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Lack of radiation awareness among referrers: implications and possible solutions


Dr. Ishaq Fahmi Uri,
Radiology Department, John Radcliffe Hospital, Oxford Radcliffe Hospitals, Headley Way, Headington, Oxford OX3 9DU, United Kingdom
Tel.: +44 (0) 1865 220 825
Fax: +44 (0) 1865 220 801


Aim:  In the recent years, there has been a substantial increase in the use of ionising radiation investigations where it is known that this is associated with adverse effects most notably, risk of cancer. In the UK, it is estimated that 700 new cancer cases/year will develop as a result of medical radiation. According to radiation regulations, all referrers should have awareness of the relevant radiation doses. With these facts in mind, the author wanted to assess the referrers’ knowledge of radiation-induced cancer risk and radiation doses received by patients.

Methods:  Referrers from three hospitals took part in a questionnaire. An introduction about natural radiation & radiation risks was provided. The referrers were asked to (i) rank different radiological investigations from lowest to highest radiation dose, (ii) estimate the equivalent doses of radiation in chest X-ray (CXR) numbers and (iii) give an estimation of cancer risk upon performing them.

Results:  After receiving 100 different responses, the online survey was deactivated. A total of 37% of all respondents ranked the radiological investigations correctly, 15% thought that Ultrasound and magnetic resonance imaging utilise ionising radiation. Eleven per cent also thought that radionuclide studies do not involve ionising radiation. A total of 82% and 50% correctly estimated the risk of cancer upon performing CXR and abdomen computed tomography respectively.

Conclusion:  A large proportion of the referrers underestimated the doses and risks involved, this lack of awareness of radiation risk has serious implications on patients, and maybe applied throughout the UK, if not globally. Possible solutions have also been discussed.