1.1 Introduction
X-ray radiation is a form of ionizing radiation that is widely used in medical diagnostics and treatment. It is defined as high-energy electromagnetic waves that have the ability to penetrate biological tissues, allowing visualization of internal structures for medical purposes (Hall & Giaccia, 2012). Ionizing radiation has the capacity to damage DNA, alter cellular function, and disrupt hormonal balance, which is critical in the regulation of reproductive health (Baskar et al., 2012).
Reproductive health is a key aspect of overall human health and is defined by the World Health Organization (WHO, 2021) as a state of complete physical, mental, and social well-being in all matters related to the reproductive system, its functions, and processes. Exposure to harmful agents such as ionizing radiation threatens this balance and has been linked to infertility, miscarriage, menstrual irregularities, and congenital anomalies in offspring (UNSCEAR, 2017).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
The discovery of X-rays in 1895 by Wilhelm Conrad Roentgen marked a revolutionary moment in medical diagnostics, allowing physicians to visualize internal structures of the human body without invasive procedures (Hall & Giaccia, 2012). Since then, the use of X-ray technology has expanded across diagnostic and therapeutic procedures, making radiography an indispensable component of modern healthcare. According to Baskar et al. (2012), while X-rays provide immense clinical benefits, their ionizing nature poses potential risks to biological tissues, including the reproductive system.
Research into the health effects of X-ray exposure began in the early 20th century, initially focusing on skin burns and acute radiation sickness among medical practitioners. Over time, scientific attention shifted toward long-term occupational hazards, particularly the impact on reproductive health. Smith and Jones (2018) stated that early studies on radiology personnel demonstrated higher incidences of infertility, miscarriages, and congenital anomalies in offspring of exposed staff compared to the general population (Smith and Jones, 2018). In Nigeria, the professional practice of radiography developed alongside the expansion of tertiary hospitals, with the National Orthopedic Hospital, Lagos, emerging as a major center for diagnostic imaging. According to Adebayo et al. (2019), Nigerian radiographers have been exposed to X-ray radiation in both well-regulated and poorly monitored settings, highlighting the need for localized studies on occupational health.
Eze et al. (2021) reported that despite the existence of safety protocols, gaps in compliance, inadequate training, and limited awareness of reproductive risks contribute to ongoing exposure. On the other hand, Olowookere et al. (2020) contended that routine monitoring and proper radiation safety enforcement remain insufficient, leaving radiographers at potential risk of long-term reproductive health effects.
Radiation is a pervasive element in modern medical diagnostics, particularly in radiography, where X-ray imaging is essential for accurate diagnosis and treatment planning. According to Hall and Giaccia (2012), X-ray radiation is a form of ionizing radiation that has sufficient energy to remove tightly bound electrons from atoms, potentially causing molecular and cellular damage. Exposure to such radiation is unavoidable in the professional practice of radiography, making occupational safety a critical concern (Hall and Giaccia, 2012). Baskar et al. (2012) asserted that radiation has the ability to disrupt DNA integrity in germ cells, potentially resulting in reduced fertility, menstrual irregularities, and adverse pregnancy outcomes.
In the Nigerian healthcare context, Adebayo et al. (2019) affirmed that radiographers are frequently exposed to radiation levels that exceed recommended international safety limits due to factors such as inadequate protective equipment, poor enforcement of safety regulations, and high patient workloads. Eze et al. (2021) contended that limited awareness and knowledge about the long-term effects of occupational radiation among Nigerian radiographers exacerbate the risk to reproductive health. On the other hand, Lee et al. (2017) reported that studies from other countries suggest a clear link between occupational X-ray exposure and reproductive health disturbances, yet there is a scarcity of localized research confirming these effects in Nigeria.
Olowookere et al. (2020) stated that hospital administrators and policymakers have yet to implement comprehensive monitoring programs for radiation exposure, particularly concerning reproductive outcomes, despite evidence indicating possible long-term health risks. This study is set against the backdrop of the urgent need to assess and document the impact of X-ray radiation on the reproductive health of radiographers at the National Orthopedic Hospital, Lagos State.
1.3 Statement of Problems
Investigation revealed that exposure to ionizing radiation is an inherent part of the job for radiographers, and although protective measures are established, chronic occupational exposure is still high in many clinical settings. Studies are showing that prolonged exposure to X ray radiation is associated with biological changes in reproductive cells and tissues, which is especially concerning for professionals who are of child bearing age or planning families (World Health Organization, 2016).
Furthermore, some studies from other countries suggest associations between occupational radiation and reduced sperm quality, spontaneous abortion, and menstrual irregularities, yet these findings are not well documented for Nigerian health workers, particularly radiographers working in high volume diagnostic centers (Smith & Jones, 2018; Lee et al., 2017). It is against this backdrop that this study seeks to investigate the impact of X ray radiation exposure on the reproductive health of radiographers at the National Orthopedic Hospital, Lagos State.
1.4 Aim and Objectives of Study
The aim of this study is to investigate the impact of X-ray radiation on the reproductive health of Nigerian radiographers at the National Orthopedic Hospital, Lagos State. To achieve this aim, the study has the following objectives:
- To evaluate the reproductive health outcomes of radiographers, including fertility, menstrual regularity, and pregnancy outcomes.
- To assess the level of occupational exposure to X-ray radiation among radiographers at the hospital.
- To examine radiographers' knowledge and practices regarding radiation protection and reproductive health safety.
- To identify gaps in existing safety protocols and recommend measures to reduce reproductive health risks.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the level of occupational exposure to X-ray radiation among radiographers at the National Orthopedic Hospital, Lagos?
- What are the reproductive health outcomes experienced by radiographers exposed to X-ray radiation?
- How knowledgeable are radiographers about radiation protection measures related to reproductive health?
- What gaps exist in current radiation safety protocols, and what measures can reduce reproductive health risks?
1.6 Research Hypotheses
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
- H01: There is no significant relationship between occupational exposure to X-ray radiation and reproductive health outcomes among radiographers at the National Orthopedic Hospital, Lagos.
- H02: Occupational exposure to X-ray radiation significantly affects the reproductive health outcomes of radiographers at the National Orthopedic Hospital, Lagos.
1.7 Significance of Study
It is believed that at the completion of the study, the findings will raise awareness among radiographers about the risks associated with chronic radiation exposure. The study will inform hospital administrators about gaps in safety protocols and support the implementation of better protective measures.
Furthermore, the research will contribute to policy formulation and occupational health guidelines in Nigerian hospitals. In addition, medical educators and trainers will benefit by using the findings to improve radiation safety training programs.
Lastly, researchers will benefit by using the study as a foundation for future investigations on occupational radiation exposure and reproductive health in Nigeria.
1.8 Scope of Study
The scope of the research is focused on the impact of x-ray radiation on reproductive health of Nigerian radiographers, using National Orthopedic Hospital, Lagos State as a case study. The research is limited to staff currently employed at the hospital and does not include radiographers in private clinics or other hospitals outside Lagos State.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
- Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
1.10 Definition of Terms
X-ray Radiation: A form of ionizing electromagnetic radiation used in medical imaging. According to Hall and Giaccia (2012), it has the capacity to penetrate tissues and potentially damage DNA, causing long-term health effects.
Reproductive Health: Defined by WHO (2021) as a state of complete physical, mental, and social well-being in all matters related to the reproductive system.
Radiographer: A healthcare professional trained to perform diagnostic imaging using X-ray, CT, or other imaging modalities (Adebayo et al., 2019).
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