Knowledge, Attitudes, and Practices on Use of Thermoluminescence Dosimeters by Radiology Personnel at Kenyatta National Hospital

Abstract

Background: Radiation safety in radiology departments is of global, regional, and local concern. Thermo luminescence dosimeters (TLD) are recommended for radiation dose monitoring, but their use at work is hypothesized to be low in low- and middle-income countries (LMIC). Objective: To evaluate knowledge, attitudes, and practices of radiology personnel on the use of TLDs for radiation dose monitoring at the University of Nairobi (UoN) and Kenyatta National Hospital (KNH) radiology departments. Study setting: Radiology departments of UoN and KNH. Study design: A descriptive cross-sectional study. Sample size: Ninety (90) radiology personnel, including 12 radiologists, 41 radiographers, 2 radiology nurses and 35 radiology residents were recruited. Methodology: Ethical approval was provided by KNH- UoN ERC No-P497/06/2022. Radiology personnel were recruited purposively after providing informed consent online and submission of a digitized questionnaire used to document socio-demographic data such as age, gender, education level, and years of experience and their knowledge, attitudes, and practices regarding the use of TLDs for radiation monitoring at work. Data was uploaded from Microsoft Excel into IBM Statistical Package for Social Scientists (SPSS) software (version 25) for analysis. Demographic characteristics were summarised using frequency distributions and percentages and knowledge, attitudes, and practices were analyzed using descriptive statistics. Associations between knowledge and demographic factors were analysed using Chi square test at 95% confidence level. Results: Ninety personnel distributed as 41(45.6%) radiographers, 12(13.3%) radiologists, 35(38.9%) radiology residents and 2(2.2%) radiology nurses were recruited. More than half were male (52.2%) aged 31-40 years (68.9%). The majority were aware that dosimeters were essential for monitoring radiation dose protection (94.3%). Most radiology personnel wore the TLDs but used them infrequently as recommended. Although 93.0% accessed TLDs at work, unavailability of TLDs (61.1%) and the cost of buying, maintenance and replacement of lost TLDs (43.3%) were identified as the main barriers to using them at work. Over 70% were using TLDs at work daily, accessed records on radiation exposure (72.7%), and checked radiation dose on their devices when they took them off monthly once analysed by their respective departments (52.3%), and did not carry them home (53.4%). There were no peer mechanisms for improving radiation dose monitoring at work (64.0%). Although 75.3% of respondents undertook radiation dose monitoring training in school, 94.4% reiterated the importance of having refresher courses on radiation dose monitoring in their departments and 56% proposed that the host institutions should organize at refresher training at work annually. Conclusion: The participants had adequate knowledge on the use of TLDS; the knowledge was mainly obtained during training. They had a positive attitude regarding the need for radiation dose monitoring. However, the TLDs were not worn as frequently as recommended which is of

importance in radiation dose monitoring. Refresher training is needed to improve the practices around TLD usage and radiation safety.