PEDIATRIC X-RAY

Pediatric patients are particularly sensitive to ionizing radiation, making dose optimization and radiation protection essential during diagnostic imaging. This study assessed entrance skin doses (ESD) and radiation protection practices in pediatric X-ray examinations at the University of Benin Teaching Hospital (UBTH). Using a cross-sectional observational design, 164 pediatric patients aged 0-14 years undergoing routine X-ray examinations were observed between July and August 2025. Entrance skin doses were calculated using the indirect method based on exposure parameters and tube output specifications. Radiation protection practices were assessed using a structured checklist covering pediatric technical factors, beam collimation, patient positioning, protocols, beam quality, protective shielding, and exposure optimization. Mean ESDs exceeded international diagnostic reference levels across all examinations: chest X- rays (0.19 ± 0.08 mGy, 90% above reference), abdominal X-rays (0.58 ± 0.21 mGy, 93% above reference), skull X-rays (0.38 ± 0.13 mGy, 90% above reference), and limb X-rays (0.14 ± 0.06 mGy, 40% above reference). Only 14% of examinations achieved recommended dose levels. Overall radiation protection compliance was moderate at 63.9%, with only 11% demonstrating excellent practices. Critical deficiencies included protective shielding (51.7% compliance), weight-based technique selection (42.7%), and thyroid shielding (35.4%). A significant negative correlation existed between protection scores and entrance skin doses (r = -0.512, p = 0.001). The study concludes that pediatric X-ray doses at UBTH consistently exceed international standards, requiring urgent optimization interventions including establishing diagnostic reference levels, implementing standardized protocols, enhancing shielding practices, and conducting regular dose audits.