Radiation Safety Knowledge, Perceptions, and Self-Reported Practices Among Healthcare Workers in Radiology and Nuclear Medicine: A Cross-Sectional Survey

Background/Objectives: This study aimed to evaluate radiation safety knowledge, perceptions, and self-reported protective practices among healthcare workers (HCWs) working in radiology and nuclear medicine departments, with particular attention to occupational dose limits, radiation protection principles, dosimetry, and personal protective equipment use. Methods: A cross-sectional survey was conducted among 138 HCWs (25 specialist doctors, 101 technicians, 9 nurses and 3 radiophysicists) in radiology and nuclear medicine departments from May to June 2024. Data were collected using a structured 31-item survey assessing sociodemographic characteristics, perceived radiation exposure risk, knowledge of radiation protection principles and occupational dose limits, dosimeter use, personal protective equipment use, and awareness of institutional radiation safety procedures. The total knowledge score was calculated by summing correct responses to knowledge items (range: 0–10) and analyzed as a continuous outcome using multivariable linear regression with HC3 robust standard error. Because of the small and uneven distribution of some subgroups, item-level subgroup comparisons were interpreted descriptively and cautiously. Results: Although most HCWs reported receiving radiation safety information through formal education or institutional training, important knowledge and self-reported practice gaps remained. While 96.4% perceived themselves to be at high risk of radiation exposure, 61.6% reported not using any PPE in routine practice and 21.0% reported not using a dosimeter. Only 13.8% correctly identified the 5-year average permissible occupational dose, whereas 32.6% correctly identified the annual maximum dose limit. Knowledge of ionizing-radiation methods was higher among postgraduates than undergraduates (100% vs. 27.5%, p < 0.001) and among nuclear medicine staff than radiology staff (100% vs. 37.8%, p < 0.001). Knowledge of all three basic radiation protection methods was also higher among postgraduates than undergraduates (100% vs. 15.6%, p < 0.001). Because some subgroup distributions were small and uneven, these item-level subgroup findings should be interpreted descriptively and with appropriate caution. In multivariable linear regression with HC3 robust standard errors, technicians (B = −3.09, 95% CI = −3.52 to −2.67, p < 0.001) and nurses (B = −3.84, 95% CI = −5.26 to −2.43, p < 0.001) had lower total knowledge scores than specialist doctors. Nuclear medicine was associated with a higher total score than radiology (B = 2.33, 95% CI = 0.81 to 3.85, p = 0.003), whereas >3 years of work experience was associated with a lower score than ≤3 years (B = −1.53, 95% CI = −2.40 to −0.66, p = 0.001). When postgraduate education was evaluated instead of professional role because of collinearity, postgraduate education was associated with a higher total knowledge score. Because of the cross-sectional design, these associations should not be interpreted as causal. The internal consistency of the knowledge subscale was minimally acceptable (Cronbach’s alpha = 0.694). Conclusions: Significant gaps and variations were observed in radiation safety knowledge and self-reported practices among HCWs. These patterns differed according to educational level, professional role, departmental affiliation, and experience; however, they should be interpreted in light of the cross-sectional design and the small and uneven distribution of some subgroups. These findings identify potential areas for future institutional quality-improvement efforts, including targeted education programs and review of radiation safety policies, whose effectiveness should be evaluated in future studies.