Status of radiation protection at different hospitals in Nepal

Abstract

Nepal has a long history of medical radiology since1923 but unfortunately, we still do not have any Radiation Protection Infrastructure to control the use of ionizing radiations in the various fields. The objective of this study was an assessment of the radiation protection in medical uses of ionizing radiation. Twenty-eight hospitals with diagnostic radiology facility were chosen for this study according to patient loads, equipment and working staffs. Radiation surveys were also done at five different radiotherapy centers. Questionnaire for radiation workers were used; radiation dose levels were measured and an inventory of availability of radiation equipment made. A corollary objective of the study was to create awareness in among workers on possible radiation health hazard and risk. It was also deemed important to know the level of understanding of the radiation workers in order to initiate steps towards the establishment of Nepalese laws, regulation and code of radiological practice in this field. Altogether, 203 Radiation workers entertained the questionnaire, out of which 41 are from the Radiotherapy and 162 are from diagnostic radiology. The radiation workers who have participated in the questionnaire represent more than 50% of the radiation workers working in this field in Nepal. Almost all X-ray, CT and Mammogram installations were built according to protection criteria and hence found safe. Radiation dose level at the reference points for all the five Radiotherapy centers are within safe limit. Around 65% of the radiation workers have never been monitored for radiation. There is no quality control program in any of the surveyed hospitals except radiotherapy facilities.

A Survey of Structural Design of Diagnostic X-ray Imaging Facilities and Compliance to Shielding Design Goals in a Limited Resource Setting

“…The findings still corroborate those of an earlier study (6). If the distance from the x-ray tube to the nearest point of occupancy is not optimized and the recommended shielding materials are not used, the possibility of unintended exposure to unsuspecting staff, patients in the waiting area and the general public is high (10).…”

“…A well-designed x-ray imaging facility which takes into consideration design controls such as shielding and distance will minimize radiation exposure (6). This is rarely achieved in low-and middle-income countries with limited resources and a paucity of funds for standardized purpose-build x-ray rooms where the cost of lead shielding is also high, as noted by previous research (7,8).…”

“…This is rarely achieved in low-and middle-income countries with limited resources and a paucity of funds for standardized purpose-build x-ray rooms where the cost of lead shielding is also high, as noted by previous research (7,8). Unoptimized structural design of x-ray rooms and location of x-ray equipment within the x-ray room with marked variations from the recommended standard guidelines due to limited resources have been reported in studies conducted in limited-resource settings (6)(7)(8).…”

“…A properly designed and shielded x-ray imaging room is important for the radiation protection of the patient, staff and the general public. It is recommended that prior to equipment installation, surveys be carried out to ensure that the approved building plans have been followed and that the shielding and operating conditions in terms of design controls provide protection for all persons (3)(4)(5)(6).…”

Ionizing Radiation Leakage in Radio-Diagnostic Centers at Gaza Strip Hospitals, Palestine

“…Where is the equivalent dose rate level readings in air at each point in units of (mSv/min); intensity (I m ) in mA units and Workload in units of ( ) [6].…”