Radiation accidents in X-ray and radionuclide diagnostics and therapy: comparison of Russian and international approaches to the terminology and classification

Abstract

Introduction of new methods of nuclear medicine, X-ray diagnostics and therapy using medical sources of ionizing radiation inevitably leads to an increase in the number and types of accidents (abnormal situations). In international practice in recent years, special attention has been paid to the prevention of radiation accidents and incidents from medical exposure. The main focus is put on accidental exposure (overexposure) of patients in X-ray and radionuclide diagnostics and therapy. These approaches are implemented in Russian regulatory and methodological documents in a limited and formal way. The main attention is paid to large-scale technogenic radiation accidents, and accidents (abnormal situations) from medical irradiation are undeservedly ignored. The aim of the work was to analyze the terminology and classification of radiation accidents and incidents from medical exposure in the Russian Federation and foreign countries to develop proposals to improve approaches to their classification within the framework of revision of existing regulatory and methodological documents. The results of the work indicate that it is necessary to actualize Russian approaches to the definition and classification of radiation accidents in medicine considering the specifics of medical exposure. For this purpose, it is advisable to introduce different levels of accidents (abnormal situations), differing from each other by the scale of impact and consequences for patients, workers and public. Considering the absence of elaborated scenarios of accidents (abnormal situations) in Russian regulatory and methodological documents, such gradation can be borrowed from international regulatory documents provided that it is adapted to the specifics and realities of the Russian health care system