The radiation for diagnostic and therapeutic purposes, the rapid advances in computed tomography as well as the high radiation doses delivered by interventional procedures have raised serious safety and health concerns for both patients and medical staff and have necessitated the establishment of a radiation protection culture (RPC) in every Radiology Department. RPC is a newly introduced concept. The term culture describes the combination of attitudes, beliefs, practices and rules among the professionals, staff and patients regarding to radiation protection. Most of the time, the challenge is to improve rather than to build a RPC. The establishment of a RPC requires continuing education of the staff and professional, effective communication among stakeholders of all levels and implementation of quality assurance programs. The RPC creation is being driven from the highest level. Leadership, professionals and associate societies are recognized to play a vital role in the embedding and promotion of RPC in a Medical Unit. The establishment of a RPC enables the reduction of the radiation dose, enhances radiation risk awareness, minimizes unsafe practices, and improves the quality of a radiation protection program. The purpose of this review paper is to describe the role and highlight the importance of establishing a strong RPC in Radiology Departments with an emphasis on promoting RPC in the Interventional Radiology environment.

Culture is one of the most complicated and obscure concepts. Among the many definitions one may find in the literature, the most attractive one for the purpose of this text is that culture is the total range of activities and ideas of a group of people with shared traditions, which are transmitted and reinforced by members of the group.The term culture is not only associated with a high level of art, civilization and religion but also strongly affects business, communication, marketing and safety.

During the recent years the concept of safety culture has been gaining ground in organizations mainly due to the rapid advancement of technology and the concern about employees’ health and safety. Safety culture reflects attitudes, values, norms and practices that professional and employees share concerning risk and safety. Safety culture is often used in conjunction with terms like “nuclear safety culture”, “patient safety culture”, “health safety culture”, “occupational safety culture”, “organization safety culture” and “environment safety culture”.

Regarding the safe use of ionizing radiation in the medical field and nuclear industry, International Radiation Protection Association (IRPA) first established the concept of radiation protection culture (RPC). The proposal was favourably greeted by the participating Associate Societies, the World Health Organisation (WHO) and the European ALARA Network. At the first Workshop of IRPA on RPC in 2009, professionals proposed a number of definitions for RPC and prepared the action plan for the development of a strong RPC. Two years later, after a series of meetings, the Association published the final draft on Guiding Principles for Establishing a RPC and very recently.A thorough understanding of the term RPC is the first step towards developing a strong RPC in a Radiology Department. According to IRPA, RPC is defined as “The combination of knowledge, values, behaviours and experience of radiation protection in all its aspects for patients, workers, population and environment, and in all exposure situations, combining scientific and social dimensions.In other words, RPC is the assembly of attitudes, strategies and practices among staff and leaders that should be emphasized in radiation protection safety. As it is obvious, RPC is a part of safety culture oriented on the effects and risks of ionization radiation.

Each Radiology Department has guidelines and practical rules for the safe use of ionizing radiation even if not all members of the department are aware of that. Does this actual mean that every Radiology Department has a RPC program? On this question, opinions diverge. Some support that RPC exists in every Radiology Department; however this culture can be positive or negative, strong or weak. Others recognize that culture is a combination of attitudes and regulations and claim that RPC is either present or absent within a Radiology Department. In authors’ opinion, RPC exists in most Radiology Departments. The challenge is to improve rather than to build a RPC. Most often, it proves to be more difficult to improve an existing culture rather than to create a new one as workers and all stakeholders must unlearn the old behaviors and practices before they adopt the new ones.

The objectives of RPC are to provide a safe working environment, promote knowledge of radiation risks, minimize unsafe practices, control radiation risks, share responsibility among workers and improve the quality of an already existing radiation protection program. All the aforementioned objectives are achieved through the active participation and interaction of all the workers inside the department. The key role for the implementation of RPC in a Radiology Department is initially the development of a strategic plan where every decision and process takes into account radiation safety of staff and patients. Then this strategic plan must be turned into an action plan in order to create the conditions for the incorporation of radiation safety in the routine work of the department.

Regards,

Eliza Miller

Managing Editor

Journal of Medical Physics and Applied Science