Awareness of Hazards of X-Ray Imaging and Perception Regarding Necessary Safety Measures to be Taken During X-Ray Imaging Procedures Among Patients in Public Sector Tertiary Hospitals of Karachi, Pakistan

Background X-ray imaging is a common procedure performed on a regular basis for diagnostic purposes all over the world. The use of X-rays is increasing rapidly with the introduction of new radiation-oriented therapeutic practices. Although it carries significant diagnostic benefits, extensive exposure to X-ray imaging has been shown to be associated with multiple dose-dependent health risks. Awareness and knowledge among patients regarding the effects of X-ray imaging, therefore, becomes important. Through this study, we aimed to assess the knowledge and awareness of the hazards of X-ray imaging among different groups of patients visiting two of the public sector tertiary hospitals in Karachi, Pakistan. We also aimed to evaluate the necessary safety measures undertaken during X-ray imaging in these hospitals, and the perception of patients regarding the importance of these measures. Materials and methods A cross-sectional study was conducted in October and November 2018 at two well-known public sector tertiary care hospitals, Dr. Ruth KM Pfau Civil Hospital, Karachi and Jinnah Postgraduate Medical Centre, Karachi. A non-probability convenience sampling technique was adapted to recruit 200 participants for the study. A pretested questionnaire was used to assess the knowledge of radiation among patients and their perception regarding the necessary safety measures required to be undertaken during the X-ray imaging procedure. Data were entered and analyzed using the IBM Statistical Package for the Social Sciences 17.0 (IBM Corp., New York, USA). Frequencies were calculated for individual variables. Chi-square test was employed to measure the relationship between categorical variables. A p-value of <0.05 was considered to be significant. Results Out of 200 participants, 58% knew what radiation was, 42% did not. The relationship between the level of education of patients and the awareness of the term ‘radiation’ was found to be statistically significant (p-value = 0.003). Television was the most common source of information (65.5%). One participant (0.5%) thought that it was possible for X-ray imaging to cause cancer. Similarly, only one participant (0.5%) thought that it could cause decreased fertility, five participants (2.5%) thought it could cause burns, seven (3.5%) thought it could cause cataract, and 20 (10%) were of the view that anemia could be caused. The majority of the participants (80.5%) thought that a lead sheet was important during the X-ray procedure for safety and protection. Most participants (71.5%) said that they were never provided with any such lead sheets. When asked if the participants requested for a lead sheet if not provided, the majority (71%) denied requesting for it. On analyzing, we found that a higher percentage of uneducated participants denied requesting a sheet compared to the educated ones. The relationship between the level of education and the choice of requesting for a lead sheet was found to be statistically significant (p-value =0.012). Conclusions The patients visiting the public sector tertiary care hospitals of Karachi seem to lack the knowledge and awareness regarding the hazards of ionizing radiations and the necessary safety measures required to be undertaken during X-ray imaging. More awareness programs should be conducted to increase the level of patients' awareness to protect them from unnecessary health risks.