Abstracts ASN Report 2019

ג ِ ב «ƏƳǣƏɎǣȒȇ ȵȸȒɎƺƬɎǣȒȇ ɀǣɎɖƏɎǣȒȇ ǣȇ ȇɖƬǼƺƏȸ ȅƺƳǣƬǣȇƺ ӉӅׇŁňĶĿĸĴŅ ŀĸķļĶļŁĸ ķĸŃĴŅŇŀĸŁŇņё ļєĸє ӅӊՌ łĹ ŇĻĸ ĹĴĶļĿļŇļĸņё ŊĸŅĸ ļŁņŃĸĶŇĸķ ļŁ ӅӃӄӌє ג ِ ב ِ׏ «ƏƳǣƏɎǣȒȇ ȵȸȒɎƺƬɎǣȒȇ Ȓǔ ȇɖƬǼƺƏȸ ȅƺƳǣƬǣȇƺ professionals Ņłŀ ŇĻĸ ŅĴķļłĿłĺļĶĴĿ ʼnļĸŊŃłļŁŇё ŇĻĸ ŃĸŅņłŁŁĸĿ ĴŅĸ ņňĵĽĸĶŇĸķ to a risk of external exposure –in particular on the fingers– due Ňł ŇĻĸ ĻĴŁķĿļŁĺ łĹ ĶĸŅŇĴļŁ ŅĴķļłŁňĶĿļķĸņ ҎĶĴņĸ ŊļŇĻ ĹĿňłŅļŁĸіӄӋё ļłķļŁĸіӄӆӄׇłŅ ŌŇŇŅļňŀіӌӃҏ ŊĻĸŁ ŃŅĸŃĴŅļŁĺ ĴŁķ ļŁĽĸĶŇļŁĺ ņё and a risk of internal exposure through accidental intake of radioactive substances. The results concerning radiation protection of professionals (see Graph 10) show that the radiation protection measures implemented by nuclear medicine departments are generally satisfactory on three points, namely the appointing of a RPE-O dedicated to this activity (and holding a valid certificate issued by the employer in all the departments inspected), the analysis of the dosimetric results of the medical staff, and the consistency between the delimiting of restricted areas and the results of the working environment verifications. Two areas for improvement have nevertheless been brought to light, namely the refreshing of personnel training and the coordination with outside companies (only 30% of departments have established coordination measures with all these companies). ňŅŇĻĸŅŀłŅĸё ŇĻĸ ŅĴķļĴŇļłŁ ŃŅłŇĸĶŇļłŁ ŇĸĶĻŁļĶĴĿ ʼnĸŅļĹļĶĴŇļłŁņ ĻĴʼnĸ been carried out over the last two years at the regulatory frequency for all the sources and devices and for the radioactivity measuring ĴŁķ ķĸŇĸĶŇļłŁ ķĸʼnļĶĸņё ļŁ ŁĸĴŅĿŌ ӌӃՌ łĹ ŇĻĸ ӉӅׇķĸŃĴŅŇŀĸŁŇņ ļŁņŃĸĶŇĸķє ĻĸŅĸ ĴŃŃĿļĶĴĵĿĸ ҎӆӈׇķĸŃĴŅŇŀĸŁŇņҏё ŇĻĸ ļķĸŁŇļĹļĸķ nonconformities have been corrected. ג ِ ב ِ « א ƏƳǣƏɎǣȒȇ ȵȸȒɎƺƬɎǣȒȇ Ȓǔ ȇɖƬǼƺƏȸ ȅƺƳǣƬǣȇƺ patients The radiation protection of nuclear medicine patients can also be ĶłŁņļķĸŅĸķ ņĴŇļņĹĴĶŇłŅŌ ļŁ ŇĻĸ ķĸŃĴŅŇŀĸŁŇņ ļŁņŃĸĶŇĸķ ļŁ ӅӃӄӌє Ļĸ ӆӊׇķĸŃĴŅŇŀĸŁŇņ ҎłňŇ łĹ ŇĻĸ ӉӅׇļŁņŃĸĶŇĸķҏ ŇĻĴŇ ĶĴŅŅŌ łňŇ ŇĻĸŅĴŃĸňŇļĶ łŅ ķļĴ壳ņŇļĶ ŃŅłĶĸķňŅĸņ ňņļŁĺ ļłķļŁĸіӄӆӄׇķł ĸĹĹĸĶŇļʼnĸĿŌ ĻĴŁķ łʼnĸŅ a written document to the patient in accordance with the Order łĹ Ӆӄׇ ĴŁňĴŅŌ ӅӃӃӇׇĴŁķ ŇĻĸ ŅĸĶłŀŀĸŁķĴŇļłŁņ łĹ ŇĻĸ є Ļĸ external quality controls of the last two years have moreover been carried out on all the medical devices at the correct frequency ĴŁķ ĴŁŌ ŁłŁĶłŁĹłŅŀļŇļĸņ ķļņĶłʼnĸŅĸķ ĻĴʼnĸ ĵĸĸŁ Ņĸŀĸķļĸķ ļŁ ӋӄՌ of the departments. In all the other cases, either the control has not been carried out at the regulatory frequency, or it has not covered all the devices concerned. Nevertheless, the organisation put in place for the intervention of medical physicist, indicating the duties and time of presence on site, is only fully defined in 73% of the departments. In 27% of the cases, the Medical Physics Organisation Plan (POPM) does ŁłŇ ĶłʼnĸŅ ĴĿĿ ŇĻĸ ŅĸńňļŅĸŀĸŁŇņ łĹ ňļķĸ łє ӅӃׇłŅё Ňł Ĵ ĿĸņņĸŅ extent, the medical physics organisation described in the POPM is insufficient with regard to the risks associated with the activity. ג ِ ב ِ ב ¨ȸȒɎƺƬɎǣȒȇ Ȓǔ Ɏǝƺ ǕƺȇƺȸƏǼ ȵɖƫǼǣƬ ƏȇƳ Ɏǝƺ ƺȇɮǣȸȒȇȅƺȇɎ The questions relating to protection of the public and the environment are dealt with satisfactorily in many of the centres inspected (see Graph 11). Ļňņё ŁĸĴŅĿŌ ӌӃՌ łĹ ŇĻĸ ķĸŃĴŅŇŀĸŁŇņ ĻĴʼnĸ Ĵ ķĸĿļʼnĸŅļĸņ ĴŅĸĴ ŇĻĴŇ complies with the requirements of ASN resolution 2014-DC-0463 łĹ Ӆӆׇ ĶŇłĵĸŅ ӅӃӄӇׇҎķĸķļĶĴŇĸķ ĴŁķ ŃŅłŇĸĶŇĸķҏє Ł ĴĵłňŇ ӋӈՌ łĹ the departments the activity concentration of the effluents discharged after decay complies with the regulatory limits ҎӄӃׇ ńѼ ҂ĵĸĶńňĸŅĸĿņ ŃĸŅ ĿļŇŅĸҏ ĹłŅ ĶłŁŇĴŀļŁĴŇĸķ ĸĹĹĿňĸŁŇņ ĴĹŇĸŅ ņŇłŅĴĺĸё łŅ ӄӃӃׇ ńѼ ĹłŅ ĸĹĹĿňĸŁŇņ ĹŅłŀ ŇĻĸ Ņłłŀņ łĹ ŃĴŇļĸŁŇņ treated with iodine-131). ňŅŇĻĸŅ ŃŅłĺŅĸņņ ŀňņŇ ŁĸʼnĸŅŇĻĸĿĸņņ ĵĸ ŀĴķĸѓ Ҋ in departments other than nuclear medicine department that use unsealed sources, since only about 77% of them have carried out non-contamination verifications at the end of therapeutic procedures in accordance with the planned protocol; Ҋ 66% of the inspected departments had complete and functional traceability of alarm device verifications. ג ِ ב ِ ג ³ǣǕȇǣǔǣƬƏȇɎ ƺɮƺȇɎɀ ǣȇ ȇɖƬǼƺƏȸ ȅƺƳǣƬǣȇƺ ňŇ łĹ ŇĻĸ ӉӅׇķĸŃĴŅŇŀĸŁŇņ ļŁņŃĸĶŇĸķё ӇӅׇĻĴʼnĸ Ĵ ņŌņŇĸŀ ĹłŅ recording adverse events. These departments analysed the events and reported them to ASN. ӄӇӈׇ ņ ŊĸŅĸ ŅĸŃłŅŇĸķ ļŁ ӅӃӄӌё ŊĻļĶĻ ļņ ӄӈՌ Ŀĸņņ ŇĻĴŁ ļŁ ӅӃӄӋє As in the preceding years, most of the notified events concerned ŃĴŇļĸŁŇņ ĸŋĴŀļŁĸķ ĹłŅ ķļĴ壳ņŇļĶ ŃňŅŃłņĸņ ҎӉӌՌҏє Ļĸ ŀĴĽłŅļŇŌ of the reported events have no expected clinical consequences. • ³ǣǕȇǣǔǣƬƏȇɎ ƺɮƺȇɎɀ ƬȒȇƬƺȸȇǣȇǕ ȵƏɎǣƺȇɎɀ ٢׏׎׎ ژ 0³«ɀً Ȓȸ ۏחה Ȓǔ Ɏǝƺ ȸƺȵȒȸɎƺƳ 0³«ɀ٣ The majority of the ESRs reported in nuclear medicine and concerning patients are linked to errors in administering an RPD to a patient (interchanging of syringes or of patients), to dose errors (adult dose injected into a child, injection of a higher or lower activity than that prescribed, etc.) or to errors during the preparation of the medication (interchanging of bottles). One case concerns a person who was administered a therapeutic ķłņĸ łĹ ļłķļŁĸіӄӆӄׇĴņ ĴŁ łňŇŃĴŇļĸŁŇё ŊĻĸŅĸĴņ Ļĸ ŊĴņ ņňŃŃłņĸķ Ňł ňŁķĸŅĺł Ĵ ņĶļŁŇļĺŅĴŃĻŌ ĸŋĴŀļŁĴŇļłŁ ŊļŇĻ ļłķļŁĸіӄӅӆє ŁĸׇĶĸŁŇŅĸ ASN inspection in the nuclear medicine department Ȓǔ Ɏǝƺ ȇǕȒɖǼƿȅƺ RȒɀȵǣɎƏǼ !ƺȇɎȸƺ ٫ zȒɮƺȅƫƺȸ א ׎׏ ח 216 ASN Report on the state of nuclear safety and radiation protection in France in 2019 ׎ ٲ ו MEDICAL USES OF IONISING RADIATION