Introduction The main purpose of this study was to determine the diagnostic reference level (DRL) for routine digital radiography examinations in Mazandaran province. Materials and methods Thirteen digital radiographic examinations at 18 high-patient-load radiography centres were investigated. The indirect dosimetry method was performed based on the IAEA report. Average entrance skin dose (ESD) and the third quartile of ESD as the DRL were evaluated from the measurement made by a semiconductor dosemeter. Results DRL for the examinations of digital radiography was obtained as: Skull (postero-anterior [PA]): 2.2, skull (lateral [LAT]): 2.4, cervical spine (antero-posterior [AP]): 1.6, cervical spine (LAT): 1.7, thoracic spine (AP): 3.6, thoracic spine (LAT): 9.9, lumbar spine (AP): 5.3, lumbar spine (LAT): 11.8, chest (PA): 1.4, chest (LAT): 2.1, abdomen (AP): 4.3, pelvis (AP): 3.2 and hip (AP): 2.1 mGy. Conclusion Although DRL was not higher compared with the international organisations’ levels, it can be reduced by adequate training of radiographers.

Background:The aim of this study was to estimate the cancer risks and mortalities of different types induced by routine examinations of digital radiography for one year in Mazandaran province, Iran. Materials and Methods: Radiation parameters and calculated entrance skin dose (ESD) values of 13 digital radiographic examinations were collected from 2340 patients at 18 high-patient-load radiography centers. Organ mean doses were estimated based on the collected parameters applying PCXMC software. The BEIR VII-Phase 2 model was used to calculate the induced cancer risks and mortalities of various cancer types at different ages. Results: The average ± standard deviation (SD) lifetime risks (incidence probability in 100,000 people) induced by radiations from radiography examinations for one year was 51.29±4.73 and 99.62±7.36 for new-born males and females, respectively. The lifetime cancer risk decreased with age and reached 3.77±0.62 and 4.88±0.07 for 80-year men and women, respectively. The average lifetime risks of mortality due to cancers induced by annual radiographies were obtained at 14.18±1.62 and 22.83±2.55 for new-born males and females, respectively. This risk reduced with age and was reached 1.97±0.27 and 2.45±0.38 for men and women at the age of 80 years, respectively. Conclusion: Our results showed that there are low but significant risks of cancer incidence for patients undergoing digital radiography, which included a large percentage of the population in Mazandaran province, especially for children and newborns. Therefore, further efforts like appropriate patient setup and beam geometry should be carried out to decrease patient doses.