Radiographers: essential health and safety practices in the workplace

Radiographers work at the intersection of clinical care and technology. One moment they may be positioning a patient for an X-ray; the next, they may be supporting someone who is frightened, in pain or unable to move without help. Behind each image is a set of safety decisions that protect patients, colleagues and the radiographer too.

Good practice is not simply a matter of wearing a lead apron or pressing the right button. It involves understanding the risks in each room, following the right procedures and speaking up when something does not feel safe. Here are the essential health and safety practices radiographers can build into everyday work.

Make radiation protection part of every examination

Ionising radiation is an essential diagnostic tool, but exposure should be carefully controlled. In the UK, work with medical ionising radiation is governed by the Ionising Radiation (Medical Exposure) Regulations 2017 (IR(ME)R), while workplace exposure is covered by the Ionising Radiations Regulations 2017 (IRR17). Employers should have suitable procedures, training and local rules in place. Radiographers need to understand how those arrangements apply to their role.

For each examination, the aim is to obtain the clinical information needed while keeping exposure as low as reasonably practicable. That means checking that the examination is appropriate, using the correct protocol and avoiding unnecessary repeats. A rushed exposure can cost more than a few seconds if poor positioning means the image must be taken again.

Before exposure, check the patient’s identity using the approved process and confirm the examination and body part. Take care with laterality: “left” and “right” are easy words to say, and costly ones to get wrong. Confirm relevant clinical information and pregnancy status in line with local procedures. If details are unclear, pause and check rather than relying on assumption.

Collimation is another practical safeguard. Restricting the X-ray beam to the area needed for the examination can reduce unnecessary exposure and improve image quality. Use exposure settings suited to the patient and clinical task, and follow local guidance on repeat analysis. Trends in repeat images can highlight opportunities for refresher training or workflow changes—not just individual errors.

Use protective equipment and distance wisely

Personal protective equipment (PPE) supports radiation protection, but it does not replace good technique. Where local rules require protective aprons, thyroid collars or other shielding, use the correct equipment and check that it is in good condition. Damaged protective garments should be taken out of service and reported. Storage matters too: aprons are generally hung on suitable racks rather than folded, which can damage their protective material.

When appropriate, step behind a protective screen or leave the room before exposure. If you must remain with a patient, follow local rules, use available shielding and position yourself as far from the primary beam as practicable. Never stand in the beam to hold a patient unless this is specifically justified and permitted under local procedures. If a patient needs support, ask whether a carer or another staff member can help, and provide suitable protection and instructions where required.

Dosimeters should be worn as instructed by the employer, usually in the specified position and not shared. A dosimeter is a monitoring tool, not a shield; wearing one correctly helps identify exposure patterns and supports timely action if readings are unexpected. Report lost, damaged or unusual dosimeter results promptly. A badge left in a pocket beside a mobile X-ray unit is not especially helpful to anyone.

Keep controlled areas safe and equipment reliable

Radiation-controlled areas need clear signs, access arrangements and local rules. Make sure doors, warning lights and exposure indicators are working as intended, and follow the department’s procedures for controlled and supervised areas. If a warning light fails or a door does not close properly, report it and use the appropriate contingency arrangements rather than hoping nobody notices.

Before using imaging equipment, carry out the required checks. Look for visible damage, loose cables, unexpected warning messages or faults with positioning and movement. Only staff with appropriate training should operate or adjust equipment. If a unit behaves unpredictably, stop using it, make it safe if possible and report the fault through the correct system.

Mobile imaging brings extra challenges because the examination room may be a busy ward, an emergency department or a cramped side room. Check the surroundings before moving the unit: people, beds, pumps and trailing cables can turn a simple journey into an obstacle course. Agree where staff will stand, keep bystanders clear during exposure and use the required warning signs or communication. In a crowded space, a short explanation can prevent someone walking into the exposure area at the wrong moment.

Do not overlook MRI safety

MRI does not use ionising radiation, but it has its own serious hazards. The powerful magnetic field is always present, including when a scan is not running. Ferromagnetic objects can be drawn towards the scanner with dangerous force, and some implants or devices may be affected by the magnetic field or radiofrequency energy.

Screen everyone and everything entering the MRI controlled area according to local procedures. That includes patients, visitors, staff, wheelchairs, trolleys and equipment. Do not assume an item is safe because it is labelled “medical” or has been used in another department. Check the specific manufacturer information and approved local guidance. If an implant or device is uncertain, stop and seek advice from the MRI safety team before proceeding.

Remove or secure personal metal items as required, and make sure patients understand why the screening questions matter. A small hair accessory or forgotten item in a pocket can become a serious problem near the scanner. Clear communication is especially important for patients who are distressed, confused or unable to answer questions independently.

Prevent infection through consistent routines

Radiography often involves close contact with patients and shared equipment. Hand hygiene should take place at the appropriate moments, including before and after patient contact and after removing gloves. Gloves do not replace hand hygiene, and they should be changed between tasks when needed.

Clean examination surfaces and equipment according to local infection prevention procedures, paying particular attention to contact points such as detector plates, positioning aids and control surfaces. Use products approved for the equipment; the wrong cleaning agent can damage a detector while failing to provide the intended disinfection. Where equipment cannot be cleaned between uses in the usual way, follow the department’s approved alternative process.

Use PPE based on the assessment of the task and the patient’s needs. This may include gloves, aprons or face protection, depending on the likely exposure to blood, body fluids or respiratory secretions. Dispose of clinical waste and sharps in the correct containers. If a sharps injury or exposure occurs, follow the immediate reporting and occupational health procedures without delay.

Protect your back, shoulders and hands

Patient handling is one of the most common physical demands in imaging. Transferring a patient from a bed to a table, holding an awkward position or repeatedly moving equipment can strain the back, shoulders and wrists. “I’ll just lift them quickly” is not a safe moving-and-handling plan.

Assess what the patient can do, what support they need and whether the transfer can be made safer with equipment or assistance. Use slide sheets, hoists or other aids when indicated, and follow local moving-and-handling training. Adjust the examination table and equipment to a workable height where possible. If the patient is in pain, dizzy, weak or unable to follow instructions, reassess rather than pushing ahead with the original plan.

Good positioning protects both the patient and the radiographer. Explain the movement before starting, agree a simple cue and give the patient time to respond. For staff, vary tasks where practical, avoid twisting while lifting and report discomfort early. A minor ache is easier to address before it becomes a reason for prolonged absence.

Communicate clearly and support patient dignity

Safety depends on patients understanding what is happening. Explain the examination in plain language, check consent in line with local procedures and invite questions. Some patients may have hearing, language, learning or communication needs; adapt your approach and use approved support such as an interpreter when appropriate.

Respect privacy during changing and positioning. Provide suitable gowns or coverings, expose only the area needed and explain any necessary contact before it happens. When a chaperone is appropriate or requested, follow local policy. These steps are not extras: they help patients feel respected and make cooperation more likely.

For children, people with cognitive impairment and patients who are distressed, additional planning may be needed. Consider who can provide support, how instructions can be made accessible and whether the examination can be completed safely at that time. If a patient’s condition changes or they become distressed during the procedure, pause and reassess. The image can wait; a person’s immediate wellbeing cannot.

Manage contrast, medicines and emergencies carefully

Where radiographers administer contrast media or other medicines, they must work within their training, role and local medicines governance. Follow the correct checks for the patient, medicine, dose, route and timing, and document administration as required. Confirm that relevant allergies, previous reactions and clinical risks have been assessed under the department’s protocol.

Be prepared to recognise and respond to adverse reactions. Know where emergency equipment is kept, how to summon help and what your responsibilities are. Equipment should be checked according to local schedules, with faults or missing items reported. Regular drills can help turn a written procedure into a confident response when seconds matter.

After an incident or near miss, use the organisation’s reporting system. Reporting is not about finding someone to blame; it helps identify patterns and prevent a repeat. A near miss involving an incorrect protocol, a faulty cable or a patient who nearly fell may reveal a process that needs attention.

Support a safer working culture

Training and supervision should match the equipment, procedures and risks of the role. Keep mandatory and role-specific learning up to date, and ask for guidance when a task falls outside your competence. New starters and temporary staff also need a proper introduction to local rules; familiarity with one department does not guarantee familiarity with another.

Fatigue and workload affect attention. In a busy service, small interruptions can make it easier to miss a check or lose track of a patient’s position. Use agreed identification and handover processes, minimise avoidable distractions during critical checks and speak up if staffing or workload creates an immediate safety concern. A calm, respectful challenge is often the simplest form of risk control.

Radiographers keep patients and colleagues safer through consistent habits: verify, explain, assess, protect, clean and report. No single checklist can replace professional judgement, but reliable routines make good judgement easier to apply—even on the busiest shift, when the phone is ringing and the mobile unit is somehow parked behind three beds.