The internal dosimetry user group position statement on molecular radiotherapy.

The Internal Dosimetry User Group (IDUG) is an independent, non-profit group of medical professionals dedicated to the promotion of dosimetry in molecular radiotherapy (www.IDUG.org.uk). The Ionising Radiation (Medical Exposure) Regulations 2017, IR(ME)R, stipulate a requirement for optimisation and verification of molecular radiotherapy treatments, ensuring doses to non-target organs are as low as reasonably practicable. For many molecular radiotherapy treatments currently undertaken within the UK, this requirement is not being fully met. The growth of this field is such that we risk digressing further from IR(ME)R compliance potentially delivering suboptimal therapies that are not in the best interest of our patients. For this purpose, IDUG proposes ten points of action to aid in the successful implementation of this legislation. We urge stakeholders to support these proposals and ensure national provision is sufficient to meet the criteria necessary for compliance, and for the future advancement of molecular radiotherapy within the UK.

The new lens dose limit: implication for occupational radiation protection.

AIM AND OBJECTIVES: The aim of this article was to explore the implications of the new Euratom dose limit for occupational radiation protection in the context of medical occupational radiation exposures. The European Directive 2013/59/Euratom takes into account the new recommendations on reduction in the dose limit for the lens of the eye for planned occupational exposures released in 2012 by the International Commission on Radiological Protection (ICRP 118). MATERIALS AND METHODS: Different dose-monitoring procedures and devices were considered. Occupational eye lens doses reported by previous studies were analyzed, mainly considering workers involved in interventional procedures with X-rays. The current status of eye lens radiation protection and the main methods for dose reduction were investigated. RESULTS: The analysis showed that the workers, potentially exceeding the new limit, are clinical staff performing interventional procedures with a relatively high X-ray dose. Regarding radiological protection issues, the considered literature reports that the proper use of personal protective equipment may reduce the eye lens absorbed dose. CONCLUSION: The evaluation of the occupational eye lens dose is essential to establish which method of personal dose monitoring should be preferred. Furthermore, education and training about the right use of personal protective equipment are important for medical staff working with ionizing radiation.

A European survey on the regulatory status for the estimation of the effective dose and the equivalent dose to the lens of the eye when radiation protection garments are used.

Following the proposal of the ICRP for the reduction of the dose limit for the lens of the eye, which has been adopted by the International Atomic Energy Agency and the European Council, concerns have been raised about the implementation of proper dose monitoring methods as defined in national regulations, and about the harmonisation between European countries. The European Radiation Dosimetry Group organised a survey at the end of 2017, through a web questionnaire, regarding national dose monitoring regulations. The questions were related to: double dosimetry, algorithms for the estimation of the effective dose, methodology for the determination of the equivalent dose to the lens of the eye and structure of the national dose registry. The results showed that more than 50% of the countries that responded to the survey have legal requirements about the number and the position of dosemeters used for estimation of the effective dose when radiation protection garments are used. However, in only five out of 26 countries are there nationally approved algorithms for the estimation of the effective dose. In 14 out of 26 countries there is a legal requirement to estimate the dose to the lens of the eye. All of the responding countries use some kind of national database for storing individual monitoring data but in only 12 out of 26 countries are the estimated effective dose values stored. The personal dose equivalent at depth 3 mm is stored in the registry of only seven out of 26 countries. From the survey, performed just before the implementation of the European Basic Safety Standards Directive, it is concluded that national occupational exposure frameworks require intensive and immediate work under the coordination of the competent authorities to bring them into line with the latest basic safety standards and achieve harmonisation between European countries.

THE REQUIREMENTS FOR PERSONAL MONITORING OF OCCUPATIONAL EXPOSURE: INTERNATIONAL EXPERIENCE AND UKRAINIAN REALITIES. / VYMOGY DO INDYVIDUAL'NOGO DOZYMETRYChNOGO KONTROLIu PROFESIINOGO OPROMINENNIa: SVITOVYI DOSVID TA UKRAÏNS'KI REALIÏ.

The article includes analysis and generalizations about international and national experience as well as regulatory requirements for the organization and performance of occupational monitoring for radiation exposure (category A personnel), filling of the national dose registries. It is shown that for practical reasons it is justifiable to provide universal individual monitoring of category A personnel, regardless of the expected dose of radiation. The establish ment and functioning the national dose registry should not be limited to the mechanical collection and accumulation of data of non-guaranteed quality. Instead, both a quality management program and a scientific and methodological center should become components of the dose monitoring and registration system ensuring the quality and reliability of data on occupational exposure doses. Besides the dose records, the data sets should include information about methods used, work conditions, employees' health status. Information exchange infrastructure and data protection policies should be built in accordance with national approaches under the auspices of the State Agency for E-Governance in Ukraine.

Establishment of the central radiation dose registration system for decontamination work involving radioactive fallout emitted by the Fukushima Daiichi APP accident.

With respect to radiation protection for decontamination efforts involving radioactive fallout emitted by the accident at the Fukushima Daiichi Atomic Power Plant, new regulations were established and obligated employers to monitor, record, and store of workers' dose records, and to check their past dose records at the time of employment. However, cumulative doses may not be properly maintained if a worker declares incorrect values for past doses. In response, with facilitation from the Ministry of Health, Labour and Welfare, primary contractors of decontamination works decided to establish a central dose registration system. There are four major issues in the design of the system to be resolved, included the following: primary contractors (a) do not have a legal responsibility to perform dose control for subcontractors, (b) do not have the right to control decontamination sites, (c) often organize joint ventures, and (d) correspond to a wide range of ambient dose rates. To resolve the issues, requirements of the system included the following: (a) centralize the operation of radiation passbooks, which records past doses and the results of medical examinations to each worker; (b) develop a database system that could register all dose data and accept inquiry from primary contractors; (c) establish a permanent data storage system for transferred records; and (d) provide graded type of services that are appropriate to the risk of radiation exposure. The system started its operation in December 2013 and provided dose distributions in April and July 2015. The average yearly dose in 2014 was 0.7 mSv, which increased by 0.2 mSv from 0.5 mSv in 2012 and 2013. However, no cumulative dose from 2012-2014 exceeded 20 mSv, which was far below than the dose limits (100 mSv/5 years and 50 mSv/year). Although current dose distributions of decontamination workers were within appropriate levels, careful monitoring of dose distribution is necessary for preserving the proper implementation of radiation protection prescribed in the regulations.

Outdoor Exposure to Solar Ultraviolet Radiation and Legislation in Brazil.

The total ozone column of 265 ± 11 Dobson Units in the tropical-equatorial zones and 283 ± 16 Dobson Units in the subtropics of Brazil are among the lowest on Earth, and as a result, the prevalence of skin cancer due to solar ultraviolet radiation is among the highest. Daily erythemal doses in Brazil can be over 7,500 J m. Erythemal dose rates on cloudless days of winter and summer are typically about 0.147 W m and 0.332 W m, respectively. However, radiation enhancement events yielded by clouds have been reported with erythemal dose rates of 0.486 W m. Daily doses of the diffuse component of erythemal radiation have been determined with values of 5,053 J m and diffuse erythemal dose rates of 0.312 W m. Unfortunately, Brazilians still behave in ways that lead to overexposure to the sun. The annual personal ultraviolet radiation ambient dose among Brazilian youths can be about 5.3%. Skin cancer in Brazil is prevalent, with annual rates of 31.6% (non-melanoma) and 1.0% (melanoma). Governmental and non-governmental initiatives have been taken to increase public awareness of photoprotection behaviors. Resolution #56 by the Agência Nacional de Vigilância Sanitária has banned tanning devices in Brazil. In addition, Projects of Law (PL), like PL 3730/2004, propose that the Sistema Único de Saúde should distribute sunscreen to members of the public, while PL 4027/2012 proposes that employers should provide outdoor workers with sunscreen during professional outdoor activities. Similar laws have already been passed in some municipalities. These are presented and discussed in this study.

Radiation safety during remediation of the SevRAO facilities: 10 years of regulatory experience.

In compliance with the fundamentals of the government's policy in the field of nuclear and radiation safety approved by the President of the Russian Federation, Russia has developed a national program for decommissioning of its nuclear legacy. Under this program, the State Atomic Energy Corporation 'Rosatom' is carrying out remediation of a Site for Temporary Storage of spent nuclear fuel (SNF) and radioactive waste (RW) at Andreeva Bay located in Northwest Russia. The short term plan includes implementation of the most critical stage of remediation, which involves the recovery of SNF from what have historically been poorly maintained storage facilities. SNF and RW are stored in non-standard conditions in tanks designed in some cases for other purposes. It is planned to transport recovered SNF to PA 'Mayak' in the southern Urals. This article analyses the current state of the radiation safety supervision of workers and the public in terms of the regulatory preparedness to implement effective supervision of radiation safety during radiation-hazardous operations. It presents the results of long-term radiation monitoring, which serve as informative indicators of the effectiveness of the site remediation and describes the evolving radiation situation. The state of radiation protection and health care service support for emergency preparedness is characterized by the need to further study the issues of the regulator-operator interactions to prevent and mitigate consequences of a radiological accident at the facility. Having in mind the continuing intensification of practical management activities related to SNF and RW in the whole of northwest Russia, it is reasonable to coordinate the activities of the supervision bodies within a strategic master plan. Arrangements for this master plan are discussed, including a proposed programme of actions to enhance the regulatory supervision in order to support accelerated mitigation of threats related to the nuclear legacy in the area.

European activities in radiation protection in medicine.

The recently published Council Directive 2013/59/Euratom ('new European Basic Safety Standards', EU BSS) modernises and consolidates the European radiation protection legislation by taking into account the latest scientific knowledge, technological progress and experience with implementing the current legislation and by merging five existing Directives into a single piece of legislation. The new European BSS repeal previous European legislation on which the national systems for radiation protection in medicine of the 28 European Union (EU) Member States are based, including the 96/29/Euratom 'BSS' and the 97/43/Euratom 'Medical Exposure' Directives. While most of the elements of the previous legislation have been kept, there are several legal changes that will have important influence over the regulation and practice in the field all over Europe-these include, among others: (i) strengthening the implementation of the justification principle and expanding it to medically exposed asymptomatic individuals, (ii) more attention to interventional radiology, (iii) new requirements for dose recording and reporting, (iv) increased role of the medical physics expert in imaging, (v) new set of requirements for preventing and following up on accidents and (vi) new set of requirements for procedures where radiological equipment is used on people for non-medical purposes (non-medical imaging exposure). The EU Member States have to enforce the new EU BSS before January 2018 and bring into force the laws, regulations and administrative provisions necessary to comply with it. The European Commission has certain legal obligations and powers to verify the compliance of the national measures with the EU laws and, wherever necessary, issue recommendations to, or open infringement cases against, national governments. In order to ensure timely and coordinated implementation of the new European legal requirements for radiation protection, the Commission is launching several actions including promotion and dissemination activities, exchange and discussion fora and provision of guidance. These actions will be based on previous experiences and will rely on the results of recent and ongoing EU-funded projects. Important stakeholders including the Euratom Article 31 Group, the association of the Heads of European Radiological protection Competent Authorities (HERCA) and different European professional and specialty organisations will be involved.

Modernisation and consolidation of the European radiation protection legislation: the new Euratom Basic Safety Standards Directive.

With the publication of new basic safety standards for the protection against the dangers arising from exposure to ionising radiation, foreseen in Article 2 and Article 30 of the Euratom Treaty, the European Commission modernises and consolidates the European radiation protection legislation. A revision of the Basic Safety Standards was needed in order (1) to take account of the scientific and technological progress since 1996 and (2) to consolidate the existing set of Euratom radiation protection legislation, merging five Directives and upgrading a recommendation to become legally binding. The new Directive offers in a single coherent document basics safety standards for radiation protection, which take account of the most recent advances in science and technology, cover all relevant radiation sources, including natural radiation sources, integrate protection of workers, members of the public, patients and the environment, cover all exposure situations, planned, existing, emergency, and harmonise numerical values with international standards. After the publication of the Directive in the beginning of 2014, Member States have 4 y to transpose the Directive into national legislation and to implement the requirements therein.

Regulating the path from legacy recognition, through recovery to release from regulatory control.

Past development of processes and technologies using radioactive material led to construction of many facilities worldwide. Some of these facilities were built and operated before the regulatory infrastructure was in place to ensure adequate control of radioactive material during operation and decommissioning. In other cases, controls were in place but did not meet modern standards, leading to what is now considered to have been inadequate control. Accidents and other events have occurred resulting in loss of control of radioactive material and unplanned releases to the environment. The legacy from these circumstances is that many countries have areas or facilities at which abnormal radiation conditions exist at levels that give rise to concerns about environmental and human health of potential interest to regulatory authorities. Regulation of these legacy situations is complex. This paper examines the regulatory challenges associated with such legacy management and brings forward suggestions for finding the path from: legacy recognition; implementation, as necessary, of urgent mitigation measures; development of a longer-term management strategy, through to release from regulatory control.

[Medical and hygienic aspects of instrumental supervision system over nuclear materials and radioactive substances transport on Russian Federation territory].

Hygienic evaluation of radiation situation in operation of mobile and stationery elements within a project of national system for instrumental supervision over nuclear materials and radioactive substances transport, created with a Global initiative against nuclear terrorism. Levels of exposure to ionizing radiation of the screening complexes appeared to match requirements on radiation safety for service personnel and general population.

[Regulatory supervision and radiation survey in the area of location of former military technical bases].

Activities related to the rehabilitation of areas and facilities of the temporary storage of spent nuclear fuel and radioactive waste (SNF and RW) at Andreeva Bay and Gremikha on the Kola Peninsula and in the Primorsky Krai in the Russian Far East is an important component of the regulatory functions of the Federal Medical biological Agency (FMBA of Russia). Technical support to the FMBA of Russia in this activity is provided by A.L Burnazyan Federal Medical Biophysical Center Main research interests include evaluation of radiological threats to determine the priority directions of regulation, a detailed analysis of the radiation situation at areas, territories and in vicinity of temporary waste storage facilities, radiation control and environmental monitoring, the development of digital maps and geoinformation systems, project expertise in the field of rehabilitation of PVC including the management of SNF and RW Implementation of these natural, practical and theoretical works is completed by development a set of regulatory documents ensuring adherence to radiation safety for the stuff population and the environment, and the also documents governing the management of SNF and RW waste in the territories of PVC.

Thirty-sixth Lauriston S. Taylor Lecture on radiation protection and measurements--from the field to the laboratory and back: the what ifs, wows, and who cares of radiation biology.

My scientific journey started at the University of Utah chasing fallout. It was on everything, in everything, and was distributed throughout the ecosystem. This resulted in radiation doses to humans and caused me great concern. From this concern I asked the question, "Are there health effects from these radiation doses and levels of radioactive contamination?" I have invested my scientific career trying to address this basic question. While conducting research, I got acquainted with many of the What ifs of radiation biology. The major What if in my research was, "What if we have underestimated the radiation risk for internally-deposited radioactive material?" While conducting research to address this important question, many other What ifs came up related to dose, dose rate, and dose distribution. I also encountered a large number of Wows. One of the first was when I went from conducting environmental fallout studies to research in a controlled laboratory. The activity in fallout was expressed as pCi L⁻¹, whereas it was necessary to inject laboratory animals with µCi g⁻¹ body weight to induce measurable biological changes, chromosome aberrations, and cancer. Wow! That is seven to nine orders of magnitude above the activity levels found in the environment. Other Wows have made it necessary for the field of radiation biology to make important paradigm shifts. For example, one shift involved changing from "hit theory" to total tissue responses as the result of bystander effects. Finally, Who cares? While working at U.S. Department of Energy headquarters and serving on many scientific committees, I found that science does not drive regulatory and funding decisions. Public perception and politics seem to be major driving forces. If scientific data suggested that risk had been underestimated, everyone cared. When science suggested that risk had been overestimated, no one cared. This result-dependent Who cares? was demonstrated as we tried to generate interactions by holding meetings with individuals involved in basic low-dose research, regulators, and the news media. As the scientists presented their "exciting data" that suggested that risk was overestimated, many of the regulators simply said, "We cannot use such data." The newspaper people said, "It is not possible to get such information by my editors." In spite of these difficulties, research results from basic science must be made available and considered by members of the public as well as by those that make regulatory recommendations. Public outreach of the data is critical and must continue to be a future focus to address properly the question of, "Who cares?" My journey in science, like many of yours, has been a mixture of chasing money, beatings, and the joys of unique and interesting research results. Perhaps through our experiences, we can improve research environments, funding, and use of the valuable information that is generated. Scientists that study at all levels of biological organization, from the environment to the laboratory and human epidemiology, must share expertise and data to address the What Ifs, Wows, and Who Cares of radiation biology.

[Experimental evaluation of the occupational exposure to static magnetic fields on a 3 T magnetic resonance scanner]. / Valutazione sperimentale dell'esposizione lavorativa ai compi magnetici statici prodotti da una risonanza magnetica da 3 T.

The recent postponement until 31 October 2013 of the deadline for transposition of the EU Directive 2004/40/EC, concerning the minimum health requirementsfor the exposure of workers to the risks arising from electromagnetic fields between 0 and 300 GHz, keeps on suspending the Italian law which was aimed to implement the EU regulations on the occupational exposure to electromagnetic fields, including those generated by Magnetic Resonance Imaging (MRI) units. Waiting for the revision of the exposure limits proposed by the EU Directive taking into account results from new studies and evolution of knowledge, the time-weighted values of static magnetic field proposed by the Italian Ministry of Health (D.M 02/08/91) still survive as limits for worker's exposure. The comparison between the proposed thresholds and the time required to position patients allows to calculate how long the MRI staff can stay at different values of static magnetic field, i.e. the maximum workload of each worker. In order to evaluate more accurately how many time the members of MRI staff are near the magnet bore and the real value of worker's exposure to the static magnetic field during the handling of patients, a teslameter Metrolab THM1176-PDA was used. Personal exposure measurements on the radiologists and the radiographers who worked on a 3 T GE Healthcare Discovery 750 MR were carried out during the positioning of self-sufficient and collaborative patients. The sensor was worn at the chest level on the side that was nearest to the magnet bore. Results show wide variations occurring between individual working procedures concerning the handling of patients, especially during the initial position phase. The mean values of the time spent by radiographers inside the magnet room (B > 0.5 mT) to place the patient and to take him outside at the end of the exam were respectively 220 and 127 seconds. The mean value of the time spent by radiologists was 162 seconds when they had to insert a peripheral vein access (arm) and inject contrast medium. The time fraction spent in magnetic flux density above 200 mT was near 31% for radiographers and about 7% for radiologists. The maximum of the static magnetic field recorded was 1550 mT for radiographers and 409 mT for radiologists. The measuring system has proven to be useful in evaluating the compliance with time weighted exposure limit stated by Italian law and also to find the maximum magnetic flux density to which the staff is actually exposed. This is the quantity of significance in evaluating workers' exposure following international guidelines.

Radiological protection issues arising during and after the Fukushima nuclear reactor accident.

Following the Fukushima accident, the International Commission on Radiological Protection (ICRP) convened a task group to compile lessons learned from the nuclear reactor accident at the Fukushima Daiichi nuclear power plant in Japan, with respect to the ICRP system of radiological protection. In this memorandum the members of the task group express their personal views on issues arising during and after the accident, without explicit endorsement of or approval by the ICRP. While the affected people were largely protected against radiation exposure and no one incurred a lethal dose of radiation (or a dose sufficiently large to cause radiation sickness), many radiological protection questions were raised. The following issues were identified: inferring radiation risks (and the misunderstanding of nominal risk coefficients); attributing radiation effects from low dose exposures; quantifying radiation exposure; assessing the importance of internal exposures; managing emergency crises; protecting rescuers and volunteers; responding with medical aid; justifying necessary but disruptive protective actions; transiting from an emergency to an existing situation; rehabilitating evacuated areas; restricting individual doses of members of the public; caring for infants and children; categorising public exposures due to an accident; considering pregnant women and their foetuses and embryos; monitoring public protection; dealing with 'contamination' of territories, rubble and residues and consumer products; recognising the importance of psychological consequences; and fostering the sharing of information. Relevant ICRP Recommendations were scrutinised, lessons were collected and suggestions were compiled. It was concluded that the radiological protection community has an ethical duty to learn from the lessons of Fukushima and resolve any identified challenges. Before another large accident occurs, it should be ensured that inter alia: radiation risk coefficients of potential health effects are properly interpreted; the limitations of epidemiological studies for attributing radiation effects following low exposures are understood; any confusion on protection quantities and units is resolved; the potential hazard from the intake of radionuclides into the body is elucidated; rescuers and volunteers are protected with an ad hoc system; clear recommendations on crisis management and medical care and on recovery and rehabilitation are available; recommendations on public protection levels (including infant, children and pregnant women and their expected offspring) and associated issues are consistent and understandable; updated recommendations on public monitoring policy are available; acceptable (or tolerable) 'contamination' levels are clearly stated and defined; strategies for mitigating the serious psychological consequences arising from radiological accidents are sought; and, last but not least, failures in fostering information sharing on radiological protection policy after an accident need to be addressed with recommendations to minimise such lapses in communication.

Mapping radon-prone areas using γ-radiation dose rate and geological information.

Identifying radon-prone areas is key to policies on the control of this environmental carcinogen. In the current paper, we present the methodology followed to delineate radon-prone areas in Spain. It combines information from indoor radon measurements with γ-radiation and geological maps. The advantage of the proposed approach is that it lessens the requirement for a high density of measurements by making use of commonly available information. It can be applied for an initial definition of radon-prone areas in countries committed to introducing a national radon policy or to improving existing radon maps in low population regions.

[Measurement and assessment of electromagnetic fields near radiophones in line with provisions of European Directive 2013/35/EU and Polish labour law]. / Pomiary i ocena pola elektromagnetycznego przy radiotelefonach przenosnych w kontekscie wymagan Dyrektywy Europejskiej 2013/35/UE i Polskiego prawa pracy.

BACKGROUND: The activities of rescue and uniformed services require the use of wireless communication devices, such as portable radiophones. Assessment of workers' exposure to electromagnetic fields emitted by radiophones is important in view of occupational safety and health (OSH), legislation requirements and reports on possible adverse health effects in users of devices emitting radiofrequency electromagnetic field. MATERIALS AND METHODS: In this study 50 portable radiophones of conventional and trunked communication systems were investigated. The assessment of electromagnetic hazards to users involved unperturbed electromagnetic field measurements near radiophones' antennas. RESULTS: The electric field strength corresponding to the occupational exposure level (fields of so-called safety zones established by OSH legislation in Poland) was measured at a distance of 45-65 cm from the portable radiophones antennas of conventional system and 75-95 cm from antennas of trunked system radiophones, depending on their type and mode of work. The assessment was based on the averaged results of series of measurements. The electric field strength exceeding action levels defined by Directive 2013/35/EU was found up to 15 cm from radiophone antennas of conventional system and up to 10 cm from the antennas of trunked system radiophones. CONCLUSIONS: Taking into account the range of safety zones and the use of portable radiophones near the body, their users should be classified into the group of workers occupationally exposed to electromagnetic fields. Electromagnetic field measurement results and typical conditions of using portable radiophones justify the need for additional assessment of electromagnetic hazards--the analysis of compliance with relevant exposure limit values provided by Directive 2013/35/EU.

[Radiation hygiene in interventional radiology suite]. / Higiena radiacyjna w pracowniach radiologicznych.

Exposure of both patients and medical staff to relatively high doses of radiation is one of the features characteristic of interventional radiology (IR). Regulations regarding this kind of therapeutic management can be found in many legal references and recommendations of European Union Law. The purpose of the paper is collection and systematic analysis of activities and procedures associated with the question of radiation hygiene which should be observed in IR suites. Requirements regarding equipment of the IR suite, as well as radiation protection of patients and medical staff, constitute main questions included in the paper, worked out on the basis of valid regulations and occupational experience of the authors. Particular attention is paid to borderline requirements regarding modern IR suite equipment and its organization. Part of the paper is devoted to the understanding of physical laws of ionizing radiation in biological space and its surroundings. Understanding of physical laws, proper utilization of IR suite equipment, and strict compliance with recommendations of radiation protection by both patients and medical staff are critical for limitation of the harmful influence of radiation during interventional therapeutic procedures. An additional role of the paper is to make it easier to take decisions when creating new IR suites, in accordance with valid regulations and the rule of functionality.