Basic Safety Standards Research Articles

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

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. 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. 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. 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.

Radionuclides distribution and radiation hazards assessment of black sand separation plant’s minerals: a case study

This study assessed the radioactivity levels and associated risks in the black sand-separated products obtained from the black sand separation plant in Delta, Egypt. A total of sixteen samples were taken from hot spots during and after the separation process. These include water samples and other samples that represent monazite, rutile, zircon, granite, ilmenite, and silica products. The hot spots included the area where the ore was stored. The activity concentrations of 232Th\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$^{232}Th$$\\end{document}, 226Ra\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$^{226}Ra$$\\end{document}, and 40K\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$^{40}K$$\\end{document} were determined in these samples using a p-type HPGe detector. Based on gamma spectrometric analysis, samples of rutile, zircon, and monazite had the highest amounts of radioactivity because they contained the highest NORM’s activity concentrations. In addition, it indicated that the radiological hazard indices of the collected samples were higher than the average world limits for sand texture. These findings suggest that the black sand separation process reveals potential risks to human health and the environment, and therefore, appropriate measures need to be taken to mitigate these risks, especially for the safety of the workers on-site. Reducing the risk associated with those sites should be controlled by implementing the recommendations declared for the series of International Basic Safety Standards of the International Atomic Energy Agency (GSR) Part 3, as affirmed in Document No. 103 of 2007 by the International Commission on Radiological Protection (ICRP) as will be presented in the paper body.

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.

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.

Organizational Health Literacy as a supportive tool for the effective implementation of the 2013/59/EURATOM Directive in Italy.

Since 2013, European countries have transposed the 2013/59/EURATOM Directive that lays down basic safety standards for protection against dangers arising from exposure to ionising radiation. In the years between the issuance of the European Directive and its formal transposition, Italian researchers investigated solutions to renew the technological, educational, and organizational culture in radiology departments. This article proposed a reflection on the contribution of Organizational Health Literacy (OHL) to implement Legislative Decree 101/2020 in the practice of Italian radiology departments. By implementing OHL principles, examinations with exposure to ionizing radiation and related informative processes could be personalized based on patients' knowledge, abilities, and competencies, as well as on the services' provision. These principles can be in fact integrated with the organizational, training, and management requirements set by the Directive. According with the state-of-the-art, decision-makers and health managers could support the application of OHL principles in Italian radiology departments.

Mechanisms of Diffusion of Radon in Buildings and Mitigation Techniques

Radon is a naturally occurring radioactive gas found in rocks, soil, and building materials. Precisely because of its gaseous nature, it tends to concentrate in indoor environments, resulting in a danger to human health. The effects of radon have been described, documented, and attested by the international scientific community and recognized as the second cause of lung cancer after cigarette smoking and in synergy with it. In December 2013, the Council of the European Union issued Council Directive 2013/59/Euratom, which establishes basic safety standards relating to protection against the dangers deriving from exposure to ionized radiation and managing the health risks associated with radon. In addition, designing buildings against radon risk in synergy with the use of low environmental impact materials is one of the objectives of building sustainability certifications. This work presents how radon creeps into buildings and reports several technologies that are needed to remove and mitigate the risk associated with indoor radon in existing and new buildings.

IMPACT OF LEGISLATIVE CHANGE ON THE CLASSIFICATION OF RAW MATERIALS AND BUILDING MATERIALS IN TERMS OF NATURAL RADIOACTIVITY

Natural radioactivity is present in the human environment to a greater or lesser extent, also in varioustypes of raw or building materials. Monitoring of the concentration of natural radioactive isotopesof potassium 40K, radium 226Ra and thorium 228Th or 232Th in samples of raw and/or constructionmaterials allows assessing the exposure of people to ionizing radiation emitted by these materials.Exceeding the limit value of the radioactive concentration index for raw and/or building materials,defined in the Ordinance of the Council of Ministers (Polish Journal of Laws/Dz.U. No. 33/2021),may result in an effective radiation dose greater than 1 mSv/year – the dose limit for the population.In Poland, pertinent legislation requiring the establishing of the natural radioactivity of raw and/orbuilding materials dates back to the 1970s and has been changed several times by now. However, themost significant changes in the legislation have occurred recently. Due to the obligation of imposingthe application of the provisions of the of European Council 2013/59/EURATOM of 5 December2013 laying down basic safety standards for protection against risks arising from exposure to theeffects of ionizing and repealing Directives 89/618/Euratom, 90/641/ Euratom, 96/29/Euratom,97/43/Euratom and 2003/122/Euratom (the so-called BSS version), it was necessary to adopt theamendment to the Atomic Law. The implementation of the BSS Directive in Poland was issued on thebasis of the resolution of the Parliament of June 13, 2019 amending the Atomic Law Act and the FireProtection Act (Polish Journal of Laws/Dz.U. 2019, item 1593). The amendment of the Atomic LawActs led to the harmonisation of regulations on radioactivity in raw and building materials betweenPoland and the Member States. This article presents the impact of an amendment of the AtomicLaw and of the accompanying normative acts on the studies of the natural radioactivity of raw andconstruction materials, using the example of an analysis of the concentration of natural radioactiveisotopes present in the coal combustion products (CCP), i.e. fly ash, slags and ash-slag mixtures.

The failure of Euratom to harmonize the EU nuclear safety and environmental regulation. Can a recent ECJ judgment become a breakthrough, beneficial for EU’s quest for a sustainable, renewable-driver future?

The Treaty Establishing the European Atomic Energy Community (known as the Euratom Treaty), which was signed on 25 March 1957, contained commitments to promote nuclear energy technology and to integrate financial and technical efforts to develop that technology in the six signatory countries, in order to enhance wealth creation and the wellbeing of their citizens. The 66 year history of the Euratom Treaty undoubtedly shows that it didn’t fulfil its promises and worse, it became completely obsolete in the light of the European integration efforts contained in the Treaty on the Functioning of the European Union (TFEU). This article examines its fundamental shortcomings, whereby national interests in nuclear energy were at the forefront and whereby the harmonization of Nuclear Safety Standards and the protection of the environment and the health of the EU citizens became secondary, when confronted with industrial interests and the promotion of nuclear technologies (promotion which still continues for an industrial nuclear sector which is fully mature). This provoked a painful discord between nuclear counties and non-nuclear EU Member States, still the Achilles’ heel of Euratom as can be concluded from the discussion regarding nuclear energy as part of the EU Green Taxonomy. Euratom can be seen as the flagship of the pro-nuclear countries, albeit that the content of the Treaty is obsolete, as will be explained below from a legal angle. Because the EU Commission is the executive body of the Euratom Community, it is to blame for the failure to harmonize the safety standards as foreseen in the Euratom Treaty and for the unwillingness to integrate the EU legal environmental principles into nuclear law. It will be argued that the Nuclear Basic Safety Standards, as foreseen by the Euratom Treaty and the secondary Euratom Directives, are ‘empty shells’ and should no longer stand in isolation from the EU environmental acquis. The Justification and the ALARA principles should be informed by the Precautionary Principle and the Polluter Pays Principle. This entails that with the risks of global warming (such as heat waves, floodings, cooling water, wildfires, terrorism etc.) and the many caveats on nuclear decommissioning and disposal of high-level nuclear waste, the equation between the advantages of nuclear power (e.g., minor CO2 emissions) and its major risks should be reconsidered, not leaving this justification process to the nuclear industry, as in Belgium. The EU national governments should undertake this justification process at every stage of their political decisions regarding nuclear energy (e.g., life time extension), in full transparency and giving access to justice, as foreseen in the AARHUS Convention. A specialized EU Nuclear Safety Agency should receive a mandate by the EU Commission to harmonize such a justification process in the EU Member States and to harmonize the Nuclear Basic Safety Standards. The elementary decisions on the future of (nuclear) energy should be taken in a democratic way and not based on the promotional Euratom Treaty, in the light of the EU Green Deal and the energy transition towards renewable energy sources.

Generic justification of medical exposure to ionising radiations in two European countries

Abstract The European Directive 2013/56/EURATOM aims to safeguard patients, members of the public and workers by setting out basic safety standards for protection against the dangers arising from exposure to ionising radiation. However, each European member state must consider how the Directive should be transposed at a national level and this has led to different organisational models being adopted. With regard to medical exposure to ionising radiation (MEIR), Ireland and Italy are interesting countries to compare because they have transposed the Directive in contrasting ways. Comparison of these models may highlight ways to harmonise approaches and improve efficiency. Case studies were prepared by reviewing national laws, analysing scientific documents and conducting interviews with managers of organisations assigned the responsibility for MEIR. The case studies focused on the generic justification (GJ) of MEIR, determining if the benefits of a radiological practice outweigh the risks, at a population level. Ireland implemented a centralised model by designating responsibility for the regulation of MEIR to an independent competent authority, the Health Information and Quality Authority (HIQA). The Health Technology Assessment Directorate in HIQA has built upon their experience in conducting evidence synthesis to inform health policy, but it may experience challenges as the single gateway for GJ decisions. In Italy, GJ is entrusted to national professional scientific radiological societies. The decentralised Italian model facilitates an immediate response to GJ applications from stakeholders, but the absence of strong national coordination may lead to duplication, loss of information and or partial knowledge of processes. Collaboration between European member states in the area of GJ of MEIR could support the standardisation of practices in Europe. This could be facilitated through the creation of a European working group. Key messages • The creation of a European working group focused on generic justification in radiation protection exposure is advocated. • A European working group would lead to less duplication of effort and a more streamlined process for generic justification.

Applicability of 'Toolkit for Safety Assessment' tool to interventional radiology using probabilistic risk assessment techniques.

Interventional radiology brings extensive benefits to patients. Nevertheless, certain procedures may result in high doses of radiation, leading to health risks to occupationally exposed individuals (OEIs). Therefore, a more comprehensive risk analysis is essential to ensuring safety and minimising radiation exposures for all OEIs. The Toolkit for Safety Assessment (TOKSA) tool performs risk assessments based on the concepts described in 'General Safety Requirements' Part 3 (Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards) and Part 4 (Safety Assessment for Facilities and Activities). This tool was developed based on the 'Ibero-American Forum of Radiological and Nuclear Regulatory Agencies' risk models and can promote the use of the risk assessment processes by OEIs. The aim of this study was to experimentally analyse the applicability of the TOKSA tool in interventional radiology with the use/support of probabilistic risk assessment techniques. The results were used to reduce the risks associated with a hemodynamics room in a hospital in Belo Horizonte, Brazil.

Assessment of dose rates to non-human biota from radioactive discharges from Sellafield Ltd. using PC-CREAM

PC-CREAM is a tool for assessing the radiological impact of routine discharges of radionuclides to the environment. It can be used for prospective assessments, to calculate doses to members of the public for authorisation of proposed discharges, or for retrospective assessments of previous discharges where doses are compared with dose limits. These types of assessment are a fundamental requirement of regulations governing the control of radioactive discharges. However, the latest publications of the basic safety standards for radiation protection, EU (Council of the European Union, 2014) and the IAEA (IAEA, 2014), now include the requirement to demonstrate protection of the environment as well as members of the public. To this end, a module has been added to PC-CREAM for calculating dose rates to non-human biota (Anderson et al., 2022). The methodology used for this calculation is based on the recommendations contained in ICRP Publication 108 (ICRP, 2008), which provides a general framework for protection of the environment. The additional module means that PC-CREAM can be used to assess doses to humans and dose rates to biota in an integrated way, for the same set of discharges and using the same dispersion models. This paper describes an assessment of dose rates to biota living in the vicinity of the Sellafield nuclear site, carried out using the new biota module of PC-CREAM. Historical discharges from Sellafield to the sea and atmosphere were considered for the period 1951 to 2017, excluding those from the Windscale fire in 1957. Dose rates calculated for marine biota (flatfish, crabs and brown seaweed) are less than 1 mGy d−1 and are below the lower derived consideration reference level (DCRL) for the ICRP marine reference animals and plants (RAPs). Dose rates for terrestrial biota (bees, deer, earthworms, frogs, wild grass, pine trees and rats) are less than the relevant lower DCRL for terrestrial RAPs, ie 0.1 mGy d−1. Dose rates were also calculated for a user defined organism ‘seabird’ to represent birds which inhabit both marine and terrestrial environments near Sellafield. For seabird, the lower DCRL of 0.1 mGy d−1 is exceeded throughout the 1950s, 1960s and 1970s, when the discharges were at their highest, due to exposures from the marine environment. Since the mid-1980s, no dose rates were calculated that exceeded the lower DCRLs.

The New Conception of Radiological Sustainability Possibilities by Reutilization of Residues Products and Building Materials

The concept of radiological sustainability has been reviewed using the possibility of the reutilization of NORMs regarding the 2050 sustainable development concepts. This study is reviewing the capability of re-production of NORM residues based on their properties and the applicable treatment before reutilization. Linking the waste producers and construction materials industry as mineral end-users could contribute to the creation of industrial symbiosis and result in waste reduction and preserving natural resources on one hand, and CO2 reducing and energy saving on the other hand. According to EU-BSS (European Basic Safety Standards Directive), the characterization of NORMs as a secondary raw material for use as construction materials is necessary, however as an additive or secondary material their radiological behavior and material properties are quite important regardless of their origin. This is to say that the reutilization of NORM residues provides a better financial and environmental solution while reducing possible radiological effects on humans. NORM residue or waste could become a high material resource for the cement industry. In this regard, the assessment of radium equivalents (Raeq) and external and internal indexes (I-indexes) are useful tools to classify NORM residues before their inclusion in building products. This assessment and/or indexes reflect the risk of external exposure much better than the specific activity concentration of Ra-226, Th-232 and K-40. Equally, building material properties such as density and thickness should be taken into consideration when designing building materials that contain NORM residue. Furthermore, mixtures or additives of NORM residues are proven to result in the reduction of activity concentration in the raw residue with other raw materials, and this offers flexible reuse options depending on the final product. By integrating radiological considerations into sustainable development initiatives, we can work towards a safer, healthier and more sustainable future.

European radon abatement policy: state and ongoing discussion

Radon is a hazardous air pollutant which can cause detriment to individuals and to the society. Thus, the natural consequence is avoiding it or in practice, limiting exposure. This has led to regulation on national and international level whose objective is reduction of radon exposure. In Europe, the Basic Safety Standards (BSS) issued in 2013, whose implementation is mandatory for EU Member States, caused a boost to efforts towards radon regulation as well as to radon research since a number of components of radon abatement policy appeared not resolved sufficiently reliable in the sense of quality assurance. In this contribution, we present the state of implementation of EURATOM Basic Safety Standards in Europe and in Germany, as a particular example. We also address a number of topics currently discussed.

Clinical audit in European radiology: current status and recommendations for improvement endorsed by the European Society of Radiology (ESR)

Clinical audit is an important quality improvement activity and has significant benefits for patients in terms of enhanced care, safety, experience and outcomes. Clinical audit in support of radiation protection is mandated within the European Council Basic Safety Standards Directive (BSSD), 2013/59/Euratom. The European Society of Radiology (ESR) has recognised clinical audit as an area of particular importance in the delivery of safe and effective health care. The ESR, alongside other European organisations and professional bodies, has developed a range of clinical audit-related initiatives to support European radiology departments in developing a clinical audit infrastructure and fulfilling their legal obligations. However, work by the European Commission, the ESR and other agencies has demonstrated a persisting variability in clinical audit uptake and implementation across Europe and a lack of awareness of the BSSD clinical audit requirements. In recognition of these findings, the European Commission supported the QuADRANT project, led by the ESR and in partnership with ESTRO (European Association of Radiotherapy and Oncology) and EANM (European Association of Nuclear Medicine). QuADRANT was a 30-month project which completed in Summer 2022, aiming to provide an overview of the status of European clinical audit and identifying barriers and challenges to clinical audit uptake and implementation. This paper summarises the current position of European radiological clinical audit and considers the barriers and challenges that exist. Reference is made to the QuADRANT project, and a range of potential solutions are suggested to enhance radiological clinical audit across Europe.

Occupational Exposure to Welding Fumes and Associated Respiratory Morbidities among arc Welders in Ikenne, Nigeria.

Few studies have been conducted on the respiratory morbidities of welders in Nigeria, and further research is needed to determine the extent of fume exposure and the implicated metals at workplaces. This study was done to determine whether welding gases are associated with respiratory illness among welders in Ikenne Local Government Area, Ogun State, Nigeria. A cross-sectional study comparing 142 welders and 142 controls was carried out. Lung function testing and clinical assessments were done. The Chi-square test & the independent T-tests were used to test for the association between socio-demographic characteristics and respiratory symptoms & the association between differences in means of lung function parameters among welders and controls respectively. Chromium, nickel, manganese, carbon monoxide, and nitrogen dioxide levels were higher than the recommended values. Forced expiratory volume in the first second (FEV1) was significantly lower in welders (2.62±0.7) than in controls (2.81±0.7) (t=2.148, p<0.05). FEV1/FVC was significantly lower among welders (75±13.7) compared to controls (80.7±8.0). (t=4.165, p<0.001). The study showed that the welders presented with more respiratory morbidities than the controls, this may be a result of exposure to high levels of welding fumes beyond the recommended values for prolonged periods without using personal protective equipment, which results in significant morbidities. There should be enforcement of basic workplace safety standards by ensuring that the use of personal protective equipment (PPE) is enforced and the construction of workshops that are well-ventilated through the welders' association and relevant law enforcement agencies.

The first indoor radon mapping in the Campania region, Italy

ABSTRACT For the first time, a map of the 222Rn gas has been produced in the Campania region, the southern part of Italy, based on the activity concentration measured in indoor environments. This work is part of the radon mitigation policy and complies with the recent Italian Legislative Decree 101/2020, which implements the European Basic Safety Standards, Euratom Directive 59/2013, where Member States must declare areas with elevated levels of indoor radon concentration. The obtained map, divided by Campania municipalities, identifies priority areas with activity concentration values exceeding the reference level of 300 Bq m–3. In addition, an effective statistical analysis of the dataset has been carried out.

Measurements and computational fluid dynamics investigation of the indoor radon distribution in a typical naturally ventilated room

Based on the European Union Basic Safety Standards to protect people against exposure to ionizing radiation, establishing and addressing the reference levels for indoor radon concentrations is necessary. Therefore, the indoor radon concentration should be monitored and control in dwelling and workplaces. However, proper ventilation and sustainability are the major factors that influence how healthy the environment in a building is for its occupants. In this paper, the indoor radon distribution in a typical naturally ventilated room under two scenarios (when the door is closed and open) using the computational fluid dynamics (CFD) technique was studied. The CFD code ANSYS Fluent 2020 R1 based on the finite volume method was employed before the simulation results were compared with analytical calculations as well as passive and active measurements. The average radon concentration from the CFD simulation was found to be between 70.21 and 66.25 Bq m−3 under closed and open-door conditions, respectively, at the desired ventilation rate of 1 ACH (Air Changes per Hour). Moreover, the highest concentrations of radon were measured close to the floor and the lowest values were recorded near to the inlet, resulting in the airflow velocity profile. The simulation results were in good agreement with the maxima of 19% and 7% compared to analytical calculations at different indoor air velocities in the open- and closed-door scenarios, respectively. The measured radon concentrations obtained by the active measurements also fitted well with the CFD results, for example, with a relative standard deviation of around 7% and 2% when measured by AlphaGUARD and RAD7 monitors at a height of 1.0 m above the ground in the open-door scenario. From the simulation results, the effective dose received by an individual from the indoor air of the workplace was also calculated.

Radiation safety of current European practices of therapeutic nuclear medicine: survey results from 20 HERCA countries

The purpose of this study was to acquire up-to-date information on nuclear medicine treatments in Europe and on the implementation of the requirements of the Basic Safety Standards Directive in HERCA Heads of the European Radiological Protection Competent Authorities (HERCAs) member states. An electronic survey was distributed to competent authorities of 32 HERCA member states. The questionnaire addressed 33 explicitly considered treatments using 13 different radionuclides, and for each treatment, a similar set of questions was included. Questions covered the use of treatments, hospitalisation of patients and radioactive waste management related to therapeutic nuclear medicine involving other radionuclides than the well-known 131I. The survey also covered justification of treatments, individual treatment planning, involvement of a medical physics expert (MPE) and radiation protection instructions given to the patient at the time of release. Responses were obtained from 20 HERCA countries. All of these countries used Na[131I]I for benign thyroid diseases and thyroid ablation of adults. 223RaCl2 (Xofigo®) for bone metastases, 177Lu-somatostatin analogues for neuroendocrine tumours and 177Lu-labelled PSMA for castration resistant prostate cancer (PC) and PC-metastases were used in 90%, 65% and 55% of countries, respectively. Only a few countries had specific criteria for hospitalisation and waste management for new therapeutic nuclear medicine. Regulatory requirements for justification of new therapeutic nuclear medicine were in place in almost all countries. Individual treatment planning was required for all therapies in 55% and for some therapies in 28% of the responding countries. Implementation of the requirement for MPEs to be closely involved in nuclear medicine practices varied to a great extend among countries. Almost all responding countries answered that some radiation protection instructions existed for patients released after treatment with radionuclides other than 131I treatment, however only few countries had developed specific guidelines in the field.

Regulating through disclosure: the case of food hygiene barometer ratings in China

This paper provides the first assessment of China’s twenty-year experiment with food hygiene barometer rating systems, originally developed in the West for publicly communicating the grades awarded by food safety inspectors to individual businesses. This approach to regulating through disclosure is often celebrated for efficiently ‘nudging’ improved business compliance by empowering consumers to make ‘better’ decisions, but little is known about disclosure-based regulation in China or other low- and middle-income countries. Combining policy document and quantitative social media analysis with key informant interviews (n = 35), we show that barometers have failed to improve hygiene in China’s rapidly expanding private food sector: more than 75% of restaurants in four diverse case-study localities remain merely ‘Adequate’ with many of those unable in practice to meet basic safety standards. This is because regulatory implementation has been hesitant and unreliable; consumers ignore or distrust barometers; and food businesses lack the capacity and competitive incentive to improve. That failure to empower consumer sovereignty and leverage business behaviour change, however, also reflects how barometers – despite their liberal individualist conceit - were adapted to China’s revolutionary ‘mass line’ traditions of societal supervision of government regulators as much as food businesses. We conclude that barometers – far from being a ‘light-touch’ alternative to command-and-control regulation- require significant governance capacity, which may be lacking in low- and middle-income countries that struggle to conduct even basic regulatory oversight. Disclosure-based regulation also requires high levels of economic development, formalisation and trust to inculcate consumer and business responsiveness to information disclosures. Finally, our paper contributes to debates about risk communication and regulation by drawing the novel conclusion that the conceits underpinning seemingly universal tools of regulating through disclosure, get adapted to national state traditions and norms in ways that are far removed from their origins.

Substantiation of a new approach to the criteria for assessing the radiation dose of patients during computed tomography

BACKGROUND: In accordance with the requirements of the IAEA basic safety standards and the International Commission on Radiation Protection, comparing the radiation dose for patients undergoing computed tomography (CT) in diagnostic and treatment clinics with national or international DRLs is important for controlling medical radiation doses. The search for ways to improve DRLs calculations determines the relevance of such studies.&#x0D; AIM: To analyze the dependence of effective doses (EDs) in CT of different body parts on patients weight and to calculate the standard ED for the patient (70 and 80 kg).&#x0D; MATERIALS AND METHODS: CT acquisition protocols in 209 patients were single phase (SP) CT, while 114 patients underwent multi-phase (MP) CT. ED was calculated according to the normalized coefficients for each body area. The values of standard ED was calculated by data approximation using linear function of ED relatively body weight for each type CT scanner and body area scanned.&#x0D; RESULTS: The increase in ED following a CT examination was proportional to the body weight of patients. For SP and MP CT scans, the standard EDs were calculated according to all body areas. The mean ED, median ED, and DRLs (mSv) in these groups was slightly higher than standard ED (mSv) if the criterion was 70 kg and were close to standard ED if the criterion was 80 kg. These values give a basis for improving the guidelines concerning the recommended limits of radiation doses for CT in individual patients according to indications and body parts studied.&#x0D; CONCLUSIONS: In the study, a methodology for assessing and comparing the dose of CT-radiation at two hospitals in the two CT scanners, considering weight of a standard patient, is described. Our results show that the calculation and analysis of the standard ED of CT-examining areas of the body instead of mean ED and median ED help to compare the radiation exposure in different medical facilities more properly. Given the recent sharp increase in the number of CT studies, not exceeding the standard ED for patients with CT will reduce the long-term consequences in the form of oncological pathology among the population.

WEO Newsletter.

WEO Newsletter.