ORIGINAL ARTICLE

DETERMINATION OF WORKLOAD AND USE FACTORS IN

THE GENERAL RADIOGRAPHY ROOM OF A MAJOR
NIGERIAN TEACHING HOSPITAL
1

Esien-Umo E. , Mallam S. P. , Ishiekwen C. A. , Egbe N. O.

Radiology Department, Ahmadu Bello University Teaching Hospital, Zaria
2
Manpower Training and capacity Development Department,Nigerian Atomic energy Commission, Abuja
4
Department of Radiography, University of Calabar, Calabar
1,3

ABSTRACT

INTRODUCTION

Radiographic workload and use factor were

estimated in order to determine the workload
pattern and distribution in the general radiography
room of Ahmadu Bello University Teaching
Hospital, Zaria. The exposure factors (kVp and
mAs) for each exposure were recorded manually
for 12 weeks (3 calendar months) involving 2281
patients. The use factor was also determined by
recording the direction of the primary beam for
each exposure. For each exposure, the mAs were
accumulated in a 5kVp wide beam. The kVp
distribution of the workload was determined and
normalized per patient for this room. Results
show that the normalized workload for the general
radiography room was 1.52mAmin per patient.
When multiplied by the average number of
patients(190 patients) examined weekly in this
room, a total workload of 288.8mAmin per week
is obtained. The workload spectrum ranged from
40kVp - 115kVp with the bulk of the workload
occurring between70-75kVp. For this room, the
primary beam was directed at the chest stand/erect
bucky for 51% of the total workload, 47%
directed at the floor and the remaining 2% at the
other 2 walls. When compared with NCRP147,
this study showed that though the average number
of patients/week was higher, the normalized
workload per patient was lower.

The provision of adequate shielding barrier in any

diagnostic Radiology facility is very vital as this is
the preferred method of controlling external
radiation1. Structural shielding barrier is designed
to protect people in an occupied area outside an
area of high radiation intensity2. A prerequisite to
designing shielding barrier for any x-ray facility is
knowledge of the use to which the room is going
to be put and the number of patients that are
expected to be imaged in a year and this
information allows estimate of workload to be
made3. One of the factors that determine the
amount of shielding between an x-ray source and
an adjacent area is the workload (W) of the x-ray
tube4, defined as the time integral of the x-ray tube
over a week and is conventionally given in units of
milliampere minutes per week5.
Fundamentally, workload (W) is proportional to
the number of electrons that bombard the x-ray
tube target during the week's operation6. At one
kVp at a fixed distance, the workload predicts the
primary dose, scatter dose and leakage dose
generated by the x-ray-tube's operation 7.
Traditionally it is assumed that the entire
workload in an installation is performed at a single
8
kVp; for example 1000mAmin/wk at 100kVp .
This report ignored the fact that diagnostic
workload is spread over a wide range of x-ray tube
potentials. NCRP, (2004)applies a theoretical
model based on workload distribution which
shows that the kVp distribution of workloads is
spread over a wide range of x-ray tube potentials.
This is important for shielding barrier design
because the distribution of kVp is much more
important than the magnitude of workload since
attenuation properties of barriers exhibit strong
kVp dependence 9,10. For example, the radiation

Key words: x-ray shielding, workload, use factor,

radiography, primary beam
Corresponding Author

ESIEN-UMO, E.

Tel: +2348023832233
E-mail: emmyesien@yahoo.com

Nigerian Journal of Medical Imaging and Radiation Therapy

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Vol. 1 No. 3. November 2012

Determination of Workload and use Factors in the General Radiography Room of A Major Nigerian Teaching Hospital

level on the protected side of 1.0m lead barrier

varies exponentially with kVp (three orders of
magnitude over the range of 60-100 kVp),
whereas it varies only linearly with the
workload 9,10. Leakage radiation shows an even
more dramatic change with kVp, falling by more
than eight orders of magnitude over the range
from 150 to 50 kVp 9,10. The transmission of x-ray
beam through a shielding barrier depends strongly
on the operating potential so that the knowledge of
W as a function of kVp is desirable in accurately
predicting the dose to a shielded area 11.
The use factor U, is the fraction of the primary
beam workload that is directed to a particular
barriere 9,10. The value of U will depend on the
barrier of concern5. In the general radiography
room, the equipment is arranged to allow many
different beam orientations so that the different
barriers will have different use factors.
The general radiography room of Ahmadu Bello
University Teaching Hospital, Zaria, was
commissioned for use in 2005 and since the
commissioning; the workload and use factors
have never been estimated. The number of
patients coming to the general radiography room
for radiological examinations have consistently
increased over the years and the x-ray tube was
recently replaced in 2010.

0877 manufactured by General Electric (GE)

Medical Systems in September, 2004.
The kVp and mAs for every x-ray exposure in this
room was recorded manually for 3 months (12
weeks). A total of 2281 patients were surveyed.
The workload at each kVp for all exposures was
computed and then normalized by the number of
patients surveyed in the room. For each exposure,
the mAs were accumulated in a 5 kVp wide bin.
By considering all the exposures in this room, a
workload spectrum was achieved using the NCRP
147 theoretical model of workload distribution
which is based on the number of patients seen in
the room per week. For example using the
Simpkin6approach a total workload of 288mA
min/wk (1.52mA min/wk X 190patients/wk) was
obtained.
The use factor for each barrier in the room was
determined by calculating the fraction of the total
workload for which the primary beam was
directed at that barrier. The barriers were
categorized as floor, primary and secondary
barriers. Again using the Simpkin6 approach, the
use factors for the different barriers were
determined.
RESULTS AND DISCUSSION
The results of the workload and use factor surveys
in the general radiographic room are shown in
Tables I & II. Table I presents the results of the
workload survey for the general radiography
room. The table contains the survey results for the
mean, standard error (error in the mean) and
standard deviation for the normalized workload,
the number of patients and the total weekly
workload. The standard error in the normalized
workload was 7% of the mean. The standard
deviation in the normalized workload even
though is in the order of the mean is very large.
This may be due to the fact that the radiologic
technique for each patient varies according to
clinical procedure, patient, image receptor and
repeat rate6. The standard error of the weekly
number of patients, Nweek is 3% of the mean while
the standard deviation is 8% of the mean. The
standard error in the total workload is 8% of the
mean while the standard deviation is 100% of the
mean.

This study estimates the workload per patient, the

average number of patients per week, total
workload, workload distribution as well as the use
factors for the different barriers in the general
radiography room as a way of estimating the
sufficiency of shielding for the use of the room
and determining the radiation exposure to its
environs.
METHODOLOGY
The general radiography room in the radiology
department was used for this study because it is
large, allowing enough space for the maneuvering
of the x-ray tube and patients for different beam
orientations; the x-ray machine is bigger, and can
perform all types of x-ray examinations and the
number of patients examined could be high.The xray machine used is a silhouette general x-ray
machine; model MS-185N with serial number
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Determination of Workload and use Factors in the General Radiography Room of A Major Nigerian Teaching Hospital

TABLE I. Workload survey results for the total normalized workload, the number of patients
imagedper week, and the total workload per week for the General Radiography Room

Mean

Normalized workload

Number of patient

Total workload

MA min/patient

per week

per week (mA min)

Standard Standard

Standard Standard

Standard Standard

error deviation

Mean

error deviation

Mean

error deviation

Sw

Wnorm

oN

Wnorm

otot

Stot

1.52

190

288.8

22.17

290

Wnorm
1.52

0.11

SN

4.87 16.88

Table II presents the primary beam use factors

measured for the general radiography. 51% of the
total workload was directed at wall No. 1
containing the chest stand/erect bucky while 47%
was directed at the floor. The remaining 2% was
directed at the other two walls (Walls No. 2 and

Wall No. 3). This means that out of the 190

patients/week in this room, 97 patients were for
chest stand/erect bucky examinations and the
remaining 93 patients were for x-ray table
(floor/other barrier) examinations.

TABLE II. Measured primary use factors for the General Radiography Room
(Wall # 1 contains the erect bucky/chest stand)
Use factor
Floor

Wall #1

Wall #2

Wall #3

0.47

0.51

0.012

0.008

Fig. I shows the workload distribution plot for the

general radiography room. The distribution is
5kVp bin wide, with the stated kVp the highest in
that bin. For this room, the workload distribution
is a summation of the workload directed at the
wall containing the chest stand/erect bucky, the
floor and other barriers.

Nigerian Journal of Medical Imaging and Radiation Therapy

The entire workload occurred between 45kVp 115kVp with the peak of the spectrum located in
the range of 70kVp - 75kVp. This is because the
most frequently used kVp occurs within this
range.

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Determination of Workload and use Factors in the General Radiography Room of A Major Nigerian Teaching Hospital

FIG. 1. The workload distribution plot of the normalized workload per patient for the general
-1
radiography room. The total workload for this room is 288.8mA min wk .

The normalized workload (Wnorm) per patient from

table 1 for this general radiography room is
1.52mA min/patient. This is less than the
recommended value of 2.45mA min/patient by
NCRP 147. The reason is due to the lower
workload distribution for this room which ranged
from 45kVp -115kVp while the recommended
value of NCRP 147 ranged from 40kVp - 135kVp.
The standard deviation for the normalized
workload per patient is 100% of the mean, thereby
agreeing with the clinical observation that the
radiologic technique for each patient varies
considerably according to the clinical procedure,
patient, image receptor and repeat rate6.
The average number of patients per week (Nweek)
is 190 patients/week which is high when
compared with the 112 patients/week
recommended by NCRP 147. The reason for this
high patient turnout is due to the fact that the
facilities for diagnostic purposes in several third
world countries are very few compared to the
demand12.But the standard deviation for the
average number of patients per week is very low
about 6% of the mean. This means that the
variation in the room usage is very close. This
information can be used to predict the future room
usage when planning a new radiologic installation
by the management of the hospital6.
Nigerian Journal of Medical Imaging and Radiation Therapy

The total workload for this room is 288.8mA min

-1
week . This is higher than the recommended
-1
value of 240mA min week by NCRP 147. This
higher workload is due to the higher number of
patients/week of 190patients/wk compared with
112patients/wk by NCRP 147. The standard
deviation is quite large and is 100% of the
mean.The total workload (Wtot) for this room is
17% higher than the recommended value by
NCRP 147. Using this workload in the calculation
of barrier thickness will result in barrier thickness
greater than what NCRP 147 would present. The
implication of this is that the barrier thickness
calculated from this workload of 288.8mA-min
-1
week would result in adequate protection for this
installation.
CONCLUSION
This study represents the first attempt to measure
the workload distribution in Ahmadu Bello
University Teaching Hospital, Zaria. Although
there were some challenges recording the
parameters manually, it is therefore concluded
that these results are reasonable and can be used
by the shielding designer as these workload
distribution is specific to this installation6.
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Determination of Workload and use Factors in the General Radiography Room of A Major Nigerian Teaching Hospital

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Nigerian Journal of Medical Imaging and Radiation Therapy

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