Abstracts of the ASN Annual Report 2023

ANDRA 2023 was marked by the start of the examination of the creation authorisation application for the Cigéo deep geological repository, submitted on 16 January 2023. Cigéo project Following the acceptability analysis of the Cigéo creation authorisation application file, ASN began its technical examination in June 2023. ASN notes a positive dynamic within the project owner’s team and correct working by the governance bodies set up to identify, prioritise and rule on the most important technical choices regarding the project. These points confirm the demonstration that the French National Radioactive Waste Management Agency (Andra) has the technical capabilities needed to successfully complete the Cigéo project. Operation of Andra’s existing facilities ASN considers that operating conditions in Andra’s facilities remained satisfactory in the areas of nuclear safety, radiation protection and environmental protection in 2023. It also underlines the good quality of the safety assessments produced by Andra and the fact that the periodic safety reviews of the disposal facilities are carried out satisfactorily. The evaluation of the longterm impacts of the radiological and chemical substances in the disposal facilities on the flora and fauna nonetheless remains a subject for which management must be consolidated by Andra. ASN assessments by activity sector THE MEDICAL SECTOR On the basis of the inspections carried out in 2023 and an analysis of the period 2019-2023 enabling the entire fleet of facilities to be covered, ASN considers that the state of radiation protection in the medical sector is being maintained at a satisfactory level, relatively comparable from one year to the next, although with a number of persistent shortcomings which in 2023 led to an enforcement approach being adopted in the field of Fluoroscopy-Guided Interventional Practices (FGIPs). It underlines the advances made in the field of clinical audits, with the first experiments launched in 2023 in radiotherapy and radiology, but is urging that they be extended to higher-risk activities, radiosurgery in particular, as well as to therapeutic nuclear medicine. However, ASN identifies a number of signals which could indicate that the current situation could deteriorate: ∙ a finding that resources are on the whole shrinking, with pressure on Medical Electroradiology Manipulator (MERM), medical practitioner, medical physician staffing levels, with the expansion of temporary work and the postponement of tasks; ∙ in imaging, the use of insufficiently well-understood services to assist the Radiation Protection Experts-Officers (RPE-Os) and the medical physicians in the plants, liable to lead to a loss of radiation protection expertise and a lack of flexibility in implementing the regulation radiation protection requirements (training, verifications, etc.); ∙ the emergence of mobile radiology and constant growth in teleradiology with the technical and organisational constraints linked to this organisation method that are under-estimated by the facilities (communication problem, software interfacing); ∙ increasingly complex organisations, with sharing of resources and the risk of dilution of responsibilities, against a backdrop of health care authorisation reforms and buy-out of centres; ∙ conflict situations in a context of pressure on human resources or organisational changes of which it became aware during inspections or through the whistle-blower reporting system. In this context, ASN draws the decision-makers’ attention to the need to assess the impact of these changes on the organisations and on the work of the participants and to precisely define the roles and responsibilities of all parties involved, so that the radiation protection requirements are met. In radiotherapy, even if the safety fundamentals are in place, the OEF process is running out of steam and less detailed ESR analyses and less frequent OEF committee meetings underline the need to restore some meaning to this approach in order to maintain the interest of the professionals and retain a collective dynamic attitude. The repetition of target errors (in particular wrong-side 26 ABSTRACTS – ASN Report on the state of nuclear safety and radiation protection in France in 2023 ASN Assessments

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