의료법상 방사선 안전관리책임자의 범위 -치과의사와 치위생사를 중심으로-

이태회 ( Taehui Lee ),송영지 ( Youngji Song ) 제주대학교 법과정책연구원 2015 法과 政策 Vol.21 No.2

According to current medical service act, a manager for radiation safety can remain in the position if the person receive training or continuing education only once a year. This research found out that the radiation safety managers perform their functions with inadequate specialized training. I think that any specialist needs acquisition of new knowledge and having an awareness about their own business through regular refresher training although the person is eligible for the work. However, current radiation safety system have a large number of problems. If the person who does not receive enough training to have expertise in radiation safety and has not accurate knowledge about the harmfulness of radiation exposure is continually appointed as the radiation safety manager, we can not expect high quality health and medical treatment. Therefore, it is necessary that the current provision, that is, the selected radiation safety manager need to receive training only once the year revise that the manager should receive refresher training every year. Now, the radiation safety manager of dental hospital or dental clinic is a dentist, a radiological technician, or a person who works in diagnostic radiology more than three years as dental hygienist(except the dental clinic or dental hospital equipped ‘Panorama’ or ‘Cephalo’). I think if a dentist is appointed as the radiation safety manager, the person need to received refresh training every year. If not, it is hard to expect that the dentist is continually aware of the harmfulness of radiation. If a dental hygienist who actually conducts radiography is appointed as a radiation safety manager, it is necessary that the person should have further education about radiation field and spend substantial amount of time for radiation education during the refresh training of dental hygienist. Because the dental hygienists do not have professional knowledge and skills about radiation field if they only receive the current training. The other alternative is dental clinics employ a radiological technician and appoint the person as radiation safety manager. If the dental clinics do this, they can provide patients with high quality medical care because the radiological technicians have sufficient knowledge and skills about radiation safety.

치과의료기관 내원환자의 방사선 피폭에 대한 불안감에 영향을 미치는 요인

이은경,장계원 한국구강보건과학회 2022 한국구강보건과학회지 Vol.10 No.3

Objectives: This study was conducted to investigate how anxiety in dental patients regarding radiation exposure can be reduced. Methods: The study was conducted in dental facilities during the six months from August 2019 to January 2020 to investigate the anxiety of patients concerning radiation exposure. It then analyzed the factors affecting their levels of anxiety regarding exposure. Results: The results showed statistically significant differences between anxiety relating to dental radiation exposure and knowledge of radiation (-0.252, p < 0.01) and perceptions of radiation (-0.582, p < 0.01). An examination of the factors affecting the anxiety of dental patients regarding exposure to radiation showed that a high recognition of the need for dental radiography (p < 0.05) and more negative perceptions of radiation (p < 0.001) resulted in greater anxiety regarding radiation exposure (p < 0.001). Conclusions: In order to reduce anxiety about radiation exposure, educational materials should be produced and patient education conducted so patients can have correct knowledge and perceptions of dental radiation. In addition, relevant regulations or legal guidelines should be prepared so that radiation safety education for patients can be practiced systematically.

치과 의료기관 종사자의 방사선 방어에 대한 지식, 태도 및 행위

김선주 ( Sun Ju Kim ) 한국치위생학회 2004 한국치위생학회지 Vol.4 No.1

The purpose of this study was to understand the relationship among knowledge, attitude, and behavior of dental personnel about the defense against dental radiation according to general features, and help them recognize the importance of defense against dental radiation. A questionnaire survey of 187 dental personnel who were working in 121 medical institutions such as university hospitals, general hospitals, hospitals, clinics, and public health centers in Seoul area was conducted from December 2002 to January 2003. Study findings are as follows: 1. The average knowledge score for the defense of radiation was 9.51(full score=14): By the demographic features, the know level for the defense of radiation was appeared to be different with the occupational category, age, academic background, workplace, year of working, and whether having the education of radiation or not. By questionnaire items, the knowledge for the defense of radiation was high in general but for the item, `the average amount of being bombed with radiation according occupations cannot be over 20mSv in a year for prescribed 5 years`, it was 18.7%: and for the item, `the longer the length between focus and film, the less the amount of skin exposure`, it was 40.6%, showing less knowledge for these two items. 2. The average attitude score for the defense of radiation was 64.24 (full score=75): By the demographic features, the attitude score was higher with respondents who were 31-35 years old, 11-15 years of working, and having radiation education. The attitude score by questionnaire items was generally high for all the items. 3. The average behavior score for the defense of radiation was 45.43: ⓐ By the demographic features, the behavior score for the defense of radiation was appeared to be higher with respondents who were dentists for occupational category, the aged for age, holding higher diploma for academic background, working in the university hospitals for workplace, and having longer occupational career for the year of working. ⓑ The behavior score for the defense of radiation by questionnaire items was lower than that of the attitude score for all the items, For the item, `the amount of X-ray radiation is adjusted according to such conditions as patients` age, radiating areas, and kind of films`, the score was 4.03: and for the item, `Must receive the education of safety management of radiation periodically`, the score was 1.73 and it was the lowest one. 4. As for the correlation among the knowledge, attitude, and behavior for the defense of radiation, the higher the level of knowledge and attitude, the higher the level of behavior.

치과위생사의 방사선 안전관리 수행도 관련 요인

정종윤 ( Jong Yun Jeong ),한미아 ( Mi Ah Han ),박종 ( Jong Park ),류소연 ( So Yeon Ryu ) 한국치위생학회 2016 한국치위생학회지 Vol.16 No.2

Objectives: The purpose of the study was to investigate the related factors of performance of radiation safety management in dental hygienists. Methods: A self-reported questionnaire was completed by 183 dental hygienists using dental radiography in 110 dental clinics in G area by convenience sampling methods. The questionnaire consisted of general characteristics of the subjects, radiation-related characteristics, and performance and management of radiation safety. Results: Performance score of radiation safety management was 35.71±12.49 in dental hygienists. The performance score of radiation safety management were associated with sex, numbers of dental hygienists, the average numbers of admitted patients per day, the total clinical experience, existence of manual for radiation safety management and perceived need for education of radiation safety management. Conclusions: The performance score was relatively low. The performance score was associated with radiation safety manual and safety equipment. The preparation of radiation protective environment and equipment will improve the performance of radiation safety management in dental hygienists.

치과위생사의 방사선 안전관리 실태 및 피폭 불안감에 영향을 미치는 요인

이혜경(Hye-Kyung Lee) 한국산학기술학회 2018 한국산학기술학회논문지 Vol.19 No.6

본 연구는 치과위생사를 대상으로 방사선 관리에 대한 지식, 태도, 안전관리 행위, 방사선 피폭 불안감을 분석하고 이에 영향을 미치는 요인들을 분석함으로써 방사선 안전 관리 수준을 향상하고 방사선 취급에 대한 올바른 인식 전환과 불안감을 줄이는 방안을 도출하고자 연구하였다. 연구기간은 2017년 9월 10일부터 10월 31일까지 전라북도에 근무하는 치과위생사 280명을 대상으로 SPSS 12.0 프로그램을 사용하여 빈도, 기술통계, 다중회귀분석을 실시하여 분석하여 다음과 같은 결과를 얻었다. 방사선 질 관리에 대한 지식 정도의 평균은 8.07 였고, 정답률은 75.3% 였다. 태도 정도는 96.1%가 긍정적인 태도를 보였으며, 방사선 안전관리 행위는 촬영자는 4.11 였고, ‘방사선 촬영 시 항상 TLD(개인선량계)를 착용한다’는 4.58 로 가장 높았다. 환자 방사선 안전관리 행위는 3.86 였고, ‘방사선촬영 전 가임기 여성의 임신 여부를 확인한다’는 4.69 로 가장 높았다. 방사선 피복 뷸안감은 3.86 였고, ‘임신 중 일 때 태아의 건강 문제로 염려된다’는 4.13로 가장 높았다. 방사선 피폭불안감에 영향을 미치는 요인으로는 방사선 안전관리 행위가 낮을수록, 연령이 낮을수록, 방사선 촬영경력이 낮을수록, 최종학력이 높을수록, 월 소득이 많을수록, 직위가 높을수록 유의한 영향을 미치는 것으로 나타났다(p<0.05). 이상의 연구결과를 토대로 치과위생사는 방사선 질 관리에 대한 지식, 태도, 안전관리 행위는 높았으나, 방사선 피폭 불안감은 높은 불안감을 가지고 있어 방사선 안전 관리 수준을 향상시켜 방사선 피폭 불안감을 줄일 수 있는 방안 마련이 이루어져야 할 것으로 사료된다. The purpose of this study was to analyze the knowledge, attitudes, safety management behavior, and radiation anxiety of dental hygienists and to analyze affecting factors in order to improve the level of radiation safety management and reduce anxiety. The study period consisted of 280 dental hygienists working in Jeollabuk-do from September 10 to October 31, 2017 using the SPSS 12.0 program, frequency, descriptive statistics, and multiple regression analysis. The average knowledge level of radiation quality control was 8.07, and the correct answer rate was 75.3%. The attitude level was 96.1%, and the radiation safety management behavior was 4.11 for the photographer and 4.58 for the `always wear a TLD (personal dosimeter) during radiography`. Patient radiation safety management behavior was 3.86, and the highest was `4.69` to confirm pregnancy of the woman before radiography. Radiation-covered lining was 3.86, and was the highest at 4.13 for `I am concerned about fetal health when I am pregnant`. Factors affecting radiation exposure anxiety were lower radiation safety management behaviors, lower age, lower radiographic experience, higher educational background, higher monthly income, and higher job title (p<0.05). Based on the above results, dental hygienists had strong knowledge, attitudes, and safety management practices for radiation quality control. However, since anxiety related to radiation exposure was high, it is possible to improve radiation safety management level and reduce radiation exposure anxiety.

이동형 치과 X선 발생장치 사용실태와 위험지각

한경순 한국치위생과학회 2014 치위생과학회지 Vol.14 No.4

The aim of this study was to analyze perception of risk and using status of hand-held dental x-ray unit among dental hygienists in metropolitan area. This research was based on perception of risk and using status of hand-held dental x-ray unit survey in 257 dental hygienists from July 7 to 31, 2014. Data were analyzed with t-test, one way ANOVA, and multivariable logistic regression analysis using SPSS Windows 21.0 program and significance level was set at p<0.05. The hand-held dental x-ray unit to cover all type patients was 24.8%. The 62.6% of patients and 81.3% of operator doesn`t wear lead apron, the experience rate of radiation education was 40.1%. The average of risk perception was 3.08 points. The associated factors of risk perception were career, number of radiation exposure per day, and possession of fixed x-ray unit. The increased of accumulated dose when the occupationally exposed work continues, it is necessary to effort of defense against dental radiation.

치과에서의 방사선안전관리

이삼선 대한구강악안면방사선학회 2007 Imaging Science in Dentistry Vol.37 No.3

Although the diagnostic information provided by radiographs may be of definite benefit to the patients, the radio-graphic examination does carry the potential for harm from exposure to ionizing radiation. Therefore we should try to expose radiation as low as reasonably achievable and to give diagnostic information to patients as much as possible. All of dentists should have competence in radiation protection, I wish to deal with what we should do for the optimization of radiation protection in dental clinic.

치과방사선검사의 방사선안전관리 : 국내외 현황 및 전망

김은경(Eun-Kyung Kim) 대한치과의사협회 2014 대한치과의사협회지 Vol.52 No.3

Recently the patient exposure by medical and dental x-ray examination has grown rapidly and diagnostic radiology represents the largest source of man-made radiation. For the patient protection, the principle of justification and optimization should be followed. All the radiographic examinations have to show a potential benefit to the patient weighing against the potential risk. After they are justified, the radiographic exposure should be kept as low as reasonably achievable, taking into account economic and social factors. For the safe use of radiation in dentistry, the radiation safety management in accordance with the legislation is important. The present status and the future of radiation safety management in dental radiology in Korea and other country will be discussed.

CBCT의 선택과 처방

안창현(Chang-Hyeon An) 대한치과의사협회 2014 대한치과의사협회지 Vol.52 No.3

The emergence of Cone Beam Computed Tomography(CBCT) in the late 1990s represented an innovative advancement in the field of dental and maxillofacial radiology because it greatly reduced the radiation exposure to patients and offered 3D images easily. The 3D information generated by this technique brings the potential of improved diagnosis and treatment planning for a wide range of clinical applications in dentistry. The use of CBCT includes diagnosis and surgical assessment of the orofacial hard tissue lesions, dental implant treatment planning and postoperative evaluation, TMJ assessment, diagnosis of craniofacial fracture, orthodontics, endodontics, and so on. All CBCT examinations should be justified on an individualized needs. The clinical benefits to the patient for each CBCT scan must outweigh the potential risks associated with exposure to ionizing radiation. CBCT scans should be taken with initially obtained medical and dental histories of patients and a close clinical examination. CBCT should be considered as an imaging alternative of other conventional radiography in cases where the anatomical structures of interest may not be seen. The smallest possible field of view(FOV) and the lowest setting of tube current and scan time should be chosen, and the entire images scanned should be interpreted by a qualified expert.

교육용 치과 엑스선 발생장치에 대한 방사선 안전 관리 실태 조사

이미현(Mi hyeon Lee),유윤식(Yun sik Yu),이재승(Jae seung Lee),임인철(In chul Im) 한국방사선학회 2014 한국방사선학회 논문지 Vol.8 No.7

본 연구의 목적은 교육용 치과 엑스선 발생장치를 설치 및 가동 중인 전국 치위생(학)과를 대상으로 방사선 작업종 사자의 방사선 안전 관리 실태를 설문 조사하고 이를 체계적으로 추이 분석하여 교육용 치과 엑스선 발생장치의 안전한 이용 기반을 확립하기 위한 기초 자료로 제공하고자 하였다. 이를 위하여 교육용 치과 엑스선 발생장치의 방사선 안전 관리와 관계되는 원자력 관계 법령 및 국내 방사선 안전성 평가 및 규제 기술 개발 현황에 대한 용역 보고서를 참고하여 포괄적인 문헌 조사를 하였으며 이를 토대로 응답자의 일반적 특성, 방사선안전관리자의 위상, 방사선 안전관리 현황과 지식 및 의식 수준에 대한 설문지를 작성하였다. 본 연구는 국내 교육기관 내 방사선안전관리자와 교육용 치과 엑스선 발생장치를 운전 가능한 학사 및 실습 조교, 전임 교원 224명을 대상으로 설문 조사를 시행하여 설문 응답 누락 및 불충분한 응답을 제외한 95부를 회수하여 분석 자료로 이용하였다. 분석 방법은 일반적 특성 및 방사선안전관리자의 위상은 빈도와 백분율을 구하였으며 방사선 안전 관리 현황과 지식 및 의식 수준은 빈도 분석과 설문 문항별 연관성 분석을 위한 x² 검정(chi-square test)과 수준간 연관성을 구하기 위한 피어슨 상관분석(Pearson orrelation analysis)을 하였다. 결과적으로 교육용 치과 엑스선 발생장치의 운영은 대부분 대학 이상의 사회적 교육 수준이 높고 치위생학을 전공한 20대에서 40대의 여성이 담당하고 있었으며 남성과 비교하여 방사선 안전 관리에 대한 의식 수준이 높게 나타났으며 통계적으로 유의한 선형적 관계를 보였다(x²>5, 0.1<r<0.3, p<0.05). 또한 국가 기술 면허의 보유는 치과위생사가 55.4%로 가장 많았으나 방사성동위원소 취급자 일반 면허자(28.2%) 또는 방사선사 면허자(16.4%)와 비교하여 방사선 안전 관리에 대한 의식 및 지식 수준이 낮게 나타났으며 통계적으로 유의하게 뚜렷한 선형적 관계를 보였다(x²>5, 0.3<r<0.7, p<0.01). 특히 업무 경력이 증가할수록 방사선 안전 관리에 대한 지식은 높게 나타났으나 의식수준은 감소하는 것으로 분석되었다(x²>5, 0.3<r<0.7, p<0.01). 따라서 방사선 안전 관리에 대한 전문적 지식 체계의 확립과 국내ㆍ외 방사선 안전 관리 체계를 포괄적으로 이해할 수 있는 제도화된 개선책 마련이 시급할 것으로 판단되었으며 교육용 치과 엑스선 발생장치의 사용에 따른 방사선작업종사자와 주변 일반인의 방사선 위해로부터 방어를 위한 체계적인 방사선 안전 관리 지침서의 개발이 필요하다고 판단되었다. The purpose of this study is to offer data base for establishment of dental training x-ray generator based safety usage through surveying real radiation safety management state of radiation worker's in plan of operations that have dental training x-ray generators and use it. For it, comprehensive references were surveyed referring reports of current state of regulation technique development and domestic radiation safety evaluation and nuclear related legislation regarding radiation safety management of dental training x-ray generators. On the basis of it, questionnaires were filled in about respondent's general characteristic radiation safety manager's status current state of radiation safety management and the level of knowledge & consciousness. For the study, the survey was conducted to 224 people of radiation safety managers and university graduates training assistants and full-time professors who can treat dental training x-ray generators in education center. through this survey 95 questionnaires were used as analysis materials except the insufficient and omitted responses. As a method of analysis, the frequency and percentage were figured out with the general characteristics and safety manager's status. Chi-square test for frequency and correlation per question analysis and Pearson correlation analysis for crosslevel correlation were done with current state of radiation safety management and knowledge & consciousness level. As a result, running dental training x-ray generators was dealt with by 20's to 40's who have high education level over post undergraduate degree and major in dental hygienic. In addition, female have higher consciousness level for radiation safety management than male. It shows significal linear relation statistically(x²>5, 0.1<r<0.3, p<0.05). While the possession of national technical license was the highest of 55.4% in dental hygienists, their level of knowledge & consciousness for radiation safety management was lower than radioisotope licensers (28.2%) or radiation licensers (16.4%). It also shows clearly significal linear relation in statistics (x²>5, 0.3<r<0.7, p<0.01). As work experience rises, it was analysed that while knowledge level of radiation safety management increases consciousness level of it decreases(x²>5, 0.3<r<0.7, p <0.01). Therefore it is judged that professional knowledge system for radiation safety management would be established and institutionalized reform measures which make to understand radiation safety management system in general would be rapidly arranged. Furthermore, development of radiational safety management guidebook is needed to protect radiation workers and circumjacent general people from radiational hazard of using dental training x-ray generators.