Effectiveness of online trainings on radiation protection in the context of the COVID-19 pandemic.

Over 212 healthcare professionals from the country have used the online trainings on radiation protection conducted during the COVID-19 pandemic. Each training, lasting up to 10 working days, is accompanied by mandatory Google Form-based questionnaires, which includes topic key questions about each lecture as well as pre- and post-training tests and provided to participants. In addition, the ability to conduct a dialogue with patients about radiation risks, group discussions, as well as a special module for radiation protection officers were assessed online. The trainings also allow participants to focus on the most important issues from their point of view in their daily work, indicating them in pre-tests, allowing the trainers to conduct lectures more adequately for each group of participants. Analysis of the tests have shown that online training is not inferior in efficiency to face-to-face training and national regulatory body received an improved opportunity to indirectly assess this efficiency.

Changing face-to-face to online radiation protection training: experiences of trainers and trainees.

The SCK CEN Academy for Nuclear Science and Technology functions as the umbrella structure coordinating the education and training activities of the Belgian Nuclear Research Centre (SCK CEN). One of the main activities of the SCK CEN Academy is to provide customised training to professionals working in the nuclear industry, healthcare, research or governmental institutions. The courses and practical sessions are usually given in a face-to-face (FTF) format. This has drastically changed in the last 2 y because of the COVID-19 pandemic when it was necessary to switch course delivery from FTF to an online format. Feedback was collected from trainees and trainers in different training courses in radiation protection provided in FTF and online format. The analysis of this feedback allows training providers to make better-informed decisions on the best-suited training format depending on the content, target audience and the duration of the learning activity.

Determination of scattered radiation dose for radiological staff during portable chest examinations of COVID-19 patients.

The COVID-19 pandemic has resulted in a large increase in the number of patients admitted to hospitals. Radiological technologists (RTs) are often required to perform portable chest X-ray radiography on these patients. Normally, when performing a portable X-ray, radiation protection equipment is critical as it reduces the scatter radiation dose to hospital workers. However, during the pandemic, the use of a lead shield caused a heavy weight burden on workers who were responsible for a large number of patients. This study aimed to investigate scatter radiation doses received at various distances, directions, and positions. Radiation measurements were performed using the PBU-60 whole body phantom to determine scatter radiation doses at 100-200 cm and eight different angles around the phantom. The tests were conducted with and without lead shielding. Additionally, the doses were compared using the paired t test (p < 0.005) to determine suitable positions for workers who did not wear lead protection that adhered to radiation safety requirements. Scatter radiation doses of all 40 tests showed a highest and lowest value of 1285.5 nGy at 100 cm in the anteroposterior (AP) semi upright position and 134.7 nGy at 200 cm in the prone position, respectively. Correlation analysis between the dosimeter measurement and calculated inverse square law showed good correlation, with an R2 value of 0.99. Without lead shielding, RTs must stay at a distance greater than 200 cm from patients for both vertical and horizontal beams to minimize scatter exposure. This would allow for an alternative way of performing portable chest radiography for COVID-19 patients without requiring lead shielding.

The young generation in radiation protection (IRPA YGN) in social media and online learning: 'Brave New World' or 'Online Nightmare'?

While online working seems to have become more common since the start of the Covid-19 pandemic, social media has the potential to offer greater interactivity and networking capacities. Thus it seems relevant for the IRPA Young Generation Network to investigate the use of social media by members of the young generation in radiation protection (RP) through an online survey. It was also the opportunity to collect early feedback about on-line learning. The survey received 89 answers from 15 countries. The most commonly used social media platforms were first Facebook, then LinkedIn and Twitter, but other social media were reported. The respondents have a multi-objectives approach while on social media, using it for different purposes (chiefly for sharing news and RP related information/educational material) and different audiences (e.g. public, professional). Yet, they are making a very moderate use based on the frequencies of publication and consultation and the challenges they see in social media. The survey also collected the view of the young generation about their practical experience in learning in a virtual setting and its advantages and disadvantages vs. in-person learning. Most participants expressed mixed-feelings about on-line learning. The results show that the young generation can play a role in supporting the extra- and intra-communication activities of the RP community.

Lessons being learned from the Covid-19 pandemic for radiological emergencies and vice versa: report from expert discussions.

In order to examine what lessons radiological emergency management may offer for the management of the Covid-19 pandemic, and vice versa, a series of three online webinars were conducted with leading experts, scholars and practitioners from a wide range of disciplines essential for emergency management and long-term risk governance. The first webinar debated the lessons we are learning from the Covid-19 pandemic for radiological risk communication, the second explored issues around longer-term outcomes of a crisis and how to balance these with short-term actions whilst the third focused on the key challenges of the 'transition phase', using lessons learned from the Chernobyl (1986) and Fukushima Daichii (2011) accidents. This paper reviews the discussions and provides valuable lessons for the radiation protection community. Results of the discussions indicated that: (a) non-radiological and non-epidemiological consequences of emergencies, for example psychological (mental health), societal and economic, should not be underestimated; (b) multidisciplinary expertise is imperative for communication efforts and for effective emergency management, including decision-making in the application of protective measures; (c) stakeholder engagement, including the involvement of the potentially affected population, should be encouraged from an early stage; and (d) trust is increased if policy-makers and the main science agencies show a unified voice.

Compensatory Considerations for Radiological Emergency Response and Public Protective Actions during the COVID-19 Pandemic.

ABSTRACT: Epidemiological evidence and models have demonstrated that the current COVID-19 pandemic introduces a significant public risk to implementing large-scale community evacuations in response to disasters. While guidance documented in the US Environmental Protection Agency Protective Action Guidance (PAG) Manual is widely accepted as the standard basis for public and emergency worker protective actions for a radiological emergency, it is based primarily on assessing the risks associated with the radiological factors alone. However, as demonstrated in response to the nuclear incident in Fukushima, these events seldom occur in isolation from other risk-inducing events. Today, the COVID-19 pandemic represents a significant public health risk that must also be considered alongside the radiation risks in determining appropriate public and emergency worker protection action decisions. In particular, the significant public health risks associated with community transmission and mortality of COVID-19 challenge our most familiar and rehearsed radiological response strategies. The 1992 and 2017 US Environmental Protection Agency PAG manuals allow for considerations in protective action decision making. Much of the radiation emergency response community has been conditioned through decades of structured training and exercises to focus public protection considerations on specific guidelines referenced numerically in tables within the manual. Discussion regarding adjustment of specific PAG values is provided in the footnotes and bases portions of the PAG manual but is often not included in jurisdictional plans or routinely considered in exercises. However, when properly applied, the protective action guidance provides the necessary flexibility for decision-makers to account for additional public health risks or impediments, and jurisdictions can use this guidance to build a more effective response strategy. The authors have applied the full guidance and flexibility provided in the 2017 US Environmental Protection Agency PAG Manual to develop more specific guidance for their respective jurisdictions' radiation emergency response plans and will outline a process for consideration of protective action decisions to maximize the protection of public health and safety.

South African radiographers' radiation protection practices, a qualitative study.

INTRODUCTION: Radiation protection is multifarious, and consequently, a radiographers' application of radiation protection is multifaceted. Studies have shown varying radiation protection practices among radiographers. The first quantitative phase of this explanatory, sequential mixed-method study used the theory of planned behaviour to explore South African radiographers' radiation protection behaviour. Overall, South African radiographers' attitudes to radiation protection, subjective norm, perceived behavioural control, and radiation protection intention was high. This second phase of the study aimed to explore the reasons for South African radiographers' radiation protection practices. METHODS: This study used an exploratory and descriptive qualitative approach. Data was collected through 13 in-depth semi-structured telephone interviews. Thematic analysis was used in order to uncover original phenomena. Data saturation was achieved and the study adhered to trustworthiness and ethical measures. RESULTS: Thematic analysis identified two themes. The participants had the appropriate radiation protection knowledge, but radiation protection compliance remained a personal choice. Impediments such as feeling rushed during imaging of trauma and challenging patients, patients knowledge of radiation protection, resources, imaging referrals, inadequate training when transitioning from analogue to digital radiography and managerial support contributed to radiation protection compliance. Strategies such as further education, research and a change in mindset were suggested to further foster radiation protection compliance. CONCLUSION: Even though participants' knowledge of radiation protection aligned with the legislated guidelines, limited internalising of the knowledge resulted in compliance being a personal choice. Participants reflected on their insouciant attitude and observed a similar attitude in their radiographer colleagues. Patient and work-related impediments were identified to contribute to radiation protection compliance. Strategies to further foster compliance were suggested. IMPLICATIONS FOR PRACTICE: Understanding the reasons for radiographers' choice in radiation protection will allow the development of strategies that foster optimum application of radiation protection practises. Developing a radiation protection culture that enhances personal compliance supported by education and evidence should be considered.

[Medical applications of ionising radiation for the diagnosis of coronavirus-associated lung disease : Statement by the German Commission on Radiological Protection]. / Strahlenanwendung in der Diagnostik von COVID-19 : Stellungnahme der Strahlenschutzkommission.

ISSUE: Since the start of the global pandemic, a number of publications have suggested using ionising radiation to diagnose a COVID-19 infection. Some proposals call for the use of computed tomography (CT) to screen for presymptomatic SARS-CoV-2-infections. INTENT OF THE CONSULTATION: With these proposals in mind, the German Commission on Radiological Protection (SSK) agreed during its 307th meeting on 2 and 3 July 2020 to establish a working group aimed at evaluating the use of ionising radiation in connection with a COVID-19 infection. The working group focussed on radiological protection aspects with a view to using computed tomography to diagnose COVID-19. The group started its work on 5 October 2020. Although not commissioned by the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU), representatives of the BMU and the Federal Office for Radiation Protection (BfS) were involved in the consultations. STATEMENT: The SSK issues the following statement: 1. The use of CT in asymptomatic persons to diagnose COVID-19 outside of approved studies is not evidentially justified. 2. Pursuant to Section 83 (3) of the German Radiation Protection Act, a CT scan for the diagnosis or follow-up of a COVID-19 pneumonia requires the prior justifying indication from a doctor with the requisite specialist knowledge in radiation protection. To this end, specialist medical associations provide recommendations based on up-to-date findings.

The role of experts in the development of recovery handbooks: UK and European experience.

The importance of involving experts in the development of strategies for managing areas contaminated as a result of a nuclear accident is now well recognised. Following the Chernobyl accident in 1986, the initial focus, quite understandably, was on the technical aspects of reducing doses to the affected population. Subsequently, work carried out in the UK and elsewhere in Europe looked at the broader impacts of protective actions on agriculture, the environment, and society. From 1997, a group of experts from academia, government, and non-government organisations met regularly in the UK to debate these issues. One of the outputs included the first version of the UK Recovery Handbook for Radiation Incidents in 2005. Based on the success of the UK group, a European network of experts was established, leading to the development of European handbooks in 2009. The UK handbooks are living documents that are updated regularly with substantive input from experts.

Development of computer simulator 'Kawauchi Legends' as disaster response medical training software: overcoming the COVID-19 pandemic.

Medical disaster response training is provided for international students in Kawauchi Village to share the lessons learnt from the accident at Fukushima Daiichi nuclear power plant. At present, this is difficult due to the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this article is to report the development of hands-on medical training software on a topic that does not require in-person attendance. The 'Kawauchi Legends' disaster simulator was developed as a useful tool to teach the medical response to various disasters, and this was applied in a 3-day webinar in October 2020. Fourteen students participated in the webinar and successfully learnt medical management, manipulating their avatars in the virtual environment. This software can be an effective substitute for in-person disaster training without physical involvement. Such innovative teaching methods mean that lessons from the Fukushima accident can continue to be shared, even in the COVID-19 pandemic situation.

Get Protected! Recommendations for Staff in IR.

PURPOSE: Evaluation and registration of patient and staff doses are mandatory under the current European legislation, and the occupational dose limits recommended by the ICRP have been adopted by most of the countries in the world. METHODS: Relevant documents and guidelines published by international organisations and interventional radiology societies are referred. Any potential reduction of patient and staff doses should be compatible with the clinical outcomes of the procedures. RESULTS: The review summarises the most common protective measures and the needed quality control for them, the criteria to select the appropriate protection devices, and how to avoid unnecessary occupational radiation exposures. Moreover, the current and future advancements in personnel radiation protection using medical simulation with virtual and augmented reality, robotics, and artificial intelligence (AI) are commented. A section on the personnel radiation protection in the era of COVID-19 is introduced, showing the expanding role of the interventional radiology during the pandemic. CONCLUSION: The review is completed with a summary of the main factors to be considered in the selection of the appropriate radiation protection tools and practical advices to improve the protection of the staff.

Microbial Contamination Risk and Disinfection of Radiation Protective Garments.

ABSTRACT: Healthcare-associated infections are a major public health concern for both patients and medical personnel. This has taken on greater urgency during the current COVID-19 pandemic. Radiation Personal Protective Equipment (RPPE) may contribute to risks of microbial contamination. This possibility was tested in 61 personal or shared-use lead aprons and thyroid collars at Columbia Presbyterian Irving Medical Center. Fifty percent tested positive for either bacterial or fungal contamination, mostly around the neckline of lead vests and thyroid collars. Repeated testing of garments some weeks to months later confirmed continued presence of microbial contamination. The possibility that hospital-approved disinfection agents could degrade the radio-protective features of these garments was also examined. Samples of identical construction to garments in regular use were subjected to either daily or weekly wipes with hypochlorite or alcohol-based hospital-approved cleaning agents for 6 mo. A third group of samples was maintained in contact with the cleaning agents for 6 mo. All samples were fluoroscoped four times during the study. None demonstrated any degradation in radioprotection. All samples were photographed monthly. Physical degradation of the outer plastic covering by concentrated hypochlorite and limited mechanical damage around stitched seams of the samples cleaned daily with alcohol was noted. Based on the high prevalence of microbial contamination, regular cleaning and disinfection protocols should be implemented. Regular cleaning with medical-facility-approved cleaning and disinfecting agents is likely to be effective at reducing the microbial load and unlikely to result in significant reduction in radioprotective properties of these garments.

Time, distance, shielding and ALARA; drawing similarities between measures for radiation protection and Coronavirus disease pandemic response.

The practice of radiation oncology requires stringent adherence to specific steps and principles designed to minimize exposure of an individual to unnecessary doses of radiation. The basic principles of such measures to reduce the risk of exposure and limit the doses of irradiation follow the "as low as reasonably achievable " or ALARA principle by using the concepts of time, distance and shielding. Potential exposures in radiation oncology are controlled through combination of optimal design and installation of radiation delivery equipment with well-defined standard operating procedures (SOPs). In the modern era of viral pandemics, similar principles can also be applied toward prevention of viral transmission and protection of populations at risk. In the ongoing COVID-19 pandemic, the probability of an individual getting infected is dependent on the viral load that an individual is exposed to in public spaces over a period of time. All prevention and control measures are based on preventing any such exposure to the virus, that can be achieved through limiting space for movement of the virus, using barriers and increasing distance to vulnerable surfaces, and limiting the duration of exposure. Apart from adhering to the laid-down provisions of a lock-down, preventive measures recommended for the general public include maintaining hand-hygiene, social distancing, and using facemasks to break the chain of transmission. Appropriate triage and customization of treatment protocols can help curtail hospital visits and time-spent by cancer patients during pandemic times, thereby reducing their risk of exposure as well as allowing efficient utilization of resources. The outbreak of the contagious COVID-19 pandemic threatens to disrupt healthcare systems globally with its unprecedented challenges. However, despite all the difficulties and hardships, it has also enabled new ways of learning and communication, which are likely to persist even in the post-COVID world.