IN SPA FACILITIES THERE ARE TWO TYPES OF IONISING RADIATION TO WHICH THE SPA CUSTOMERS AND THE WORKERS ARE EXPOSED: radon, which is the main source of exposure. Apart from the usual sources found in buildings, namely the subjacent ground and the construction materials, the radon can also be present in the spa water which has become charged with radon during its underground routing and is released when the water is used during the treatments; ambient radiation generated by the other radionuclides present in the spa water (above all uranium-238, radium-226, radium-228, lead-210 and polonium-210). Deposits of material contaminated by these radionuclides can form and create “hot spots”, particularly in the pool sand filters and the water treatment system. Analyses of the poultices applied to the skin of patients have revealed no radioactivity to date. In June 2022, 111 spa facilities accredited by the French health insurance organisation were present in 90 towns(*). Since 2018, ASN has carried out 14 inspections on 13 sites. These facilities have the particularity of being subject to three regulations relating to ionising radiation: the Public Health Code as a PAB, the Labour Code as a specific workplace where workers may be exposed to radon and, possibly, as an activity using radioactive substances of natural origin. THE INSPECTION FINDINGS REVEAL THAT: only one of the facilities took radon risk into account in the occupational risks analysis, showing that the facilities have not identified the new requirements of the Labour Code regulations, which have been applicable since 2018; all the facilities have carried out at least one campaign to measure the radon concentration in the interior air of the premises frequented by the spa customers and the workers. The procedure provided for in the Public Health Code has therefore been initiated. The results show that the measured concentrations are broadly higher than those measured in PABs as a whole. This can be explained by the use of spa water which can constitute an additional source of radon. The radon concentration in the premises is moreover strongly influenced by two factors: the intermediate storage of the spa water which allows degassing of the radon, and the ventilation of the premises; the exposure of the spa customers is very limited in time (typically three weeks for a health cure reimbursed by the healthcare system). The workers are more exposed than the customers because they go into places where the concentration is higher and their exposure time is longer; in the facilities where the reference level of 300 Bq/m3 is exceeded (5 facilities where places frequented by customers exceed this level and 6 facilities were places frequented by the workers exceed this level, out of the 13 sites inspected), the works to reduce the radon concentration, which are provided for in the regulations, have only been carried≈out in half the cases (2 facilities out of 5 for the places frequented by the customers and 3 facilities out of 6 for the places frequented by the workers). Few facilities had checked the effectiveness of the works. As in PABs in general, they do not always manage to achieve a radon concentration below the reference level of 300 Bq/m3. This is a known difficulty and it is sometimes necessary to proceed iteratively. The simplest actions implemented first can prove insufficient and need to be supplemented by more consequential work later on; as regards the radiation produced by the other radionuclides of natural origin, no characterised substance displayed a level of radioactivity that makes radiation protection measures necessary. Based on these findings, ASN will continue its oversight in this sector, particularly through re-inspections, and in 2024 it will conduct an awareness-raising campaign with all the spa facilities. In this context, an overview of the inspections and the points requiring attention in the application of the regulations shall be issued along with information on the new radon dose coefficients, which will become applicable in 2024 and will have a significant impact on management of the radon risk in premises where the workers’ activity is mainly non-sedentary. RESULTS OF THE INSPECTIONS OF SPA FACILITIES * Information from the website ameli.fr. ASN Report on the state of nuclear safety and radiation protection in France in 2023 119 • 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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