A survey of radiation safety training among South African interventionalists

Abstract

Interventionalists are highly specialised doctors who undergo rigorous training. The use of ionising radiation is an integral part of their medical practice and potentially poses major occupational health risks, such as skin damage, genetic and chromosomal aberrations, carcinomas and cataract formation. [1] The use of this modality for diagnostic, treatment and interventional procedures has increased substantially, posing greater occupational risks. [2] In medicine, occupational radiation protection is challenging and increased vigilance is required to protect radiation healthcare workers (HCWs). [1] Ionising radiation places patients at risk of developing skin reactions and alopecia, malaise, gastrointestinal problems, damage to heart and lungs, and primary and secondary carcinomas. [3] Patients may receive an increased radiation dose owing to over-investigation, because of the complexity and duration of procedures or poor radiation safety practices by operators. [3] Improved knowledge of radiation safety for patients may assist in reducing these complications and thus improve the quality of care. [4] Specialists require dedicated training in radiation safety, as it effectively reduces radiation risk and optimises radiation safety practices. [5] There is a need to elevate the level of training received by interventional cardiologists to that of interventional radiologists. [6] This may be challenging, as the cardiologists' curriculum already comprises an enormous volume of work, but it is important that professional and regulatory bodies find a way to implement and foster these changes in the interest of interventionalists and their patients. [6] Developing a culture of learning will assist in developing a culture of radiation protection (CRP), which is essential to lessen radiation exposure. A CRP is a combination of the knowledge, beliefs and practices in an organisation that promotes radiation safety in the workplace. [7] Creating and sustaining a CRP is the responsibility of the catheterisation laboratory team (doctors, nurses and radiographers) and managers. [8] The latter are responsible for ensuring that the equipment is functional and maintained and for providing sufficient and correct personal protective equipment (PPE). [8] A CRP creates awareness of the risks of radiation injury to patients and operators and facilitates improved compliance with PPE use. [7] This culture can be stimulated by including radiation safety training in the formal curriculum of all interventionalists. [9] The objective of this article is to present the findings of the perceptions of South African (SA) interventionalists on the radiation safety training they received and to offer insights into the importance of developing and promoting such training programmes for all interventionalists in SA. MethodsIn this cross-sectional study, we collected data by means of a structured survey. The study forms part of a larger multiple-methods study, which is described elsewhere. [10] The study population consisted of SA radiologists, adult...

An Africa point of view on quality and safety in imaging

“…Another evidence for progress in awareness is the increased research by scientists and students. Over the last ten years, several African undergraduate, postgraduate students and doctoral students have done research and published dissertations and theses on different aspects radiation safety [ 39 , 40 ].…”

Using the theory of planned behaviour to determine radiation protection among South African diagnostic radiographers: a cross‐sectional survey

“…7 A South African study explained that radiation protection practices were lacking because radiation is invisible, and effects possibly occurring later in life. 21 Similarly, an Iranian study showed that the majority of radiographers had a weak or moderate performance of radiation protection. 22 Studies in Northern Nigerian 23 and California 24 also indicated poor radiation protection practices.…”

“…Likewise, a retrospective evaluation of 100 pre‐processed neonatal chest X‐rays revealed that 77% were not collimated optimally 7 . A South African study explained that radiation protection practices were lacking because radiation is invisible, and effects possibly occurring later in life 21 . Similarly, an Iranian study showed that the majority of radiographers had a weak or moderate performance of radiation protection 22 .…”

“…Providing optimal radiation protection in areas with the varying power dynamics of differently ranked medical personnel is challenging. Rose et al.’s 21 South African study noted that power disparities and ‘egos’ of the medical team might hinder radiation protection compliance. A similar finding was noted in an Australian study showing medical dominance as a hindrance to radiation protection 37 .…”

“…6 In the same vein, respondents in Rose et al. 's 21 South African study, acknowledged that radiation protection practices were lacking because radiation is invisible and effects may occur much later. Respondents in Rose et al.’ s 21 South African study indicated that they would rather perform interventional procedures without personal protective equipment than compromise the care of patients.…”