Investigation on the Radiation Safety Management in Computed Tomography Radiological Technologists

 

Ki-Jeong Kim, Hong-Ryang Jung*, Cheong-Hwan Lim, Woo-Taek Lim, Jeong-Hee Kim, Mi-Hwa Lee

Dept. Health Care, The Graduate School of Hanseo University, 46. Hanseo 1-ro, Haemi-Myun, Seosan-Si, Chungcheognam-do, Province, 31962, Republic of Korea

 

ABSTRACT:

Background/Objectives: This study aimed at investigating the attitudes, knowledge and behaviors of radiological technologists on radiation, and how they are preparing plans to reduce unnecessary radiation doses on practitioners, patients and their caretakers. Methods/Statistical analysis: This study was conducted with 231 radiological technologists working in a CT examination room. For this, we contacted radiological technologists working at hospitals for at least 1 month from March to April of 2016.  The following findings were obtained. Data collected through the survey was analyzed using SPSS ver. 23.0. Findings: Knowledge level of radiation safety management by general characteristics showed statistically significant differences according to clinical experience (p < 0.05), hospital size (p < 0.05), and educational level (p < 0.05). Attitude level of radiation safety management by general characteristics showed statistically significant differences according to age (p < 0.01), marital status (p < 0.01), and hospital size (p < 0.001). Behavior level of radiation safety management by general characteristics showed statistically significant differences according to clinical experience (p < 0.001) and hospital size (p < 0.05). In the relation between knowledge, attitude, and behavior on radiation safety management, higher level of radiation safety management knowledge correlated to higher levels of attitude and behavior.  In addition, higher levels radiation safety management attitudes correlated to higher levels of radiation safety management behavior. Improvements/Applications: The correct radiation safety management through practitioner training was necessary to reduce radiation doses on computed tomography radiological technologists and patients.

 

 

1. INTRODUCTION:

In modern medicine, radiation for medical use played a key role in protecting human health from diseases and in medical development with its use in diagnosis, treatment, and research of human diseases. Recently, radiation medical equipment is used as the most crucial type of medical equipment in order to diagnose and treat physiological and pathologic conditions of the human body. The use for patient treatment is expected to expand further due to competitive developments of cutting edge radiation medical equipment¹.

 

Clinical increase of radiation use can lead to increased radiation exposure for radiological technologists and patients. Thus, securing stability is considered the most basic and important factor in diagnosis and treatment when using radiation^2,3. While use of radiation within the medical industry offers significant benefits to diagnosis and treatment, there is a hazardous downside due to radiation exposure⁴.

 

Generally, radiation exposure can cause direct effects to oneself, and genetic effects to descendants by potential exposure⁵. In addition, direct effects of radiation exposure can cause cell damage and cytotoxicity caused by ionization reactions in human body composition cells. It indirectly causes secondary cytotoxicity with ionization of water molecules in cell and by generating chemically very active free radical. In order to maximize all benefits following radiation use and minimize the damage, proper use and management of radiation is indispensable and is positioning to be a major sector of modern health and the medical field^6,7,8.

 

In modern medicine, medical imaging examinations including radiation examinations have a very important role. Currently in the medical field, radiation inspection, especially computed tomography (CT) examinations have seen a sharp increase as it is widely used in checking abnormal lesions, accurate location determination, differential diagnosis of lesions, treatment method determination, and treatment effect determination⁹.

 

Considering that CT examinations are clinically widely used, 50mSv to 150mSv of radiation exposure can be had within just a few CT examinations. When this exposure is conducted repeatedly on individual patients, it can be said that the dangers have a great significance^10,11.

 

Radiological technologists performing clinical work are the people who engage in treatment and iatrochemistry examinations; they aim to contribute to public health and medical improvement. It is of great importance that efforts be made for reducing the amounts of radiation exposure, radiation protection, and others through specialized medical knowledge and highly technical skills^12,13.

 

In this study, we intend to instill the importance of radiation exposure protection for patients by figuring out factors affecting radiation protection behaviors with radiological technologists working in CT examination room as the subject, and contribute to establishing radiation protection management and health and sanitary measures by suggesting a proper improvement plan.

 

2. MATERIALS AND METHODS:

2-1. Research subject:

This study was conducted with 231 radiologic technologists working in CT examination rooms.

 

By randomly selecting medical institutions of each region, surveys were conducted on subjects within 30 days from March 20, 2016 to April 20, 2016.

 

Even for cluster random sampling, sampling close to population distribution was considered. According to Borg and Gall ¹⁴, regular sampling must include 200 people who are to be extracted in order to obtain a normal distribution close to the population. In this research, it intends to extract more than 200 people.

 

A total of 250 surveys were distributed and 240 were collected, resulting in a recovery rate of 96.0%. Nine copies that were not properly written were excluded, 231 copies were used as analysis data in the study.

 

2-2. Research method:

The tool used in the study was a survey written referring to literature and previous studies related to radiation safety management. According to research purpose and subjects, the survey tool was edited and supplemented.

 

The survey was composed of a total of 36 questions including 6 general characteristic questions, and 10 questions each about radiation safety management knowledge, attitude, and behavior.

 

2-3. Statistical analysis:

Data collected through the survey was analyzed using SPSS ver. 23.0.

1.     General characteristics of subjects were determined through frequency and percentage.

2.     T-test and ANOVA was used to verify the differences in knowledge, attitude, and behavior on radiation safety management according to general characteristics of subjects.

3.     Pearson’s Correlation Coefficient was calculated to determine the relation between knowledge, attitude, and behavior on radiation safety management.

 

3. RESULTS:

3-1. General characteristics of subjects:

The general characteristics of the subjects of the study are as follows as seen in Table 1.

 

Table 1: The general characteristics of the subjects.

Characteristics	Categories	N	(%)
Gender	Male Female	185 46	80.1 19.9
Age (year)	20 ~ 29 30 ~ 39 40 ~ 49 50 ~	46 108 53 24	19.9 46.8 22.9 10.4
Marital status	Married Unmarried	140 91	60.6 39.4
Clinical experience (year)	Under 5 5 ~ 10 Over 10	131 69 31	56.7 29.9 13.4
Educational level	Diploma degree Bachelor Master	99 98 34	42.9 42.4 14.7
Hospital size	Under 300 Under 500 Over 500	52 80 99	22.5 34.6 42.9

 

3-2. Knowledge about radiation safety management:

Concerning the knowledge level of radiation safety management, 6.67 ± 1.34 was an average score with the highest of 10 and the lowest of 3 from a 10-scale test.

 

In addition, knowledge level of radiation safety management by general characteristics showed statistically significant differences according to clinical experience (p < 0.05), hospital size (p < 0.05), and educational level (p < 0.05) as seen in Table 2.

 

3-3. Attitude on radiation safety management:

Concerning the attitude level of radiation safety management, 3.41 ± 0.88 is an average score with the highest of 3.95 ± 0.71 and the lowest of 2.78 ± 1.09 by item, from a 5-scale test.

 

Besides, attitude level of radiation safety management by general characteristics showed statistically significant differences according to age (p < 0.01), marital status (p < 0.01), and hospital size (p < 0.001) as seen in Table 3.

 

3-4. Behavior on radiation safety management:

Concerning the behavior level of radiation safety management, 3.68 ± 0.98 is average score with the highest of 4.54 ± 0.81 and the lowest of 2.78 ± 1.00 by item from a 5-scale test.

 

Behavior level of radiation safety management by general characteristics showed statistically significant differences according to clinical experience (p < 0.001) and hospital size (p < 0.05) as seen in Table 4.

 

Table 2: General characteristics according to the knowledge on radiation safety

Characteristics	Categories	N	Mean ± SD	t(F)	P
Gender	Male Female	185 46	6.80 ± 1.19 6.42 ± 1.49	292.199	0.299
Age (year)	20 ~ 29 30 ~ 39 40 ~ 49 50 ~	46 108 53 24	6.64 ± 1.87 6.77 ± 1.72 7.76 ± 1.76 8.82 ± 1.14	194.606	0.067
Marital status	Married Unmarried	140 91	6.41 ± 1.39 7.76 ± 0.80	219.737	0.759
Clinical experience (year)	Under 5 5 ~ 10 Over 10	131 69 31	5.44 ± 1.06 6.82 ± 0.91 7.35 ± 0.78	356.869*	0.028
Educational level	Diploma degree Bachelor Master	99 98 34	6.62 ± 1.30 7.32 ± 0.89 8.79 ± 1.02	515.023*	0.015
Hospital size	Under 300 Under 500 Over 500	52 80 99	5.35 ± 1.51 7.13 ± 1.09 8.09 ± 1.21	500.224*	0.032

^*P < 0.05

 

Table 3: General characteristics according to the attitude on radiation safety management

 ^**P < 0.01, ^***P < 0.001

Characteristics	Categories	N	Mean ± SD	t(F)	P
Gender	Male Female	185 46	3.41 ± 0.58 3.41±0.49	1.102	0.299
Age (year)	20~29 30~39 40~49 50~	46 108 53 24	3.57 ± 0.56 3.38 ± 0.58 3.22 ± 0.51 3.64 ± 0.52	4.841**	0.003
Marital status	Married Unmarried	140 91	3.54 ± 0.56 3.33 ± 0.56	2.767**	0.006
Clinical experience (year)	Under 5 5~10 Over 10	131 69 31	3.45 ± 0.56 3.35 ± 0.57 3.37 ± 0.59	0.789	0.455
Educational level	Diploma degree Bachelor Master	99 98 34	3.42 ± 0.53 3.40 ± 0.60 3.40 ± 0.58	0.044	0.957
Hospital size	Under 300 Under 500 Over 500	52 80 99	3.20 ± 0.60 3.29 ± 0.50 3.62 ± 0.53	13.318***	0.000

Table 4: General characteristics according to the behavior on the radiation safety management

Characteristics	Categories	N	Mean ± SD	t(F)	P
Gender	Male Female	185 46	3.33 ± 0.31 3.37 ± 0.28	1.838	0.759
Age (year)	20~29 30~39 40~49 50~	46 108 53 24	3.42 ± 0.30 3.33 ± 0.32 3.31 ± 0.28 3.31 ± 0.28	1.464	0.225
Marital status	Married Unmarried	140 91	3.39 ± 0.29 3.31 ± 0.31	1.869	0.072
Clinical experience (year)	Under 5 5~10 Over 10	131 69 31	3.32 ± 0.26 3.53 ± 0.32 3.83 ± 0.36	1.901***	0.000
Educational level	Diploma degree Bachelor Master	99 98 34	3.37 ± 0.29 3.28 ± 0.33 3.35 ± 0.27	1.913	0.150
Hospital size	Under 300 Under 500 Over 500	52 80 99	3.32 ± 0.31 3.41 ± 0.30 3.83 ± 0.30	0.082*	0.032

^*P < 0.05, ^***P < 0.001

 

3-5. Relation between knowledge, attitude, and behavior on radiation safety management:

The result of examination of the relation between knowledge, attitude, and behavior on radiation safety management is as follows, as can be seen in Table 5.

 

Table 5: Relationship among knowledge on radiation safety management relevant attitude and behaviors.

Classification	Knowledge	Attitude	Behavior
Knowledge Attitude Behavior	1.000 .385***(0.000) .321*(0.034)	1.000 .351*(0.015)	1.000

^*P < 0.05, ^***P < 0.001

 

4. CONCLUSION:

The study has its purpose on determining the knowledge, attitude, and behavior of radiation safety management for radiologists working in computed tomography laboratories with high exposure doses among the field of diagnostic radiology. It aims to analyze factors influencing safety management behavior in computed tomography laboratories in order to establish protection plans that will prevent health problems in radiologists as well as general users, and to provide basic data for health education programs about radiation safety.

 

For this, we contacted radiological technologists working at hospitals for at least1 month from March of 2016 to April of 2016 and obtained the following findings.

1.     Concerning the knowledge levels of radiation safety management, it was found that the level was higher with increased clinical experience (p< 0.05), Hospital size (p<0.05), and education level (p < 0.05).

2.     Concerning the attitude level of radiation safety management, it had statistically significant differences according to age (p < 0.01), marital status (p < 0.01), and hospital size (p < 0.001)

3.     Concerning the behavior level of radiation safety management, statistically significant differences were shown with clinical experience (p<0.001) and hospital size (p < 0.05).

4.     In the relation between knowledge, attitude, and behavior on radiation safety management, higher level of radiation safety management knowledge correlated to higher level of attitude and behavior, and higher level radiation safety management attitude correlated to higher level of radiation safety management behavior.

 

5. REFERENCES:

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8.  Kim C G, The Development of Bismuth Shielding to Protect the Thyroid Gland in Radiations Environment, Indian Journal of Science and Technology, 2016, 9(25).

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13.  Gall M D, Borg W R, Gall J P, Educational research: An introduction . Longman Publishing, 1996.

 

 

 

 

Received on 19.11.2018         Modified on 19.12.2018

Accepted on 19.01.2019         © RJPT All right reserved