Evaluation of radiation dose to neonates in a special care baby unit K. Alzimami a,n , A. Sulieman b,c , A. Yousif c , E. Babikir a , I. Salih d,e a Radiological Sciences Department, College of Applied Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia b Salman bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P.O. Box 422, Alkharj, Saudi Arabia c Sudan University of Science and Technology, College of Medical Radiological Science, P.O. Box 1908, Khartoum, Sudan d Sudan Atomic Energy Commission, P.O. Box 3001, Khartoum, Sudan e Taibah University, Physics Department, Al-madinah Almunawwara, Saudi Arabia HIGHLIGHTS  Neonate radiation dose has been evaluated using mathematical equation.  Neonates are exposed to unnecessary radiation due to use of unsuitable X-ray machines.  Radiation dose is of concern due to neonate sensitivity and multiple exposures during neonate treatment.  Mathematical equation based on exposure factors is suitable for neonate dose measurements. article info Article history: Received 4 August 2013 Accepted 25 November 2013 Keywords: Radiation exposure Pediatric radiology Neonate dose Chest X-rays Effective dose abstract The purpose of this study was to evaluate the patient entrance surface dose (ESD), organ dose and effective dose for neonates in the special care baby unit (SCBU) up to 28 days after birth. A total of 135 patients were examined during 4 months. ESDs were calculated from patient exposure parameters using DosCal software. Effective doses were calculated using software from the National Radiological Protection Board (NRPB). The mean patient ESD per procedure was 80 70.02 μGy. The mean and range of the effective dose per procedure were 0.02 (0.01–0.3) mSv. The radiation dose in this study was higher compared to previous studies. A dedicated X-ray machine with additional filtration is recommended for patient dose reductions. & 2013 Elsevier Ltd. All rights reserved. 1. Introduction Pre-term birth, which is defined as childbirth occurring at less than 37 completed weeks of gestation, has been estimated to be 9.6% of all births worldwide (Beck et al., 2010). Newborn pre-term infants up to 28 days after birth have higher rates of medical disorders and respiratory illnesses compared with neonates born at term (Spiegel, 1995). Therefore, an incubator is used to maintain environmental conditions suitable for a neonate (Spiegel, 1995). Neonates in a special care baby unit (SCBU) often require frequent chest and abdomen radiographs in a short period of time to monitor the treatment progress of the neonate and to check the postion of the various tubes and catheters used in SCBU (Spiegel, 1995). Radiographic exposure of neonates attracts particular interest because of their greater cell proliferation rate and the increased opportunity for expression of delayed cancer effects as a consequence of relative longer life expectancy. Neonates may also receive a higher radiation dose than necessary if exposure factor settings are not adjusted for their smaller body size (ICRP 90, 2003). It is therefore important to evaluate neonates’ radiation exposure in order to ensure that the neonate doses are kept to a minimum whilst maintaining the quality of radiographic images. The International Commission on Radiological Protection (ICRP) (ICRP 2007) recommended the use of a diagnostic reference level (DRL) for patients in order to determine whether the protection has been adequately optimized. The use of DRL has been shown to reduce the overall dose and the range of doses observed in clinical practice. Although the radiation risk for neonates is well known (ICRP 90, 2003), still few studies have been performed in the field of measurement of radiation dose and the related risk during neonate management in baby care units compared to the fre- quency of the procedures (Olgar et al., 2008; Dougeni et al., 2007; Mutch and Wentworth, 2007; Şorop and Dădulescu, 2011; Thierry- Chef et al., 2013; Puch-Kapst et al., 2009; Govender et al., 2013; Iyer et al., 2013; Toossi and Malekzadeh, 2012). Wide variations of patient doses were reported in the previous studies, suggesting that optimization is not fulfilled yet. To our knowledge, no study Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/radphyschem Radiation Physics and Chemistry 0969-806X/$ - see front matter & 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.radphyschem.2013.11.035 n Corresponding author at: Radiological Sciences Department, College of Applied Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia. Tel.: þ966 1 4693571; fax: þ966 1 4693565. E-mail address: kalzimami@ksu.edu.sa (K. Alzimami). Please cite this article as: Alzimami, K., et al., Evaluation of radiation dose to neonates in a special care baby unit. Radiat. Phys. Chem. (2013), http://dx.doi.org/10.1016/j.radphyschem.2013.11.035i Radiation Physics and Chemistry ∎ (∎∎∎∎) ∎∎∎–∎∎∎