Knowledge on ionizing radiation among non-radiologist clinicians at Kenyatta National Hospital – Kenya

Abstract

Background: Low dose ionizing radiation used in diagnostic imaging has the potential to cause detrimental health effects. Knowledge of the requesting clinician on ionizing radiation will deter inappropriate and unjustifiable imaging requests.

Objective: To document the knowledge of ionizing radiation (IR) among the teaching hospital non-radiologist clinicians.

Design: Cross-sectional survey.

Setting: Kenyatta National Hospital (KNH), the largest teaching and referral hospital in Nairobi, Kenya.

Subjects: A total of 170 non-radiology hospital clinicians were recruited into the study after ethical approval and informed consent using simple random sampling method over a six-week period in August -October 2013.

Results: Health workers with ionizing radiation (IR) training were more likely to correctly identify all the imaging modalities that use IR compared to those without IR training (50.9% versus 27.5%; OR = 2.83, 95% CI 1.35-5.91). There was significant heterogeneity in knowledge across the cadres (p < 0.0001). Those with formal IR training were able to identify that an abdominal CT has the highest radiation dose compared to those with no formal training (69.8% vs 37.1% p= < 0.001). Length of professional experience, field of clinical training, and formal training in IR of the clinicians had no influence on their knowledge of IR doses. With respect to organ sensitivity only 42% of participants correctly rated bone marrow as a very sensitive organ.

Conclusions: The results from this study show that health workers lack the basic knowledge on ionizing radiation doses and its harmful effects. This is likely to impact negatively on their attitude and practice. The implications here are serious for the patient as they are possibly being exposed to unnecessary radiation and its attendant risks which include carcinogenesis.

Recommendations: To bridge this knowledge gap, there is need to increase awareness about ionizing radiation through continuous medical education,development of imaging referral guidelines and incorporating modules on medical radiation and its risks during the clinicians’ training programs.