# Assessment of Diagnostic Radiology Facilities Technical Radiation Protection Requirements in KSA
## 4 Discussion  
More than 95% of the list of the examined inspection facilities were accepted based on the national regulations and matched with the standards regulations. The operator should be familiar with the guidance and documents related to the radiation protection program at each facility. The shielding design for the walls and the areas around the entrance to the X-ray room were found to be around 12%. The shielding requirements for the operator console for unnecessary radiation exposure were sufficient. In addition, personal protective tools at each facility such as lead glass and thyroid shield are available. The lead apron holder was available in most of the inspected facilities but not used at all times. The security and storage of all mobile X-ray machines at each facility were found to be in good condition. It is important to mention that protective barriers such as gonad shields and leaded screens were available in most inspected facilities. Overall, the examined facilities show good and sufficient shielding conditions based on SFDA regulation. SFDA staff carried out another site visit inspection program in 2016. The inspection report for that site visit shows a total number of 737 hospitals (governmental, clinic, dental, universities, others) in 83 cities were selected. The SFDA report concluded that about 21.9% of the inspected facilities do not have any personal radiation dosimeter such as a thermoluminescent dosimeter (TLD) or optically stimulated luminescence (OSL) and 40.7% of those facilities do not keep a record for the personal dosimeter reading at their facilities. Only 11.1% of the inspected facilities do not have any personal protective tools such as a lead apron. About 38.2% of the examined facilities do not carry out the annual periodic maintenance for the used X-ray machines at those facilities. Finally, a percentage of 33.9% of the examined facilities \begin{table}
\begin{tabular}{l c c} \hline \hline \multicolumn{1}{c}{**Radiation Protection Assessment Framework**} & \multicolumn{2}{c}{**The Number of Diagnostic Inspected Facilities and Their Percentage**} \\ \cline{2-3}  & **Accepted** & **Not Accepted** \\ \hline Check for any leakage of radiation or cracks in the wall of the & 96 (88.1\%) & 13 (11.9\%) \\ X-ray room/patient entrance door and the surrounding & & \\ \hline Existence of alarm light (illuminated radiation ON/OFF & & \\ indicator) during the exposure; radiation warning signs written & 91 (83.5\%) & 18 (16.5\%) \\ in Arabic and English language & & \\ \hline \hline \end{tabular}
\end{table} 
Table 2: _Cont._  
Figure 2: Contribution of each (accepted) category of radiation protection measure to the total inspected facilities with percentage. do not have any alarm warning light at their entrance to the room [28]. In general, the radiation workers or the operators in all examined X-ray facilities exhibited a very good understanding of the general rules and safety instructions in the medical radiation field. They scored an accepted 95% during the assessment of their radiation protection rules and the radiation safety culture as shown in Table 2. It was found that the highest percentage of the accepted facilities cover the radiation safety and awareness of the radiological practices undertaken in these facilities and matched with the SFDA requirements. The majority of the facilities did not use radiation-warning signs, although these radiation-warning signs were available in those facilities. Overall, the inspected facilities show good and sufficient shielding conditions based on SFDA regulations. For assessment of the annual dose for diagnostic radiology workers in KSA, we reviewed the data published in the literature for the period from 1998-2022 to predict the value of the annual effective dose for diagnostic radiology facilities in Saudi Arabia. Table 3 provides evidence that the annual effective dose for all monitored workers in diagnostic radiology facilities received an acceptable dose level based on the national and international recommended value (20 mSv/y).