title: The compliance with and knowledge about radiation protection in operating room personnel: a cross-sectional study with a questionnaire.
abstract: BACKGROUND
  Radiation protection is becoming more important with an ongoing increase in radiation exposure due to the use of X-rays in minimally invasive procedures in orthopaedic and trauma surgeries. However, sufficient education in medical physics and radiation protection can often be improved.
  
  
  METHODS
  A questionnaire consisting of four questions about personal data and ten questions about radiation protection was distributed to lead consultants, consultants, residents, medical students, and medical technical assistants at two institutions, a level 1 trauma center and a children's hospital.
  
  
  RESULTS
  This study consisted of 83 participants. The compliance with radiation protection, i.e., usage of a dosimetry, an apron, and a thyroid shield on a regular basis was only seen in 54 %. Participants from the trauma center wore a dosimeter and thyroid shield significantly more often. The regular use of a thyroid shield differed significantly between job positions. It was observed in 80 % of students, but only 15 % of technical assistants. Only 65 % of all knowledge questions were answered correctly. There was a discrepancy between incorrectly answered knowledge questions (35 %) and those marked as uncertain (20 %). Different job positions did not have an impact on the answers to the questions in most instances.
  
  
  CONCLUSIONS
  The compliance with and the knowledge about radiation protection seems to be unnecessarily low in trauma physicians and technical assistants. The discrepancy in falsely answered questions and those marked as uncertain may suggest that participants may overestimate their knowledge about radiation protection, which is potentially harmful due to the increased radiation exposure. Therefore, we advocate a quick and valuable training of trauma surgeons and medical staff addressing the important preventive measures, some of which are illustrated in the present study. These consist of wearing dosimetry and protection devices, reduction in X-ray duration, preferably antero-posterior C-arm positioning with the image intensifier close to the patient and the surgeon, maximal distance, collimation, and increased voltage. Furthermore, the use of visual feedback on complex and potentially hazardous radiation facts may be useful for training purposes.
  
  
  METHODS
  Cross-sectional study with a questionnaire.
authors.affiliation: Division of Trauma Surgery, Department of Surgery, University Hospital Zürich, University of Zürich, Rämistrasse 100, 8091, Zürich, Switzerland, thorsten.jentzsch@usz.ch.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Jentzsch
authors.forename: Christiane M
authors.initials: CM
authors.lastname: Pietsch
authors.forename: Brigitte
authors.initials: B
authors.lastname: Stigler
authors.forename: Leonhard E
authors.initials: LE
authors.lastname: Ramseier
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.forename: Clément M L
authors.initials: CM
authors.lastname: Werner
mesh_terms: D002983:Clinical Competence; D003430:Cross-Sectional Studies; D006282:Health Personnel; D006776:Hospitals, Pediatric; D006801:Humans; D016273:Occupational Exposure / Q000517:prevention & control*; D009873:Operating Rooms; D011835:Radiation Protection / Q000706:statistics & numerical data*; D011874:Radiometry / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013557:Switzerland; D014193:Trauma Centers