ASN Report 2018

7 —  Blood product irradiators 7.1  ̶  Description The irradiation of blood products is used to prevent post- transfusion reactions in blood-transfusion patients. The blood bag is irradiated with an average dose of about 20 to 25 grays. Since 2009, source irradiators have been gradually replaced by X-ray generators, for which notification to ASN has been required since 2015. In 2018, the inventory stood at 29 irradiator devices equipped with X-ray generators. 7.2  ̶  Technical rules applicable to facilities A blood product irradiator must be installed in a dedicated room designed to provide physical protection (fire, flooding, break-in, etc.). Access to the device, which must have a lockable control console, must be limited to authorised persons only. Irradiators equipped with X-ray generators must be installed in rooms that comply with the provisions of ASN’s new technical resolution 2017-DC-0591 of 13 June 2017 mentioned in section 4.2. 8 —  Synthesis and prospects ASN considers that the radiation protection situation in the medical sector remained stable in 2018; no particular deficiency was detected in the areas of radiation protection of workers, patients, the public or the environment. Further progress must still be made however, to better anticipate the arrival of new machines, or even new technologies and radiopharmaceuticals, for example, but also to improve the level of radiation protection culture in non-specialist users of ionising radiation. Such is the case with surgeons who are increasingly required to perform fluoroscopy-guided procedures in the operating theatres. The year 2019 should be marked by the gradual updating of the regulatory framework governing patient radiation protection, with the publication of several ASN resolutions, particularly those concerning quality assurance in medical imaging, the qualification of physicians using ionising radiation and the updating of diagnostic reference levels. ASN is going to continue developing its inspection programme, giving priority to radiotherapy, nuclear medicine and fluoroscopy-guided interventional practices. The preparation in 2019 of the new registration system applicable to fluoroscopy- guided interventional practices involving risks, which is to replace the existing notification system, is part of the drive to tighten oversight in this sector. ASN also plans to start the updating of the doctrine concerning the discharging of artificial radionuclides into the public sewage networks, and then to examine the changes in the management of contaminated effluents necessary to accompany the announced development of cancer treatments based on the administration of new radiopharmaceutical drugs. With regard to imaging, the development of a communication scale applicable to significant radiation protection events, like the one that has existed for radiotherapy since 2008 (the ASN-SFRO scale), and the setting up of a national experience feedback committee to study these events, are also scheduled for 2019. In radiotherapy, ASN will be particularly attentive to the deployment of the clinical audits announced by the professionals. The work to better anticipate and manage the organisational and technical changes will be continued in 2019, with volunteer radiotherapy centres and the assistance of the professionals, hospital federations and healthcare institutions. Lastly, the new committee for analysing new practices or techniques using ionising radiation will be set up in 2019. It will comprise members from learned societies and professional associations involved in radiotherapy and medical imaging. 228  ASN report on the state of nuclear safety and radiation protection in France in 2018 07 – MEDICAL USES OF IONISING RADIATION