Assessment of entrance surface dose and health risk from common radiology examinations in Iran.

Medical X-ray exposures are the largest man-made source of population exposure to ionising radiation in many countries. Although information on medical exposure is already incorporated into national legislative documents, in Isfahan there is no data on the assessment of patient's entrance surface dose (ESD) and the health risk from conventional radiography in daily clinical practice. The aim of this study was to investigate ESDs and the consequent health risk for the patients undergoing routine X-ray procedures in hospitals  under the control of Isfahan University of Medical Sciences, Iran, in year 2011. The values of ESDs were measured for common radiographical examinations with the highest absorbed dose to the patient in seven hospitals (Alzahra, Ashrafi-Khomeini-shahr, Feyz, Isabne-Maryam, Kashani, Nour-Aliasghar and Seyed-Al Shohada) and six stationary X-ray machines (General Electric, USA; Phillips, The Netherlands; Siemens, Germany; Shimadzu, Japan; Toshiba, Japan and Varian, USA). The results of the ESD measurements as well as the calculated effective dose values between different X-ray examinations showed values significantly greater than those recorded in some other countries especially for the high tube potential technique (such as the skull) by factors of 2.5-5.0. Based on the fatality risk of 5 % per sievert, it was estimated that, for chest and skull examinations approximately two (40.18 person-Sv×5 % per sievert) and one (2.53 person-Sv×5 % per sievert) cases of health risk, respectively, may in the future be attributable to diagnostic X rays done in year 2011 in Isfahan. Efforts should be taken to further lower patient doses while securing image quality. The need to provide relevant education and training to staff in the radiology sections is of utmost importance.