Diagnostic Radiology Services and Occupational Radiation Anxiety in Kazakhstan.

Radiology services play a vital role in modern healthcare, yet disparities in access and concerns about occupational radiation exposure remain understudied in many countries, including Kazakhstan. This study evaluates national trends in diagnostic imaging services, workforce distribution, and radiation-related anxiety among medical personnel. We analyzed national diagnostic imaging infrastructure and workforce data from 2018-2024. Individual radiation exposure data (n = 177) were obtained from dosimetry records in Astana's medical facilities. Additionally, a cross-sectional survey (n = 324) was conducted using the Spielberger-Hanin Anxiety Scale to assess radiation-related anxiety and associated factors. Between 2018 and 2024, the number of CT rooms in Kazakhstan more than doubled from 162 to 358 (+121%), while X-ray examinations declined from 20.6 to 14.6 million (-29.2%) and fluorography dropped by 67.7%. CT scans increased over threefold, from 491,738 to 1.6 million. Radiologists grew from 3529 to 4511 (+27.8%), and ultrasound doctors from 1396 to 2178 (+56.1%). Interventional physicians had the highest quarterly radiation dose (0.65 ± 0.58 mSv, p = 0.001). Among radiology professionals, 32% reported anxiety related to occupational exposure. Anxiety was significantly associated with not using aprons (58% vs. 27%, p < 0.001), lack of dosimeter use (27% vs. 12%, p = 0.001), and inadequate safety training (27% vs. 6%, p < 0.001). Spielberger-Hanin scores ≥ 45 indicated high levels of situational (58%) and personal (56%) anxiety in this group. Kazakhstan's diagnostic radiology capacity has grown rapidly, especially in CT availability, yet regional disparities and occupational anxiety remain critical concerns. Targeted workforce distribution, improved protective practices, and enhanced radiation safety education are urgently needed.