ASN Report 2018

In the light of the events reported to ASN in 2018, the most significant consequences from the radiation protection aspect concern: ∙ ∙ for medical workers: fluoroscopy-guided interventional practices (external exposure of operators, and their hands in particular) with cases where dose limits are exceeded, and nuclear medicine (contamination of workers, external exposure); ∙ ∙ for the patients: interventional practices with deterministic effects observed in some patients having undergone long and complex procedures, radiotherapy with overdoses linked more particularly to overlapping (1) procedures and prescription errors and, lastly, nuclear medicine, with radiopharmaceutical administration errors; ∙ ∙ for the public and the environment: nuclear medicine, with losses of sources, leaks from radioactive effluent pipes and containment structures. Detailed information per category is provided in sections 2 to 6. 1. Treatment overlap: irradiation during a second treatment of an anatomical region which has already been irradiated; the area concerned by an overlap receives summed doses resulting from several separate irradiations. 1.2.6  –  The risks and the oversight priorities In order to establish its oversight priorities, ASN has classified the nuclear-based medical activities according to the risks for the patients, the personnel, the public and the environment. This classification takes particular account of the doses delivered or administered to the patients, the conditions of use of ionising radiation sources by the medical professionals, the possible impact on the environment, the significant events reported to ASN and the radiation protection situation in the institutions exercising these activities. Breakdown of ERSs per area of exposure in 2018 (%) 56 Patient 30 Populations 4 Environment 10 Worker Diagram 3 Breakdown of ESRs per activity category concerned in 2018 (%) 29 Computed Tomography 5 Interventional radiology 22 External-beam radiotherapy 14 Conventional and dental radiology 1 Brachytherapy 29 Nuclear medicine Diagram 4 Number of ESRs per activity category during the period 2010‑2018 0 50 100 150 200 250 300 2018 2017 2016 2015 2014 2013 2012 2011 2010 Radiotherapy Nuclear medicine Computed Tomography Conventional and dental radiology Interventional radiology Number of significant events Diagram 2 204  ASN report on the state of nuclear safety and radiation protection in France in 2018 07 – MEDICAL USES OF IONISING RADIATION