Clinical and patient background
The Gambia government/MRC Pneumonia surveillance project started in 2008, a few years after the completion of a vaccine trial in two regions of the Gambia. Initially a film/screen method was widely used in X-ray departments. Now, there is a shift to the use of DR and provisions of shields and aprons being applied to patient escorts – women who are mainly of child bearing age. Weekly records of TLDs from staff members were recorded in measuring doses with the international recommended dose limits of occupational exposure workers. Additionally, an assessment of staff was routinely conducted by a senior radiographer every six months, to see how well the staff effectively applied these methods.
Dose management methods and techniques that were used
The use of gonad, aprons, glove shields, and TLDs was introduced in both the (X-ray) departments in the project. Each staff member had designated responsibilities for the effective application of these dose management techniques. Prior to the examination, patients escorts were informed about the radiation dose management techniques and how they would help the staff manage the dose limit to patients, who were predominantly children (0-5yrs).
Conclusions and results
The use of shields in dose management has benefit coupled with TLDs. Readings by the senior traveling radiographer of records and assessments (for each individual assistant and technician) during each examination, show that these techniques have contributed not only to enhanced dose management, but also to raise the awareness level of local mothers about the harmful effects of exposure to radiation. Participants in the study were also protected by these methods and there were no reports of incidents or radiation exposure illness.
Discussion of case outcome(s) and future implications
Shields and TLDs are excellent tools for managing radiation dose to the patients and the general public. Providing these materials to each department is essential, and when applied, will help manage dose to patients and those helping out during each procedure. However, lack of such materials in most departments has hindered the application of these dose management strategies. With such initiatives undertaken by each department, there will be positive impact to patients and the general public regarding the effects of radiation exposure. The display of warning signs/symbols will also go a long way in protecting the entire population from unnecessary exposure to radiation dose.