Radiation awareness and occupational concerns among radiographers and students

INTRODUCTION: Radiographers and other healthcare professionals are routinely exposed to ionising radiation (IR). Although acute effects are rare, long-term and reproductive risks associated with chronic low-dose exposure remain a concern. Existing literature highlights gaps in radiation protection knowledge and inconsistent safety practices, yet little is known about radiographers' perceptions. This study explores European radiographers' views on occupational IR risks to health and reproduction. METHODS: A cross-sectional online survey was distributed through professional networks and the European Federation of Radiographer Societies between March and July 2024. The survey assessed demographics, knowledge and perceptions of radiation protection, and concerns regarding health, fertility and offspring. Quantitative data were analysed using descriptive statistics, chi-squared tests and Spearman correlations, while qualitative free-text responses were examined using content analysis. RESULTS: A total of 629 respondents from 32 countries completed the survey. While 96% reported understanding occupational radiation risks and 93% felt able to protect themselves, concern remained: 30% were worried about health effects, 24% about fertility and 19% about their children's health. Younger participants and students expressed significantly greater concern about reproductive risks than older radiographers (p < 0.05). Qualitative comments highlighted barriers to consistent protection, including discomfort and limited availability of shielding, workflow pressures and uncertainty about long-term low-dose effects. CONCLUSION: European radiographers and students in this survey demonstrate strong awareness of radiation protection but retain notable concerns about reproductive and long-term risks. These findings indicate a need for continued, practice-oriented education and improved access to ergonomic, well-maintained protective equipment. IMPLICATIONS FOR PRACTICE: Clear communication of current standards, reliable access to shielding, and supportive policies for pregnant or planning radiographers may help reduce anxiety, particularly among younger staff, and strengthen safety culture across clinical settings.