[Consideration of radiation dose management issues for healthcare workers in medical institutions: A questionnaire survey of participating institutions in a radiation management system implementation support project].

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.