EVALUATION OF THE EFFECTIVENESS OF RADIATION PROTECTION EQUIPMENT ON RADIOGRAPHERS IN NORTH TAPANULI DISTRICT HOSPITAL

Abstract

The indispensable role of ionizing radiation in contemporary healthcare, spanning diagnostic imaging and therapeutic interventions, is counterbalanced by the inherent occupational risks it poses to healthcare professionals, particularly radiographers. These frontline practitioners, routinely engaged in procedures involving radiation sources, face cumulative exposure that can lead to significant long-term health sequelae, including an elevated risk of cataracts, radiation-induced dermatitis, and various forms of cancer. The accelerating pace of technological advancement in medical imaging, while enhancing diagnostic precision, often necessitates more complex protocols and prolonged patient management, potentially increasing radiation exposure durations if stringent protective measures are not meticulously applied. This situation underscores a critical research gap concerning the actual effectiveness of radiation protection tools and practices in specific, often resource-constrained, regional healthcare settings, which may differ substantially from findings in better-equipped urban institutions. The absence of localized, empirical data impedes the development of targeted interventions and the optimization of safety protocols essential for safeguarding the well-being of radiographers. This study, therefore, aims to comprehensively and quantitatively evaluate the effectiveness of radiation protection equipment and established practices among radiographers at Tapanuli Utara District Hospital, by precisely quantifying occupational external radiation doses and meticulously assessing adherence to radiation safety protocols, guided by the ALARA principle and fundamental radiation physics. A central hypothesis posits that a discernible disparity may exist between the intended efficacy of protective measures and their real-world implementation, leading to suboptimal dose management. A cross-sectional descriptive study design was employed, involving all twenty-five (n=25) radiographers at the hospital, who were purposively sampled. Occupational doses were measured using thermoluminescent dosimeters (TLDs) worn for six months, while adherence to protocols was systematically documented via a validated observational checklist assessing personal protective equipment (PPE) usage, collimation, and shielding. Statistical analyses included descriptive statistics, t-tests, ANOVA, Pearson correlation, and multiple linear regression. The findings revealed an average cumulative occupational radiation dose of 3.2 ± 1.5 mSv, with significant inter-individual variability and some exceeding 5 mSv. Observational data indicated a 72.5% compliance rate for PPE, with a statistically significant negative correlation (r = -0.68, p < 0.001) between PPE usage and lower doses. Proper collimation showed the strongest negative correlation (r = -0.75, p < 0.001). However, underutilization of gonadal shielding (35%) and leaded glasses (42%) was noted. Notably, radiographers performing complex interventional radiology procedures exhibited higher average doses (4.1 ± 1.8 mSv) compared to diagnostic radiography (2.8 ± 1.2 mSv), suggesting current protocols may be insufficient for these higher-risk procedures. In conclusion, the effectiveness of radiation protection at Tapanuli Utara District Hospital is moderate, necessitating urgent enhancements. The findings highlight the critical importance of consistent adherence to protocols, particularly PPE and collimation, for achieving ALARA. Practical implications include the need for enhanced training, regular audits, and potential adoption of advanced shielding technologies, especially for interventional radiology. Future research should explore advanced dose monitoring and psychosocial factors impacting compliance to further refine safety practices in similar regional healthcare settings.