Introduction: The use of radioactive radiations in healthcare facilities must comply with radioprotection safety rules in order to avoid threatening the health of workers and patients. This study aimed to assess the working conditions, the protective measures and the medical monitoring of workers directly involved in X-ray work at hospitals in Douala, Cameroon. Materials and Methods: A descriptive cross-sectional study was carried out during the 1st quarter of 2018, across various state and private health facilities of the city of Douala. Sampling was non-random, based on convenience and all the willing participants that fulfilled the inclusion criteria were enrolled. Quantitative analyses were conducted using EPI INFO 7.0 software and the results were presented in both univariate and bivariate forms. Results: The sample consisted of 56 men and 31 women with a mean age of 34.75 ± 8.77 years. X-ray technicians were over-represented (41.38%). Day/night shift work was the main work pattern (68.96%). The distribution of work zones A&B was known by 87.5% of the participants. Hazard warning signs were effective in work zones A and B (75.86%), and the walls of the premises were also reinforced in these work zones (88.51%), but the use of radiation dosimeters was rare (9.20%). Radiation aprons (94.30%) and hand-held dosimeters (63.20%) were the most commonly used personal protective equipment. The majority of the participants did not benefit from medical follow-up by an occupational health specialist (62.1%). Conclusion: The implementation of radiation protection measures remains a significant concern in Douala based health facilities, and requires stricter administrative controls and sanctions to prevent serious health consequences for exposed staff.
References
[1]
Gérard, J., Thariat, J., Giraud, P. and Cosset, J. (2010) Histoire de l’évolution des techniques de radiothérapie. BulletinduCancer, 97, 743-751. https://doi.org/10.1684/bdc.2010.1142
[2]
Tubiana, M., Dutreix, J. and Pierquin, B. (1996) One Century of Radiotherapy in France 1896-1996. InternationalJournalofRadiationOncologyBiologyPhysics, 35, 227-242. https://doi.org/10.1016/0360-3016(96)00091-0
[3]
French National Cancer Institute (INCA) (2009) The Safety and Quality of External Radio-Therapy: A National Priority. In: ComprendrelaRadiothérapie, 14th Edition, Institut National du Cancer (INCa), 67-71.
[4]
Atun, R., Jaffray, D.A., Barton, M.B., Bray, F., Baumann, M., Vikram, B., et al. (2015) Expanding Global Access to Radiotherapy. TheLancetOncology, 16, 1153-1186. https://doi.org/10.1016/s1470-2045(15)00222-3
[5]
Borras, J.M., Barton, M., Grau, C., Corral, J., Verhoeven, R., Lemmens, V., et al. (2015) The Impact of Cancer Incidence and Stage on Optimal Utilization of Radiotherapy: Methodology of a Population Based Analysis by the ESTRO-HERO Project. RadiotherapyandOncology, 116, 45-50. https://doi.org/10.1016/j.radonc.2015.04.021
[6]
Institut National de Recherche et de Sécurité (INRS) (2018) Ionising Radiation. 41 p. https://www.inrs.fr/risques/rayonnements-ionisants.html
[7]
Lirsac, P.N., Ammerich, M. and Nolibe, D. (2000) Bases biologiques radioprotection: De la CIPR 26 à la CIPR 60. 14 p.
[8]
SCENIHR (Scientific Committee on Emerging and Newly Identified Health Risks) (2012) Health Effects of Security Scanners for Passenger Screening (Based on X-Ray Technology), 26 April 2012. 47 p.
[9]
Little, M. (2003) Risks Associated with Ionizing Radiation. BritishMedicalBulletin, 68, 259-275. https://doi.org/10.1093/bmb/ldg031
[10]
Russ, A., Burns, C., Tuler, S. and Taylor, O. (2006) Medical Exposures. Health Risks of Ionizing Radiation: An Overview of Epidemiological Studies, 19-42.
[11]
Hasegawa, A., Tanigawa, K., Ohtsuru, A., Yabe, H., Maeda, M., Shigemura, J., et al. (2015) Health Effects of Radiation and Other Health Problems in the Aftermath of Nuclear Accidents, with an Emphasis on Fukushima. TheLancet, 386, 479-488. https://doi.org/10.1016/s0140-6736(15)61106-0
[12]
Russ, A., Burns, C., Tuler, S. and Taylor, O. (2006) Atomic Bomb Survivors. Health Risks of Ionizing Radiation: An Overview of Epidemiological Studies. 43-57.
[13]
Cordoliani, Y. (2010) Les enjeux de la radioprotection en imagerie médicale. JournaldeRadiologie, 91, 1184-1185. https://doi.org/10.1016/s0221-0363(10)70170-0
[14]
Niu, S.L. (2011) Protection of Workers against Radiation: Safe Work. International Labor Organization (ILO), 17 p. https://www.ilo.org/publns
[15]
Etard, C., Sinno-Tellier, S. and Aubert, B. (2010) Exposure of the French Population to Ionising Radiation from Medical Diagnostic Procedures in 2007. Joint IRSN Report.
[16]
Verger, P. and Chérié-Challine, L. (2000) Evaluation of the Health Consequences of the Chernobyl Accident in France. Institut de Protection et de Sureté Nucléaire, 63-69.
[17]
Mozziconacci, J.G., Ayivi, J., Loat, A., Ifergan, J., Mourbrun, M. and Drevet, B. (2005) Rôle de la personne compétente dans la sensibilisation au principe ALARA à travers l’application de la directive européenne 97-43. JournaldeRadiologie, 86, 455-460. https://doi.org/10.1016/s0221-0363(05)81389-7
[18]
Ongolo-Zogo, P., Nguehouo, M.B., Yomi, J. and Nko’o Amven, S. (2012) Connaissances en matière de radioprotection: Enquête auprès des personnels des services hôspitaliers de radiodiagnostic, radiothérapie et médecine nucléaire a Yaoundé Cameroun. Radioprotection, 48, 39-49. https://doi.org/10.1051/radiopro/2012017
[19]
Jouad, S. and Essolbi, A. (2013) Etude de l’observance des règles de la radioprotection en radiolo-gie conventionnelle dans les hôpitaux Segma de la région de Marrakech Tensift al Haouz. Dissertation, Ecole Nationale de Santé Publique, Management des Organisations de Santé, 97 p.
[20]
Mbo Amvene, J., Djonyang, B., et al. (2017) Observance of Radiation Protection Rules in the Imaging Departments of Hospitals in the Far North of Cameroon. Health Sciences and Diseases, 18, 83-87.
[21]
Rozgaj, R., Kašuba, V., Šentija, K. and Prlić, I. (1999) Radiation-Induced Chromosomal Aberrations and Haematological Alterations in Hospital Workers. OccupationalMedicine, 49, 353-360. https://doi.org/10.1093/occmed/49.6.353
[22]
Ministry of Public Health (MINSANTE) (2010) Politique, planification des RHS et situation des effectifs. Analyse de la situation des ressources humaines pour la santé au Cameroun. 70-96.
[23]
Owona Manga, L.J., Kouassi Yao, M., Bita Fouda, A.A., Kollo, B., Dissongo, J. and Vandi, D. (2015) Social and Professional Conditions of Health Personnel in a Public Hospital in Yaoundé, Cameroon. Revue Internationale des Sciences Médicales, 17, 60-65.
[24]
Ministry of Labour and Social Security (MTPS) (1984) Arrêté N˚ 039/MTPS/IMT du 26 novembre 1984 fixant les mesures générales d’hygiène et de sécurité sur les lieux de travail. Yaoundé: MTPS. 24 p.
[25]
Kazemi, R., Motamedzade, M., Golmohammadi, R., Mokarami, H., Hemmatjo, R. and Heidarimoghadam, R. (2018) Field Study of Effects of Night Shifts on Cognitive Performance, Salivary Melatonin, and Sleep. SafetyandHealthatWork, 9, 203-209. https://doi.org/10.1016/j.shaw.2017.07.007
[26]
Smith, L., Folkard, S. and Poole, C.J.M. (1994) Increased Injuries on Night Shift. TheLancet, 344, 1137-1139. https://doi.org/10.1016/s0140-6736(94)90636-x
[27]
Kouassi, Y.M., Wognin, S.B., N’gbesso, R., Yeboue-Kouame, Y.B., Tchicaya, A.F., Alla, D. and Bonny, J.S. (2005) Étude de l’observance des règles de radioprotection en milieu hospitalier à Abidjan. Archives des Maladies Professionnelles et de l’Environnement, 66, 369-374. https://doi.org/10.1016/S1775-8785(05)79108-6
[28]
Tapsoba, T.L., Ouattara, T.F., Belemlilga, H.G.L., Sanon, H., Bamouni, Y.A., Ouédraogo, V. and Cissé, R. (2010) Application des règles de protection contre les rayons X dans les services de radiologie de Ouagadougou. MédecineNucléaire, 34S, e9-e12. https://doi.org/10.1016/j.mednuc.2010.07.011
[29]
Yekpe, A.P., Adjadohoun, S., Legonou, C., et al. (2020) État des lieux de la radioprotection du personnel de services d’imagerie médicale du sud Benin en 2019. Journal Africain d ImagerieMédicale, 12, 213-219. https://doi.org/10.55715/jaim.v12i4.165
[30]
Casanova, P., Ndiaye, M., Ndao, A.S. and Sow, M.L. (2015) L’organisation générale de la radioprotection au Sénégal. Radioprotection, 50, 255-257. https://doi.org/10.1051/radiopro/2015018
[31]
Akanni, D.W.M.M., Savi de Tové, K.-M., Damien, B.G., Kiki, S.M., Adjadohoun, S.B.M.G., Yekpe-Ahouansou, P. and N’zi, K.P. (2020) Connaissances en radioprotection des travailleurs exposés aux rayonnements ionisants en milieu médical en Afrique francophone sub-saharienne. Radioprotection, 56, 43-48. https://doi.org/10.1051/radiopro/2020067
[32]
Etard, C. (2010) Obligations of the Radiologist for the Radiation Protection of Patients. Journal de Radiologie, 91, 1207-1211. https://doi.org/10.1016/S0221-0363(10)70175-X
[33]
Belaroussi, L., Nahime, L. and Benali, B. (2020) Rôles du médecin du travail dans la radioprotection au Maroc. Journal Marocain des Sciences Médicales, 22, 3 p.
[34]
Ministère de la Santé Publique (MINSANTE) (1995) Loi N° 95 /08 du 30 Janvier 1995 portant sur la radioprotection. 6 p.
[35]
Republic of Cameroon (RC) (2013) Order No. 1150/A/MINSANTE of 11 June 2013 Laying Down the Conditions for the Delimitation and Signposting of Supervised and Controlled Areas and Specially Regulated or Prohibited Areas, as Well as the Hygiene, Safety and Maintenance Rules Imposed Therein. 20 p.
[36]
Agence Internationale de l’Énergie Atomique (AIEA) (2011) Radioprotection et sûreté des sources de rayonnements: Normes fondamentales internationales de sûreté édition provisoire. Edition provisoire. Vienne, 257 p.
[37]
Boulay, M.H., Soula, M.C., Gauron, C. and Biau, A. (2002) Organisation de la radioprotection dans les établissements de soins: Évaluation et constatats en Ile-de-France. Documents pour le médecin du travail, INRS, No. 90, 2ème Trim, 167-173.
[38]
N’kama Tol’mata, B.A., Fakhreddine My Othman, A.I. and Belrhiti, Z. (2013) Study of the Adherence of Radiology Staff to the Safety System against Ionizing Radiation: The Case of IBN Sina Hospital. Dissertation, Ecole Nationale de Santé Publique, Management des Organisations de Santé, 65 p.
[39]
Jammet, H.P. (1968) Soins médicaux aux travailleurs soumis aux radiations ionisantes. Proceedings of the First International Congress of Radiation Protection, 511-516. https://doi.org/10.1016/B978-1-4832-8312-8.50088-6
[40]
Yeboue-Kouame, Y.B., Tchicaya, A.F., Alla, D., et al. (2005) Étude de l’observance des règles de radioprotection en milieu hospitalier à abidjan. ArchivesdesMaladiesProfessionnellesetdel’Environnement, 66, 369-374. https://doi.org/10.1016/s1775-8785(05)79108-6
[41]
Guiegui, C.P., Owona, M.L.J., Aka, I.N.A., N’gassam, T.L., N’guessan, A.M.L., Kra, A.A.C., Ouattara, Y.M. and Wognin, S.B. (2019) Observance des Mesures de Radioprotection en Milieu Hospitalier Public à Yaoundé en 2016. Health Sci. Dis, 20, 91-94.
