Asian Review of Environmental and Earth Sciences ISSN: 2313-8173 Vol. 3, No. 1, 10-17, 2016 http://www.asianonlinejournals.com/index.php/AREES 10 Radiation Protection Measures in Radio-Diagnostic Centers in Gaza Hospitals, Palestine Samer S. Abu Zer1 Samir S. Yassin2 Mohamed R. Al Agha3 Khalid Jamal Khadoura4  1 Radiology Department, Shifa Hospital, Gaza Strip, Palestine Occupied. 2 Physics Department, The Islamic University of Gaza. 3 Environment and earth science department, The Islamic University of Gaza. 4 Head Nurse of Internal Medicine Dep., Shifa Hospital, Faculty of Nursing, The Islamic University of Gaza, Palestine. ( Corresponding Author) Abstract Whereas radio-diagnostic centers have potential to present hazardous effects due of ionizing radiation. Radio-diagnostic workers awareness, practices regarding radiation protection issues, availability of radiation protection devices and effective personal radiation exposure monitoring process has an important role to safe working in these places. We carried out this study in nine governmental Gaza governorates hospitals. The study instrument was close-ended structured questionnaire consists of five parts. 182 radio-diagnostic workers participated in the work. Based on the obtained data, the participants reported that 35.2% of personal radiation protection devices are available in the radio-diagnostic centers at governmental Gaza governorates hospitals. In spite the fact that 74.8% of participants have awareness about radiation protection issues, but it is only about 53.4% of participants follows the radiation protection practices. There is an obvious poor of personal radiation exposure monitoring process. Conclusively, the results represented in this work reflect that majority of participants believe there is no radiation safety officer to provide the service. Therefore, there is a desperate need for rules, regulations and radiation protection act in the field of radiation in medical field. Keywords: Radiation protection, Radio-diagnostic, Awareness, Practices. Contents 1. Introduction ......................................................................................................................................................................... 11 2. Objectives ............................................................................................................................................................................. 11 3. Materials and Methods ........................................................................................................................................................ 11 4. Results and Discussion ......................................................................................................................................................... 11 5. Conclusion ............................................................................................................................................................................ 17 References ................................................................................................................................................................................ 17 Citation | Samer S. Abu Zer; Samir S. Yassin; Mohamed R. Al Agha; Khalid Jamal Khadoura (2016). Radiation Protection Measures in Radio-Diagnostic Centers in Gaza Hospitals, Palestine. Asian Review of Environmental and Earth Sciences, 3(1): 10-16. DOI: 10.20448/journal.506/2016.3.1/506.1.10.17 ISSN | 2313-8173 This work is licensed under a Creative Commons Attribution 3.0 License Asian Online Journal Publishing Group http://creativecommons.org/licenses/by/3.0/ http://crossmark.crossref.org/dialog/?doi=10.20448/journal.506/2016.3.1/506.1.10.17 https://orcid.org/orcid-search/quick-search?searchQuery=Samer S. Abu Zer https://orcid.org/orcid-search/quick-search?searchQuery=Samir S. Yassin https://orcid.org/orcid-search/quick-search?searchQuery=Mohamed R. Al Agha https://orcid.org/orcid-search/quick-search?searchQuery=Khalid Jamal Khadoura http://search.crossref.org/?q=10.20448/journal.506/2016.3.1/506.1.10.17 http://crossmark.crossref.org/dialog/?doi=10.20448/journal.506/2016.3.1/506.1.10.17 https://orcid.org/orcid-search/quick-search?searchQuery=Samer S. Abu Zer https://orcid.org/orcid-search/quick-search?searchQuery=Samir S. Yassin https://orcid.org/orcid-search/quick-search?searchQuery=Mohamed R. Al Agha https://orcid.org/orcid-search/quick-search?searchQuery=Khalid Jamal Khadoura http://search.crossref.org/?q=10.20448/journal.506/2016.3.1/506.1.10.17 http://crossmark.crossref.org/dialog/?doi=10.20448/journal.506/2016.3.1/506.1.10.17 https://orcid.org/orcid-search/quick-search?searchQuery=Samer S. Abu Zer https://orcid.org/orcid-search/quick-search?searchQuery=Samir S. Yassin https://orcid.org/orcid-search/quick-search?searchQuery=Mohamed R. Al Agha https://orcid.org/orcid-search/quick-search?searchQuery=Khalid Jamal Khadoura http://search.crossref.org/?q=10.20448/journal.506/2016.3.1/506.1.10.17 http://crossmark.crossref.org/dialog/?doi=10.20448/journal.506/2016.3.1/506.1.10.17 https://orcid.org/orcid-search/quick-search?searchQuery=Samer S. Abu Zer https://orcid.org/orcid-search/quick-search?searchQuery=Samir S. Yassin https://orcid.org/orcid-search/quick-search?searchQuery=Mohamed R. Al Agha https://orcid.org/orcid-search/quick-search?searchQuery=Khalid Jamal Khadoura http://search.crossref.org/?q=10.20448/journal.506/2016.3.1/506.1.10.17 http://crossmark.crossref.org/dialog/?doi=10.20448/journal.506/2016.3.1/506.1.10.17 https://orcid.org/orcid-search/quick-search?searchQuery=Samer S. Abu Zer https://orcid.org/orcid-search/quick-search?searchQuery=Samir S. Yassin https://orcid.org/orcid-search/quick-search?searchQuery=Mohamed R. Al Agha https://orcid.org/orcid-search/quick-search?searchQuery=Khalid Jamal Khadoura http://search.crossref.org/?q=10.20448/journal.506/2016.3.1/506.1.10.17 http://crossmark.crossref.org/dialog/?doi=10.20448/journal.506/2016.3.1/506.1.10.17 https://orcid.org/orcid-search/quick-search?searchQuery=Samer S. Abu Zer https://orcid.org/orcid-search/quick-search?searchQuery=Samir S. Yassin https://orcid.org/orcid-search/quick-search?searchQuery=Mohamed R. Al Agha https://orcid.org/orcid-search/quick-search?searchQuery=Khalid Jamal Khadoura http://search.crossref.org/?q=10.20448/journal.506/2016.3.1/506.1.10.17 Asian Review of Environmental and Earth Sciences, 2016, 3(1): 10-17 11 1. Introduction Ionizing radiation in medical imaging is one of the powerful diagnostic tools in medicine. Radiation which is applied in radiology departments has hazardous effects on biological systems [1, 2]. The level of awareness concerning with radiation protection influences in staff behavior. If they have not enough information related to mentioned issue, their action will not be safe and resulted to adverse effects [3, 4]. All of these individuals may be considered radiation workers, depending on their level of exposure and on national regulations. All workers require appropriate monitoring continuously by common personnel dosimeters like film badge and thermo-luminescence dosimeter. They must also receive education and training appropriate to their jobs and protect by tools and equipment [5]. In Gaza governorates hospitals, there is no radiation protection program, lack of clear information about radiation protection measures and guidelines. Therefore, the study results will help in implementing modification to alleviate risk factors. In addition, to develop an action plan and new management strategies for radiation protection enhancements and provide clear information to the decision makers. 2. Objectives The main objective of the study is to evaluation of radiation protection measures at governmental Gaza governorates hospitals. The other specific objectives are:  To identify the availability of radiation protection devices in the radio-diagnostic centers.  To measure the level of radio-diagnostic workers awareness about radiation protection issues.  To measure the level of radio-diagnostic workers practices about radiation protection issues.  To evaluate the personal radiation exposure monitoring process.  To help the planners and decision makers to modify the future plans regarding radiation protection to be more and to develop radiation safety culture. 3. Materials and Methods The present study is a descriptive analytical cross sectional study. We carried out this study in nine governmental Gaza governorates hospitals. The target population of this study is the radio-diagnostic workers who have been working at radio-diagnostic centers in these hospitals. This estimated approximately 185 medical radiographers and 45 radiologists. The hospitals were selected because of their large and diverse of their radio-diagnostic services. The sample size was calculated by using sample size calculator from the survey system on the web, with confidence level of 95% and confidence interval of 5. The calculated sample size was 144 of the 230 radio- diagnostic workers. We decided to give rise this number to 182 in order to increase the response rate and to compensate the uncertainties. The study instrument was face to face interview through close-ended structured questionnaire. The validity of the questionnaire was tested by six specialists in the fields of radiology, medical physics, public health and statistics. A pilot study was conducted before starting real data collection. It was served as a pre-test for the questionnaire to check the ambiguity in the question statements and the time taken to complete the questionnaire. Twenty radio- diagnostic workers were chosen to participate in the pilot study. They were selected by the convenience method from the hospitals that have been previously identified. Slight modifications were also done on the questionnaire. The questionnaire content reliability and internal consistency determined by using Cronbach's Alpha in SPSS. 3.1. The Questionnaire Consists of Five Parts and Includes the Following Part one: consisted of eight questions about socio-demographic factors and related work information. This includes: age, sex, occupation, academic qualification, years of experience, name of hospital, type of radio-diagnostic machines who use it, and daily work hours inside the radio-diagnostic rooms. Part two: consisted of ten questions related to the availability of radiation protection devices in the radio- diagnostic centers. This contains (lead apron, gonad shield, lead curtains, lead shields or barrier, thyroid shields, lead glass, lead gloves, breast shields, radiation warning signs and caution lights). Part three: consisted of eighteen questions to measure the level of radio-diagnostic workers awareness about radiation protection issues. This also gives some information about the general understanding of radiation protection issues. Part four: consisted of fifteen questions related to describe of radio-diagnostic workers practices about radiation protection issues. Part five: consisted of six questions to evaluate the personal radiation exposure monitoring process. Data checked, coded, entered and analyzed using SPSS 20 (Statistical Package for the Social Science Inc. Chicago, Illinois USA, version 20) statistical package. 4. Results and Discussion Tale (1), shows 79.1% (n=144) of participants are medical radiographers and 20.9% (n=38) are radiologists. Most of radio-diagnostic workers that formulate 82.8%% (n=144) have a bachelor degree. There is a wide variation in sex of radio-diagnostic workers, where 76.1% (n=144) of the study participants are males and 23.9% (n=43) females. This result indicates that the most of radio-diagnostic workers are males and this is attributed to the community culture towards women who working in radiology field and their fear from transmitting the risk of radiation to their future generations. The study shows that the participants ages were between 30 and 39 years which formulates 46.4% (n=84) of the participants, this indicates that the radio-diagnostic population are young labors. Asian Review of Environmental and Earth Sciences, 2016, 3(1): 10-17 12 The study population was categorized into four groups according to their practical experience and refers that most of the radio-diagnostic workers have sufficient practical experience in radio-diagnostic field. Clearly, it is found that the largest number of study participants from Al Shifa Medical Complex, who formulates 31.3% (n=57) of the study participants. However, the lowest number of study participants from Abdel Aziz Rantessi hospital who formulates 4.9% (n=9) of the participants, this result is not a surprise since the participants proportions depend on the number of radio-diagnostic workers in each hospital, where Al Shifa Medical Complex is a major one. Basic X-ray machines is the most common used, which formulates 83% (n=151) of participants. While 14.8% (n=27) of participants used with mammography machines, this result is reasonable because the basic X-ray machines are the most prevalent in terms of the number and use in the hospitals. Whereas, the dealing with the mammography machines restricted to females workers. Most of radio-diagnostic workers that formulate 34.1% (n=60) working between 3 and 4 hours inside the radio- diagnostic rooms per day, while 27.8% (n=49) of the participants working between 2 and 3 hours per day. Table-1. Socio-demographic and related work factors of the study participants. Item Frequency Percentage 1. Age From 20-29 years 44 24.3% From 30-39 years 84 46.4% From 40-49 years 38 21% More than 50 years 15 8.3% 2. Sex Male 137 76.1% Female 43 23.9% 3. Occupation Radiologist 38 20.9% Medical radiographer 144 79.1% 4. Academic qualification Diploma 16 9.2% Bachelor 144 82.8% Higher degree 14 8% 5. Practical experience 1-4 years 32 18% 5-9 years 64 36% 10-14 years 48 27% 15-20 years 34 19.1% 6. Name of hospital Abu Yousef Al Najjar hospital 12 6.6% European Gaza hospital 16 8.8% Nasser medical complex 29 15.9% Al Aqsa Martyrs hospital 20 11% Al Shifa Medical complex 57 31.3% Al Naser pediatric hospital 12 6.6% Abdel Aziz Rantessi Martyr 9 4.9% Kamal Adwan Martyr hospital 17 9.3% Beit Hanoun hospital 10 5.5% 7. Type of radio-diagnostic machine Basic X-ray 151 83% CT scan 80 44% Fluoroscopy 107 58.8% Panorama 44 24.2% Mammography 27 14.8% Portable X-ray 76 41.8% 8. Daily work hours in radio-diagnostic rooms 1-2 hours 21 11.9% 2-3 hours 49 27.8% 3-4 hours 60 34.1% 4-5 hours 32 18.2% More than 5 hours 14 8% The personal radiation protection devices are the principal for radiology workers [6]. A visible warning sign and caution light required to alert individuals to radiological conditions [7]. However, according to the participants knowledge, it is about 35.2% of personal radiation protection devices are available in the radio-diagnostic centers at governmental Gaza governorates hospitals, Table 2. As it displays in the figure (4.26), the maximum rate about the availability of personal radiation protection devices specified to lead aprons and thyroid shields by 95.6% (n=174) and 75.8% (n=138) respectively. The minimum rate that related to the availability of personal radiation protection devices specified to lead curtains, breast shields and gonad shields by 5.5% (n=10), 7.1% (n=13) and 15.9% (n=29) respectively. Asian Review of Environmental and Earth Sciences, 2016, 3(1): 10-17 13 Table-2. Participants response about the availability of radiation protection devices. Radiation protection devices Yes(frequency and percentage) No(frequency and percentage) Don't know (frequency and percentage) Lead aprons 174(95.7%) 7(3.8%) 1(0.5%) Gonadal shields 29(16%) 142(78%) 11(6%) Lead curtains 10(5.5%) 135(74.2%) 37(20.3%) Lead shields / barriers 73(40.2%) 92(50.5%) 17(9.3%) Thyroid shields 138(75.9%) 41(22.5%) 3(1.6%) Lead glass 76(41.8%) 98(53.8%) 8(4.4%) Lead gloves 38(20.9%) 134(73.6%) 10(5.5%) Breast shields 13(7.1%) 155(85.2%) 14(7.7%) Radiation warning signs 41(22.5%) 132(72.5%) 9(5%) Caution lights 48(26.4%) 122(67%) 12(6.6%) Average 35.2% 58.1% 6.7% As shown in Figure1 in spite the fact that 74.8% of participants have awareness about radiation protection issues, but it is only about 53.4% of participants follows the radiation protection practices. This result is surprising and alarming. Clearly it seems unsatisfactory and indicates that the approximately half of participants have negative practices toward radiation protection issues. Figure-1. Study participant awareness and practices level regarding radiation protection issues. Table 3 shows that the radiation protection advisers are not available in the most of radio-diagnostic centers that surveyed. About 60.4% (n=111) of study participants have a personal radiation exposure monitoring device. Approximately 55% (n=61) of participants who have personal radiation exposure monitoring device use this device during their work in radio-diagnostic rooms, while 31.5% (n=35) of participants sometimes use this device and 13.5% (n=15) of participants don’t use this device during their work in radio-diagnostic rooms. The most of participants who have a dosimeter don't receive guidance about the proper handling with the personal radiation exposure monitoring devices, this represents about 75.7% (n=84) of participants. There are a big problem in personal radiation exposure monitoring process, majority of the participants 64.9% (n=72) believe that the measurements results doesn’t take into consideration by the safety officers. There is no one of radio-diagnostic workers receive a new personal radiation exposure monitoring device when the devices collect to measure of radiation dose. Table-3. Responses of study participants to evaluation the personal radiation exposure monitoring processitems Items Frequency and percentage 1. Does the hospital have Radiation Protection Adviser (RPA)? Yes 8(4.4%) No 174(95.6%) 2. Does the hospital provide you with any personal radiation monitoring device? Yes 111(60.4%) No 71(39.6%) 3. If yes, do you use it during your work in the radio-diagnostic rooms? Yes 61(55%) Sometimes 35(31.5%) No 15(13.5%) 4. Did you receive a guidance about the proper handling with the personal radiation monitoring device? Yes 27(24.3%) No 84(75.7%) 5. Are the measurements results taken into consideration by the safety officers? Yes 39(35.1%) No 72(64.9%) 6. Do you receive another personal radiation monitoring device when the device collect to measure of radiation dose? Yes 0(0%) No 111(100%) As shown in Figure (2) there are a miscellaneous reasons advanced by the study participants about the negligence in personal radiation exposure monitoring process. Majority of participants 64.9% (n=63) believe that there is no radiation safety officer to provide the service. While about 57.7% (n=56) believe that another reason was Asian Review of Environmental and Earth Sciences, 2016, 3(1): 10-17 14 put forward by the participants. This is due to the carelessly of hospital management, that represent about 57.7% (n=56). Another opinion reports that there is lack of fund to purchase these devices and this represents about 32.0% (n=31). Finally, 24.7% (n=24) of participants believe that the radio-diagnostic workers do not request the dosimeters. Figure-2. Participants response about the reasons for lack of personal radiation exposure monitoring devices. The independent samples t-test, frequency, one-way analysis of variance (ANOVA), mean and the standard deviation were carried out and developed in order to identify the relationship between the level of availability the personal radiation protection devices, awareness and practices regarding radiation protection issues and evaluation of personal radiation exposure monitoring process as a dependent variables. However, the socio-demographic and work related factors for workers as independent variables. According to one-way variance (ANOVA) analysis, (P value=0.003), the results in Table 4 reflect there is a difference in the practices mean among the radio-diagnostic workers according to their age groups. The highest mean value (72) was for age group more than 50 years, while the lowest mean value (49.05) was for age group between 30 and 39 years. Clearly that the calculated p-value is less than the significant level which is equal 0.05 (p-value < 0.05).So, the alternative hypothesis that there is statistically significant relationship between the participants practices regarding radiation protection and their age groups is accepted. Clearly that there is a statistically significant difference according to the participants age groups (p-value=0.037), this difference is highest among radio-diagnostic workers with age groups more than 50 years, with mean value (41.11). The lowest mean (23.11) is among age group between 20 and 29 years. This is logical result and reflects that the new employees are not included in the personal radiation exposure monitoring process. Table-4. The dependent variables according to participants age groups Items Age No. Mean Std. F Sig. Availability of devices From 20-29 years 44 40.00 21.67 2.024 0.112 From 30-39 years 84 34.29 19.59 From 40-49 years 38 30.26 15.85 More than 50 years 15 39.33 18.31 Awareness From 20-29 years 44 73.61 14.68 2.18 0.092 From 30-39 years 84 74.07 14.26 From 40-49 years 38 74.42 14.47 More than 50 years 15 83.70 9.73 Practices From 20-29 years 44 53.03 21.23 4.721 0.003 From 30-39 years 84 49.05 21.45 From 40-49 years 38 55.44 25.66 More than 50 years 15 72.00 18.55 Radiation monitoring From 20-29 years 44 23.11 26.22 2.879 0.037 From 30-39 years 84 33.93 25.67 From 40-49 years 38 25.00 26.78 More than 50 years 15 41.11 33.85 The results in Table 5 shows that there are no statistically significant differences the dependent variables due to participants sex. Table-5. The dependent variables according to participants sex Items Sex No. Mean Std. t Sig. Availability of devices Male 137 34.67 18.87 -0.474 0.636 Female 43 36.28 21.05 Awareness Male 137 74.53 14.72 -0.266 0.791 Female 43 75.19 12.32 Practices Male 137 52.99 23.25 -0.047 0.963 Female 43 53.18 21.01 Radiation monitoring Male 137 29.56 27.34 -0.548 0.584 Female 43 32.17 26.82 According to one-way variance (ANOVA) analysis in Table 6 (p-value=0.029).There is a statistically significant relationship between radio-diagnostic workers awareness toward radiation protection issues due to their Asian Review of Environmental and Earth Sciences, 2016, 3(1): 10-17 15 occupation. There are a highly statistically significant differencesbetween the radio-diagnostic workers evaluation regarding personal radiation exposure monitoring process and their occupation (p-value=0.000). Table-6. The dependent variables according to participants occupation Items Occupation No. Mean Std. t Sig. Availability of devices Radiologist 38 32.63 17.96 -0.902 0.368 Medical radiographer 144 35.83 19.84 Awareness Radiologist 38 70.32 15.30 -2.199 0.029 Medical radiographer 144 75.96 13.73 Practices Radiologist 38 48.07 25.94 -1.635 0.104 Medical radiographer 144 54.86 21.89 Radiation monitoring Radiologist 38 8.77 16.32 -5.952 0.000 Medical radiographer 144 35.88 26.76 Clearly in Table 7 that there is a statistically significant difference in the radio-diagnostic workers practices according to their academic qualification (p-value=0.008). This result may be attributed to the quality of education materials and curriculum given to the three different groups. There is statistically significant difference between the evaluation regarding personal radiation exposure monitoring process among radio-diagnostic workers and their academic qualifications (p-value=0.013). As shown in Table 8 there is a statistically significant difference in the radio-diagnostic workers awareness level due to their years of practical experience (p-value=0.017). There is a highly statistically significant difference in the radio-diagnostic practices due to their practical experience years (p-value=0.000). Table-7. The dependent variables according to participants academic qualification Items Education No. Mean Std. F Sig. Availability of devices Diploma 16 31.25 19.28 0.435 0.648 B.Sc. 144 36.11 20.11 Higher degree 14 35.71 16.51 Awareness Diploma 16 78.13 10.44 0.462 0.631 B.Sc. 144 74.50 14.68 Higher degree 14 75.00 14.25 Practices Diploma 16 70.42 19.62 4.967 0.008 B.Sc. 144 52.04 22.32 Higher degree 14 55.24 23.45 Radiation monitoring Diploma 16 47.92 27.13 4.433 0.013 B.Sc. 144 30.09 26.76 Higher degree 14 20.24 25.47 This result may be attributed to long-term of occupational radiation doses for those who have more than 20 years of work. So, this group of radio-diagnostic workers has become more concerned about the health impacts from radiation exposures than those who have less period of experience. Hence, they applied the protection procedures more carefully to decrease the probability of radiation risks on their health. There are a highly statistically significant differences in the evaluation of personal radiation exposure monitoring process due to their practical experience years (p-value=0.000). Table-8. The dependent variables according to participants practical experience Items Experience No. Mean Std. F Sig. Availability of devices From 1-4 years 32 39.06 24.14 1.261 0.287 From 5-9 years 64 35.31 19.92 From 10-14 years 48 30.83 15.96 From 15-19 years 19 39.47 17.79 More than 20 years 15 32.00 16.56 Awareness From 1-4 years 32 78.99 12.91 3.088 0.017 From 5-9 years 64 71.09 14.21 From 10-14 years 48 73.61 14.24 From 15-19 years 19 78.07 13.67 More than 20 years 15 81.48 13.55 Practices From 1-4 years 32 53.13 18.97 7.493 0.000 From 5-9 years 64 47.19 22.04 From 10-14 years 48 49.72 22.04 From 15-19 years 19 67.02 22.50 More than 20 years 15 75.11 19.76 Radiation monitoring From 1-4 years 32 13.54 20.93 5.414 0.000 From 5-9 years 64 32.29 25.70 From 10-14 years 48 30.21 25.65 From 15-19 years 19 33.33 31.43 More than 20 years 15 48.89 29.86 Asian Review of Environmental and Earth Sciences, 2016, 3(1): 10-17 16 As shown in Table 9 there are highly statistically significant differences in the participants evaluation of availability of radiation protection devices(p-value=0.000), participants awareness (p-value=0.028) and participants practices (p-value=0.001) due to their hospitals. Table-9. The dependent variables according to participants hospitals Items Hospital No. Mean Std. F Sig. Availability of devices European Gaza hospital 16 31.25 10.25 8.337 0.000 Nasser Medical Complex 29 43.45 20.58 Abu Yousef Al Najjar hospital 12 22.50 6.22 Al Aqsa Martyrs hospital 20 34.00 11.42 Al Shifa Medical Complex 57 38.77 19.28 Abdel Aziz Rantessi hospital 9 63.33 11.18 Al Naser hospital 12 31.67 23.29 Kamal Adwan hospital 17 22.35 16.78 Beit Hanoun hospital 10 15.00 9.72 Awareness European Gaza hospital 16 70.83 15.52 2.221 0.028 Nasser Medical Complex 29 71.26 13.03 Abu Yousef Al Najjar hospital 12 70.37 17.14 Al Aqsa Martyrs hospital 20 74.17 16.74 Al Shifa Medical Complex 57 78.36 12.93 Abdel Aziz Rantessi hospital 9 69.14 14.46 Al Naser hospital 12 85.65 14.88 Kamal Adwan hospital 17 73.53 8.68 Beit Hanoun hospital 10 71.67 13.21 Practices European Gaza hospital 16 43.33 26.22 3.484 0.001 Nasser Medical Complex 29 42.76 21.49 Abu Yousef Al Najjar hospital 12 56.11 16.69 Al Aqsa Martyrs hospital 20 42.00 25.05 Al Shifa Medical Complex 57 59.53 21.19 Abdel Aziz Rantessi hospital 9 54.81 22.80 Al Naser hospital 12 67.22 13.77 Kamal Adwan hospital 17 56.08 19.73 Beit Hanoun hospital 10 63.33 25.39 Radiation monitoring European Gaza hospital 16 25.0 21.08 1.58 0.134 Nasser Medical Complex 29 24.71 28.74 Abu Yousef Al Najjar hospital 12 45.83 18.97 Al Aqsa Martyrs hospital 20 27.50 26.64 Al Shifa Medical Complex 57 26.90 28.65 Abdel Aziz Rantessi hospital 9 42.59 22.22 Al Naser hospital 12 38.89 32.05 Kamal Adwan hospital 17 27.45 25.65 Beit Hanoun hospital 10 43.33 26.29 Clearly in Table 10 that there is a statistically significant difference in the radio-diagnostic workers practices according to their daily work hours (p-value=0.008). This difference is high among radio-diagnostic workers who work more than 5 hours (67.1), the lowest is among radio-diagnostic workers who work between 2 and 4 hours (46.7). Table-10. The dependent variables according to participants daily work hours in radio-diagnostic rooms Items Daily work hours No. Mean Std. F Sig. Availability of devices From 1-2 hours 21 32.4 21.2 0.504 0.733 From 2-3 hours 49 36.9 22.7 From 2-4 hours 60 36.0 18.5 From 4-5 hours 32 33.1 17.5 More than 5 hours 14 40.0 15.2 Awareness From 1-2 hours 21 74.6 13.6 1.928 0.108 From 2-3 hours 49 73.7 15.9 From 2-4 hours 60 72.3 14.8 From 4-5 hours 32 80.7 11.3 More than 5 hours 14 75.0 11.9 Practices From 1-2 hours 21 56.2 20.5 4.192 0.003 From 2-3 hours 49 52.9 21.9 From 2-4 hours 60 46.7 21.7 From 4-5 hours 32 62.3 22.8 More than 5 hours 14 67.1 21.8 Radiation monitoring From 1-2 hours 21 31.0 29.5 1.002 0.408 From 2-3 hours 49 32.7 26.1 From 2-4 hours 60 25.6 27.7 From 4-5 hours 32 35.9 28.4 More than 5 hours 14 25.0 25.9 Asian Review of Environmental and Earth Sciences, 2016, 3(1): 10-17 17 5. Conclusion A descriptive analytical cross sectional study, based on the analysis of data collected by a close-ended structured questionnaire consists of five parts which designed for matching the study needs and 182 radio-diagnostic workers participated in the work. We conducted the independent samples t-test, frequency and one-way analysis of variance (ANOVA). These tests detect the difference between the availability of personal radiation protection devices, awareness and practices level regarding radiation protection issues and evaluation of personal radiation exposure monitoring process as a dependent variables. However, the socio-demographic and work related factors among radio- diagnostic workers are independent variables. According to the results displayed in chapter four, the participants reported that 35.2% of personal radiation protection devices are available in the radio-diagnostic centers at governmental Gaza governorates hospitals. The results indicate unsatisfactory practices toward radiation protection issues, where approximately half of participants have negative practices. In general, the results revealed that there is an obvious poor of personal radiation exposure monitoring process. There is also a statistically significant difference in the participants awareness level due to their years of practical experience and occupation. Overall, the results represented in this work reflect that majority of participants believe there is no radiation safety officer to provide the service. Therefore, there is a desperate need for rules, regulations and radiation protection act in the field of radiation in medical field. References [1] L. Persson and K. Shrader-Frechette, "An evaluation of the ethical principles of the ICRP’s radiation protection standards for workers," Health Physics, vol. 80, pp. 225-234 2001. [2] E. Karen, J. E. Thomas, Parnell-Parmley, S. Haidar, and R. Moineddin, "Assessment of radiation dose awareness among pediatricians," Pediatr Radiol., vol. 36, pp. 823-832, 2006. [3] R. Jascobs, M. Vanderstappen, R. Bogaerts, and F. Gijbels, "Attitude of the Belgian dentist population towards radiation protection," Entomaxillofacial Radiology, vol. 33, pp. 334-339 2004. [4] B. Svenson, H. G. Grondahl, and B. Soderfeldt, "A logistic regression model for analyzing the relation between dentists attitudes, behavior and knowledge in oral radiology," Acta. Ondontologica Scandinavica, vol. 56, pp. 215-219, 1998. [5] N. Rahman, S. Dhakam, A. Shafqut, S. Qadir, and T. F. Ali, "Knowledge and practice of radiation safety among invasive cardiologists," JPMA, vol. 58, pp. 119-122, 2008. [6] W. Klein, L. Miller, S. Balter, W. Laskey, D. Haines, A. Norbash, and J. Goldstein, "Occupational health hazards in the interventional laboratory: Time for a safer environment," Catheterization and Cardiovascular Interventions Journal, vol. 73, pp. 432-438, 2009. [7] Radiation Protection Manual, "A publication of institute of nuclear medicine and allied science (INMAS), DRDO, Delhi, India," Radiological Protection Bulletin, vol. 231, pp. 18-23, 2010. Views and opinions expressed in this article are the views and opinions of the authors, Asian Review of Environmental and Earth Sciences shall not be responsible or answerable for any loss, damage or liability etc. caused in relation to/arising out of the use of the content.