Assessment of Radiation Protection Awareness and Compliance Among Radiographers in Teaching Hospitals in South East Nigeria

Radiographers in Nigerian teaching hospitals are among the occupational groups with the highest potential for cumulative ionizing radiation exposure, yet the level of radiation protection awareness and practical compliance in this cadre remains inadequately documented. This study assesses radiation protection knowledge, attitudes, and compliance behaviors among 120 practicing radiographers across five teaching hospitals in Enugu, Anambra, Imo, Abia, and Ebonyi States, South East Nigeria. A validated self-administered questionnaire adapted from international radiation protection awareness tools was distributed to consenting participants. Questionnaire domains include knowledge of dose limits, understanding of the ALARA principle, use of personal dosimeters, practical implementation of distance and shielding principles, and reporting of equipment defects. Concurrently, structured observational checklists were applied during routine imaging procedures to assess actual compliance behaviors independently of self-reported knowledge. Results reveal that while 84 percent of respondents correctly identified the annual occupational effective dose limit, only 52 percent reported consistently wearing their personal dosimeters during procedures. Observational compliance scores averaged 67 percent, significantly lower than mean knowledge scores of 78 percent, indicating a knowledge-practice gap. Multivariate analysis identifies years of experience, hospital category, and access to continuing professional education as significant predictors of compliance scores. The study recommends structured in-service radiation protection training programs and peer review compliance monitoring systems for teaching hospitals in the South East zone. Keywords: radiation protection, radiographers, teaching hospital, South East Nigeria, compliance