ASSESSMENT OF THE UTILIZATION OF RADIATION SAFETY MEASURES BY RADIATION WORKERS IN TERTIARY HOSPITALS IN ENUGU URBAN

ABSTRACT       It is of paramount interest both to the staff and patients that radiation safety measures are undertaken to ensure that excess unnecessary radiation is not absorbed by the body. The aim of this study was to assess the rate of utilization of radiation safety measures by radiation workers in tertiary hospitals in Enugu urban. A prospective study of 135 radiation workers was conducted using questionnaires and observations. Observations were carried out by the researcher using spy sheets while the questionnaires were of the semi-structured type containing twenty-seven (27) questions tailored to suit the objectives of this study. Descriptive statistics of frequency distribution and percentages was used to analyze the data.   The frequency of female radiation workers is a little more than males (51.5%,n=67 Vs 48.5%, n=63). Age group between 32 to 40 years had the highest frequency of radiation workers (21.03%). There is no form of utilization of radiation monitoring devices in the three tertiary hospitals under study. Non-availability of the radiation monitoring devices is the major reason for non-utilization of these devices in NOHE and ESUTH. In UNTH, it is a contributing factor together with the attitude of radiation workers to radiation safety measures. There is availability of not less than two (2) lead aprons in each of the three tertiary hospitals. There is proper utilization of the lead aprons in each of the hospitals under study.  There is a minimal number of repeat cases in the three hospitals under study. The repeat cases are as a result of poor radiographic technique.   The results showed that there was no form of utilization of radiation monitoring devices in the three tertiary hospitals. It is also found that non-availability of these radiation monitoring devices was the major reason for non-utilization of these monitoring devices. There was proper utilization of the lead apron as a result of its availability. The result also showed that there is no significant association between availability of radiation monitoring devices and consistency of its utilization. There was minimal number of repeat cases and repeat cases encountered were as a result of poor radiographic technique.  Keywords: Radiation safety measures, radiation monitoring devices, utilization, radiation workers, UNTH, ESUTH, NOHE. LIST OF TABLES Table: 1 Number of Radiation workers in each of the hospitals--------------------------30 Table: 2 Age range of the Radiation workers -----------------------------------------------31 Table: 3 Gender of the radiation workers in the three tertiary hospitals ---------------- 32 Table: 4 Duration of practice of the radiation workers in the hospitals ------------------ 33 Table: 5 Provision of radiation monitoring devices in each of the tertiary hospitals ----34 Table: 6 Comparison of the use of personnel monitoring devices in the different tertiary hospitals ------37 Table: 7 Availability of radiation protective devices in the three tertiary hospitals -------38 Table: 8 Utilization of radiation safety measures in the three tertiary health institutions ---39
LIST OF FIGURES Figure 1: Geiger-Muller probe------------------------------------------------------------15 Figure 2: Alpha radiation survey meter-------------------------------------------------15 Figure 3: The pancake type of Geiger-Muller probe----------------------------------16 Figure 4a: Frequency of use of radiation monitoring devices in UNTH--------—35 Figure 4b: Frequency of use of radiation monitoring devices in NOHE-----------36 Figure 4c: Frequency of use of radiation monitoring devices in ESUTH-----------37
TABLE OF CONTENT Title Page ----------------------------------------------------------------------------------i Approval Page ----------------------------------------------------------------------------ii Certification ------------------------------------------------------------------------------iii Dedication --------------------------------------------------------------------------------iv Acknowledgement ------------------------------------------------------------------------v Abstract -----------------------------------------------------------------------------------vi List of Tables ----------------------------------------------------------------------------vii List of figures----------------------------------------------------------------------------                  viii Table of Content ------------------------------------------------------------------------ix CHAPTER ONE 1.0 Introduction ---------------------------------------------------------------------------1 1.1 Background of Study ----------------------------------------------------------------- 1 1.2 Statement of Problem ----------------------------------------------------------------- 3 1.3 Objectives of Study --------------------------------------------------------------------4 1.4 Significance of Study ------------------------------------------------------------------ 4 1.5 Scope of Study -------------------------------------------------------------------------- 5 1.6 Operational definition of terms-------------------------------------------------------- 5 1.7 Review of related Literatures ---------------------------------------------------------- 6 CHAPTER TWO 2.0 Theoretical Background ---------------------------------------------------------------- 15 2.1 Radiation and its types------------------------------------------------------------------- 15 2.1.1 Alpha particles--------------------------------------------------------------------------15 2.1.2 Beta particle-----------------------------------------------------------------------------17 2.1.3 Gamma and X-radiation----------------------------------------------------------------18 2.2 Production of X-rays -------------------------------------------------------------------------19 2.3 Equipment used for the production of X-rays --------------------------------------------- 19 2.4 Interaction of the x-rays with body tissues ------------------------------------------------- 20 2.4.1 Chemistry of interaction-------------------------------------------------------------20 2.4.2 Biological effects of radiation------------------------------------------------------21 2.5 Radiation safety measures -------------------------------------------------------------------- 22 2.5.1 Principle of radiation protection---------------------------------------------------22 2.5.2 Monitoring radiation----------------------------------------------------------------24 CHAPTER THREE 3.0 Research Methodology ------------------------------------------------------------------------- 25 3.1 Research Design --------------------------------------------------------------------------------- 25 3.2 Location of study--------------------------------------------------------------------------------25 3.3 Target Population ------------------------------------------------------------------------------ 25 3.4 Subject description ----------------------------------------------------------------------------- 26 3.5 Sources of Data collection --------------------------------------------------------------------- 26 3.6 Methods of Data collection ------------------------------------------------------------------- 26 3.7 Method of Data Analysis ---------------------------------------------------------------------- 28 CHAPTER FOUR 4.0 Data Analysis and Presentation ---------------------------------------------------------------28 CHAPTER FIVE 5.0 Discussion ----------------------------------------------------------------------------------------- 41 5.1 Summary of findings ----------------------------------------------------------------------------- 43 5.2 Recommendations ---------------------------------------------------------------------------- 44 5.3 Limitation of study----------------------- ------------------------------------------------------ 45 5.4 Areas of further research ----------------------------------------------------------------------- 46 5.5 Conclusions---------------------------------------------------------------------------------------46 References Appendix   INTRODUCTION  Radiation safety measures are measures undertaken to ensure the protection of people and environment from the harmful effects of ionizing radiation which includes both particle radiation and high energy electromagnetic radiation. Ionizing radiation is widely used in industry and medicine and it presents a significant health hazard. The sources of ionizing radiation can cause harm to both humans and to the environment. It causes microscopic damage to living tissues resulting in skin burns and radiation sickness at high exposures and statistically elevated risks of cancer at low exposures. The most important source of ionizing radiation is that used in medicine for diagnostic and therapeutic purposes. 1 Several International guidelines and regulations have been published addressing ionizing radiation, their sources and dose Limits. It is important not to forget that the primary aim of radiography and radiology is to produce diagnostic images, which assist to establish correct diagnosis and thus be a benefit to the treatment of patients. Taking radiation dose into consideration, the ALARA principle must be followed. The relevance of radiation protection aspects and patient doses are sometimes similar for both therapeutic and diagnostic procedures. Radiation protection for patient and staff is one of the main issues in diagnostic radiography, which explains why many international and national organizations together with other scientific and professional societies have put all their efforts into improving   radiation safety in diagnostic radiology over the last years. Radiation protection can therefore be divided into occupational radiation protection which is the protection of workers, medical radiation protection which is the protection of patients and the radiographer and the public radiation protection which is the protection of individual members of the public and the population as a whole.3 It is therefore essential that radiation workers be protected when they need to work outside the protective cubicle. There should be protective devices in the diagnostic room for the workers and patient’s relatives who come into the room to assist the patient. These devices are used to protect staff, patient’s relatives and patient from receiving unnecessary radiation dose from the primary beam and from the scattered radiation. These devices include:4 • Lead rubber aprons of at least 0.25mm lead equivalent • Lead rubber gloves of at least 0.35mm lead equivalent. • Thyroid shields • Gonad shields • Lead goggles These devices should therefore be taken care of to prevent damage and enhance efficiency, For example the lead aprons should be hung up on a sturdy hanger and should never be folded to avoid cracks, splits or tears. Monthly visual inspections of all protective devices should be undertaken to assess their conditions.4 Medical staff and patients should be adequately protected from the effects of radiation and this can be achieved by;4    • Limitation of field size to the area of interest. • Optimal film processing • Use of automatic exposure timer if available. • Compression of obese patients to reduce scatter radiation. • Use of gonad shields, lead aprons etc • X-ray unit must have adequate shielding • Staff who are required outside the barrier must wear lead apron • All staff must stand behind the protective barrier during the exposure. • Performance of basic quality assurance tests • Reduction of number of repeats by careful patient positioning and the use of immobilizing devices. The International Atomic Energy Agency (IAEA) has stipulated 20mSv on the average of 5years and not more than 50mSv in a single year as the annual permissible dose limit for a radiation worker5. The dose limit should not exceed an effective dose of 6mSv in a year, an equivalent dose to the lens of the eye of 50mSv in a year and an equivalent dose to the extremities or skin of 150mSv in a year. Then for the public, the effective dose should not exceed 1mSv in a year, equivalent dose to the lens of the eye should not exceed 15mSv in a year and an equivalent dose to the skin should not exceed 50mSv in a year.