Knowledge and Awareness of Radiation Protection Among Healthcare Workers: A Cross-Sectional Study
DOI:
https://doi.org/10.62255/mjhp.v4i1.253Abstract
Ionising radiation from diagnostic procedures poses significant occupational risks to healthcare workers (HCWs), yet awareness remains suboptimal in many settings, particularly in low- and middle-income countries. This cross-sectional study assessed radiation protection knowledge and awareness among 140 HCWs from inpatient, intensive care, and emergency units in Indonesia, identifying independent predictors of awareness. Knowledge was evaluated using a validated 15-item instrument (categorized as poor, acceptable, or good), while awareness was measured as a binary outcome. Data were analyzed using Pearson’s chi-square test and multivariable binary logistic regression, adhering to STROBE guidelines. The sample was predominantly female (69.3%) with bachelor’s degrees (57.1%). Overall, 46.4% demonstrated good knowledge, 48.6% acceptable, and 5.0% poor, while 68.6% were classified as aware. Multivariable analysis revealed that knowledge level was the sole independent predictor of awareness: compared to poor knowledge, acceptable knowledge significantly increased awareness odds (aOR = 3.48; 95% CI: 1.12–10.80; p = 0.031), as did good knowledge (aOR = 8.65; 95% CI: 2.10–35.60; p = 0.003). These findings confirm that radiation protection knowledge strongly and independently drives awareness among clinical staff. Consequently, healthcare institutions must prioritize continuous, evidence-based radiation safety education—particularly for personnel in high-exposure units—as the foundational strategy to effectively bridge the knowledge–awareness gap and mitigate occupational radiation risks.
Downloads
Keywords:
radiation protection, healthcare workers, knowledge, awareness, logistic regression, occupational health, STROBEReferences
Alamoudi, D., Alhalwani, A., Ahmed, M. E., Hamidaddin, A. A., Asiri, N., Abuzenada, S. A., Munshi, W., & Al-Saleh, W. (2025). Radiation Protection Knowledge for Nurses at King Abdulaziz Medical City-Jeddah in Saudi Arabia: A Cross-Sectional Study. Journal of Radiation Protection and Research. https://doi.org/10.14407/jrpr.2024.00290
Alharbi, A., Nurfianti, A., Mullen, R., McClure, J., & Miller, W. (2024). The effectiveness of simulation-based learning (SBL) on students’ knowledge and skills in nursing programs: a systematic review. BMC Medical Education, 24. https://doi.org/10.1186/s12909-024-06080-z
Allam, S., Algany, M. M. A., & Khider, Y. I. A. (2024). Radiation safety compliance awareness among healthcare workers exposed to ionizing radiation. BMC Nursing, 23. https://doi.org/10.1186/s12912-024-01858-4
Alyousef, K., Assiri, A., Almutairi, S., Aldalham, T., & Felimban, G. (2023). Awareness of Radiation Protection and Common Radiation Dose Levels Among Healthcare Workers. Global Journal on Quality and Safety in Healthcare, 6, 1–5. https://doi.org/10.36401/jqsh-22-14
Andaloussi, L. H., Harrass, H., Aschawa, H., & Hlousse, F. Z. (2021). Medical staff who use ionizing radiation at Ibn Rochd University Hospital Center of Casablanca, Morocco: evaluation of radiation protection knowledge. E3S Web of Conferences. https://doi.org/10.1051/e3sconf/202131901046
Barare, C., & Odongo, J. (2022). Awareness on Ionizing Radiation among Non Radiation Healthcare Workers at Teaching and Referral Hospital in East Africa. Journal of Medical Imaging and Radiation Sciences. https://doi.org/10.1016/j.jmir.2022.10.055
Bartal, G., Vañó, E., & Paulo, G. (2021). Get Protected! Recommendations for Staff in IR. Cardiovascular and Interventional Radiology, 44, 871–876. https://doi.org/10.1007/s00270-021-02828-y
Baudin, C., Vacquier, B., Thin, G., Chenene, L., Guersen, J., Partarrieu, I., Louet, M., Pointe, H. D. Le, Mora, S., Verdun-Esquer, C., Lestavel, P., Rousseau, F., Roy, H., Bensefa-Colas, L., Boyer, L., & Bernier, M.-O. (2024). Radiation protection in a cohort of healthcare workers: knowledge, attitude, practices, feelings and IR-exposure in French hospitals. Journal of Radiological Protection, 44. https://doi.org/10.1088/1361-6498/ad39f7
Behzadmehr, R., Doostkami, M., Sarchahi, Z., Saleh, L. D., & Behzadmehr, R. (2020). Radiation protection among health care workers: knowledge, attitude, practice, and clinical recommendations: a systematic review. Reviews on Environmental Health, 36, 223–234. https://doi.org/10.1515/reveh-2020-0063
Bolowia, N. (2025). Knowledge and Awareness about Radiation Protection and Hazards among Healthcare Workers in Tobruk Medical Centre. AlQalam Journal of Medical and Applied Sciences. https://doi.org/10.54361/ajmas.258118
Cao, L., Wu, J., Jiang, L., Tao, Y., Huang, H., & Xue, X. (2025). Exploring influences on radiation protection compliance: a directed acyclic graph-based cross-sectional study in a non-teaching hospital in western China. PeerJ, 13. https://doi.org/10.7717/peerj.20083
Charmchi, R., Moradimajd, P., Saei, A., Paydar, R., & Abolghasemi, J. (2025). Comparison of the effectiveness of radiation protection principles training through multimedia and instructional booklet on the awareness of operating room staff. Journal of Education and Health Promotion, 14. https://doi.org/10.4103/jehp.jehp_1885_23
De Mello, D. S., & Ribeiro, G. (2024). Annual Training Program in Radiological Protection in a Radiotherapy Service – A Case Study. Brazilian Journal of Radiation Sciences. https://doi.org/10.15392/2319-0612.2024.2507
Elmorabit, N., Marrakchi, A., Chelh, F. Z., Zaizoune, S., Azougagh, M., & Ennibi, O. (2024). Knowledge and practices of interventional radiology staff regarding radiation protection. Multidisciplinary Reviews. https://doi.org/10.31893/multirev.2025062
Emayof, M., & Awath. (2025). Assessment of Knowledge, Awareness, and Practice Towards Radiation Protection among Physicians: A Cross-Sectional Study at Tobruk. Libyan Journal of Medical and Applied Sciences. https://doi.org/10.64943/ljmas.v3i3.104
Fataftah, J., Tayyem, R., Al-Dwairy, S., Manasra, A. R. Al, Ibrahim, A., Ryalat, R. Al, Alwreikat, M., Al-Shraah, H., Alharbi, R., & Alharbi, B. (2024). Awareness of radiation hazards and knowledge of radioprotective measures among radiologists and non-radiology staff: a cross-sectional survey. Egyptian Journal of Radiology and Nuclear Medicine, 55. https://doi.org/10.1186/s43055-024-01300-4
Fujiwara, A., Fujimoto, S., Ishikawa, R., & Tanaka, A. (2024). Virtual reality training for radiation safety in cardiac catheterization laboratories - an integrated study. Radiation Protection Dosimetry, 200, 1462–1469. https://doi.org/10.1093/rpd/ncae187
Gavagan, L., Arnejo, A., Dowling, A., & Maxwell, M. (2024). The application of Lean Six Sigma methodologies to Radiation Safety Training for Ancillary workers at the Regional Hospital in Mullingar. Physica Medica. https://doi.org/10.1016/j.ejmp.2024.103241
Göde, A., Erdem, H., Dadak, A., & Aç?kgöz, G. (2025). Investigation of the role of radiation protection knowledge of health workers on radiation attitude. BMC Health Services Research, 25. https://doi.org/10.1186/s12913-025-13565-0
Horita, S., Sakuda, H., Igarashi, T., Iwanaga, H., Ichida, T., Okuda, Y., Shiraishi, J., Ueno, H., Ota, K., & Kusama, T. (2024). [Questionnaire Survey of Radiation Protection Education in Hospitals]. Nihon Hoshasen Gijutsu Gakkai Zasshi. https://doi.org/10.6009/jjrt.2024-1394
Júnior, J. P. B. (2022). Social desirability bias in qualitative health research. Revista de Saúde Pública, 56. https://doi.org/10.11606/s1518-8787.2022056004164
Kyei, K., Addo, H. B., & Daniels, J. (2025). Radiation safety: knowledge, attitudes, practices and perceived socioeconomic impact in a limited-resource radiotherapy setting. Ecancermedicalscience, 19. https://doi.org/10.3332/ecancer.2025.1855
Massaquoi, I., Abu, A., Kamara, S., & Sesay, M. (2025). Investigate the Radiation Safety Awareness Among Medical Workers at Government Hospital, Bo. International Journal of High Energy Physics. https://doi.org/10.11648/j.ijhep.20251101.11
Nasr, B., Guyomard, B., Visvikis, D., & Bert, J. (2023). Radiation protection training by Monte Carlo Simulation and virtual reality. Annals of Vascular Surgery. https://doi.org/10.1016/j.avsg.2023.07.022
Ninkovic-Hall, G., Chapman, A., Saratzis, A., Lakshminarayan, R., Carradice, D., & Sritharan, K. (2025). A survey of UK standards of radiation protection amongst orthopaedic surgeons. The British Journal of Radiology, 98, 1504–1510. https://doi.org/10.1093/bjr/tqaf162
Popovic, B., Varlot, J., Girard-Bertrand, B., Basile, J. L., Thouvenot, C., Fay, R., Villani, N., Tran, N., & Camenzind, E. (2022). Impact of Simulation-Based Training on Radiation Exposure of Young Interventional Cardiologists. The American Journal of Cardiology. https://doi.org/10.1016/j.amjcard.2022.07.014
Radzi, J. M., & Raj, N. D. A. (2023). Assessment of Knowledge and Practice on Radiation Protection in Radiological Imaging Among Healthcare Professionals at HPUniSZA. Asian Journal of Medicine and Biomedicine. https://doi.org/10.37231/ajmb.2023.1.s.655
Rahimi, A., Nurdin, I., Ismail, S., & Khalil, A. (2021). Malaysian Nurses’ Knowledge of Radiation Protection: A Cross-Sectional Study. Radiology Research and Practice, 2021. https://doi.org/10.1155/2021/5566654
Rodrigues, B., Lopes, P., Mello-Moura, A., Flores-Fraile, J., & Veiga, N. (2024). Literacy in the Scope of Radiation Protection for Healthcare Professionals Exposed to Ionizing Radiation: A Systematic Review. Healthcare, 12. https://doi.org/10.3390/healthcare12202033
Safina, F., Tabassum, S., Satiwan, K., Shahbaz, B., & Naeem, M. (2025). Knowledge of Radiation Hazards and Attitude toward Radioprotection among Radiography Healthcare Professionals. Biological and Clinical Sciences Research Journal. https://doi.org/10.54112/bcsrj.v6i6.1925
Saida, E. K., Nadia, M., Hicham, E. B., Frédéric, D., & Chakib, L. (2024). O-319 KNOWLEDGE, ATTITUDES AND PRACTICES OF HOSPITAL RADIOLOGY STAFF WITH REGARD TO RADIATION PROTECTION. Occupational Medicine. https://doi.org/10.1093/occmed/kqae023.1214
Shubayr, N. (2024a). Evaluation of emergency nurses’ knowledge of medical response in nuclear and radiological emergencies?: a cross-sectional study. BMC Nursing, 23. https://doi.org/10.1186/s12912-024-02451-5
Shubayr, N. (2024b). Operating room radiation safety measures: Awareness, compliance, and perceived risks among nurses and other healthcare workers. International Nursing Review. https://doi.org/10.1111/inr.13071
Song, Y., Zhang, L., & Wang, W. (2022). An Analysis of the Effect of Personal Protective Equipment (PPE) Training Based on the Information–Motivation–Behavior Skills Model in the Practice of COVID-19 PPE Application. Infection and Drug Resistance, 15, 4829–4835. https://doi.org/10.2147/idr.s366049
Su, P., Zhu, Z., He, J., He, R., Feng, H., Du, P., Lönn, L., Konge, L., & Yin, F. (2022). Focus on radiation protection improves both correct behavior and procedural performance during simulation-based training - a randomized comparison. Annals of Vascular Surgery. https://doi.org/10.1016/j.avsg.2022.10.003
Tanming, T., Makmee, P., & Luengalongkot, P. (2024). Guidelines for promoting awareness of radiation protection among professional nurses. International Journal of Healthcare Management, 18, 858–867. https://doi.org/10.1080/20479700.2024.2392429
Vassileva, J., Applegate, K., Paulo, G., Vañó, E., & Holmberg, O. (2021). Strengthening radiation protection education and training of health professionals: conclusions from an IAEA meeting. Journal of Radiological Protection, 42. https://doi.org/10.1088/1361-6498/ac40e9
Wally, S. F., Sabir, S. A., Alharbi, S., Albalawi, I., Alharbi, K., Binsulaiman, N., Albalawi, N., & Alshareef, A. (2024). Radiation Safety Awareness Among Non-radiology Staff at Tabuk Hospitals, Saudi Arabia. Cureus, 16. https://doi.org/10.7759/cureus.70603
Wang, T., Voss, J., & Dolansky, M. (2020). Promote Radiation Safety for Nurses: A Policy Perspective. Journal of Radiology Nursing. https://doi.org/10.1016/j.jradnu.2020.12.003
Xie, Y., Wang, X., Lan, Y.-Y., Xu, X., Shi, S., Yang, Z., Li, H., Han, J., & Liu, Y. (2025). Assessment of radiation knowledge among medical personnel in nuclear emergency preparedness: a cross-sectional study. Frontiers in Public Health, 13. https://doi.org/10.3389/fpubh.2025.1547818
Xu, X., Xie, Y., Li, H., Wang, X., Shi, S., Yang, Z., Lan, Y.-Y., Han, J., & Liu, Y. (2024). Awareness and preparedness level of medical workers for radiation and nuclear emergency response. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1410722
Yadav, P., Verma, D., Gautam, S., Verma, M. K., Barma, D., Chouhan, V., Jain, M., & Hrangkhawl, W. (2025). Knowledge And Practice of Radiation Protection Among Healthcare Professionals in The Operation Theater: A Comprehensive Review. African Journal of Biomedical Research. https://doi.org/10.53555/ajbr.v28i3s.7764
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Berliana Devianti Putri, Anisa Dewi Setiawati, Winda Kusumawardani, Cendra Devayana Putra, Gabriel Loi

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.






