Abstract

Diagnostic Reference Levels (DRLs) serve as benchmarks for evaluating the quality of radiological equipment and procedures by assessing patient radiation doses and identifying the need for corrective actions when necessary. This study aims to encourage healthcare professionals to monitor patient radiation doses and ensure compliance with radiation protection principles, ultimately reducing exposure while maintaining diagnostic effectiveness. Radiation doses were assessed for various radiological procedures across two major Hospitals in Kebbi State, focusing on chest (PA, AP, LAT), abdomen (AP), pelvis (AP), cervical spine (AP), lumbar spine (AP, LAT), hip (AP), and thoracic spine (AP, LAT) examinations. Data collection included both patient and equipment parameters, which were analysed using Cal Dose X-5.0 software to estimate entrance skin dose (ESD) and effective dose (ED) for 1000 patients. Statistical analysis was conducted to determine the mean, standard deviation, Relationship (t-test) and third quartile values, which were compared with international DRL recommendations. The mean ESD ranged from 1.07 mGy to 7.39 mGy, while ED values ranged from 0.09 mSv/year to 0.87 mSv/year. ESD values for most examinations exceeded the thresholds established by ARPNSA (2017), NRPB (2000), and other studies, while ED values remained below the Nigeria Nuclear Regulatory Agency’s limit of 1.0 mSv/year. The 75th percentile DRLs for Abdomen AP, Chest AP, Chest PA, Chest LAT, Cervical AP, Cervical LAT, Skull AP, Skull PA, Skull LAT, Paranasal AP, Shoulder AP, Femur AP, Lumbar AP, Lumbar Sacral AP, Thoraco-lumbar AP, Pelvis AP, and Hip Joint AP were 8.07, 2.59, 1.63, 2.84, 4.79, 4.64, 6.46, 5.62, 6.09, 2.49, 5.75, 4.59, 9.15, 5.56, 2.68, 6.12, and 8.07 mGy, respectively. Abdomen AP, Hip Joint AP, Lumbar Spine AP, and Pelvis AP examinations aligned with DRL values from the European Commission (1999) and IAEA (1996). However, DRLs for other examinations exceeded these benchmarks. Variability in doses between centres was attributed to factors such as outdated X-ray machines, suboptimal radiographic techniques, and insufficiently documented radiation protection practices. These findings highlight the urgent need for the development of standardized dose measurement protocols, implementation of quality assurance programs, and dose optimization strategies in Kebbi State to enhance patient safety and compliance with international radiation safety standards.

Keywords

entrance skin dose, effective dose, diagnostic reference levels, X-ray and Kebbi