to radiation. Radiologe. 2007 May;47 Suppl 1:S27-38; quiz S39.
  24. Guénel P, Laforest L, Cyr D, Févotte J, Sabroe S, Dufour C, Lutz JM, Lynge E. Occupational risk factors, ultraviolet radiation, and ocular melanoma: a case-control study in France. Cancer Causes Control. 2001 Jun;12(5):451-9.
  25. Sont WN, Zielinski JM, Ashmore JP, Jiang H, Krewski D, Fair ME, Band PR, Létourneau EG. First analysis of cancer incidence and occupational radiation exposure based on the National Dose Registry of Canada. Am J Epidemiol. 2001 Feb 15;153(4):309-18.
  26.   Muirhead CR, O'Hagan JA, Haylock RG, Phillipson MA, Willcock T, Berridge GL, Zhang W. Mortality and cancer incidence following occupational radiation exposure: third analysis of the National Registry for Radiation Workers. Br J Cancer. 2009 Jan 13;100(1):206-12.
  27. Dehghani A, Ranjbarian M, Mohammadi A, Soleiman-Zade M, Dadashpour-Ahangar A. Radiation safety awareness amongst staff and patients in the hospitals. Int J Occup Hyg.  2015; 6(3):114-9.
  28. Jończyk‑Potoczna K, Strzelczuk‑Judka L, Szłyk E, Stefaniak Ł. Medical students’ awareness of radiation exposure related to radiological imaging procedures. J Med Sci.  2016;83:244-9.
  29. Davoudian Talab A, Badiee Nejad A, Beit Abdollah M, Mahmoudi F, Barafrashtehpour M, Akbari G. Assessment of awareness, performance, and attitudes of radiographers toward radiological protective principles in Khuzestan, Irangraphers. J Health Res Comm. 2015;1(3):16-24
  30. Mojiri M, Moghimbeigi A. Awareness and attitude of radiographers towards radiation protection. J Paramed Sci. 2011;2(4):1-5.
  31. Su WC, Huang YF, Chen CC, Chang PS. Radiation safety knowledge of medical center radiological technologists in taiwan. Radiat Oncol. 2000;50(2):1-3.
  32. Szarmach A, Piskunowicz M, Świętoń D, Muc A, Mockałło G, Dzierżanowski J, Szurowska E. Radiation safety awareness among medical staff. Pol J Radiol. 2015 Feb 1;80:57-61.