Assessment of Knowledge and Level of Radiation Safety Awareness among Radiographers Working in Nuclear Medicine.

BACKGROUND: Radiopharmaceuticals are used for the diagnosis, treatment, staging, and follow- up of various diseases. However, there is concern that the ionizing radiation (gamma rays, α and ß particles) may result in the exposure of radiographers with limited knowledge of the principles of radiation protection and safety, raising the risk of cancer induction. OBJECTIVE: The aim of the study is to investigate the knowledge and level of radiation safety awareness among radiographers at a tertiary hospital. METHODS: It is an analytical cross-sectional study. A validated two-part questionnaire was administered to consenting radiographers at a Nuclear Medicine Department. Part 1 gathered demographic information (age, gender, work experience, attendance to/or passing ionizing radiation protection courses), and part 2 covered questions related to knowledge and level of awareness of radiation protection principles. RESULTS: Five radiographers voluntary participated (2/5 males and 3/5 females). Three age groups were distinguishable, 21-30, 41-50 and 51-60 years. In the age group of 21-30 years, there was one male with just over 4 years of experience while in the age group 41-50, there were three females with less than three years of experience, and in the age group 51-60, there was one male radiographer with over 20 years of experience. All the radiographers showed a high level of awareness and knowledge of radiation safety principles. CONCLUSION: Education coupled with training in radiation protection is an essential tool for instilling radiation awareness among the radiographers. However, education alone is not enough; further skills in the preparation and administration of radiopharmaceuticals will reduce the exposure.

Administered Pediatric Radiopharmaceutical Doses at a Tertiary Hospital in South Africa: A Comparison with Corresponding Activities Based on North American Consensus Guidelines and Administration of Radioactive Substances Advisory Committee Guidelines.

BACKGROUND: Diagnostic nuclear medicine reveals physiological processes in vivo, facilitating early detection of disease prior to anatomical changes. However, in pediatric studies, the selection of appropriate dosing guidelines is challenging. Administration of Radioactive Substances Advisory Committee (ARSAC) and North American Consensus (NAC) guidelines are extensively used. OBJECTIVE: To determine appropriate pediatric dosing guideline for a South African Tertiary Hospital (SATH). METHODS: A combination of retrospective and empirical studies was conducted. Age, weight, name of the nuclear medicine study and administered activities were extracted from archived pediatric patients' files in a SATH who were attended from 2012-2015. To increase the sample size when calculating would be administered activities based on ARSAC and NAC guidelines, weights for sixty pediatric patients (empirical data) from the commonly conducted nuclear medicine studies were used. RESULTS: The most commonly performed nuclear medicine studies at a SATH were bone scans, 99mTc-HIDA scans, renal scans, thyroid scans, MIBG scans and gastroesophageal reflux scans. The mean pediatric administered radiopharmaceutical activities based on SATH, ARSAC and NAC guidelines were; bone scans (57.7, 15.2 and 10.0 MBq/kg), 99mTc-HIDA scans (13.7, 5.0 and 3.6 MBq/kg), renal scans (13.9, 3.4 and 7.8 MBq/kg), thyroid scans (7.0, 2.6 and 1.5 MBq/kg), MIBG scans (15.5, 15.1 and 7.7 MBq/kg) and gastroesophageal reflux scans (2.1, 1.9 and 1.7 MBq/kg). High variability of Administered Radiopharmaceutical Activities (ARAs) was observed for SATH guidelines compared to ARSAC and NAC guidelines. CONCLUSION: NAC guidelines are recommended for dosing pediatric patients at SATH. These guidelines will certainly reduce pediatric doses, which are currently high.

Extremity Exposure with 99mTc - Labelled Radiopharmaceuticals in Diagnostic Nuclear Medicine.

BACKGROUND: Extremity exposures may raise the risk of cancer induction among radiographers involved in the preparation and administration of technetium-99m labelled radiopharmaceuticals. OBJECTIVE: To estimate finger doses on radiographers at a South African tertiary hospital. METHODS: Adhesive tape was used to securely fix a calibrated thermoluminescent dosimeter (TLD) on fingertips and bases of ring and index fingers of both hands of five radiographers who prepared and administered technetium-99m labelled radiopharmaceuticals. Rubber gloves were worn to avoid TLD contamination. TLDs doses were read with a Harsaw TLD Reader (Model 3500) after a week. RESULTS: Five radiographers prepared and administered technitium-99m labelled radiopharmaceuticals (activity range; 78.20 GBq - 132.78 GBq during a one-week measurement period). A radiographer handling 132.78 GBq received 4.74±0.52 mSv on both hands; 5.52, 4.55, 5.11 and 4.60 mSv on the fingertip of the index finger of the dominant hand (FIDH), fingertip of the ring finger of the dominant hand (FRDH), fingertip of the index finger of the non-dominant hand (FINDH) and fingertip of the ring finger of the non-dominant hand (FRNDH), respectively. The respective doses received on the finger bases were 4.50 mSv, 4.60, 4.21 and 3.48 mSv. The radiographer handling 78.20 GBq received 0.85±0.18 mSv on both hands, 1.04, 1.17, 0.77 and 1 mSv for the FIDH, FRDH, FINDH and FRNDH, respectively, while respective doses for the bases were 0.8, 0.9, 0.6 and 0.8 mSv. CONCLUSION: The extremity exposures were below the annual limit (500 mSv). However, the use of syringe shields could still reduce the finger doses further.