A survey of radiation protective equipment compliance amongst physicians performing fluoroscopy at Tygerberg Hospital
Date
2023-12
Authors
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Journal ISSN
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Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Background: A high level of radiation protection equipment compliance is essential to protect physicians against ionizing radiation exposure. Initially, the majority of fluoroscopically guided interventional procedures were performed by radiologists, subsequently there have been a steady increase in physicians from other specialties employing procedural fluoroscopy. Compliance with the use of radiation protective equipment varies considerably in practise. Likely reasons could be differences in radiation safety training, variation in radiation safety knowledge and attitudes and practices inherent to different specialties. To better understand compliance with radiation protection equipment, the knowledge, attitudes, and usage patterns amongst exposed workers need critical examination. Objectives: The aim of the study was to determine factors associated with a low level of radiation protection equipment compliance amongst physicians performing fluoroscopically guided interventional procedures. Methods: A self-administered questionnaire was distributed to eligible subjects. Questions explored the following domains: demographic variables, radiation safety knowledge, attitudes towards radiation safety and practices associated with radiation protection equipment. Results: The proportion of subjects reporting compliant use of radiation protection equipment items were as follows: 8.4% for lead caps, 16.9% for eyewear, 3.3% for lead gloves, 56% for thyroid shields and 89.8% for lead aprons. For cap usage a low radiation safety knowledge level (OR=11.3, 95%CI=1.3-95.8; p = 0,049) and not supplying the item (OR = 5.8, 95%CI=1.1-30.2; p = 0,023) were associated with low compliance levels. Female gender (OR=5.1, 95%CI=1.2-21.9 p=0.028); radiology practice (OR=15.6, 95%CI=2.9-85.2; p=0,001); not supplying orthopods with eyewear (OR=22.5, 95%CI=2.7-189 p < 0,001) and less than 5 years of experience performing fluoroscopically guided interventional procedures (OR=8.1, 95%CI=1.8-36.5; p = 0.005) were identified as risk factors for low compliance with eyewear usage. Practising as an orthopod (OR=0.2, 95%CI=0-0.9 p=0.023) was identified as a protective factor against low compliance for eyewear. For thyroid shields female gender (OR=14.3, 95%CI=1.7-119.1; p = 0.003); not supplying orthopods with shields (OR=4.9, 95%CI=1.5-16.2, p < 0,001) and less than 5 years of experience performing fluoroscopically guided interventional procedures (OR=26.6, 95%CI=3.2-219.6, p < 0.001) were identified as risk factors. Practising as an orthopod (OR=0.1, 95%CI=0-0.3, p < 0.001) was identified as a protective factor against low compliance. No statistically significant associations were observed for low compliance in lead apron usage. Physicians with a low radiation safety knowledge of <40% (OR=11.3, 95%CI=1.3-95.8, p = 0.049) were 11.3 times more likely to be non-compliant with lead glove usage. Conclusions: The level of radiation protection equipment usage amongst the study population is far from desirable. Significant variation exists amongst subjects’ knowledge of radiation safety. Agreeable attitudes towards radiation safety practice were universally reported by subjects. Providing radiation protection equipment that fits the user is critical in addressing low compliance levels going forward.
AFRIKAANSE OPSOMMING: Agtergrond: 'n Hoe vlak van voldoening aan die dra van stralingsbeskermingstoerusting is noodsaaklik om dokters teen blootstelling aan ioniserende straling te beskerm. Aanvanklik was die meerderheid van fluoroskopies geassisteerde intervensionele prosedures deur radioloe uitgevoer. Met die verloop van tyd was daar 'n bestendige toename in dokters van ander spesialiteite wat prosedurele fluoroskopie gebruik. Voldoening aan die gebruik van stralingbeskermingstoerusting verskil aansienlik in die praktyk. Waarskynlike redes kan verskille in stralingsveiligheidsopleiding, variasie in stralingsveiligheidskennis, gesindhede en praktyke inherent aan verskillende spesialiteite wees. Om die gebruik van stralingsbeskermingstoerusting beter te verstaan, moet die kennis, gesindhede en gebruikspatrone onder blootgestelde werkers krities evalueer word. Doelwitte: Die doel van die studie was om faktore te bepaal wat verband hou met 'n lae vlak van stralingsbeskermingstoerusting gebruik onder dokters wat fluoroskopies geleide intervensionele prosedures by Tygerberg Hospitaal uitvoer. Metodes: 'n Selfgeadministreerde vraeboog is aan kwalifiserende persone versprei. Vrae het die volgende domeine ondersoek: demografiese veranderlikes, stralingsveiligheidskennis, gesindhede teenoor stralingsveiligheid, en stralingsbeskermingstoerusting praktyke. Resultate: Die proporsie persone wat stralingsbeskermingstoerusting gebruik het, was soos volg: 8.4% vir lood hooftooisels, 16.9% vir loodbrille, 3.3% vir loodhandskoene, 56% vir skildklierskerms en 89.8% vir loodjasse. Vir hoof-beskerming was 'n lae vlak van stralingsveiligheidskennis (WV=11.3, 95%VI=1.3-95.8; p = 0.049) en die nie-voorsiening van die item (WV = 5.8, 95%VI=1.1-30.2; p = 0.023) geassosieer met lae nakomingsvlakke. Die vroulike geslag (WV=5.1, 95%VI=1.2-21.9 p=0.028); die radiologie spesialiteit (WV=15.6, 95%VI=2.9-85.2; p=0.001); die nie-voorsiening van loodbrille aan ortopede (WV=22.5, 95%VI=2.7-189 p < 0.001) en minder as 5 jaar ervaring met die uitvoering van fluoroskopies-geleide intervensionele prosedures (WV=8.1, 95%VI=1.8-36.5; p = 0.005) is geidentifiseer as risikofaktore vir lae nakomingsvlakke van loodbril gebruik. Die ortopediese spesialiteit (WV=0.2, 95%VI=0-0.9 p=0.023) was geidentifiseer as 'n beskermende faktor teen lae nakoming vir loodbril gebruik. Die vroulike geslag (WV=14.3, 95%VI=1.7-119.1; p = 0,003) was geassosieer met die gebruik van skildklierbeskerming; Die nie-voorsiening van ortopediese chirurge met skildklierbeskerming (WV=4.9, 95%VI=1.5-16.2, p < 0,001) en minder as 5 jaar ervaring met die uitvoering van fluoroskopies geleide intervensionele prosedures (WV=26.6, 95%VI=3.2-219.6, p < 0.001 ) is as risikofaktore geidentifiseer. Die ortopediese spesialiteit (WV=0.1, 95%VI=0-0.3, p < 0.001) was geidentifiseer as 'n beskermende faktor teen lae nakomingsvlakke vir die gebruik van skildklier beskerming. Geen statisties beduidende assosiasies is waargeneem vir lae nakomingsvlakke in die gebruik van loodjasse nie. Dokters met 'n stralingsveiligheidskennis van minder as 40%, soos bepaal deur die vraeboog, was 11.3 keer meer geneig om nie te voldoen aan die gebruik van loodhandskoene nie (WV=11.3, 95%VI=1.3-95.8, p = 0.049). Gevolgtrekkings: Die vlak van stralingsbeskermingstoerustinggebruik onder die studiepopulasie is ver van wenslik. Daar is beduidende variasie in die dokters se kennis oor stralingsveiligheid. Gunstige gesindhede teenoor die beoefening van stralingsveiligheids is universeel gerapporteer. Die verskaffing van stralingsveiligheidstoerusting wat by die gebruiker pas, is van kritieke belang om lae nakomigsvlakke aan te spreek.
AFRIKAANSE OPSOMMING: Agtergrond: 'n Hoe vlak van voldoening aan die dra van stralingsbeskermingstoerusting is noodsaaklik om dokters teen blootstelling aan ioniserende straling te beskerm. Aanvanklik was die meerderheid van fluoroskopies geassisteerde intervensionele prosedures deur radioloe uitgevoer. Met die verloop van tyd was daar 'n bestendige toename in dokters van ander spesialiteite wat prosedurele fluoroskopie gebruik. Voldoening aan die gebruik van stralingbeskermingstoerusting verskil aansienlik in die praktyk. Waarskynlike redes kan verskille in stralingsveiligheidsopleiding, variasie in stralingsveiligheidskennis, gesindhede en praktyke inherent aan verskillende spesialiteite wees. Om die gebruik van stralingsbeskermingstoerusting beter te verstaan, moet die kennis, gesindhede en gebruikspatrone onder blootgestelde werkers krities evalueer word. Doelwitte: Die doel van die studie was om faktore te bepaal wat verband hou met 'n lae vlak van stralingsbeskermingstoerusting gebruik onder dokters wat fluoroskopies geleide intervensionele prosedures by Tygerberg Hospitaal uitvoer. Metodes: 'n Selfgeadministreerde vraeboog is aan kwalifiserende persone versprei. Vrae het die volgende domeine ondersoek: demografiese veranderlikes, stralingsveiligheidskennis, gesindhede teenoor stralingsveiligheid, en stralingsbeskermingstoerusting praktyke. Resultate: Die proporsie persone wat stralingsbeskermingstoerusting gebruik het, was soos volg: 8.4% vir lood hooftooisels, 16.9% vir loodbrille, 3.3% vir loodhandskoene, 56% vir skildklierskerms en 89.8% vir loodjasse. Vir hoof-beskerming was 'n lae vlak van stralingsveiligheidskennis (WV=11.3, 95%VI=1.3-95.8; p = 0.049) en die nie-voorsiening van die item (WV = 5.8, 95%VI=1.1-30.2; p = 0.023) geassosieer met lae nakomingsvlakke. Die vroulike geslag (WV=5.1, 95%VI=1.2-21.9 p=0.028); die radiologie spesialiteit (WV=15.6, 95%VI=2.9-85.2; p=0.001); die nie-voorsiening van loodbrille aan ortopede (WV=22.5, 95%VI=2.7-189 p < 0.001) en minder as 5 jaar ervaring met die uitvoering van fluoroskopies-geleide intervensionele prosedures (WV=8.1, 95%VI=1.8-36.5; p = 0.005) is geidentifiseer as risikofaktore vir lae nakomingsvlakke van loodbril gebruik. Die ortopediese spesialiteit (WV=0.2, 95%VI=0-0.9 p=0.023) was geidentifiseer as 'n beskermende faktor teen lae nakoming vir loodbril gebruik. Die vroulike geslag (WV=14.3, 95%VI=1.7-119.1; p = 0,003) was geassosieer met die gebruik van skildklierbeskerming; Die nie-voorsiening van ortopediese chirurge met skildklierbeskerming (WV=4.9, 95%VI=1.5-16.2, p < 0,001) en minder as 5 jaar ervaring met die uitvoering van fluoroskopies geleide intervensionele prosedures (WV=26.6, 95%VI=3.2-219.6, p < 0.001 ) is as risikofaktore geidentifiseer. Die ortopediese spesialiteit (WV=0.1, 95%VI=0-0.3, p < 0.001) was geidentifiseer as 'n beskermende faktor teen lae nakomingsvlakke vir die gebruik van skildklier beskerming. Geen statisties beduidende assosiasies is waargeneem vir lae nakomingsvlakke in die gebruik van loodjasse nie. Dokters met 'n stralingsveiligheidskennis van minder as 40%, soos bepaal deur die vraeboog, was 11.3 keer meer geneig om nie te voldoen aan die gebruik van loodhandskoene nie (WV=11.3, 95%VI=1.3-95.8, p = 0.049). Gevolgtrekkings: Die vlak van stralingsbeskermingstoerustinggebruik onder die studiepopulasie is ver van wenslik. Daar is beduidende variasie in die dokters se kennis oor stralingsveiligheid. Gunstige gesindhede teenoor die beoefening van stralingsveiligheids is universeel gerapporteer. Die verskaffing van stralingsveiligheidstoerusting wat by die gebruiker pas, is van kritieke belang om lae nakomigsvlakke aan te spreek.
Description
Thesis (MMed)--Stellenbosch University, 2023.