Safety first: Residents need more radiation education

Knowledge among residents is limited regarding radiation safety for patients and healthcare workers, according to a study published online April 5 by Academic Radiology.

Despite an increase in radiation exposure from medical imaging that the American population has undergone in recent years, surveys have found a lack of knowledge and awareness about radiation doses and safety among referring physicians, regardless of their specialties. Lead author Gelareh Sadigh, MD, of the Emory University School of Medicine in Atlanta, and colleagues investigated the frequency of discussion about radiation safety in residency curricula, residents’ level of awareness of radiation doses and safety principles and self-reported behavior.

To achieve their study’s aims, Sadigh et al asked residents from 15 of Emory University’s residency programs to complete a radiation safety survey. Of 532 residents, 173, or 32.5 percent, completed the survey.

Thirty-nine percent of residents said that radiation safety was discussed in their residency curriculum at least every six months. Ninety-five percent responded that they believe there is a link between radiation exposure and development of cancer.

Knowledge about specific estimated dose effects, however, was limited. Overall, 10 percent of residents could estimate the radiation dose associated with fetus brain malformation in pregnancy versus 26 percent of radiology residents. Twenty-seven percent of residents knew that there is risk of developing cataract in interventional personnel, versus 47 percent of radiology residents.

The lifetime risk of cancer mortality from a single abdominal CT in pediatric patients was estimated by 22 percent of overall residents and 29 percent of radiology residents. Thirty-five percent of overall residents had knowledge of children’s greater radiosensitivity than adults, versus 50 percent of radiology residents. Lastly, relative radiation dose from an abdominal CT compared to a chest x-ray was estimated by 51 percent of residents and 48 percent of radiology residents.

No significant difference was found in residents' knowledge across their postgraduate training years. The use of lead thyroid shields was reported by 86 percent of respondents (97 percent from radiology and 80 percent from nonradiology) and radiation-monitoring badges were worn by 39 percent of participants (68 percent in radiology versus 15 percent nonradiology).

The study’s authors suggested that radiation safety knowledge and culture is not fully disseminated to other physician specialties and offered several solutions. “Standard basic radiation safety and protection curriculum for of all residents, particularly nonradiology residents, may decrease this knowledge gap,” wrote Sadigh and colleagues.

They also advised use of open-source educational tools and implementation of radiology consulting services.