This plan follows on from the preceding plans (the assessment of the 3rd plan is available on asn.fr). It can be broken down into 13 actions focusing on three lines: Line 1 aims to implement an information and awarenessraising strategy. The health issue that radon represents requires continuation of the awareness-raising and information measures directed towards all the players (regional authorities, employers, building professionals, health professionals, teachers, etc.) and the general public, both nationally and locally, with the promotion and accompanying of regional measures for the integrated management of the radon risk in the home. A specific communication campaign shall target smokers, because they constitute the population the most at risk of developing lung cancer linked to cumulative exposure to radon and tobacco. The operational implementation of the information system incorporating all the radon monitoring results, as well as the consolidation and centralising of the existing measures, would appear moreover to be essential for informing the public. Line 2 aims to continue to improve knowledge. The publication in 2018 of a new map on the municipal scale, based on three radon-potential zones, enabled a graded approach to radon risk management to be implemented. This map must nevertheless be improved so as to better integrate certain geological factors that could facilitate radon transfer to buildings (karst zones in particular). Furthermore, the 4th Radon Plan provides for the updating of knowledge of exposure of the French population by organising the collection of measurement data obtained in particular during the local awareness-raising operations organised by the ARS and the regional authorities to cover the areas for which insufficient data are available. These operations consist in proposing screening kits to the inhabitants of a given region to raise their awareness of the radon risk. Lastly, line 3 aims to take better account of the management of the radon risk in buildings. In order to help members of building trade organisations improve their skills, these organisations have recently developed training courses dealing with methods to prevent and reduce concentration levels and various media to address the needs. The various French-language aids have been listed. To supplement the offering, a guide intended for professionals and private individuals alike was published in 2023. It provides recommendations concerning prevention in new constructions and remediation in existing buildings (see box next page). The progress made in understanding the effectiveness of construction standards in reducing radon concentrations in indoor air shall be consolidated. A system of specific indicators, chosen according to their relevance and the data available for monitoring them, has been put in place. Monitoring how these indicators evolve over several years will enable the effectiveness of the national strategy deployed under the national action to be determined. 3.3 DOSES RECEIVED BY PATIENTS In France, exposure for medical purposes represents the greatest part of the artificial exposures of the public to ionising radiation. It has been regularly reviewed by IRSN since 2002. Although exposure has been increasing for the last 30 years, it has tended to stabilise since 2012, whereas at the same time the number of medical procedures has greatly increased. Nuclear medicine, the third-biggest contributor to the collective effective dose, is the discipline that saw the greatest increase between 2012 and 2017, in terms of both frequency and contribution to the collective effective dose. The average effective dose per inhabitant resulting from diagnostic radiological examinations was evaluated at 1.53 mSv for the year 2017 (IRSN ExPRI study 2020) for some 85 million diagnostic procedures performed in 2017 (81.6 million in 2012), i.e. 1,187 procedures for 1,000 inhabitants per year. It is to be noted that as before, the individual exposure in 2017 is very varied. Consequently, although about 32.7% of the French population underwent at least one procedure (dental procedures excluded), half the patients received a dose of 0.1 mSv or less, 75% received 1.5 mSv or less, while the most exposed 5% of patients received a dose exceeding 18.1 mSv. DIAGRAM Trend in the distribution of initial and ten-yearly measurements per results bracket since 2016 3 0% 20% 40% 60% 80% 100% 2022-2023 2021-2022 2020-2021 2019-2020 2018-2019 2017-2018 2016-2017 Results ≤ 300 Bq/m3 Results > 300 and < 1 000 Bq/m3 Results ≥ 1 000 Bq/m3 DIAGRAM Trend in the distribution of measurements after corrective actions and works per results bracket since 2016 4 0% 20% 40% 60% 80% 100% 2022-2023 2021-2022 2020-2021 2019-2020 2018-2019 2017-2018 2016-2017 Results ≤ 300 Bq/m3 Results > 300 and < 1 000 Bq/m3 Results ≥ 1 000 Bq/m3 ASN Report on the state of nuclear safety and radiation protection in France in 2023 113 • 01 • Nuclear activities: ionising radiation and health and environmental risks 01 05 15 08 11 04 14 06 07 13 AP 03 10 02 09 12
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