Council Directive 2013/59/Euratom of 5 December 2013 laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation: medico-legal and legal-comparative study.

Abstract: This paper is a scientific contribution on basic safety standards, related to protection against hazards arising from exposure to ionizing radiation: medico-legal issues resulting from the research of the University of Campania and the study conducted by the Italian Society of Medical and Interventional Radiology are reported.

Cavity ionization chamber responses in the JAEA and the NMIJ high-energy photon reference fields for radiation protection.

A dosimeter should ideally be calibrated in a reference field with similar energy and doserate to that which the dosimeter is being used to measure. Environments around nuclear reactors and radiation therapy facilities have high-energy photons with energies exceeding that of60Co gamma rays, and controlling exposure to these photons is important. The Japan Atomic Energy Agency and National Metrology Institute of Japan have high-energy reference fields with energies above several megaelectronvolts for different types of accelerators. Their reference fields have different fluence-energy distributions. In this study, the energy dependencies of the two-cavity ionization chambers, which are often used by secondary standard laboratories, were experimentally and computationally evaluated for each high-energy field. These results agreed well within the relative expanded uncertainties (k= 2), and their capabilities for air kerma measurements in each high-energy reference field were confirmed. Therefore, the capabilities of the air-kerma measurements were verified in the two high-energy reference fields.

Perspectives of the role of ICRP and the system of protection in meeting the United Nations sustainable development goals.

Established in 2015 the United Nations (UN) sustainable development goals (SDGs) were agreed with the aim to balance the need to address social and ethical obligations such as ending poverty and other deprivations, while tackling climate change and the other planetary boundaries. In 2018 the International Commission on Radiological Protection (ICRP) initiated a review and revision of the System of Radiological Protection which will lay the foundation for Radiation Protection standards, regulations, guidance and practice worldwide for the next 40 years. Recognising the importance of the UN SDG's the ICRP has started to consider what the role of the revised system of protection should be in enabling delivery. On the 15 May 2024 the Society for Radiological Protection and World Nuclear Association ran a workshop exploring the intersection of the System of Radiological Protection and the SDG's. The outputs of the workshop are summarised in this paper showing the views from a variety of practitioners working across the radiation protection sectors on the key factors to be considered in the revision of the system of radiological protection to enable delivery of the UN SDG's.

A practitioners view on the ICRP review of the system of radiological protection-feedback from SRP 2023 workshop.

In 2018 the International Commission on Radiological Protection (ICRP) initiated a review and revision of the System of Radiological Protection which will lay the foundation for radiation protection (RP) standards, regulations, guidance and practice worldwide for the next 40 years. On the 25 April 2023 the Society for Radiological Protection ran a workshop at their Annual Conference presenting the current status and progress in the ICRP Review and Revision, along with inviting a number of panellist's across different areas of the profession and wider audience to share their thoughts. The outputs of the workshop are summarised in this paper showing the views from a variety of practitioners working across the RP sectors on the key factors to be considered in the review.

Assessment of safety culture in radiotherapy facilities using safety performance indicators.

This paper describes the development of the Safety Performance Indicators (SPIs), the methodology for assessment of the safety culture of radiotherapy institutions using SPIs and common strengths and common areas for improvement. SPIs were categorized into eight sections which all together contain 23 attributes and each attribute has scoring criteria from 0 to 2 (in steps of 0.5). The maximum absolute cumulative score of SPIs was 46. A relative cumulative SPIs score of >80% indicates an institution strong commitment towards safety while score <50% indicates need for additional guidance to enhance safety culture. The assessment using SPIs was conducted for 17 radiotherapy institutions. The methodology of assessment includes interactive discussion, direct observations and document analysis. The relative cumulative SPIs score of seven institutions was found to be >80% while it was found in the range of 67.0% to 80% for the remaining ten institutions. Institutions were communicated about the cumulative SPIs score, areas of strengths, and areas for improvement. SPIs were found to be a good tool for safety culture assessment and can be utilized by the radiotherapy institutes for self-assessment to identify the areas of improvement. Based on SPIs score, regulatory body can grade the institutions from a radiation safety compliance point of view.

Radiation protection adherence and associated factors among radiology personnel.

The aim of the study was to investigate radiation protection adherence among radiology personnel and associated factors. In light of the increasing integration of ionizing radiation in medical diagnostics and treatment-specifically in areas such as computed tomography, fluoroscopy, and therapeutic radiology-it is vital for radiology personnel to consistently uphold rigorous radiation protection standards. This cross-sectional study employed a self-administered questionnaire to collect demographic data and assess various aspects of radiation protection adherence among radiology personnel. The gathered data were entered into SPSS 16 for statistical analysis. Among the 119 participants, 72 (60.5%) worked in the radiology department, and 88 (77.9%) were married. Significant associations were observed between adherence levels and marital status, age groups, years of experience, and department type. Study findings showed a significant association between several demographic factors and radiation protection adherence. Furthermore, our results highlight the value of implementing radiation protection courses to enhance adherence among personnel.

Enhancing radiation safety awareness and practices among female radiographers: a comprehensive approach.

OBJECTIVE: This study evaluates the level of radiation safety awareness and adherence to protective practices among pregnant female radiographers in the United Arab Emirates, aiming to identify gaps and develop targeted interventions for enhancing occupational safety. METHODS: Employing a cross-sectional design, the study surveyed 133 female radiographers using a self-developed questionnaire covering demographics, awareness and knowledge, workplace practices, communication, and satisfaction. RESULTS: The survey showed high awareness among radiographers, with 97% acknowledging radiation risks during pregnancy, although 42.9% had not received formal training. Concerns over long-term health effects were significant, with 66.2% of participants worried about potential impacts. Despite these concerns, 83.5% had been informed about radiation risks and protective measures, indicating active information provision in many workplaces. However, inconsistencies in information dissemination across different work settings were noted. CONCLUSIONS: The findings highlight the need for standardized radiation safety protocols for pregnant radiographers. The variability in safety training and information dissemination suggests the importance of establishing uniform safety practices. Recommendations include developing comprehensive education and training programs for pregnant radiographers, ensuring open communication for radiation safety and pregnancy-related concerns, and enforcing clear guidelines for workplace accommodations.

A Compendium of Radiation Safety Practices That Can Complement Organizational Worker Well-being Initiatives.

ABSTRACT: Organizations are learning that efforts to protect the health and safety of their workers from risks both at work and outside of work yield great dividends in the form of increased productivity, morale, and reduced healthcare costs. This realization has given rise to a variety of worker well-being initiatives that span far beyond the typical boundaries of traditional workplace health and safety programs. Examples include providing information and services on diet, exercise, personal habits, and mental health issues. Interestingly, the radiation safety profession has been historically involved with a series of progressive worker well-being practices that perhaps are not fully appreciated by the broader well-being community. These include the ability to comprehensively track occupational doses, training regarding doses arising from outside the workplace (such as medical procedures and environmental exposures), and fetal protection policies, to name a few. Described here is the shift in perspective from health and safety merely for the workplace to a more holistic approach, but the degree to which the actions may be implemented varies. Included then is a compendium of radiation safety practices that may be possibly folded into the discussion of larger organizational well-being efforts.

Transfer functions forQA/QBinternational regulatory limits for the safe transport of radioactive materials.

This paper presents a proposed revision of the International Atomic Energy Agency transport regulations, related to theA1andA2limit values used to determine the radioactive transport classification. Based on the 'Qsystem', a novel methodology was introduced to deriveQAandQBvalues related to scenarios involving external exposure from a distant source. These values are key parameters that respectively represent the total effective dose and total equivalent dose to the skin, from all primary and secondary particles contributing to radiation exposure. The International Working Group (WGA1/A2) is established and associated with the TRANSSC Technical Expert Group on Radiation Protection. A review of theA1andA2values is performed in response to identified limitations within the existingQsystem. The followed approach is based on Monte Carlo simulations that enabled the development of transfer functions aimed at reducing computational time and increasing the flexibility of dose evaluations for any radionuclide with known particle emission spectra. This method allows updating theQAandQBvalues to account for future data evolutions (decay data, fluence-to-dose conversion coefficients) and standardizing the calculation of regulation limits across all referenced radionuclides and scenarios related to external exposure. The transfer functions are established using three Monte Carlo simulation codes-FLUKA, Geant4, and MCNP-and address the previous limitations of the 'Qsystem', reflecting the latest International Commission for Radiation Protection recommendations and improvements in calculation techniques. The results of the WG show consistent agreement across the codes, with minor discrepancies observed at low primary energies due to statistical uncertainties and different handling of stopping power for electrons/positrons in the codes. This revised approach aligns with current standards and recommendations, ensuring that the radiological consequences of transport accidents are acceptable for the newA1andA2limits from a radiological protection perspective.

Methodology for shielding design and evaluation for container scanners.

There has been an increase in the use of high energy photon beam for container scanners in many countries for multi purposes such as detecting high atomic number materials which might be nuclear materials, drugs, high explosive materials and other contrabands etc. High energy photon beams generally 6 and 9 MV can be used for scanning such materials. However, it is important to ensure that radiation level beyond the container scanner installation is within the permissible dose limit specified by the national competent authority for the protection of public and radiation workers. In this paper, challenges in the biological shielding during the installation of high energy X-ray system for scanning vehicles containing suspected materials are discussed. The purpose of the present study is to develop a methodology for shielding design and evaluation for container scanner installations. The basic concept pertaining to shielding evaluation of radiotherapy installations provided in National Council on Radiation Protection and Measurements (NCRP)/International Atomic Energy Agency (IAEA) reports are referred, and appropriately used to calculate optimized shielding thicknesses requirements for container scanner installation. Workload is estimated based on number of containers scanned, machine ON time and dose rate at 1 m. The shielding evaluation includes use of beam stopper in the primary beam, scattering by heterogeneous metallic scrap materials or any other suspected materials contained in the vehicle and their impact on the thickness of shielding walls. A model lay out plan to be used for installation of container scanner is developed. A methodology for shielding evaluation for various protective walls and ceiling of this model is also discussed. The study provides basic requirement for designing a structural room for installing 9MV container scanner from radiological safety view point.

Role of independent research at AERB for ensuring safety of nuclear facilities in India.

The mission of Atomic Energy Regulatory Board (AERB) of India is to ensure that the use of ionising radiation and nuclear energy in India does not cause unacceptable impact on the workers, members of the public and to the environment. AERB has the mandate to carry out detailed safety review for the siting, construction, commissioning, operation and decommissioning of nuclear and radiation facilities established within the country. To deliver and maintain a strong, credible and technically sound regulation, AERB has established the Safety Research Institute (SRI) at Kalpakkam with a robust technical infrastructure and wide knowledge base. This paper highlights the independent safety research activities carried out at SRI and its role to support and facilitate the decision-making process by AERB at various stages of regulatory review for ensuring safety of the nuclear facilities in India.

Overt Scientific Bias and Clandestine Acts by Trusted Scientists: The Flawed Application of the Linear No-threshold Model.

ABSTRACT: The Health Physics Society (HPS) released a video documentary on the history of the linear no-threshold (LNT) model in April 2022. It exposed many scientific and ethical failings of many leaders, influential scientists, and organizations that have resulted in the current system of radiological protection. Since then, the society received many comments; most were supportive, while a few criticized the video documentary as delivering an anti-LNT message. Shortly thereafter, many emails discovered via an independent Freedom of Information Act request revealed multiple layers of coordination between prominent people in the field of radiation protection to coopt the leadership within the HPS and suppress information they perceived or assumed to be contrary to a pro-LNT message. Many of these emails were published by JunkScience.com, an independent organization that exposes faulty scientific data and analyses used to advance special interests and hidden agendas. This Forum article is intended to document in the peer-reviewed literature the JunkScience.com findings of clandestine acts by trusted scientists within the radiation protection community. The emails exposed strong personal biases, actions taken by leaders within the National Commission on Radiation Protection and Measurements (NCRP) to "save the Society" from its "downward spiral," and actions taken by NCRP and HPS members serving on a National Academies of Sciences committee to suppress scientific information relevant to the debate about health effects in low-dose environments. These anti-science actions harm our entire profession and the trust that Congress bestows on our scientific organizations expecting to receive objective recommendations based on sound science. It is important that these events are recorded in the scientific literature from a historical perspective. The radiation protection community will be judged not by what is revealed in this article but by what actions are taken from here.

Modification of algorithm for accurate estimation of Hp(3) based on response of head TLD badge calibrated using ISO cylindrical phantom.

In India, the prevailing approach to eye lens dosimetry is the placement of an existing dosemeter on the forehead region after slight modification serves as a dedicated Eye Lens Dosemeter. A methodology for estimating the eye lens dose in terms of the Hp(3) has been previously explored employing an algorithm based on the response characteristics of this dosemeter using ISO slab phantom. It was observed that the performance of the dosemeter in terms of Hp(3) using previous algorithm showed under response at higher angles of incidence and photon beams of energy < 200 keV. Further, study was conducted to modify the algorithm following the latest ISO recommendations. This involved generation of data from the response of existing dosemeter on a cylindrical phantom. The results of this study revealed better performance of the newly established algorithm in estimating eye lens dose in terms of Hp(3) when compared to the earlier algorithm.

Evaluation of uncertainty in personal dose measured using CaSO4:Dy-based TLD badge at different workplaces.

The metrological quality of a measurement is characterised by evaluating the uncertainty in the measurement. In this paper, uncertainty in personal dose measured using individual monitoring CaSO4:Dy-based thermoluminescence dosimeter badge is evaluated by application of the guide to the expression of uncertainty in measurement method. The present dose reporting quantity, whole body dose (WBD) and the proposed quantity, personal dose equivalent, Hp(10) has been used as measurands. The influence of various input quantities on the measurement were analyzed through tests that conform to the requirements of the International Electrotechnical Commission IEC 62387. The study found that the expanded uncertainties for WBD and Hp(10) measurements were 63.4% and 41.4%, respectively, corresponding to a 95% coverage probability for workplace fields covering a wide photon energy range (33-1250 keV). However, the uncertainty estimates were quite lower for the type of workplaces that are identified using the dose evaluation algorithm. The input quantities, namely, the response to a mixture of photon beam qualities and photon energy and angular dependence contribute the most to the total uncertainty.

Improving a regional project on diagnostic reference levels for interventional procedures (OPRIPALC) with the support of a dose management system for the protection of patients and staff.

Interventional radiology is a clinical practice with important benefits for patients, but which involves high radiation doses. The optimisation of radiation protection (RP) for paediatric interventional cardiology is a priority for both patients and staff. The use of diagnostic reference levels (DRLs) has been proposed by the International Commission on Radiological Protection to improve RP in imaging procedures. Dose management systems (DMSs) allow the automatic collection of dosimetric, geometric and technical data to assist the optimisation process, with a continuous audit of the procedures, generating alerts to implement corrective actions when necessary. Patient dose indicators may be analysed individually and for different radiation events (fluoroscopy and cine runs). Occupational doses per procedure may be analysed (if electronic dosimeters are available) and linked with patient doses for an integrated approach to RP. Regional optimisation programmes require data collection and processing from several countries to set and periodically update the DRLs. Patient data is anonymised, and each participating hospital has access to their data in a central computer server. Using DMSs may be one of the best ways to support these programs in the collection and analysis of data, raising alerts about high patient and occupational doses and suggesting optimisation actions.

Validity of the 1984 Interim Guidelines on Airborne Ultrasound and Gaps in the Current Knowledge.

ABSTRACT: Airborne ultrasound is used for various purposes both in industrial and public settings, as well as being produced as a by-product by a range of sources. The International Radiation Protection Association (IRPA) published interim guidelines on limiting human exposure to airborne ultrasound in 1984, based on the limited scientific evidence that was available at that time. In order to investigate whether research since 1984 requires the development of revised exposure guidelines we considered (a) within the context of ultrasound exposure the relevance to health of the biological endpoints/mechanisms listed in the IRPA guidelines, (b) the validity of the exposure limits, and (c) whether there are biological endpoints/mechanisms not covered in the guidelines. The analysis of the available evidence showed that the biological endpoints that form the basis of the guidelines are relevant to health and the guidelines provide limits of exposure based on the evidence that was available at the time. However, the IRPA limits and their associated dosimetry were based on limited evidence, which may not be considered as scientifically substantiated. Further, there is no substantiated evidence of biological endpoints/mechanisms not covered by the IRPA guidelines. These two observations could mean that IRPA's limits are too low or too high. Research since the IRPA guidelines has made some improvements in the knowledge base, but there are still significant data gaps that need to be resolved before a formal revision of the guidelines can be made by ICNIRP, including research needs related to health outcomes and improved dosimetry. This statement makes a number of recommendations for future research on airborne ultrasound.

Expansion of Typical Values for Paediatric Patients in Ireland and Comparison with Published DRLs - Experiences of a Single Institution.

INTRODUCTION: To reduce the risks involved with ionising radiation exposure, typical values (TVs) and diagnostic reference levels (DRLs) have been established to help keep radiation doses 'as low as reasonably practicable. TVs/DRLs provide standardised radiation dose metrics that can be used for comparative purposes. However, for paediatrics, such values should consider the size of the child instead of their age. This study aimed to establish and compare paediatric TVs for chest, abdomen and pelvis radiography. METHODS: Study methods followed processes for establishing paediatric DRLs as outlined by the Health Information and Quality Authority (HIQA). Kerma-area product (KAP) values, excluding rejected images, were retrospectively acquired from the study institution's Picture Archiving and Communications System (PACS). Paediatric patients were categorised into the following weight-based groupings (5 to <15 kg, 15 to <30 kg, 30 to <50 kg, 50 to 80 kg) and stratified based on the examination that was performed (chest, abdomen, and pelvis), and where it was performed (the different X-ray rooms). Anonymised data were inputted into Microsoft Excel for analysis. Median and 3rd quartile KAP values were reported together with graphical illustrations. RESULTS: Data from 407 X-ray examinations were analysed. For the previously identified weight categories (5 to <15 kg, 15 to <30 kg, 30 to <50 kg, 50 to 80 kg), TVs for the chest were 0.10, 0.19, 0.37 and 0.53 dGy.cm2, respectively. For the abdomen 0.39, 1.04, 3.51 and 4.05 dGy.cm2 and for the pelvis 0.43, 0.87, 3.50 and 7.58 dGy.cm2. Between X-ray rooms TVs varied against the institutional TVs by -60 to 119 % (chest), -50 to 103 % (abdomen) and -14 and 24 %% (pelvis). CONCLUSION: TVs in this study follow established trends with patient weight and examination type and are comparable with published literature. Variations do exist between individual examination rooms and reasons are multifactorial. Given that age and size do not perfectly correlate further work should be undertaken around weight-based TVs/DRLs in the paediatric setting.

National Diagnostic Reference Levels for Standard Descending Thoracic Endovascular Aortic Repair and Optimisation Strategies.

OBJECTIVE: The International Commission on Radiological Protection has highlighted the large number of medical specialties that use fluoroscopy outside diagnostic imaging departments without radiation protection programmes for patients and staff. Vascular surgery is one of these specialties. Thoracic endovascular aortic repair (TEVAR) is a complicated procedure requiring radiation protection guidance and optimisation. The recent EU Basic Safety Standards Directive requires the use and periodic updating of diagnostic reference levels (DRLs) for interventional procedures. The aim of this study was to determine doses for patients undergoing TEVAR with mobile Xray systems and hybrid rooms (fixed Xray systems) to obtain national DRLs and to suggest optimisation actions. METHODS: This was a retrospective cross sectional study. The Spanish Chapter of Endovascular Surgery conducted a national survey in 11 autonomous communities representing around 77.6% of the Spanish population (47.33 million inhabitants). A total of 266 TEVAR procedures from 17 Spanish centres were analysed, of which 53.0% were performed in hybrid operating rooms. National DRLs were obtained and defined as the third quartile of the median values from the different participating centres. RESULTS: The proposed national DRLs are: for kerma area product (KAP), 113.81 Gy·cm2 for mobile Xray systems and 282.59 Gy·cm2 for hybrid rooms; and for cumulative air kerma (CAK) at the patient entry reference point, 228.38 mGy for mobile systems and 910.64 mGy for hybrid rooms. CONCLUSION: Based on the requirement to know radiation doses for standard endovascular procedures, this study of TEVARs demonstrated that there is an increased factor of 2.48 in DRLs for KAP when the procedure is performed in a hybrid room compared with mobile C-arm systems, and an increased factor of 3.98 in DRLs for CAK when the procedure is performed with hybrid equipment. These results will help to optimise strategies to reduce radiation doses during TEVAR procedures.