Abstract
A nationwide investigation was conducted in Switzerland to establish the exposure of the population by medical x rays and update the results of the 1998 survey. Both the frequency and the dose variations were studied in order to determine the change in the collective dose. The frequency study addressed 206 general practitioners (GPs), 30 hospitals, and 10 private radiology institutes. Except for the latter, the response rate was very satisfactory. The dose study relied on the assessment of the speed class of the screen-film combinations used by the GPs as well as the results of two separate studies dedicated to fluoroscopy and CT. The investigation showed that the total number of all medical x-ray examinations performed by GPs registered a 1% decrease between 1998 and 2003, and that the sensitivities of the film-screen combinations registered a shift towards higher values, leading to a reduction of the dose delivered by a GP of the order of 20%. The study indicated also that the total number of all x-ray examinations performed in hospitals increased by 4%, with a slight increase of radiographies by 1% but significant decrease of examinations involving fluoroscopy (39%), and a 70% increase for CT examinations. Concerning the doses, the investigation of a selection of examinations involving fluoroscopy showed a significant increase of the kerma-area product (KAP) per procedure. For CT the study showed an increase of the dose-length product (DLP) per procedure for skull and abdomen examinations, and a decrease for chest examination. Both changes in the frequency and the effective dose per examination led to a 20% increase in the total collective dose.
Highlights
Medical exposure to X rays represents the population’s main source of man-made irradiation
Six categories of health care providers were considered: hospitals and clinics, radiology institutes, general practitioners (GP), chiropractors, dentists using conventional radiography only and dentists equipped with a cone beam computed tomography facility
Dose data The dose data used in this study for radiography, fluoroscopy and dental radiology was derived from the various national dose surveys carried out between 2008 and 2013
Summary
Medical exposure to X rays represents the population’s main source of man-made irradiation. The last full re-evaluation surveys concerned the 1998 and 2008 data(4 – 10) and the last updating survey concerned the 2003 data[11] These surveys provided a significant amount of information on the frequency of the X-ray examinations performed in Switzerland and the associated radiation doses as well as the main trends in diagnostic and interventional radiology. They revealed, for example, the sharp increase in the use of computed tomography. The aim of this survey was to establish the population’s exposure from medical X rays in 2013
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