Kitamura Hiroko, Nakagami Koichi
Occupational Health Training Center, University of Occupational and Environmental Health, Japan.
Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan.
Sangyo Eiseigaku Zasshi. 2025 Apr 5. doi: 10.1539/sangyoeisei.2024-035-B.
To clarify the current status and challenges of radiation dose management in medical institutions participating in the Radiation Management System (Radiation MS) Implementation Support Project and to provide insights for establishing and improving radiation management systems.
A web-based questionnaire was administered to medical institutions nationwide that participated in the Radiation MS Implementation Support Project in 2022. Responses from 143 institutions that provided valid data and consent were obtained and analyzed. The survey assessed the structure of the radiation management system (comprising five elements), verification status and management of radiation workers, and implementation of awareness-raising activities regarding proper personal dosimeter use. Each questionnaire item was analyzed using descriptive statistics and chi-squared tests. To determine the optimal sequence for implementing the five elements of the radiation management system, correlation, logistic regression, decision tree (CART), and path analyses were conducted.
Among the 143 institutions, 46.9% had established a radiation exposure management organization (e.g., a committee), and 55.9% had administrators who clarified radiation management policies and guidelines. Regarding radiation workers, only 32.6% of radiation management personnel were aware of whether their institution's radiation workers were also engaged in radiation work at other facilities (referred to as "dual employment"), whereas 35.0% were aware of confirmed cases of employees from other institution receiving dual employment. Additionally, 33.6% of the institutions did not conduct sufficient awareness-raising activities regarding proper personal dosimeter use. A comparison between clinics and hospitals revealed that Occupational Safety and Health Management Systems (OSHMS) were more widely implemented in clinics than in hospitals. Additionally, clinics demonstrated a better understanding of whether radiation workers were engaged in dual employment compared to hospitals. The establishment of a radiation exposure management organization was found to be crucial for building a radiation management framework. To facilitate implementation, clarifying policies and guidelines and establishing audit mechanisms were identified as priority measures.
This study identified several challenges related to the development of radiation management systems, appointment of radiation control personnel, and personal dose management of radiation workers. Moreover, priority measures were clarified for establishing a robust radiation management framework. Addressing these issues requires medical administrators to clarify policies and guidelines related to radiation management, develop audit mechanisms, and promote the establishment of radiation exposure management organizations. Furthermore, strengthening the leadership of medical administrators and implementing Radiation MS are effective strategies for maintaining and improving management frameworks.
阐明参与放射管理系统（Radiation MS）实施支持项目的医疗机构中放射剂量管理的现状和挑战，并为建立和完善放射管理系统提供见解。
对2022年参与Radiation MS实施支持项目的全国医疗机构进行了基于网络的问卷调查。获得并分析了143家提供有效数据并同意参与的机构的回复。该调查评估了放射管理系统的结构（包括五个要素）、放射工作人员的核查状况和管理，以及关于正确使用个人剂量计的提高认识活动的实施情况。使用描述性统计和卡方检验对每个问卷项目进行分析。为了确定实施放射管理系统五个要素的最佳顺序，进行了相关性分析、逻辑回归分析、决策树（CART）分析和路径分析。
在143家机构中，46.9%建立了辐射暴露管理组织（如委员会），55.9%有明确放射管理政策和指南的管理人员。关于放射工作人员，只有32.6%的放射管理人员知道其机构的放射工作人员是否也在其他机构从事放射工作（称为“双重就业”），而35.0%知道其他机构员工双重就业的确认案例。此外，33.6%的机构没有就正确使用个人剂量计开展充分的提高认识活动。诊所和医院之间的比较显示，职业安全与健康管理系统（OSHMS）在诊所的实施比在医院更广泛。此外，与医院相比，诊所对放射工作人员是否从事双重就业有更好的了解。发现建立辐射暴露管理组织对于构建放射管理框架至关重要。为便于实施，明确政策和指南以及建立审核机制被确定为优先措施。
本研究确定了与放射管理系统发展、放射控制人员任命以及放射工作人员个人剂量管理相关的若干挑战。此外，明确了建立健全放射管理框架的优先措施。解决这些问题需要医疗管理人员明确与放射管理相关联的政策和指南，制定审核机制，并促进辐射暴露管理组织的建立。此外，加强医疗管理人员的领导力和实施Radiation MS是维持和完善管理框架的有效策略。
