National survey of healthcare providers’ views on the risk of inadvertent exposure of pregnant patients to ionizing radiation in Canadian radiotherapy departments

Background Women of child-bearing age are at risk of developing a malignancy that may require treatment with radiation therapy (RT). Radiation exposure to pregnant patients is associated with a risk of fetal malformation and death. Methods An online survey was created and distributed to all radiation oncologists (RO), radiation oncology residents (ROR), radiation therapists (RTT), and medical physicists who were members of their respective national professional organizations ( n = 2,146). Results Of the respondents, 317 (15%) completed the questionnaire. Only 58% of ROs/RORs remembered to discuss the risk of RT in pregnancy most of the time. The majority (70%) of respondents did not believe or know if RTTs discussed the risks of radiation in pregnancy. In addition, 65% either thought no warning signs existed in their department or were unsure of their existence. Furthermore, only 8% of respondents believed their center had handouts for patients. Of the respondents, 9% encountered a situation where a pregnant patient was inadvertently treated with RT, while 13% encountered a situation where a pregnant patient was almost inadvertently treated with RT. There was no significant difference by province in the proportion of respondents who reported inadvertent or almost inadvertent RT in pregnancy (range, 6–24%; p = 0.20). Conclusion Nationally, respondents believe there are inadequate mechanisms to prevent inadvertent ionizing radiation exposure to pregnant patients and one fifth of respondents encountered situations in which a pregnant patient was, or was almost inadvertently irradiated. This suggests that national guidelines and detailed institutional policies and procedures are needed.