1

BATCH -B
4TH YEAR MBBS (2024-25)

Name Designation Institution

Dr. Naeem Ullah Head of Department Saidu Medical College
Community Medicine
Dr. Seema Demonstrator Community Saidu Medical College
Mohmand Medicine Department

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 TABLE OF CONTENTS

Content Page Number

Acknowledgement 4
Authors 5
Title and Abstract 6
Introduction 8
Aims and Objectives 10
Literature Review 11
Methodology 15
Results 18
Discussion 23
Limitations 24
Conclusion 25
References 26
Annexures:
i. Consent Form 29
ii. Questionnaire 32
iii. Ethical Review Board
Approval Certificate 36

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 ACKNOWLEDGEMENT

All praises and glory to all mighty Allah, the most beneficent and
merciful, for bestowing us the power and ability to complete this
research project.
We are extremely grateful towards Professor Dr Naeem Ullah (Head
of department Community Medicine) and our Supervisor Dr Seema
Mohmand for their guidance and support in this project. Our
supervisor helped and guided us in every aspect regarding the
compiling of this [Link] goes without saying that we owe a lot to our
teachers who educated us not only regarding our fields of choice but
also in general life.
I would like to acknowledge the ward work and efforts of every single
member of our Batch in data collection, analysis and compiling of this
project. It was a true team effort which have greatly contributed to
the success of this project.

Thank you all for your invaluable contributions.

BATCH –B
4th YEAR MBBS
SESSION 2024-25

4
 AUTHORS

No. Name Class Number

1 Hassan Iqbal 746
2 Yasir Ahmad 773
3 Atta Ullah 733
4 Haad Islam 825
5 Sunbal Sardar 822
6 Zarjana Shamsher 806
7 Daniyal Ali Khan 730
8 Samad Ali 745
9 Safi Ullah 750
10 Muhammad Tayyab 752
11 Zia Ullah 755
12 Hashir Bilal 758
13 Mahnoor Fahim 767
14 Maliha Said 769
15 Muhammad Sudais 772
Hassan Khan
16 Nasir Kabir 786
17 Naqeeb Hussain 794
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18 Gulrukh Mohmand 795
19 Zaheer Ahmad 809
20 Muhammad Irfan 811
21 Omer Sami Ullah 820
22 Gamini Kaur 827
23 Javeria Sabir 838
24 Muhammad Zakryia 499

Protective Strategies Adopted by Healthcare Workers and St

udents to Reduce Radiation Exposure at the Radiology Depa
rtment at SGTH, Swat.

Abstract:
Background:
Radiation exposure in healthcare settings, particularly in radiology, poses
significant risks to both patients and healthcare professionals. Despite the
critical role of radiology in disease diagnosis, the potential for adverse health
effects, including cancer, necessitates effective protective strategies. This study
examines the current practices and awareness of radiation safety among
healthcare workers and students at the Saidu Group of Teaching Hospitals
(SGTH) in Swat, Pakistan, a region characterized by limited resources and
training.

Objective:
The primary aim of this research is to assess the knowledge, attitudes, and
implementation levels of radiation safety measures among participants in the
SGTH radiology department.

Methods:
A cross-sectional study was conducted from June to August 2024, involving 124
healthcare workers and students who completed a validated online
questionnaire. The survey evaluated demographics, training received on

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radiation protection, usage of protective equipment, and awareness of safety
protocols.

Results:
Among participants, 54.8% reported no formal training in radiation protection.
While 44.4% utilized lead aprons and 37.9% limited time in radiation areas,
adherence to protective measures was inconsistent. Only 38.7% had access to
personal radiation monitoring devices, with a mere 12.1% checking them daily.
Notably, half of the respondents felt that existing safety protocols were not
strictly enforced.

Conclusion:
The findings reveal significant gaps in training and compliance with radiation
safety protocols at SGTH. To enhance safety for both patients and healthcare
workers, it is imperative to implement comprehensive training programs and
enforce adherence to established protective measures. This study underscores
the urgent need for policy interventions aimed at improving radiation safety
practices in developing regions.
Keywords:
Radiation protection, healthcare workers, radiology, safety protocols,
developing countries.

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Introduction:
Radiation is energy emitted as waves or particles and transmitted through a me
dium or space. It can originate from both natural and artificial sources [1-3].
Radiology provides diagnosis of diseases and hence it plays a vital role in
healthcare setting. Radiation is classified into two types: ionizing and non-ionizi
ng. Ionizing radiation, which includes x-rays, is characterized by its high energy
and strong penetration ability [4]. Conversely, non-ionizing radiation has less en
ergy than ionizing radiation. It is utilized in ultrasound, which employs high-freq
uency sound waves, and in MRI scanners, which use radiofrequency and do not
cause ionization [5]. However, ionizing radiation carries a remarkable risk
during the procedures to patients as well as healthcare professionals working
in radiology department. Exposure to ionizing radiation, even at low levels, can
lead to a range of adverse health effects, including an increased risk of cancer.

8
Figure 1: Shows the different levels of ionizing radiations
The global population's average annual radiation exposure from all sources is a
bout 3 mSv per person, with medical radiation accounting for 19.7% (0.6 mSv)
of this yearly dose. Medical applications of radiation contribute to over 99.9% o
f all artificial radiation exposure, with billions of procedures conducted annually
worldwide [6]. A study reported that in the United States, 1.5-2.0% of all cancer
s are considered to be attributable to radiation from CT scans [7]. Radiation can
damage DNA through both direct and indirect mechanisms, potentially leading
to the development of cancer [8].

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Figure 2: Shows the effects of radiation exposure on the body highlighting the
necessity and importance of effective protective strategies to minimize
radiation exposure and safeguard the health of individuals within the radiology
environment.
Despite the availability of guidelines and protocols aimed at reducing radiation
exposure, there remains a noticeable gap in the consistent application of these
protective measures, particularly in developing regions. The radiology
department at Saidu Group of Teaching Hospitals (SGTH), Swat, exemplifies the
challenges faced by healthcare facilities in such areas, where resources may be
limited, and awareness of radiation safety may not be as robust as in more
developed regions.
The significance of this study lies in its potential to highlight the existing
protective strategies at SGTH and to identify areas where improvements are
10
necessary. By addressing the research gap concerning radiation protection
practices in a developing region, this study aims to contribute valuable insights
that can inform policy-making, enhance safety protocols, and ultimately reduce
radiation exposure risks for both patients and healthcare workers in similar
settings.
Aims and Objectives:

Aims:
This study aims to:
1. Assess the overall awareness and adoption of radiation safety practices
among healthcare workers and students in the radiology department at
Saidu Group of Teaching Hospitals (SGTH), Swat.
2. Identify the protective strategies employed by healthcare personnel to
minimize radiation exposure in diagnostic and therapeutic procedures.
3. Highlight key areas for improvement in safety protocols, with the goal of
contributing to the enhancement of radiation protection policies in
developing healthcare settings.

Objectives:
To achieve these aims, the specific objectives of the study are to:
1. Assess the knowledge level and attitudes of healthcare workers and
students regarding radiation safety and protection measures.
2. Investigate the types and frequency of protective equipment use, such
as lead aprons and dosimeters, among participants in the radiology
department.
3. Determine the degree of adherence to existing radiation safety protocols
and identify any factors affecting compliance.
4. Evaluate the availability and frequency of formal training and refresher
courses on radiation safety among healthcare staff and students.
5. Identify potential gaps in radiation safety practices, including limited
resources, lack of enforcement, or insufficient training, to inform policy
recommendations for improved safety measures.

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Literature review:
Radiation exposure poses a significant concern for healthcare workers,
especially those involved in procedures utilizing ionizing radiation. It is crucial
to recognize that the medical application of radiation accounts for 99.9% of all
artificial radiation exposure, putting healthcare workers at risk for developing
cancers [6]. A study conducted in the US has conclusively shown an increased
risk of brain cancer, breast cancer, and melanoma among radiologic
technologists [9]. Similarly, other studies have indicated a higher risk of
cataracts, thyroid, and non-melanoma skin cancers [10], [11]. Therefore, in
the era of the rapidly evolving use of medical radiation, it is imperative to
adopt and enforce effective protective strategies to mitigate these potential
risks. Multiple studies have emphasized the importance of protective measures
in minimizing the health risks associated with radiation exposure.

In a study by Alazzoni et al, it was found that using pelvic lead shields and
surgical caps significantly reduced radiation exposure in interventional
cardiology. The use of a lead shield led to a 76% decrease in the operator's
radiation dose, while the use of a surgical cap resulted in a significant
reduction in radiation exposure to the operator's head (4.79 [95% CI, 3.30–
6.68] µSv; P<0.001) [12] .

Table 1.1: Trial outcomes for lad Drape comparison

Table 1.2: Trial outcomes for Cap comparison

Heo et. al. conducted a survey on the importance of wearing protective

clothing in X-ray rooms and has shown a significant effect of using protective
clothing in reducing indirect exposure to scattered radiation [13] . Moreover,

12
the use of modified protective clothing with shoulder guards was found to
significantly
decrease the organ radiation doses and overall occupational radiation risk in
interventional radiology compared with standard sleeveless X-ray clothing
[14].

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Table 2 : Tissue/organ doses: Standard x-ray protective clothing versus
modified clothing with additional shoulder guard
Similarly, Koch A et al., has shown that the use of dedicated dosimeters for
real-time visualization of active radiation dose during CT intervention
effectively reduces radiation dose to participating radiologists [15]. The
dosimeter visualization tool resulted in a 58.1% total dose reduction in the

experimental group thus reducing exposure to the staff during CT-guided

interventions [15].

Table 3: Radiation doses and changes with and without live screen in different
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groups.
.

Another study has revealed that trust in radiation exposure measurements is

associated with improved health-related quality of life HRQOL (p = 0.006 to
0.001) compared with those who seldom use protective measures HRQoL (p =
0.042 to 0.001) [16] . Moreover, the correct use of Personal protective
equipment like Lead aprons, thyroid shields and particularly the Leaded
eyeglasses was also found to be effective in reducing the risks associated with
radiation exposure [17].

Despite the clear guidelines in the literature, there is a noticeable gap in the
application of protective measures in radiology setups. This is due to the lack
of knowledge, awareness, and trust in these measures, as well as inadequate
follow-up training. This issue is particularly concerning in developing countries
like Pakistan, where these measures are rarely observed and implemented.
The radiology department of SGTH, located in the periphery, faces similar
challenges, with limited observation and awareness of protective strategies
compared to more developed regions. Therefore, this study aims to assess the
protective strategies adopted by healthcare workers and students to safeguard
themselves from unnecessary radiation exposure during diagnostic and
therapeutic interventions.

Methodology:
Study Design:
A cross-sectional study design was utilized to achieve the study’s objectives.
Study Setting:
The study was conducted at the radiology department of SGTH,
Swat Khyber Pakhtunkhwa, Pakistan.
Study Population:
The target population encompassed all radiology staff, such as n
urses, radiologists, technicians, administrative personnel, and students visiting
the radiology department of SGTH Swat.
Study Duration:
A timeline of approximately three months (June-August 2024) w
as allocated for data collection, analysis, interpretation, and manuscript writing.

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Sample size and Sampling technique:
The study's objectives were achieved using a sample size of 124. Moreover, si
mple random sampling technique was employed to ensure equitable participati
on among all willing individuals.
Inclusion Criteria:
All healthcare workers (radiologists, nurses, technicians,
administrative staff) and students (medical, paramedical, nursing) visiting the ra
diology department with proper consent were invited to participate in the stud
y.
Exclusion Criteria:
Participants under 18, non-consenting individuals, those wit
h musculoskeletal disabilities, and individuals with prior radiation trauma were
excluded from the study.
Data collection Tool:
Data was collected through an online self-administered questionnaire, with me
asures taken to prevent duplicate responses. Incomplete or missed responses
were excluded from the interpretation and final analysis.
Questionnaire:
A self-administered questionnaire, after proper validation, was used. It consiste
d of the following sections:
1. The first section gathered detailed characteristics of the study participants, in
cluding age, gender, and role in the radiology department.
2. The second section evaluated protective strategies adopted by staff for radia
tion protection, such as the use of protective equipment, radiation monitoring
devices, implementation of preventive measures, and refresher training.
3. The last section assessed the preventive measures taken by students during t
heir visit to the radiology department.
Data Analysis:
The data was analyzed using Statistical Package for the Social Scie
nces (SPSS) version 27. Descriptive statistics were used to summarize participan
ts' demographic characteristics, protective strategies, personal radiation monit
oring devices, and understanding of radiation risks. The categorical data was re
ported as frequencies with percentages, and a p-value of less than 0.05 was us
ed to indicate the statistical significance of the results.
Ethical Considerations:
Data was collected in accordance with the guidelines outlinedin the
Helsinki Declaration. Informed consent was obtained from each participant prio

16
r to their participation. All data collected for this study is confidential and will n
ot be disclosed or shared with third parties.
Estimated Cost of Study:
The research study was funded independently and was not sp
onsored by any organization or institution.

Figure 3: Summary of methodology of our study.

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Results:
A total of 124 participants completed the questionnaire. Of these, 85 (68.5%)
were male and 39 (31.5%) were female. The professional distribution of the
participants was as follows: medical students accounted for 95 (76.6%)
respondents, radiologists for 16 (12.9%), radiologic technologists for 9 (7.3%),
and nursing students for 5 (4.0%) (see Table 4 and Figures 4 and 5).

Demographic Variables Frequency (n = Percentage (%)

124)
Gender Male 85 68.5
Female 39 31.5
Professional Role Medical Students 95 76.6
Radiologists 16 12.9
Radiologic 9 7.3
Technologists
Nursing Students 5 4.0
Table 4: Demographic Characteristics of Participants

Figure 4: Shows that 68.5% of total participants were male and 31.5% were
female.

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Figure 5: presents the gender and professional distribution of the participants, s
howing a majority of males and medical students.

Regarding formal training on radiation protection, 68 (54.8%) participants

reported receiving no formal training, while the remaining 56 (45.2%) had
received training in various forms. Of those trained, 22 (17.7%) received
classroom training, 13 (10.5%) had workshops or seminars, 6 (4.8%) received
on-the-job training, and 7 (5.6%) mentioned receiving written materials or
online courses. The frequency of refresher courses varied: 42 (33.9%)
participants reported never receiving refresher training, while 19 (15.3%) had
annual refreshers, and 8 (6.5%) reported receiving them every 5 years (Table 5
and Figure 6).

Training Status Frequency (n = Percentage

124) (%)
Formal Training Yes 56 45.2
Received
No 68 54.8
Types of Training Classroom Training 22 17.7
Workshops/Seminars 13 10.5
On-the-Job Training 6 4.8
Written 7 5.6
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 Materials/Online
Refresher Courses Never 42 33.9
Annual 19 15.3
Every 5 Years 8 6.5
Table 5: Formal Training on Radiation Protection

Figure 6: highlights the percentage of participants who received formal radiatio

n protection training and the types of training they underwent.

In terms of protective measures, 55 (44.4%) participants used lead aprons, 47

(37.9%) practiced limiting time in radiation areas, and 33 (26.6%) kept a safe
distance to reduce exposure. However, 30 (24.2%) indicated inconsistent use of
these measures (Table 6 and Figure 7). Enforcement of radiation safety
protocols also varied: 32 (25.8%) stated that protocols were moderately
enforced, while 21 (16.9%) reported strict enforcement, and 35 (28.2%) noted
that protocols were rarely or not enforced at all (Table 7 Figure 8).

Protective Measure Frequency (n = 124) Percentage (%)

20
Use of Lead Aprons 55 44.4
Limit Time in Radiation 47 37.9
Areas
Keep Safe Distance 33 26.6
Inconsistent Use of 30 24.2
Measures
Table 6: Protective Measures Used by Participants

Figure 7: Illustrates the protective measures adopted by participants, including

the use of lead aprons and limiting time in radiation areas.

When asked about personal radiation monitoring devices like dosimeters, 48

(38.7%) participants reported being provided with these devices, while 76
(61.3%) stated they did not receive them. Among those who had them, only 15
(12.1%) checked their devices daily, and 11 (8.9%) checked them weekly (Table
8 and Figure 9-10).

Level of Enforcement Frequency (n = 124) Percentage (%)

Strictly Enforced 21 16.9

Moderately Enforced 32 25.8
Rarely/Not Enforced 35 28.2
Table 7: Enforcement of Safety Protocols

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Figure 8: Shows participants' perceptions of how strictly radiation safety protoc
ols are enforced in their workplace.

Device Status Frequency (n = 124) Percentage (%)

Provided Yes 48 38.7

No 76 61.3
Checking Daily 15 12.1
Weekly 11 8.9
Table 8: Access and Usage of Personal Radiation Monitoring Devices

Figure 9: Showing the frequency of radiation exposure checking

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Figure 10: Displays the availability and usage frequency of personal radiation
monitoring devices like dosimeters among participants.

Discussion:

The findings highlight significant gaps in radiation safety training and adherenc
e among healthcare professionals in the SGTH Radiology Department. Despite
a majority acknowledging the importance of radiation protection, the low perc
entage of formal training received indicates a critical need for enhanced educa
tional programs.

The lack of formal training reported by 54.8% of participants is concerning. Pre

vious studies have shown that comprehensive training correlates with improve
d safety practices and reduced incidents of radiation exposure among healthcar
e workers (18-19). The reliance on informal or inadequate training methods can
lead to misconceptions about safe practices and ultimately compromise patient
and staff safety.

23
While many participants reported using protective measures such as lead apro
ns and maintaining distance from radiation sources, the inconsistency in their a
pplication suggests a disconnect between knowledge and practice. Research in
dicates that regular refresher courses significantly enhance compliance with saf
ety protocols (20). Therefore, implementing mandatory annual refresher cours
es could bridge this gap.

Although a majority recognized the existence of safety protocols, only half felt t
hey were enforced strictly. This discrepancy may lead to complacency regarding
adherence to safety measures. A study by M. Chau emphasizes that clear com
munication and consistent enforcement of safety protocols are essential for fos
tering a culture of safety within healthcare settings (21). Engaging staff in regul
ar safety drills could reinforce the importance of these protocols and improve c
ompliance rates.

Limitations:
This study has several limitations that should be acknowledged. First, the sampl
e size was limited to 124 participants from a single institution, Saidu Group of T
eaching Hospitals (SGTH), which may not fully represent the broader populatio
n of healthcare workers and students in other regions or institutions. This limita
tion affects the generalizability of the [Link], the data collected relied
on self-reported questionnaires, which depend on the honesty and accuracy of
participants in reporting their knowledge, attitudes, and practices regarding rad
iation safety. This could introduce bias, as individuals may overestimate their a
dherence to safety protocols or their understanding of radiation [Link], the
cross-sectional design provides a snapshot of participants' knowledge and prac
tices at a single point in time. This design does not allow for the assessment of
changes over time or the establishment of causal relationships between trainin
g and safety [Link], while the questionnaire covered various aspects
of radiation safety, it may not have addressed all relevant factors influencing saf
ety practices, such as institutional policies or individual risk [Link], t
he study did not include follow-up assessments to evaluate the long-term effec
tiveness of any training programs or interventions that may be implemented ba
sed on the findings. Without follow-up, it is difficult to determine whether impr
ovements in knowledge and practice are sustained over [Link], participants
may have felt pressure to provide socially desirable responses regarding their k
nowledge and use of protective measures, leading to inflated reports of compli
ance with safety [Link], this study was conducted in a developing regi
on where resources and training opportunities may differ significantly from tho

24
se in more developed areas. Therefore, the findings may not be applicable to h
ealthcare settings with different cultural or economic [Link] acknowledgin
g these limitations, future research can be better designed to address these iss
ues and provide more comprehensive insights into radiation safety practices a
mong healthcare workers.

Conclusion:
In summary, this study reveals important gaps in training and adherence to radi
ation safety practices among healthcare workers and students in the radiology
department at Saidu Group of Teaching Hospitals (SGTH) in Swat, Pakistan. Ma
ny participants reported not receiving formal training on radiation protection,
which is concerning given the potential health risks associated with radiation ex
[Link] some protective measures, like using lead aprons and limiting tim
e in radiation areas, were acknowledged, the inconsistent application of these
practices indicates a disconnect between knowledge and actual behavior. This s
uggests a need for regular refresher courses to reinforce the importance of safe
ty protocols and ensure compliance among [Link], although there a
re established safety protocols, many participants felt that these were not strict
ly enforced. This lack of enforcement can lead to complacency and increased ri
sk for both healthcare workers and patients. To foster a culture of safety, it is cr
ucial to communicate the importance of these protocols clearly and engage sta
ff in regular safety [Link], this study emphasizes the urgent need for impr
oved training programs focused on radiation protection at SGTH. By addressing
these gaps in knowledge and enhancing adherence to safety measures through
consistent training and enforcement, we can significantly reduce the risks assoc
iated with radiation exposure for everyone involved in radiological procedures.

References:

25
[1] Adelaja Osibote O. Introductory Chapter: Radiation Exposure, Dose and P
rotection. In: Adelaja Osibote O, editor. Ionizing and Non-ionizing Radiation [Int
ernet]. IntechOpen; 2020 [cited 2024 Oct 22]. Available from: [Link]
[Link]/books/ionizing-and-non-ionizing-radiation/introductory-chapter-r
adiation-exposure-dose-and-protection.

[2] UNSCEAR 1982 Report [Internet]. United Nations : Scientific Committee o

n the Effects of Atomic Radiation. [cited 2024 Oct 22]. Available from: [Link]
[Link]/unscear/en/publications/[Link].

[3] Corrigall RS, Martin CJ, Scott I. Observations of tissue reactions following
neuroradiology interventional procedures. J Radiol Prot. 2020;40(1):N9–N15.

[4] Sherer MAS, Visconti PJ, Ritenour ER, et al. Radiation Protection in Medic
al Radiography - E-Book: Radiation Protection in Medical Radiography - E-Book.
Elsevier Health Sciences; 2013
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[5] Bushberg JT, Boone JM. The Essential Physics of Medical Imaging. Lippinc
ott Williams & Wilkins; 2011.

[6] Holmberg O, Czarwinski R, Mettler F. The importance and unique aspects

of radiation protection in medicine. European Journal of Radiology. 2010;76(1):
6–10.

[7] Brenner DJ, Hall EJ. Computed Tomography — An Increasing Source of Ra

diation Exposure. New England Journal of Medicine. 2007;357(22):2277–2284.

[8] Piotrowski I, Kulcenty K, Suchorska WM, et al. Carcinogenesis induced by

low-dose radiation. Radiology and Oncology. 2017;51(4):369–377.

[9] Rajaraman P, Doody MM, Yu CL, et al. JOURNAL CLUB: Cancer Risks in U.S.
Radiologic Technologists Working With Fluoroscopically Guided Interventional
Procedures, 1994-2008. American Journal of Roentgenology. 2016;206(5):1101
–1109.
[10] Della Vecchia E, Modenese A, Loney T, et al. Risk of cataract in health car
e workers exposed to ionizing radiation: a systematic review. Med Lav. 2020;11
1(4):269–284.

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[11] Lee WJ, Bang YJ, Cha ES, et al. Lifetime cancer risks from occupational rad
iation exposure among workers at interventional radiology departments. Int Ar
ch Occup Environ Health. 2021;94(1):139–145.

[12] Randomized Controlled Trial of Radiation Protection With a Patient Lead

Shield and a Novel, Nonlead Surgical Cap for Operators Performing Coronary A
ngiography or Intervention | Circulation: Cardiovascular Interventions [Interne
t]. [cited 2024 Oct 22]. Available from:
[Link]

[13] Heo Y-J, Kim K-T, Cho C-H, et al. Measurement of Comparison to Scatterin
g Dose Space According to the Presence or Absence of Protective Clothing in th
e X-ray Room. Journal of the Korean Society of Radiology. 2012;6:313–320.

[14] Choi TW, Chung JW, Kwon Y. Modified design of x-ray protective clothing
to enhance radiation protection for interventional radiologists. Med Phys. 2023;
50(6):3825–3832.

[15] Koch A, Gruber-Rouh T, Zangos S, et al. Radiation protection in CT-guided

interventions: does real-time dose visualisation lead to a reduction in radiation
dose to participating radiologists? A single-centre evaluation. Clin Radiol. 2024;
79(6):e785–e790.

[16] Akyurt N. Health-related quality of life among radiology technicians in Tu

rkish hospitals: a cross sectional study. Int Arch Occup Environ Health. 2021;94
(6):1415–1425.

[17] Radiation Safety and Protection - StatPearls - NCBI Bookshelf [Internet].

[cited 2024 Oct 22]. Available from:
[Link]

[18] Behzadmehr R, Doostkami M, Sarchahi Z, et al. Radiation protection amo

ng health care workers: knowledge, attitude, practice, and clinical recommenda
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[19] Fataftah J, Tayyem R, Al-Dwairy S, et al. Awareness of radiation hazards a
nd knowledge of radioprotective measures among radiologists and non-radiolo
gy staff: a cross-sectional survey. Egyptian Journal of Radiology and Nuclear Me
dicine. 2024;55(1):128.

27
[20] Esfahani AJ, Mehrabi R, Gheibi N, et al. The Effectiveness of a Radiation S
afety Training Program in Increasing the Radiation Safety Knowledge of Physicia
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[21] Chau M. Enhancing safety culture in radiology: Key practices and recom
mendations for sustainable excellence. Radiography (Lond). 2024;30 Suppl 1:9–
16.

Consent Form

28
Protective Strategies Adopted by Healthcare Workers
and Students to Reduce Radiation Exposure at the Ra
diology Department at SGTH, Swat
4th Year Batch B

Supervisor:
Dr. Seema Mohmand, Demonstrator Community Medicine Department, Saidu
Medical College, Swat.

Introduction:
You are being invited to participate in a research study that aims to assess the k
nowledge, attitudes, and implementation of radiation safety measures among
healthcare workers and students in the radiology department at the Saidu Grou
p of Teaching Hospitals (SGTH), Swat. Before agreeing to participate, it is import
ant that you read and understand the purpose of the study, what will be expect
ed of you, and your rights as a participant.

Purpose of the Study:

The purpose of this study is to evaluate current radiation safety practices and p
rotective strategies in use at the SGTH radiology department. The study will ide
ntify gaps in awareness and practice of radiation safety protocols and provide r
ecommendations for improving safety measures in developing regions.

Procedures:
If you agree to participate in this study:
 You will be asked to complete an online questionnaire that includes ques
tions about your knowledge of radiation safety, the protective measures
you use, and the training you have received.
 The questionnaire will take approximately 15-20 minutes to complete.
 Your responses will be confidential and anonymous. No identifying infor
mation will be collected or shared.

Voluntary Participation:

29
Your participation in this study is entirely voluntary. You may choose not to par
ticipate or to withdraw from the study at any time without any consequences. I
f you decide to withdraw, any data you have provided will not be used.

Confidentiality:
All information collected during this study will remain strictly confidential. The
data will be stored securely and only used for the purposes of this research. Th
e results of the study may be published or presented at scientific meetings, but
your identity will not be disclosed.

Potential Risks and Benefits:

Risks: There are no known risks associated with participating in this study.
Benefits: While you may not receive any direct benefit from participating, the
information you provide will contribute to improving radiation safety practices,
benefiting healthcare workers and patients in developing regions.

Contact Information:
If you have any questions about the study or your participation, you can contac
t the following:
 Investigator: Hassan Iqbal
Email: iconhassan2723@[Link]

Consent
By signing below, you indicate that you have read and understood the informati
on provided in this form, that you agree to voluntarily participate in this study,
and that you understand you may withdraw at any time without consequence.

Participant Name: _________________________________________

__

Signature: _______________________________________________
___

Date: _______________________

Researcher Name: ________________________________________

___

30
Signature: _______________________________________________
___

Date: _______________________

Questionnaire

31
Protective Strategies Adopted by Healthcare Workers and St
udents to Reduce Radiation Exposure at the Radiology Depa
rtment at SGTH, Swat.

Please read out the form thoroughly and fill the form carefully.
Your participation in this research is entirely voluntary.

1. Age…………..

[Link].
Mark only one oval.
Male
Female
Other

3. Role at SGTH Radiology Department:.

Mark only one oval
Radiologist
Radiologic Technologist
Nurse Administrative
Staff
Medical Student
Nursing Student
Other (please specify): ___________

SECTION 2: For Staff (Radiologists, Technologists, Nurses, Administr

ative Staff) Medical/Nursing students skip to section 3.

4. Have you received any formal training on radiation protection?

Mark only one oval.
Yes
No

5. If yes, what type of training did you receive? (Check all that apply)
Mark only one oval.
Classroom training

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Online courses
On-the-job training
Workshops/Seminars
Other (please specify): ___________

6. How often do you receive refresher training on radiation safety?

Mark only one oval.
Never
Annually
Every 2 years
Every5 years
Other (please specify): ___________

7. Which of the following protective measures do you use to reduce radiation e

xposure? (Check all that apply
Mark only one oval.
Lead aprons
Thyroid shields
Lead gloves
Lead glasses
Mobile shields
Keeping a safe distance
Limiting time spent in the radiation area
Monitoring radiation dose (e.g., dosimeter badges)
Using protective barriers (e.g., lead walls)
Other (please specify): ___________

8. How consistently do you use these protective measures?

Mark only one oval.
Always
Most of the time
Sometimes
Rarely
Never

9. Are there clear protocols in place for radiation safety at your department?
Mark only one oval.
Yes

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No
Not sure

10. How strictly are these protocols enforced?

Mark only one oval.
Very strictly
Moderately strictly
Rarely enforced
Not enforced at all

11. Do you participate in regular safety drills or simulations for radiation emerg
encies?
Mark only one oval.
Yes
No

[Link] the hospital provide you with dosimeter, radiation badges etc.?
Mark only one oval.
Yes
No

13. How often do you check your personal radiation monitoring device (e.g., do
simeter badge)?
Mark only one oval.
Daily
Weekly
Monthly
Rarely
Never

SECTION 3: For Medical and Nursing Students.

14. Were you informed about radiation protection measures before your visit?
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Mark only one oval.
Yes
No

15. If yes, who provided the information? Mark only one oval.
Radiologist
Radiologic Technologist
Nurse
Administrative Staff
Written materials

16. Were you offered protective equipment (e.g., lead apron) during your visit?
Mark only one oval.
Yes. No

17. How well do you feel you understand the risks associated with radiation
exposure?
Mark only one oval.
Very well
Well
Somewhat Not well
Not at all

.18. . Do you feel the protective measures available are adequate to ensure yo
ur safety during your visit?
Mark only one oval.
Yes
No
Not sure

19. Your email if you would like to be informed about the results (Optiona l):

Thank you for your participation.

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