Radiation protection in a cohort of healthcare workers: knowledge, attitude, practices, feelings and IR-exposure in French hospitals.

The number of healthcare workers occupationally exposed to ionizing radiation (IR) is increasing every year. As health effects from exposure to low doses IR have been reported, radiation protection (RP) in the context of occupational activities is a major concern. This study aims to assess the compliance of healthcare workers with RP policies, according to their registered cumulative dose, profession, and perception of radiation self-exposure and associated risk. Every healthcare worker from one of the participating hospitals in France with at least one dosimetric record for each year 2009, 2014, and 2019 in the SISERI registry was included and invited to complete an online questionnaire including information on the worker's occupational exposure, perception of IR-exposure risk and RP general knowledge. Hp(10) doses were provided by the SISERI system. Multivariate logistic regressions were used. Dosimeter wearing and RP practices compliance were strongly associated with 'feeling of being IR-exposed' (OR = 3.69, CI95% 2.04-6.66; OR = 4.60, CI95% 2.28-9.30, respectively). However, none of these factors was associated with RP training courses attendance. The main reason given for non-compliance is unsuitability or insufficient numbers of RP devices. This study provided useful information for RP policies. Making exposed workers aware of their own IR-exposure seems to be a key element to address in RP training courses. This type of questionnaire should be introduced into larger epidemiological studies. Dosimeter wearing and RP practices compliance are associated to feeling being IR-exposed. RP training courses should reinforce workers' awareness of their exposure to IR.

Awareness of standard precautions, circumstances of occurrence and management of occupational exposures to body fluids among healthcare workers in a regional level referral hospital (Bertoua, Cameroon).

BACKGROUND: Healthcare workers (HCW) are exposed to infectious agents within biological materials including blood, tissues, other body fluids and on medical supplies, contaminated surfaces within the care delivery environment. Trends in occupational injuries are influenced by the level of awareness and observance of standard precautions (SP) among HCWs. This study aimed to assess the level of awareness of SP, exposure to body fluids, reporting pattern and management among HCWs in a Referral Hospital. METHODS: The present hospital-based cross-sectional study was carried out from 1st November 2020 to 31st May 2021. The exhaustive sampling method was used and a total of 120 consenting HCWs were invited to participate. A self-administered questionnaire addressed questions related to knowledge, experience, circumstances of exposure, reporting, management of occupational exposure to body fluids, hepatitis B vaccination status. Data were analyzed using R Statistic version 4.3.1. A p-value < 0.05 was considered significant. RESULTS: Out of the 120 participating HCWs, 104 (86.7%) reported at least one accidental exposure to body fluids over the last year. Men (aOR = 4.19; p = 0.277) and HCWs aged 35 and over (aOR = 4.11; p = 0.114) were more at risk for AEB even though the difference was not statistically significant. Nurses/midwives (aOR = 65.9; p-value = 0.0005) and cleaners (aOR = 14.7; p-value = 0.0438) faced the highest risk of exposure. Lack of knowledge (79%) and patient agitation (49%) were the most reported reasons for exposure. Half of the participants (53%) reported that they used a personal protective equipment during care. Face mask (59.2%) and gowns (30.8%) were the most commonly used PPE. Most HCWs (62%) did not report AEB. Half of the affected HCWs (50.8%) received a course of post-exposure antiretroviral therapy. Few HCWs (4.2%) were fully immunized against Hepatitis B. CONCLUSIONS: Most HCWs reported an accidental exposure to body fluids over the last year. Midwives and nurses were disproportionally affected socio-professional groups. Two-thirds of the AEB were undeclared. Only half of the participants reported using PPE systematically. Hepatitis B vaccination coverage was low. There is need to strengthen the observance of standard precautions, including preventive vaccination and the systematic reporting and management of AEB.

Shedding light on occupational exposure to the sun.

Roughly one in three non-melanoma skin cancer deaths worldwide is associated with working outdoors in the sun. Gary Humphreys reports.

Inadequate Personal Protective Equipment Factors and Odds Related to Acute Pesticide Poisoning: A Meta-Analysis Report.

INTRODUCTION: Acute pesticide poisoning (APP) continues to affect farm workers, especially in low- and middle-income countries (LMIC). The dose-response relationship between exposure and APP is well-researched, but pesticide exposure assessment in a practical environment is difficult to perform, considering various work practices and protections in place. It is well known that inadequate personal protective equipment (PPE) use is a risk factor of APP. However, it is unknown which types of inadequate PPE use, such as face or other types of general protection, are most harmful. METHODS: This study aimed to identify if inadequate PPE use is an indicator of APP risk following established specifications for meta-analysis of epidemiological studies. Included studies reported an odds ratio (OR) between PPE use to APP in agricultural workers. Data extracted from selected articles included authors, publication year, country of origin, farm type, population size, method of data collection and time frame of reported symptoms, job task, type of PPE and pesticides used, adjustments made in analysis, OR for APP, and 95% confidence intervals (CI). Meta-analysis was performed using a random effects model, where ORs were pooled to assess an overall estimate for poisoning odds. RESULTS: Our findings suggested that inadequate PPE use was associated with increased odds (OR = 1.57, 95% CI = 1.16-2.12) of having APP. Failure to use general protection and inadequate face protection increased odds of APP by 1.29 times (95% CI = 0.88-1.90) and 1.92 times (95% CI = 1.23-3.00), respectively. CONCLUSIONS: The meta-analysis results indicate that improper facial protection and general protection are not differently associated with APP odds. Our study concludes that more robust protection against inhalation and dermal contact are critical because any gaps in comprehensive full-body PPE would put workers and exposed populations at APP risk.

Human Pesticide Exposure in Bolivia: A Scoping Review of Current Knowledge, Future Challenges and Research Needs.

Numerous studies have shown that pesticide exposure is linked to adverse health outcomes. Nevertheless, in Bolivia, where there is an increasing use of pesticides, the literature is sparse. To address knowledge gaps and guide future research in Bolivia, we conducted a scoping review spanning 22 years (January 2000 to December 2022). Our search identified 39 peer-reviewed articles, 27 reports/documents on Bolivian regulations, and 12 other documents. Most studies focused on farmers and revealed high pesticide exposure levels, assessed through biomarkers of exposure, susceptibility, and effect. The literature explored a range of health effects due to pesticide exposure, spanning from acute to chronic conditions. Many studies highlighted the correlation between pesticide exposure and genotoxic damage, measured as DNA strand breaks and/or micronuclei formation. This was particularly observed in farmers without personal protection equipment (PPE), which increases the risk of developing chronic diseases, including cancer. Recent findings also showed the alarming use of banned or restricted pesticides in Bolivian crops. Despite existing Bolivian regulations, the uncontrolled use of pesticides persists, leading to harmful health effects on the population and increasing land and water pollution. This review underscores the need for the stringent enforcement of regulations and continued research efforts, and it provides a scientific foundation for decision-making by relevant authorities.

Evaluation of the risk of occupational exposure to antineoplastic drugs in healthcare sector: part II - the application of the FMECA method to compare manual vs automated preparation.

Healthcare workers handling antineoplastic drugs (ADs) in preparation units run the risk of occupational exposure to contaminated surfaces and associated mutagenic, teratogenic, and oncogenic effects of those drugs. To minimise this risk, automated compounding systems, mainly robots, have been replacing manual preparation of intravenous drugs for the last 20 years now, and their number is on the rise. To evaluate contamination risk and the quality of the working environment for healthcare workers preparing ADs, we applied the Failure Mode Effects and Criticality Analysis (FMECA) method to compare the acceptable risk level (ARL), based on the risk priority number (RPN) calculated from five identified failure modes, with the measured risk level (MRL). The model has shown higher risk of exposure with powdered ADs and containers not protected by external plastic shrink film, but we found no clear difference in contamination risk between manual and automated preparation. This approach could be useful to assess and prevent the risk of occupational exposure for healthcare workers coming from residual cytotoxic contamination both for current handling procedures and the newly designed ones. At the same time, contamination monitoring data can be used to keep track of the quality of working conditions by comparing the observed risk profiles with the proposed ARL. Our study has shown that automated preparation may have an upper hand in terms of safety but still leaves room for improvement, at least in our four hospitals.

Trends in the use of radiation protection and radiation exposure of European endourologists: a prospective trial from the EULIS-YAU Endourology Group.

INTRODUCTION: Due to the radiation exposure for the urology staff during endourology, our aim was to evaluate the trends of radiation protection in the operation room by endourologists from European centers and to estimate their annual radiation. METHODS: We conducted a multicenter study involving experienced endourologists from different European centers to evaluate whether the protection and threshold doses recommended by the International Commission on Radiation Protection (ICRP) were being followed. A 36-question survey was completed on the use of fluoroscopy and radiation protection. Annual prospective data from chest, extremities, and eye dosimeters were collected during a 4-year period (2017-2020). RESULTS: Ten endourologists participated. Most surgeons use lead aprons and thyroid shield (9/10 and 10/10), while leaded gloves and caps are rarely used (2/10 both). Six out of ten surgeons wear leaded glasses. There is widespread use of personal chest dosimeters under the apron (9/10), and only 5/10 use a wrist or ring dosimeter and 4 use an eye dosimeter. Two endourologists use the ALARA protocol. The use of ultrasound and fluoroscopy during PCNL puncture was reported by 8 surgeons. The mean number of PCNL and URS per year was 30.9 (SD 19.9) and 147 (SD 151.9). The mean chest radiation was 1.35 mSv per year and 0.007 mSv per procedure. Mean radiation exposure per year in the eyes and extremities was 1.63 and 11.5 mSv. CONCLUSIONS: Endourologists did not exceed the threshold doses for radiation exposure to the chest, extremities and lens. Furthermore, the ALARA protocol manages to reduce radiation exposure.

Understanding determinants related to farmers' protective measures towards pesticide exposure: A systematic review.

OBJECTIVE: Pesticide poisoning is the main cause of adverse effects and mortality worldwide. Protective measures can reduce the intensity of the effects of pesticides on the health of farmers. Numerous cross-sectional studies have been conducted on the determinants of performing protective measures to reduce exposure to pesticides, but there is no systematic study that comprehensively examines the impact of these factors. Therefore, the aim of this study is to identify existing studies on the determinants of effective protective measures to reduce exposure to pesticides among farmers. METHODS: In this systematic review, studies were obtained from PubMed, Web of Science and Scopus databases using a search strategy that covered articles from the first years of database design to April 20, 2023. The inclusion and exclusion criteria were based on the PICOs criteria. The study included cross-sectional studies that measured the implementation of protective measures using objective or valid subjective tools. The data were extracted and analyzed based on several criteria and ecological levels. The Ecological Model of Health Behavior was used to classify the determinants that affect the performance of protective behaviors. The National Heart, Lung and Blood Institute (NHLBI) has developed a quality assessment tool for studies. RESULTS: A total of 39 studies were ultimately selected for inclusion in this analysis. Many of these studies were conducted in developing countries. The most important factors that have an impact on protective measures include a variety of socio-demographic characteristics (age, gender, level of education, income, farming experience, experience of using pesticides), individual level (knowledge, attitude, risk perception, intention), interpersonal level (subjective norms), organizational level (education), and public policy level (government attention, health costs, governmental extension services). The quality of most studies was fair. CONCLUSIONS: Research indicates that several factors influence the use of personal protective equipment and safe behaviors when handling pesticides. These include farmers' education level, knowledge, and attitudes towards safety measures. Environmental factors such as access to information, extension services, training programs, and media coverage can also help minimize exposure to pesticides.

Directional vector visualization of scattered rays in mobile c-arm fluoroscopy.

Previous radiation protection-measure studies for medical staff who perform X-ray fluoroscopy have employed simulations to investigate the use of protective plates and their shielding effectiveness. Incorporating directional information enables users to gain a clearer understanding of how to position protective plates effectively. Therefore, in this study, we propose the visualization of the directional vectors of scattered rays. X-ray fluoroscopy was performed; the particle and heavy-ion transport code system was used in Monte Carlo simulations to reproduce the behavior of scattered rays in an X-ray room by reproducing a C-arm X-ray fluoroscopy system. Using the calculated results of the scattered-ray behavior, the vectors of photons scattered from the phantom were visualized in three dimensions. A model of the physician was placed on the directional vectors and dose distribution maps to confirm the direction of the scattered rays toward the physician when the protective plate was in place. Simulation accuracy was confirmed by measuring the ambient dose equivalent and comparing the measured and calculated values (agreed within 10%). The directional vectors of the scattered rays radiated outward from the phantom, confirming a large amount of backscatter radiation. The use of a protective plate between the patient and the physician's head part increased the shielding effect, thereby enhancing radiation protection for the physicians compared to cases without the protective plate. The use of directional vectors and the surrounding dose-equivalent distribution of this method can elucidate the appropriate use of radiation protection plates.

[Study on the fit testing for the workers wearing hearing protection device in machinery manufacturing enterprises].

Objective: To investigate the occupational noise hazards in five machinery manufacturing enterprises, and to evaluate the individual noise reduction values and influencing factors of workers wearing hearing protection device (HPD) by individual fit testing. Methods: From November 2021 to January 2022, 5 machinery manufacturing enterprises in Bao'an District of Shenzhen were selected to conduct an occupational health survey to understand the noise exposure level of workers. The 3MTM E-A-RfitTM fitness test system was used to test the baseline individual sound attenuation value level (PAR) of the daily wear of the ear protecters for 485 workers in typical noise working positions. Workers whose PAR values could not meet the requirements of noise reduction at work were instructed to wear and repeated tests were conducted. PAR results of the workers before and after the intervention were collected and analyzed. Results: The noise workers who received the suitability test were mainly distributed in 24 types of work, the job noise exposure level was 80.2 dB (A) ~ 95.0 dB (A), and the job noise excess rate was 52.5% (138/263). The median baseline PAR [M (Q(1), Q(3)) ] for 485 workers was 6.0 (0.0, 14.0) dB. The baseline PAR of male workers, those with more than 15 years of working experience, those with more than 15 years of using ear guards, those who considered ear guards comfortable to wear, those with college degree or above, and those exposed to noise level 90 dB (A) were higher, and the difference was statistically significant (P<0.05). A total of 275 workers (56.7%) did not pass the baseline PAR test, and there was no statistically significant difference in the intervention rate of workers in different noise groups (P>0.05). PAR in subjects who did not pass baseline after intervention increased from 0.0 (0.0, 3.0) dB to 15.0 (12.0, 18.2) dB. Conclusion: The workplace noise hazard of machinery manufacturing enterprises is serious, and there is a great difference between the baseline PAR and the nominal value of the hearing guard worn by the noise exposed workers. The intervention measures can effectively improve the protective effect of wearing ear protectors.

[Hierarchical fuzzy comprehensive evaluation of prevention and control level of occupational hazards in coal mines].

Objective: To establish an evaluation model for occupational hazard prevention and control levels in coal mines, to explore the combination of Analytic Hierarchy Process (AHP) and fuzzy comprehensive evaluation, to evaluate the overall situation of occupational hazard prevention and control in coal mines. Methods: In November 2021, Collect information of occupational hazards and their prevention and control status in 30 coal mines. AHP model was first constructed for the elements of occupational hazard prevention and control in coal mines. Then, the AHP and fuzzy comprehensive evaluation method was applied to comprehensively evaluate and grade the occupational hazard prevention and control in coal mines, using the principles of maximum membership and weighted average. Results: The hierarchical fuzzy comprehensive evaluation results for typical coal mine were basically consistent with its occupational hazard prevention and control situation. The dust prevention and control situation was good, the noise prevention and control situation is average, the occupational health monitoring situation was good, the occupational health management situation was average, and the overall level of occupational hazard prevention and control was good. Conclusion: The hierarchical fuzzy comprehensive evaluation model for occupational hazard prevention and control levels, combined with the principles of maximum membership and weighted average, can objectively evaluate and reflect the overall situation of occupational hazard prevention and control in coal mines.

[Research on quantitative evaluation of revise requirements of Specifications of Air Sampling for Hazardous Substances Monitoring in the Workplace (GBZ 159-2004)].

Objective: To conduct quantitative evaluation on the revise requirements of Specifications of Air Sampling for Hazardous Substances Monitoring in the Workplace (GBZ 159-2004) , clarify the problems and suggestions during its implementation for improvement, and provide a basis for the revision of the standard. Methods: From April to September 2021, stratified convenient sampling method was adopted and semi-open questionnaire was used to investigate the occupational health personnel in CDC, occupational prevention and control institutes, employers, third-party technical service institutions and universitie. The entropy weight of each index and the score based on entropy weight of GBZ 159 were calculated. Spearman rank correlation analysis was used to describe the correlation between the two indexes and radar chart was drawn for comprehensive evaluation. Results: A total of 151 questionnaires were received from the respondents, of which 147 were valid, with an effective recovery rate of 97.35%, involving 29 provinces, autonomous regions and municipalities. The median G scores of the necessity and urgency of GBZ 159 revision based on entropy weight were 2.84 and 3.17, respectively, and the difference was statistically significant (M=-25.50, P<0.001) . The trend of the score G of necessity and urgency based on entropy weight was basically the same for all secondary items (r(s)=0.9998, P<0.001) , and the score G of urgency based on entropy weight was higher than that of necessity. The highest score G of necessity and urgency based on entropy weight was "3.13 long time sampling", which were 7.56 and 8.23 respectively. This was followed by "3.12 short time sampling", which were 7.19 and 7.13 respectively. Conclusion: GBZ 159 has encountered some new problems and challenges in the implementation process, and some of its technical indicators have been out of line with the actual practice of occupational health at present. These are the two items that urgently needs to be revised and improved, such as "3.13 long time sampling" and "3.12 short time sampling" and other items need to be revised and improved.

[Comparison and analysis research on occupational exposure limits of coal dust between China and foreign countries].

Objective: To study and compare the occupational exposure limits (OELs) of coal dust between China and foreign countries, understand the OEL of coal dust in China, and provide data and basis for revising the OEL of coal dust in China. Methods: In August 2023, by searching the official websites of limits setting institutions in relevant countries and regions at home and abroad, collecting and sorting out the OELs of coal dust issued by 10 limit setting institutions in 6 countries and the background information of the formulation, and conducting specific analysis on the classification, limit level and formulation principles of coal dust OEL in each country/institution. Results: In China and Japan, the total dust and respirable dust of coal dust OEL were established respectively, while in other countries, only the time-weighted average concentration (TWA) of respirable coal dust exposure was established. The TWA prescribed by China's Notional Health Commission, the United States Occupational Safety and Health Administration (OSHA) , the United States Mining Safety and Health Administration (MSHA) and the Australian Safety Work Bureau when the SiO(2) content was less than 5% were 5, 2.4, 2 and 3 mg/m(3) respectively. China GBZ 2.1-2019 sets the limit of 2.5 mg/m(3) for respirable coal dust with SiO(2) content less than 10%. The TWA set by the American Conference of Government Industrial Hygienists (ACGIH) and the South African Department of Mines and Energy (DME) for anthracite coal were 0.4 and 0.8 mg/m(3), respectively, and bituminous coal or lignite were 0.9 and 1.8 mg/m(3), respectively. The respirable coal dust TWA set by the National Institute for Occupational Safety and Health (NIOSH) in the United States was 1 mg/m(3), and the TWA set by the New Zealand Work Safety Authority was 3 mg/m(3). Conclusion: At present, the OEL of coal dust in China is at a relatively loose level, and it is suggested to further explore the possibility of revising coal dust OEL.

[Study on the implementation effect evaluation of Specifications of Air Sampling for Hazardous Substances Monitoring in the Workplace (GBZ 159-2004)].

Systematically evaluate the implementation of Specifications of Air Sampling for Hazardous Substances Monitoring (GBZ 159-2004) , so as to provide technical basis for the future standard revision. The semi-structured interview method was used to interview the industry experts from centers for disease control and prevention, occupational disease prevention and control hospitals/institutes, employers, third-party technical service institutions and universities, and the induction method was used to refine the topics and relevant suggestions. Some technical indicators of GBZ 159 are not suitable for the current actual work of occupational health, and need to be revised and improved urgently. The revised GBZ 159 should comply with the current situation of China's industrial development and the development of occupational health testing equipment in the new era, and improve the relevant technical requirements of sampling quality control.

Comparison of the inward leakage rate between N95 filtering facepiece respirators and modified surgical masks during the COVID-19 pandemic.

BACKGROUND: Owing to shortage of surgical and N95 filtering facepiece respirators (FFRs) during the COVID-2019 pandemic, various masks were developed to prevent infection. This study aimed to examine the inward leakage rate (ILR) of sealed face masks and modified surgical masks using a quantitative fit test and compared it with the ILR of unmodified N95 FFRs. METHODS: We conducted paired comparisons of ILRs of bent nose-fit wire masks, double masks, and N95 FFRs from October to December 2021. To measure the protective effectiveness of masks, participants wore masks, and the number of particles outside and inside the mask were measured. The ILR was based on the percentage of particles entering the mask using a fit tester. RESULTS: We enrolled 54 participants (20 men and 34 women) in this study. The median ILR for surgical masks without and with a W-shaped bend in the nose-fit wire were 96.44% and 50.82%, respectively. The nose-fit wire adjustment reduced the ILR of surgical masks by a mean of 28.57%, which was significantly lower than the ILR without adjustment (P < 0.001). For double masks, with surgical or polyurethane masks on top of the W-shaped mask, the ILR did not differ significantly from that of N95. Although the filtration performance of double surgical masks matched that of N95 masks, their ILR was notably higher, indicating that double masks do not provide equivalent protection. CONCLUSIONS: Wearing N95 masks alone is effective in many cases. However, surgical mask modifications do not guarantee consistent effectiveness. Properly selected, sealed masks with a good fit overcome leakage, emphasizing their crucial role. Without evidence, mask-wearing may lead to unexpected infections. Education based on quantitative data is crucial for preventing adverse outcomes.

The "Creuseurs" ("Diggers"), at the Center of the World's Push for EVs, are in Peril: Part Two-Obstacles and Opportunities to Improve Conditions for Miners.

In part one, we reported on some of the shocking working conditions that the Electronics Watch team found on our visit to cobalt mines in the DRC. Now, we look at the vested interests in Congolese politics, the mining industry, the Congolese government's desire to regulate the cobalt supply chain, and what else might be done to improve conditions.

[The Need for Lens Radiation Protection for Healthcare Provider in Open and Internal Fixation of the Hip Joint].

Increased occupational exposure of radiation workers is a major problem during open reduction and internal fixation (ORIF) of the hip joint, as the surgeon's eye lens is in close proximity to the patient and the X-ray tube. The purposes of this study were to clarify the occupational exposure of radiation workers during ORIF of the hip joint and to examine the need for radiation protection measures. The radiation exposure of radiation workers was evaluated by making an airborne dose distribution map using phantom experiments. The radiation goggles attached with a small optically stimulated luminescence dosimeter were used in clinical practice to measure the lens dose received by the surgeon, and the necessity of radiation goggles was examined. The airborne dose distribution in ORIF of the hip joint showed a wider area of high dose rate during axial fluoroscopy of the femoral neck than during posterior-anterior fluoroscopy. In axial fluoroscopy of the femoral neck, the surgeon was always in the high dose rate range of 10 µGy/min or higher, the nurses were in the dose rate range of 4 to 10 µGy/min, and the radiologic technologists were in the dose rate range of 0.5 µGy/min or lower. The maximum 3 mm dose equivalent to the surgeon per case was 0.38 mSv. In contradiction, radiation goggles were useful in ORIF because they provided approximately 60% shielding. It is advisable to work with radiation goggles to avoid cataracts.

Outcomes for a Heat Illness Prevention Program in Outdoor Workers: A 9-Year Overview.

OBJECTIVE: To describe the outcomes effect of removing the medical surveillance component from a heat illness prevention program (HIPP) for outdoor workers from a Central Texas municipality. METHODS: Heat-related illness (HRI) frequency and workers' compensation (WC) cost were assessed retrospectively in a cohort of 329 workers from 2011-2019. During 2011-2017, the HIPP included training, acclimatization, and medical surveillance. In 2018-2019, a modified (mHIPP) was implemented that included training and acclimatization, but without medical surveillance. RESULTS: The HRI rate during HIPP averaged 19.5 per 1000 workers during the first 4 years, dropped to 1.01 per 1,000 workers over the next 3 years, (2015-2017), and increased during mHIPP, to 7.6 per 1,000 workers. DISCUSSION: Although the case increase during the mHIPP was small, medical surveillance may be an important component in lowering workforce HRI.

Radiation exposure in augmented fluoroscopic bronchoscopy procedures: a comprehensive analysis for patients and physicians.

Cancer is a major health challenge and causes millions of deaths worldwide each year, and the incidence of lung cancer has increased. Augmented fluoroscopic bronchoscopy (AFB) procedures, which combine bronchoscopy and fluoroscopy, are crucial for diagnosing and treating lung cancer. However, fluoroscopy exposes patients and physicians to radiation, and therefore, the procedure requires careful monitoring. The National Council on Radiation Protection and Measurement and the International Commission on Radiological Protection have emphasised the importance of monitoring patient doses and ensuring occupational radiation safety. The present study evaluated radiation doses during AFB procedures, focusing on patient skin doses, the effective dose, and the personal dose equivalent to the eye lens for physicians. Skin doses were measured using thermoluminescent dosimeters. Peak skin doses were observed on the sides of the patients' arms, particularly on the side closest to the x-ray tube. Differences in the procedures and experience of physicians between the two hospitals involved in this study were investigated. AFB procedures were conducted more efficiently at Hospital A than at Hospital B, resulting in lower effective doses. Cone-beam computed tomography (CT) contributes significantly to patient effective doses because it has higher radiographic parameters. Despite their higher radiographic parameters, AFB procedures resulted in smaller skin doses than did image-guided interventional and CT fluoroscopy procedures. The effective doses differed between the two hospitals of this study due to workflow differences, with cone-beam CT playing a dominant role. No significant differences in left and right eyeHp(3) values were observed between the hospitals. For both hospitals, theHp(3) values were below the recommended limits, indicating that radiation monitoring may not be required for AFB procedures. This study provides insights into radiation exposure during AFB procedures, concerning radiation dosimetry, and safety for patients and physicians.