## 4 Discussion and Summary  
There is growing concern as the global use of ionizing radiation in medical diagnostics and therapies has rapidly increased, posing a significant increased risk of radiation exposure to healthcare staff [46]. In fact, a recent report by the Lancet Oncology Commission on Radiotherapy and Theranostics that includes representatives from 44 academic and medical centers across 23 countries states that by 2050, the anticipated increase in new cancer cases would need a medical staff expansion of almost 60 percent compared with 2022 levels [47]. Increasingly, evidence shows elevated risks for various late-occurring, non-cancer consequences at lower doses and dose rates than previously understood [48]. This discovery is reshaping our understanding of radiation risks. Our study's findings established that the highest dose rate recorded during the environmental survey was directly above the \({}^{99}\)Mo/\({}^{99}\)Tc generator. Following this finding, a warning sign was installed above the generator, advising staff to limit their time in this location to 2 min within a one-hour period. Moreover, the controlled area environmental survey (Figure 4) verified all areas were within ICRP Publication 75 recommended limits. ICRP publication 144, Dose Coefficients for External Exposures to Environmental Sources, states that H*10 was created for workplace monitoring and is now utilized for environmental monitoring [49]. However, the publication further states calibration methods for personal dosimeters linking dosimeter readings to dose rate coefficients of Hp(d) are not standardized. Environmental ambient dose equivalent rates are primarily measured in the open air, and an individual dosimeter is often worn on the front of the body. As a result, in a given situation, the radiation field recorded by an area monitor in open air differs from that detected by an individual dosimeter worn on the person, where the radiation field is considerably impacted by backscatter and absorption inside the body. In 2011, the International Commission on Radiological Protection (ICRP) published a tissue response statement recommending a dose limit of 0.5 Gy for the lens of the eye to prevent cataracts, as well as for the heart and brain to prevent circulatory system illnesses, irrespective of dose rate. Consequently, it is imperative to closely monitor medical staff for equivalent doses to the eye lenses, hands, and whole-body effective dose. Furthermore, underestimating the effective dose presents significant risks, as it may lead to inadequate protective measures and compromise staff safety. The importance of real-time dosimetry studies cannot be overstated, as they have frequently revealed that actual doses are often higher than predicted, particularly due to patient movement, prolonged handling of patients, equipment variability, and limitations in predictive algorithms [38]. The International Atomic Energy Agency (IAEA) and the European Radiation Dosimetry Group endorse double dosimetry to monitor radiation exposure, especially for sensitive areas like the eye's lens or when lead aprons are worn [50; 51]. This technique involves two dosimeters--one outside the apron on the collar and one beneath it on the chest--ensuring a more accurate estimation of effective dose by accounting for areas unprotected by the apron in high-energy or prolonged exposure settings. Recent research in dosimetry underscores the importance of validating algorithmic dose estimates with empirical data. For instance, studies measuring radiation exposure in nuclear medicine workers using real-time dosimeters have demonstrated that estimated doses often differ significantly from predictions made by traditional models. This discrepancy emphasizes the need to refine dose estimation algorithms to ensure accuracy and safety [52; 53; 54]. Given the [PERSON] et al., NCS algorithm, and NCRP algorithm statistical significance (\(p<0.05\)) across most procedural steps determined for occupational radiation safety.