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A Study on the Awareness on Occupational Health Safety among Health Care

Professionals in Radiology Department in a Selected Hospital 1 2 2

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 ORIGINAL ARTICLE

A Study on the Awareness on Occupational Health Safety among Health Care

Professionals in Radiology Department in a Selected Hospital
Ancita Iral D'souza1, Sweta D'cunha2, Sucharitha Suresh2
1 2
Post-graduate, Assistant Professor
Department of Hospital Administration, Fr. Muller Medical College, Mangalore

Abstract
Health and safety are important aspects of an organization's smooth and effective functioning. Good health and safety performance ensures
an accident – free industrial environment. Awareness of occupational safety and health plays an important role in the prevention of
occupational injuries and diseases. A study was undertaken to find the occupational health safety measures and also the awareness on
Occupational Health Safety among health care professionals in Radiology department .It included 30 Radiology professionals. It was
observed by the check list that majority (80%) of the Occupational Safety Measures were present in the Radiology department. Through
questionnaire it was found that majority (83.7%) of the respondents were aware of the Occupational Health Safety in the Radiology
Department. Radiation safety is a vital component of protective measures taken at any hospital that has diagnostic radiological and
radiotherapy equipment.
Key words: Radiation Safety, Protective Clothing, Occupational Safety.

INTRODUCTION The maximum permissible doses advised by the National

The right to work in a safe and healthy environment is the Council on Radiation Protection and Measurements and
specified in most state health codes were established by setting
fundamental right of every worker. Traditionally, hospitals
the numeric values equal to the risks of “safe” non radiologic
and health institutions were considered to be safer than other
occupations. There is no implication that doses lower than the
work environments, and healthcare workers were viewed as
maximum permissible dose are absolutely safe or that doses
professionals who are capable of maintaining their health
greater than the maximum permissible dose are always toxic.
without assistance. Thus, administrators have allocated few
To minimize unnecessary dose, most radiation protection
resources to the occupational health and safety hazards. programs issue alerts when radiation badge readings exceed
Occupational health and safety is about ensuring a safe 10% and 30% of the maximum permissible dose.2
workplace. It is essential for all employers to provide a safe
George Simon and colleagues3 proposed that care must be
working environment for all employees. Employees have the taken to ensure that staff does not receive excessive radiation.
right to know what hazardous materials, equipment or Lead aprons should be worn or lead screens used for the
processes they work with or could be exposed to, and what protection of staff in X-ray rooms. X-ray personnel should
they can (and must), do to avoid injury or illness when working wear film monitors recording their exposure to radiation. A
with these materials, equipment or process.. Employees have nurse, medical student or doctor should not repeatedly hold a
an obligation under the Occupational Health and Safety Act difficult patient; such has an infant, during X-ray
2004 to report hazards identified in the workplace. examinations. A student or clinician visiting a properly
Management commitment to health and safety and strong equipped department is in no danger from radiation,
worker participation are two essential elements of any provided he takes care to avoid direct exposure and wears a
successful workplace health and safety programme. The most lead apron in an examination room.
effective accident and disease prevention begins when work Objectives
processes are still in the design stage.1
To Study the Various Occupational Health Safety Measures
*Author Correspondence: in Radiology Department in a selected Hospital.and to
Ancita Iral D'souza, Postgraduate, Department of Hospital Administration, Assess the Awareness about Occupational Health Safety
Fr. Muller Medical College, Mangalore
among the Health Care Professionals in Radiology
E-mail: [email protected]
Department.

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Ancita Iral D’souza et. al.: A Study on the Awareness on Occupational Health Safety among Health Care Professionals in Radiology Department in a Selected Hospital

MATERIAL AND METHODS The study was to assess the occupational health safety
The Research approach adopted in this study was a measures shows that the majority of the general safety
Descriptive Method. A structured questionnaire was measures, personnel safety measures ,infrastructure safety
prepared to assess the awareness of Occupational Health measures, Equipment safety measures, process safety
Safety and data was collected from all health care measures, organizational measures are present in the
Professionals involved in Radiology. Study was conducted radiology department .But the department is lagging behind
using purposive sampling techniques.and the sample size was in conducting the radiation safety programme and there is
30. Data was collected through a checklist to study the various requirement to post a Appropriate Radiation Sign at the
Occupational Health Safety Measures in Radiology entrance and a need to provide annual health checkups for
Department. employees. According to the Steven Geigle, OSH Academy
Course study guide line, the use of personnel equipment to
RESULTS
reduce employee exposure to hazards when engineering and
The results of the study includeed the findings of Observation administrative controls are not feasible or effective, will
study in the form of check list to study the presence/absence reduce these exposures to acceptable levels . Employers are
of various Occupational Health Safety Measures and also required to determine if PPE should be used to protect their
included the findings of the survey to assess the awareness of workers and have an obligation to provide PPE, including PE
Occupational Health Safety among the Radiology for eyes, head, neck, and body . Employers must also make
Professionals in the radiology department. sure employees use and maintain PPE in a sanitary and
Part 1: The checklist was divided under the following reliable condition.4 General Recommendations for medical x-
categories: General radiation safety, personnel safety ray installation by Bhabha Atomic research Centre (BARC)
measures, infrastructure safety measures, equipment safety also state the following: Each diagnostic installation should
measures, process safety measures, organizational safety have concrete walls of 9 inches thickness and also lead
measures (Table 1-3). shielding of walls needed. The personnel film badge /

Table1: The presence/absence of the general safety measures and the personnel safety measures in the radiology department.
ITEM DESCRIPTION YES NO
GENERAL RADIATION SAFETY:
1.Appropriate radiation warning sign(s) are posted at entrance ü
2. Radioactive material and radiation producing devices are secured to prevent unauthorized Access ü
3. State Regulations for Protection Against Radiation is available ü
4. Radiation Safety Manual is available ü
5. Instruments for radiation detection and measurement such as crystal dosimeter, ionization are provided in the unit ü
PERSONNEL SAFETY MEASURERS
6. All personnel have documented training of appropriate type ü
7. Appropriate personnel are supplied with dosimeters ü
8. Adequate Personal protective equipment are available and worn appropriately ü
9. which of the following PPEs are used
a. Head ü
b. Neck (thyroid gland) ü
c. Eye (goggles) ü
d. Hands (gloves) ü
e. Waist (shield) ü
f. Body (apron, shield) ü
9. Employees wear proper eye protection to prevent exposure when using or repairing ultra-violet and infra-red ü
instruments or equipment
10. PPEs are checked for cracks visually at frequent intervals and Radio graphically at least annually ü
11. Hands are washed before exiting work area ü
12. Annual health checkups are provided for employees ü
13.Continuously holding or supporting patients is prohibited during Radiography ü

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Table 2: The presence/absence of the Infrastructure Safety Measures and the Equipment Safety Measures in the
Radiology Department.
INFRASTRUCTURE SAFETY MEASURERS YES NO
14. Rooms housing diagnostic X-ray units and related equipment are located as far away as feasible ü
from areas of high occupancy and general traffic, such as maternity and paediatric wards and other
departments of the hospital that are not directly related to radiation and its use.
15. Work area is orderly and free of clutter ü
16. Food, drink, etc., prohibited ü
17. Control panel marked with appropriate warnings ü
18. Control panel are located and designed for radiation safety ü
PROCESS SAFETY MEASURERS YES NO
19. Recommended shielding is done for the walls of an X ray room/ CT Suit etc.
Concrete ü
Lead ü
Wood ü
20. Storage of undeveloped X-ray films and personnel monitoring devices when not in use is done ü
appropriately in areas protected from X-rays and other radiation sources in the installation
EQUIPMENT SAFETY MESURES
21. Proper beam projection equipments (Collimate) are used ü
22. Only X ray tubes with permissible doses of radiation are used ü
23. Regular Maintenance and calibration is done ü
24. Annual inspection is done and documented? ü

Table 3: The presence/absence of the Process Safety Measures and the Organizational Safety Measures in the
Radiology Department.
PROCESS SAFETY MEASURERS YES NO
25. To ensure minimum possible dose to the patient, the field size is restricted to the minimum that is consistent ü
with the diagnostic requirement
26. Only persons certified by the competent authority on the basis of their experience and radiation protection ü
background to undertake this job Safely shall undertake servicing of equipment.
27. No person other than those specifically concerned with a particular examination stays in room during ü
radiological examinations
28. A suitable warning signal such as red light is provided at a conspicuous place outside the room and kept ü
“ON” when the units in use to warn persons not connected with the particular examination from entering the room
ORGANISATIONAL SAFETY MEASURES
29.There a radiation surveillance programme ü
30.There is a radiation safety programme. ü
31.There is a Radiation Safety committee in the hospital ü
AWARENESS ON GENERAL ASPECTS OF RADIATION
32. Regular radiation protection surveys (audits) are conducted ü
33. Written operating procedure is readily available ü
34. There is a system for reporting of incidents and near incidents ü
35.Quarterly safety device tests are performed and documented in log ü

dosimeter should be used quarterly submitted to BARC and The awareness on Occupational Health Safety was assessed
Doors should be adequately lead lined about 1.5 and kept on the following categories: Awareness on general aspects of
closed. Under no circumstances should the x-ray beam be radiation, protective clothing and safety badge, updating
directed towards doors or windows.5 knowledge about radiation safety, health and safety, awareness
PART 11: To assess the Awareness on Occupational about the regularity of badges sent to BARC for dose
Health Safety Among the Radiology Professionals. estimation, measures taken if the radiation dose is more than

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Ancita Iral D’souza et. al.: A Study on the Awareness on Occupational Health Safety among Health Care Professionals in Radiology Department in a Selected Hospital

acceptable, awareness on radiation protection, programmes Fig. 1: Demographic Data

to ensure high level safety in radiology, measures to be taken
when radiology employee pregnant, and the measures taken
by the hospital authority towards pregnant employees in
radiology department (Table 4).

The above table reveals that the all the respondents were
aware of the side effects of radiation on health, providing the

Table 4: Awareness on the Occupational Health safety Measures.

Awareness on pre- placement examination 23(76.6%) 7(23.3%)
Awareness on the side effects of radiation on health 30(100%) 0(0%)
Awareness on Compulsory periodic health check up for staff 25(83.3%) 5(16.7%)
If yes, which are those
Chest x- ray 21(84%) -
Lab investigation 24(96%) -
Special investigation(skin, hand, finger) 22(88%) -
Awareness on pregnant employee cannot continuing the work in the radiology department 28(93.3%) 2(6.7%)
AWARENESS ON PROTECTIVE CLOTHING AND SAFETY BADGE
Awareness of Protective clothing of an approved design has to be provided for staff during work 28(93%) 2(7%)
If yes, which has To be provided.
Lead apron 28(100%) -
Gloves 24(85.7%) -
Goggles 24(85.7%) -
Awareness of Protective clothing should be worn during every-radiation exposure 27(90%) 3(10%)
Awareness on Wearing the radiation safety badge 28(93.3%) 2(6.7%)
Awareness on the typical staff dose levels in radiology 25(83.3%) 5(16.7%)
AWARENESS ON UPDATING KNOWLEDGE ABOUT RADIATION SAFETY
Awareness on training programmes On radiation safety 27(90%) 3(10%)
If yes , which following have you attended
Seminar 20(74.7%) -
Workshop 15(55.5%) -
Classes 14(51.8% )-
Awareness on frequently updating knowledge about radiation safety 21(70%) 9(30%)
If yes, how do you access the information
Journals 18(85.7%) -
News paper 10(47.6%) -
Books 8(38.1%) -
In service programme 9(42.8%) -
In service programme 8(38.1%) -
AWARENESS ON HEALTH AND SAFETY
Awareness on policy in place as pertains to health and safety 22(73.3%) 8(26.7%)
Awareness of the health and safety requirements for radiology unit 28(93.3%) 2(6.7%)
Awareness on the information about standards of health and safety practices should be given 16(53.3%) 14(46.7%)
while joining job
Awareness on risk management measures that are to be constantly reviewed and informed 22(73.3%) 8(26.7%)

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Ancita Iral D’souza et. al.: A Study on the Awareness on Occupational Health Safety among Health Care Professionals in Radiology Department in a Selected Hospital

lead apron for staff during work. The study also shows that the had had a sensitization introduction about radiation safety
majority of the respondents had the awareness on the before they started working with radiation, 18 (81.8%)
protective clothing, wearing the radiation safety badge, thought that the radiation safety measures taken at the work
typical dose level, periodic health check up for staff ,training place were inadequate. It was noted that radiation workers
programmes on radiation safety ,and also majority of the were well informed about radiation safety.6 (Table 5)
respondents were aware that the pregnant employee cannot
continuing the work in the radiology department . The The data shows that the respondents had a very good
respondents were aware of the policy pertaining to health and knowledge about the regularity of the badge to be sent to
safety(73.3%), health and safety requirements for radiology BARC for dose estimation(56.7%), taking the risk leave if the
unit(93.3%), standards of health and safety practices are to be radiation dose received more than the acceptable(96.6%),and
given while joining the job(53.3%), risk management the awareness on the measures to be taken to provide the
measures has to be constantly reviewed (73.3%). According to radiation safety(100%).the respondents had the good
the study conducted about Radiation Safety on the knowledge on the action that has to be taken if the radiology
Awareness among Radiation Workers and Clientele At employee is pregnant (80%)and about the awareness on the
Mulago Hospital, it revealed that 68.2% reported that they measures taken by the hospital authority towards pregnant

Table 5: Awareness on Radiation Safety

AWARENESS ABOUT THE REGULARITY OF BADGES SENT TO BARC FOR DOSE ESTIMATION. FREQUENCY %
Regularity of badges which has to be sent to BARC for dose estimation
Quarterly 17 56.7
Annually 2 6.7
Monthly 11 36.7
Half Yearly 0 0
AWARENESS ON THE MEASURES TAKEN, IF THE RADIATION DOSE IS MORE THAN ACCEPTABLE
If the radiation dose received more than the acceptable -measures to be taken
Risk Leave 29 96.6
Lab Examination 18 60
Special Examination( Hand, Finger, Eyes) 18 60
None of the above 1 3.3
AWARENESS ON RADIATION PROTECTION
Measures to be taken to provide radiation safety
Structural shielding in radiology department 30 100
Personal Protection Equipment in adequate quality and quantity 30 100
Maintain dosage optimizatio 30 100
AWARENESS OF THE PROGRAMMES TO ENSURE HIGH LEVEL SAFETY IN RADIOLOGY
Progammes which should be followed on order to ensure high level safety in radiology
Conduct regular radiation protection survey 30 100
System for recording illness or accidents which occur due to working condition 27 90
Radiation Protection Officer available for Consultation 27 90
AWARENESS OF MEASURES TO BE TAKEN WHEN RADIOLOGY EMPLOYEE PREGNANT
Action to be taken if the radiology employee is pregnantInform the appropriate authority 24 80
No need to inform 1 3.3
Quit the job 5 16.7
AWARENESS OF THE MEASURES TAKEN BY THE HOSPITAL AUTHORITY TOWARDS PREGNANT EMPLOYEES IN RADIOLOGY
DEPARTMENT
Hospital authorities should do for the pregnant employee in radiology department
Provide leave for entire pregnancy term 20 66.7
Make alternative working arrangements 10 33.3
Provide more protective equipments 0 0

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Ancita Iral D’souza et. al.: A Study on the Awareness on Occupational Health Safety among Health Care Professionals in Radiology Department in a Selected Hospital

employees in the radiology department(66.7%). According to better to update them regularly about the radiation safety.
the study which was conducted in the Hamdard College it There is also scope for radiation workers to have introductory
was revealed that Nearly 40% of the students accepted that seminars on radiation safety before they start working with
objects in the X-ray room emit radiation after an X-ray
radiation. They also need continuous education and update
procedure and nearly the same percentage agreed that
on radiation safety.
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