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The Importance of Radiation Protection Education and Training for Medical Professionals of All Specialties


The article is part of the series of articles on radiation protection. You can find further articles in the special section of the CVIR issue. Lately, more advanced techniques have been introduced in medical imaging expanding the diagnostic and therapeutic applications of ionizing radiation. Among the various strategies that have been proposed for the management of radiation exposure, education and training seem to have a strong impact on radiation protection and dose reduction. However, according to several studies, medical professionals appear to lack knowledge on basic radiation protection aspects. Therefore, the establishment of an accreditation and certification system in radiation protection for all medical professionals employing ionizing radiation is considered as high priority. The purpose of this review article is to highlight the importance of education and training in radiation protection, provide recommendations for an effective educational program and propose an educational program structure for the different medical specialties.

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  1. UNSCEAR. UNSCEAR 2008 Report. Sources and effects of ionizing radiation. Volume I: Sources: Report to the General Assembly, Scientific Annexes A and B. UNSCEAR 2008 Report. United Nations Scientific Committee on the Effects of Atomic Radiation. New York: United Nations; 2010.

  2. European Council Directive 2013/59/Euratom on basic safety standards for protection against the dangers arising from exposure to ionising radiation and repealing Directives 89/618/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/Euratom and 2003/122/Euratom. OJ of the EU. L13; 57: 1–73 (2014).

  3. Guidelines on radiation protection education and training of medical professionals in the European Union (2014), publication no. 175, European Commission. Available at

  4. Vañó E, Rosenstein M, Liniecki J, Rehani MM, Martin CJ, Vetter RJ. ICRP Publication 113. Education and training in radiological protection for diagnostic and interventional procedures. Ann ICRP. 2009;39(5):7–68.

    Article  Google Scholar 

  5. ICRP. ICRP statement on tissue reactions/early and late effects of radiation in normal tissues and organs—threshold doses for tissue reactions in a radiation protection context. ICRP Publication 118. Ann ICRP. 2012;41(1/2). Available at:

  6. Koenig TR, Wolff D, Mettler FA, Wagner LK. Skin injuries from fluoroscopically guided procedures. AJR. 2001;177(1):3–11.

    Article  CAS  Google Scholar 

  7. Jaschke W, Schmuth M, Trianni A, Bartal G. Radiation-induced skin injuries to patients: what the interventional radiologist needs to know. Cardiovasc Interv Radiol. 2017;40(8):1131–40.

    Article  Google Scholar 

  8. Junk AK, Haskal Z, Worgul BV. Cataract in interventional radiology—an occupational hazard? Investig Ophthalmol Vis Sci. 2004;45(13):388.

    Google Scholar 

  9. Barnard SG, Ainsbury EA, Quinlan RA, Bouffler SD. Radiation protection of the eye lens in medical workers-basis and impact of the ICRP recommendations. Br J Radiol. 2016;89(1060):20151034.

    Article  Google Scholar 

  10. Elmaraezy A, Ebraheem Morra M, Tarek Mohammed A, et al. Risk of cataract among interventional cardiologists and catheterization lab staff: a systematic review and meta-analysis. Catheter Cardiovasc Interv. 2017;90(1):1–9.

    Article  PubMed  Google Scholar 

  11. Vanhavere F, Carinou E, Gualdrini G, et al. ORAMED: optimization of radiation protection for medical staff. 7th EURADOS Report 2012. ISSN 2226-8057. ISBN 978-3-943701-01-2. Available at:

  12. El-Sayed T, Patel AS, Cho JS, Kelly JA, Ludwinski FE, Saha P, et al. Radiation-induced DNA damage in operators performing endovascular aortic repair. Circulation. 2017;136(25):2406–16.

    Article  CAS  Google Scholar 

  13. Ramanathan S, Ryan J. Radiation awareness among radiology residents, technologists, fellows and staff: where do we stand? Insights Imaging. 2015;6:133–212.

    Article  Google Scholar 

  14. Van Papendorp LWA, Suleman FE, Hanekom H. The knowledge, awareness and practices of radiation safety amongst orthopaedic surgeons. SA J Radiol. 2020;24(1):1806.;PMCID:PMC7059512.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Vano E, Ubeda C, Miranda P, Leyton F, Durán A, Nader A. Radiation protection in pediatric interventional cardiology: an IAEA PILOT program in Latin America. Health Phys. 2011;101(3):233–7.

    Article  CAS  PubMed  Google Scholar 

  16. Ribeiro A, Husson O, Drey N, et al. Ionising radiation exposure from medical imaging—a review of Patient’s (un) awareness. Radiography. 2020;26(2):e25–30.

    Article  CAS  Google Scholar 

  17. Schindera ST, Treier R, von Allmen G, et al. An education and training programme for radiological institutes: impact on the reduction of the CT radiation dose. Eur Radiol. 2011;21(10):2039–45.

    Article  Google Scholar 

  18. Hojreh A, Weber M, Homolka P. Effect of staff training on radiation dose in pediatric CT. Eur J Radiol. 2015;84(8):1574–8.

    Article  Google Scholar 

  19. Barakat MT, Thosani NC, Huang RJ, et al. Effects of a Brief educational program on optimization of fluoroscopy to minimize radiation exposure during endoscopic retrograde cholangiopancreatography. Clin Gastroenterol Hepatol. 2018;16(4):550–7.

    Article  Google Scholar 

  20. IAEA, Online training in radiation protection. Available at:

  21. ESR Eurosafe Imaging, Available at:

  22. Radiation Safety Cases. Available at:

  23. Image Gently Alliance. Available at:

  24. European Commission. Radiation Protection NO 174: European guidelines on medical physics expert, Directorate-General for Energy. 2014. Available at:

  25. Bott OJ, Dresing K, Wagner M, Raab BW, Teistler M. Informatics in radiology: use of a C-arm fluoroscopy simulator to support training in intraoperative radiography. Radiographics. 2011;31(3):E65–75.

    Article  PubMed  Google Scholar 

  26. Miglioretti DL, Smith-Bindman R. Overuse of computed tomography and associated risks. Am Fam Phys. 2011;83(11):1252–4.

    Google Scholar 

  27. Smith-Bindman R. Is computed tomography safe? N Engl J Med. 2010;363(1):1–4.

    Article  CAS  PubMed  Google Scholar 

  28. U.S. Food and Drug Administration. Initiative to reduce unnecessary radiation exposure from medical imaging. Center for Devices and Radiological Health, 2010. Available at:

  29. Cascade PN. The American College of Radiology. ACR appropriateness criteria project. Radiology. 2000;214(Suppl):3–46.

    PubMed  Google Scholar 

  30. Clinical decision support for European imaging referral guidelines, ESR. Available at:

  31. Remedios D. et al. Radiation Protection. No. 178: Referral Guidelines for Medical Imaging Availability and Use in the European Union. Directorate-General for Energy, Luxembourg. 2014.

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Correspondence to Elias Brountzos.

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Ploussi, A., Efstathopoulos, E.P. & Brountzos, E. The Importance of Radiation Protection Education and Training for Medical Professionals of All Specialties. Cardiovasc Intervent Radiol 44, 829–834 (2021).

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  • Education and training
  • Radiation protection
  • Accreditation
  • Certification