Radiation Protection Principle Observance In The Neonatal Intensive Care Units (Nicu): A Retrospective And Observational Audit At The Main Hospital Of Dezful, Iran


1 Department of Basic Sciences, School of Allied Medical Sciences, Dezful University of Medical Sciences, Dezful, Iran

2 Student Research Committee, Dezful University of Medical Sciences, Dezful, Iran


The conventional radiological procedures are a significant source of radiation to the population. Although patients can benefit from medically indicated x-ray procedures, their use involves some potential health risks. Several published literatures emphasized that the radiation effects are inversely proportional with patients’ age, suggests the high radiation tissue sensitivity of neonate and pediatric patients. Hence, it is imperative that the radiation exposure of neonates is kept as low as reasonably achievable (ALARA). Portable chest x-ray is one of the most common x-ray procedures, frequently requested for the neonates at the neonatal intensive care unit (NICU). Neonatal chest x-ray is contribute to the radiation exposure of ionizing radiations to the several most radiosensitive tissues such as the thyroid gland and breast, colon and this is increased concerns about patients’ safety. There are many dose optimization strategies that can be applied to reduce the patient radiation exposure and some authors have addressed these strategies. Other studies have discussed the rate of their use in clinical practice.
 The aim of this study was to assess the radiation protection principle observance in the NICU departments at the main hospital of Dezful, Iran.
This was a retrospective and observational audit that was conducted in the main hospital of Dezful, Iran. A standard observational check list, recommended by the ICRP, IAEA was used to data collection. Three nursing students were invited and agreed to participate in this audit. After training, the students were sent to NICU departments. The students were asked to attend as an observer in the NICU departments and record the radiation safety principle observance. The blinded of the study was also respected. We also supplemented the observational data with a retrospective survey of the images at the PACS database. We retrieved images of the chest x-rays from August 2017 to December 2017. Each image was reviewed for the probable evidence of protection such as appropriate beam collimation and shielding tools.
Our data showed that collimating the primary beam to the ROI was regarded in 20% of chest x-rays. Most of the personnel were used of same exposure parameters (42 kVp and 2.5 mAs) and the use of appropriate exposure parameters (high kVp and low mAs) were only regarded in 25% of x-rays. The focus to film distance (FFD) was in the range of 40 to 80 cm. In all, 375 portable chest x-rays were retrieved from PACS database, in which there were no evidence of shielding tools and also most collimations was not satisfactory.
Our data are commensurate with the previous studies in the literatures and emphasized that adherence to the radiation safety guidelines are seems to be necessary. Although portable chest x-rays expose neonates to very low radiation, however, due to wide frequency, the collective dose may be a reason for concern.