## 3 Results
#### 3.1.1 Environmental Radiation Exposure in the \({}^{99m}\)Tc-MDP Bone Scintigraphy Workplaces
However, higher doses recorded during imaging highlight the need for enhanced precautions, such as optimizing shielding and reducing staff proximity to patients during this phase. Emphasizing exposure management during imaging is essential to uphold \"as low as reasonably achievable (ALARA)\" principles and maintain safety. \begin{table}
\begin{tabular}{c c c c c c c c c c c} \hline \hline
**Procedure** & **Step** & **Personel \({}^{\star}\)** & \(A\) & \(I\) & \(t_{s}\) & \(t\) & \(t\) & \(d\) & \(I\) & \(E\) \\  & & & **(Mgq)** & **(m)** & **(min/s)** & **(h)** & **(h)** & **(mm)** & **(\(\textbf{q}\textbf{s}\textbf{v}\textbf{m}^{2}\textbf{M}\textbf{M}\textbf{s}^{- 1}\textbf{h}^{-1}\textbf{s}\))** & **(\(\textbf{q}\textbf{s}\textbf{v}\))** \\ \hline \multirow{4}{*}{Labeling} & Eluting [\({}^{99}\)ToTo\({}_{4}\)\({}^{-1}\)] & & & & & & & & \\  & from & & & & & & & & & \\  & [\({}^{99}\)To\({}^{99}\)To\({}^{99}\)To\({}^{99}\)Tc] & RP & 18,500 & 0.2 & 30 s & 0.01 & 0 & 6 & 0.0184 & \(6.49\times 10^{-5}\) \\  & Elebling & RP & 18,500 & 0.50 & 46 min & 0.77 & 0 & 6 & 0.02 & \(9.96\times 10^{-4}\) \\  & Removal final & RP & 18,500 & 0.30 & 15 s & \(4.00\times 10^{-3}\) & 0 & 6 & 0.02 & \(1.44\times 10^{-5}\) \\  & product & RP & 18,500 & 0.20 & 2 min & 0.03 & 0 & 5.5 & 0.02 & \(2.70\times 10^{-3}\) \\  & \(\textbf{}^{99}\)Mo breakthrough & RP & 37 & 0.30 & 2 min & 0.03 & 0 & 5.5 & 0.02 & \(2.40\times 10^{-6}\) \\  & Instant thin-layer & RP & 37 & 0.30 & 2 min & 0.03 & 0 & 5.5 & 0.02 & \(2.40\times 10^{-6}\) \\  & pH & RP & 37 & 0.30 & 30 s & 0.01 & 0 & 5.5 & 0.02 & \(5.81\times 10^{-7}\) \\  & Calibration of vial & RP & 18,500 & 0.20 & 15 s & \(4.00\times 10^{-3}\) & 0 & 6 & 0.02 & \(3.25\times 10^{-5}\) \\  & Preparing syringes & RP & 18,500 & 0.10 & 5 min & 0.08 & 0 & 6 & 0.02 & \(2.69\times 10^{-3}\) \\  & Patient & administration & RN & 740 & 0.30 & 4 min & 0.07 & 0 & 5.5 & 0.02 & \(9.73\times 10^{-5}\) \\  & Carrier after & & & & & & & & & \\  & administration & RN & 740 & 0.30 & 5 min & 0.08 & 0 & 0.5 & 0.02 & 3.96 \\  & & & & & & & & & & \\  & Patient positioning & RT & 740 & 0.30 & 8 min & 0.13 & 3 & 0.5 & 0.02 & 4.48 \\  & Patient imaging & RT & 740 & 0.25 & 8 min & 0.13 & 3 & 0.5 & 0.02 & 6.46 \\  & Patient imaging & RT & 740 & 3.00 & 30 min & 0.50 & 3 & 0.5 & 0.02 & 0.17 \\  & & RN & 370 & 1.00 & 2 min & 0.03 & 3 & 0.5  
3.2. Netherlands Commission on Radiation Dosimetry (NCS) Occupational Effective Dose Estimation Algorithm [40]  
The results of the NCS algorithm (Equation (5)) based on a single OSL to estimate staff occupational effective dose are illustrated in Figure 6[40]. The bar graph illustrates the effective radiation dose recorded at different stages of \({}^{99m}\)Tc-MDP bone scintigraphy procedures, including labeling, quality control, syringe preparation, patient administration, imaging, and patient discharge. In each stage, actual dose measurements were compared with the NCS algorithm. Notably, the imaging stage recorded the highest actual radiation dose, surpassing 0.05 \(\upmu\)Sv, while the NCS algorithm estimated a dose of 0.01 \(\upmu\)Sv for this stage, which was significantly lower. Moreover, at all stages, the NCS algorithm estimated values are substantially different from the actual occupational effective doses recorded and marked as statistically significantly different at \(p<0.05\). In summary, the NCS algorithm should be used cautiously as our analysis has highlighted a significant underestimation of occupational effective doses from \({}^{99m}\)Tc-MDP bone scintigraphy procedures. Occupational Effective Dose Estimation During Different Steps of \({}^{99m}\)Tc-MDP Bone Scintigraphy Procedure: A Double Dosimetry Algorithm Evaluation  
Hp(10) measurements are used to assess worker exposure levels and are a reasonable approximation for effective dose under conditions of complete shielding. However, staff in the majority of radiological procedures are only partially shielded.