Radioprotection (un)awareness in cardiologists, and how to improve it

Abstract

In 2010 the International Atomic Energy Agency launched the "3 A's campaign": Audit, Appropriateness and Awareness for radiological justification, which is an effective tool for cancer prevention. Cardiologists prescribe the majority of radiological testing, but their awareness of doses and risks of ionizing cardiac imaging test is low. To assess radioprotection awareness of prescribing and practicing physicians (mainly cardiologists) before and after a radioprotection course. We held a 1-day 6-h primer of radioprotection for a limited number (20-35) of physicians. The course offered 8 continuing education credits from the Italian Health Ministry and was held 9 times over 3 years. We had 425 attendees, but full data sets (with complete questionnaires) were available for 403 physicians (55% women, age 45 ± 6 years), including 55% cardiologists, 40% general practitioners, 5% others (mainly cardiology fellows). For each attendee, a radiological awareness score was obtained before and after the course, with a survey containing 10 multiple-choice questions (5 answers) on radioprotection basics (doses of common examinations in multiples of chest x-rays; associated cancer risk, etc.). Each answer was scored from 0 ("don't know"), 1 ("strongly disagree") to 4 ("strongly agree"). The radiological awareness score of the 403 attendees improved from 31 ± 3 (before) to 37 ± 2 (after training, P < 0.001 vs. pre-training). As an example, before training, 25% of attendees believed that radiation-induced cancer risk disappears after 6 months (10% of respondents), 12 months (8%) or 5 years (7%), whereas 75% (becoming 98% after training) correctly estimated that radiological damage is cumulative over one's lifetime. Awareness of radiological doses and risks, albeit essential for risk-benefit assessment of radiological testing, is suboptimal among cardiologists, but can dramatically improve with a limited teaching effort through targeted training.

Impacto do peso corporal dos pacientes na exposição radiológica durante procedimentos cardiológicos invasivos

“…Radiation reduction methods are outdated, and new proposals have been presented. [14][15][16][17][18] It has been stipulated that ionising radiation exposure should be as low as possible when it is inevitable. The "as low as reasonably achievable" (ALARA) principle, 19,20 established in 1977, essentially states that radiation exposure should be kept as low as reasonably achievable.…”

“…Therefore, medical societies are encouraging more training programs and education measures to reduce the biological risks. 1,16,17 The area exposed to biological radiation effects and the potential stochastic risks of neoplasia are as important as the total radiation dose. The present study demonstrated that there is a strong relation between the total received dose and the irradiated area, regardless of the patient's weight.…”

Radiation dose awareness of radiologic technologists in major Jordanian hospitals

“…Determining the level of awareness is critical to identify any de&iciencies in order to overcome them and eventually reduce radiation hazards to all who are involved in the process of radiologic examination. Unfortunately, several studies have assessed this level and most of them reported signi&icant inadequacy (10,(12)(13)(14)(15)(16)(17)(18)(19) .…”

Medical Radiation Knowledge among Patients in Local Hospitals

“…There are many studies that have evaluated the awareness and knowledge of expected radiation doses and associated risks among physicians, radiologists, and patients from different backgrounds and educational levels. Most of the reported results indicated a significant underestimation of radiation dose and its risks among patients [10][11][12][13][14][15][16][17]. The knowledge and awareness of the radiation doses and risks can help in making decisions regarding the frequency of scans [18].…”