Radiation Protection Experts Research Articles

Radiation shielding calculation for interventional radiology: An updated workload survey using a dose monitoring software

Shielding design is an essential aspect of radiation protection. It is necessary to ensure that barriers safeguard workers, patients, the general public, and the environment from the harmful radiation emitted by X-ray machines. The National Council on Radiation Protection and Measurements (NCRP) 147 method is widely accepted within the radiation protection experts’ (RPEs) community for structural shielding design for medical X-ray imaging facilities. However, these indications are based on data collected in 1996. In recent years, interventional radiology procedures have seen significant developments. Therefore, it is important to evaluate whether updating the data on workload in the different specialities is necessary.We extracted all interventional radiology exposure data parameters from three angiographs from two vendors using dose monitoring software for 3066 procedures and 214,697 individual exposures. The workload distribution as a function of the kVp for five interventional rooms was calculated by summing all exposures and then normalising them by the number of patients.Analysing this data, we obtained new transmission curves through lead, concrete and gypsum wallboard, finding the parameters (α, β, and γ) in the Archer equation for the secondary radiation. Finally, our aim was to share an example of shielding calculations for haemodynamics and neuroangiography rooms to illustrate the impact of updated transmission data.

Synthesis of the European ALARA network 20th workshop ‘ALARA for interventional radiology and nuclear medicine’

The European as low as reasonably achievable(ALARA) network regularly organises workshops on topical issues in radiation protection (RP). The topic of the 20th workshop was: ‘ALARA for interventional radiology (IR) and nuclear medicine (NM)’. The objective was to examine the challenges faced when applying the optimisation principle (ALARA) in IR and NM and to consider how ALARA could be better implemented for patient and staff exposures. This memorandum provides a synthesis of the workshop sessions, and recommendations coming from the working groups discussion. Parallels are drawn with the recommendations arising from the 13th EAN workshop on ‘ALARA and the medical sector (2011)’ to consider how the optimisation challenges in IR and NM have evolved over the past decade. Current levels of exposure are presented along with operational practice and the challenges and opportunities for improvement, both in monitoring and practice. Whilst RP challenges remain, the application of ALARA appears more established in IR compared with experiences reported in 2011. The application of ALARA to emerging technologies in the NM setting is in need of further development to ensure that RP is considered at all stages in the development process of new radiopharmaceuticals. Besides the obvious technical and operational aspects, the importance of education and training, human factors and broadly the RP ‘culture’ were deemed fundamental to the success of the application of ALARA and where further emphasis is needed. All concerned parties, medical physics experts (MPEs), radiation protection experts, clinical staff, manufacturers and regulators have a role to play in the application of ALARA and this is discussed in the memorandum. Many of the recommendations from the 13th EAN workshop remain applicable today and overlap with the recommendations arising from the 20th workshop. This should prompt attention given that the use of IR and the development of novel radiopharmaceuticals for NM is only anticipated to increase with time.

Derivation of dose constraint for the general public around nuclear power plants with operational data of radioactive effluent releases

For radiation protection optimization, ICRP proposed dose constraint as quantitative value for planned exposure situation based on representative person concept. The objective of this study is to derive dose constraints for the general public around nuclear power plants in Korea by applying representative person concept. The dose constraints for the general public around NPPs were derived through a total of six steps. The steps consisted of setting source terms, setting exposure pathways and scenarios, setting candidate groups for a critical group decision, setting habit data, calculating radiation doses, and proposing dose constraints. Through these steps, the radiation dose distribution of the general public around the NPPs was obtained, and dose constraints were proposed using the dose distribution. Radiation doses to the general public around all the Korea NPP sites ranged 1.63 × 10−2 to 1.32 × 10−1 mSv/y. Using the dose distribution, 0.15 mSv/y, 0.10 mSv/y, and 0.08 mSv/y were proposed as dose constraints. The dose constraint values derived in this study are proposals. Therefore, it is judged that the dose constraints should need furthermore discussion with regulators, licensees, and radiation protection experts considering societal and economic factors for radiation protection. The proposal for dose constraints developed in this study can be used to optimize radiation protection for the general public around the NPPs.

The Italian young medical physicist scenario: Results from the young AIFM group survey

PurposeThe young working group of the Italian Association of Medical and Health Physics (AIFM) designed a survey to assess the current situation of the under 35 AIFM members. MethodsAn online survey including 65 questions was designed to gather personal information, educational issues, working and research experience, and to evaluate the AIFM activities. The survey was distributed to the under 35 members between November 2022 and February 2023, through the young AIFM mailing list and social media. Results160 answers from 230 affiliates (70%, 31 years median age) were obtained. The results highlighted that 87% of the respondents had a fixed term/permanent employment, mainly in public hospitals (58%).Regarding Medical Physicists (MPs) training, 54% of the students left their region of origin due to the training plan (40%) and the availability of scholarships (25%) in the chosen university. Most of the respondents have no Radiation Protection Expert title, while the remaining 20%, 6%, and 3% are qualified to the first, second, and third level, respectively.Several young MPs (62.2%) were involved in research activities; however, only 28% had teaching experience, mainly within their workplace (20%, safety courses), during AIFM courses (4%), or university lectures (3%). ConclusionsThis survey reported the current situation of the under 35 AIFM members, highlighting the “brain drain” phenomenon from the south to the north of Italy, mainly due to the lack of post-graduate schools, scholarships, and job opportunities. The obtained results will help the future working program of the AIFM.

EFOMP Malaga Declaration 2023: An updated vision on Medical Physics in Europe

In 2006, the European Federation of Organisations for Medical Physics (EFOMP) adopted the “Malaga Declaration”. The declaration asserted the fundamental role of Medical Physics professionals in the radiation protection of patients, workers, general public, carers and comforters and research participants in hospitals. However, since that time the Medical Physics profession has evolved in Europe and new regulations and documentation have been issued, such as directive 2013/59/Euratom and the “European Guidelines on Medical Physics Expert” (RP174). EFOMP has published updated core-curricula and strived towards the recognition of the profession at the European level. In view of this, an update of the original Malaga Declaration was deemed necessary, to define the future vision that will guide the actions of the Federation in the years to come. This Declaration, which has been approved by the national member organizations of EFOMP in April 2023, is much broader than the original Malaga version. This is expected considering the rapid evolution of medical device technology over the last 17 years. The Radiation Protection Expert in hospital settings should be an MPE, since the latter has the highest level of radiation protection knowledge and training. Given the passion and energy that animated the debate, which led to the updating of the Malaga Declaration, we are confident that it represents a solid basis for the development of our profession in Europe which is in consonance with the aspirations of us all.

A real-time system to report abnormal events involving staff in a nuclear medicine therapy unit.

A system for internal and voluntary reporting of abnormal events in a Nuclear Medicine Therapy Unit is described. This system is based on the Internet of Things and is composed of an application for mobile devices and a wireless network of detectors. The application is addressed to healthcare professionals and is intended to be a user-friendly tool to make the reporting procedure little laborious. The network of detectors allows for a real-time measurement of the dose distribution in the patient's room. The staff was involved in all stages, from the design of the dosimetry system and mobile application up to their final testing. Face-to-face interviews were carried out with 24 operators in different roles in the Unit (radiation protection experts, physicians, physicists, nuclear medicine technicians and nurses). The preliminary results of the interviews and the current state of development of the application and the detection network will be described.

COVID-19 pandemic impact on the Spanish radiation protection professionals

The pandemic situation, originated due to the appearance of the SARS-CoV-2 virus, changed many aspects of our lives and jobs. This health crisis also affected the day-to-day work of radiation protection experts, including the wide range of areas involved in this sector. This study aimed to evaluate the impact of this pandemic on the Spanish radiation protection experts. For that purpose, a Google Forms online survey was developed with 39 questions. The survey covered different aspects related to the work developed by the Spanish professionals, taking into account three different time periods along the pandemic situation. According to this survey, the appearance of COVID-19 modified the labour conditions and modalities of many Spanish radiation protection professionals, especially at the beginning of the pandemic. Most on-site activities were related to the health sector and the nuclear industry, other sectors were more flexible, and the workload increased for half of the surveyed participants. Many operational activities suffered delays due to the pandemic, whereas the one-month wearing period of passive personal dosimeters was extended in most cases during the first Spanish alarm state (15th March 2020 up to the 21st June 2020). Finally, difficulties faced in terms of the working area have been identified and may be useful for the future.

Role and Collaboration of Radiation Protection Experts: Summary of Discussions between the Japan Health Physics Society and the Korean Association of Radiation Protection Related to Tritiated Water

Role and Collaboration of Radiation Protection Experts: Summary of Discussions between the Japan Health Physics Society and the Korean Association of Radiation Protection Related to Tritiated Water

The three R’s of reasonable in radiological protection: relationships, rationale, and resources

Central to applying the principle of optimisation in the system of radiological protection is the evaluation of what level of radiation exposure should be considered ‘as low as reasonably achievable’ (ALARA), after taking into account the prevailing circumstances. Determining what is ‘reasonable’ is an abstract, although somewhat intuitive concept with many potential interpretations depending on both the situation and those involved, whether individuals or organisations. There are common themes in the types of considerations that need to be addressed to determine ‘reasonableness’ regardless of the exposure situation. However, despite the consistent and agreeable nature of these themes, there remains a gap in how to apply them in real situations. For example, without measurable goalposts (or a clear process for setting such goalposts) for determining what constitutes ALARA, we can find ourselves misinterpreting the optimisation process as keeping exposures ‘as low as possible’. We propose herein, by consolidating and building on existing ideas, an easily understandable and actionable ‘reasonableness’ framework. This simple, yet broadly applicable tool is intended to help radiation protection experts in the systematic, deliberative, and collaborative reflection on all of the factors that make up ‘reasonable’ before making a decision—whether it be a proposed medical treatment or clean-up of a contaminated site. Each process execution and decision itself will necessarily retain the complexity of the prevailing circumstance. The proposed ‘Rs’ of Reasonable represent Relationships (stakeholders, empathy, and trust), Rationale (contextual, technical, and ethical), and Resources (technological, financial, and time).

External doses from plated-out decay products in radon-rich enclosed spaces

In caves in the Alps, where Radon can reach concentrations of tens of or hundreds of kBq/m3, the deposition of decay products on the skin of personnel spending even short times inside may pose a radiological risk. The radiation protection expert (RPE) is confronted with evaluating on the spot, and quickly, this hazard, to take appropriate measures as needed. In the present work, estimates are proposed to assess this problem, estimates that can be used by the RPE for the needed screening to categorize the risk presented by these environments.

Simplified Approach for Preliminary Evaluation of Effective Dose Rates for Field Applications of D-T Neutron Generators

Portable neutron generators are one of the most widespread sources of fast neutrons for different applications, from activation analysis to quantitative estimation of fissile and fertile materials in radioactive waste packages. New techniques based on these devices have been developed for homeland security, e.g. neutron interrogations of packages suspected of containing substances such as explosives. When using portable generators determination of radiation protection quantities is affected by a series of boundary conditions that could differ from an experimental set-up to another, and Radiation Protection Experts cannot assess operator exposure without the aid of time-expensive Monte Carlo simulations. As it is impossible to foresee all kind of scenarios involving such applications, and time is often a critical variable, safety assessment requires faster, even if less accurate, tools for exposure evaluation. In this article experimental measurements of dose rates in a real scenario involving a D-T neutron generator are considered, to validate the Monte Carlo model developed. Consequently, it was possible to demonstrate that the calibration factor at 14 MeV for a neutron dosimeter provides conservative dose estimates and to propose a stand-alone, fast, and easy-to-use calculation tool which is usable on field by the Radiation Protection Expert without full Monte Carlo calculations.

What Can Radiation Protection Experts Contribute to the Issue of the Treated Water Stored in the Damaged Fukushima Daiichi Nuclear Power Plant?

Decommissioning efforts are underway at the reactor where the accident occurred, namely the damaged Tokyo Electric Power Company (TEPCO) Fukushima Daiichi Nuclear Power Plant (FDNPP). However, a large amount of groundwater flowing into the site has become contaminated with radioactive substances and is stored in tanks on site, which has hampered the decommissioning work. Although the inflow of groundwater has been greatly reduced through measures such as the construction of frost walls, approximately 170 m3 of water treated by the Advanced Liquid Processing System (ALPS) is being stored in tanks, each day. The tanks used to store this treated water are expected to become full by around the summer of 2022. It is not easy to get people to understand the efforts of all concerned parties, and providing clear information to these concerned parties is also a challenge. Questions have also been raised regarding whether other alternatives have been fully explored in the ALPS subcommittee. Some people have commented that the answers to the questions raised regarding the biological effects of tritium transmutation are inadequate. Some suspect that the answers are too detailed and incomprehensible, and that the respondents may be manipulating the public with some malicious intent. In any case, each possible plan presents both advantages and disadvantages, depending on the people who are involved. That makes it an ethical and vexing issue that can sway decisions, as perspectives change. While the environmental release plan is scientifically safe, it may represent a painful alternative. On the other hand, a more careful and imaginative approach to the idea of continued storage in tanks or other forms of storage may reveal some troublesome hidden disadvantages. Under these circumstances, experts must be prepared to answer people's questions in a comprehensive and robust manner.

Low-Dose Radiation Therapy (LDRT) for COVID-19: Benefits or Risks?

The limited impact of treatments for COVID-19 has stimulated several phase 1 clinical trials of whole-lung low-dose radiation therapy (LDRT; 0.3-1.5 Gy) that are now progressing to phase 2 randomized trials worldwide. This novel but unconventional use of radiation to treat COVID-19 prompted the National Cancer Institute, National Council on Radiation Protection and Measurements and National Institute of Allergy and Infectious Diseases to convene a workshop involving a diverse group of experts in radiation oncology, radiobiology, virology, immunology, radiation protection and public health policy. The workshop was held to discuss the mechanistic underpinnings, rationale, and preclinical and emerging clinical studies, and to develop a general framework for use in clinical studies. Without refuting or endorsing LDRT as a treatment for COVID-19, the purpose of the workshop and this review is to provide guidance to clinicians and researchers who plan to conduct preclinical and clinical studies, given the limited available evidence on its safety and efficacy.

Detailed study of the distribution of activation inside the magnet coils of a compact PET cyclotron

We determined the distribution of activation products inside the magnet coils of a medical cyclotron that has been operational for fifteen years. Besides FLUKA, we based our approach on new software tools (RAW and ActiWiz) developed for high-energy accelerators at CERN. A combined analysis of measurements on the coils with Monte-Carlo simulations resulted in a detailed three-dimensional radiological characterisation of the coils. Our results provide the required information for the radiation protection expert to identify the appropriate waste elimination scheme.

Hand monitoring in nuclear medicine departments in Croatia - first results

Individual hand monitoring for workers who manipulate unsealed radioactive sources in nuclear medicine is a necessity and the results can serve as the base for optimization processes. We performed an analysis of individual hand doses for medical staff preparing and applying radiopharmaceuticals (99mTc, 123I, 201Tl, 131I, or 125I) in three Croatian clinical hospitals, for a period of one year since extremity monitoring became legally mandatory in Croatia. The majority of annual hand doses for workers were below or slightly above 150 mSv per year with only a few workers exceeding the annual dose limit of 500 mSv. The analysis confirmed that the radiation protection expert's role in an individual monitoring programme and personal dosimetry is crucial in order to achieve the optimal radiation protection of workers.

Standardisation of Medical Physics training in Europe

Medical physics has done much to advance medicine. We can be proud of our collective accomplishments. The development of our profession in Europe has been driven by the regulatory requirements for radiation safety initially of staff and lately of patients. European legislation acknowledged the importance of physics in radiation protection of patients in the 1980s by requiring a “qualified expert in radiophysics” to be available to “sophisticated departments of radiotherapy and nuclear medicine”. In the 1990s the term “medical physics expert” (MPE) was introduced and the involvement of MPEs was foreseen also in “other radiological practices”. The new European Directive (59/2013) expanded the MPE’s role in patient radiation safety. It defines the roles and responsibilities of experts who should be involved in radiation protection. The role of the Radiation Protection Expert (RPE) and the Medical Physics Expert (MPE) is clearly defined. The requirements for information, training and education are also addressed in order to highlight the importance of education and training in radiation protection. According to article 14 member states must ensure the education training and retraining to allow the recognition of radiation protection experts and medical physics experts in the field. The new law which is now implemented in all Member States proves that medical physics has a lot more to offer and places our profession on a more profound ground and provides us with opportunities that we never had before. This is our big opportunity to evolve and make ourselves leaders in radiation protection within the hospital environment and beyond. In a number of European countries, binding regulations appear also on non ionizing radiation such as MRI, US and others. Artificial Intelligence and leaderships issues are also given a lot of attention. The presentation will provide the current information on education and training across Europe together with emerging challenges and opportunities.

NON-RADIOLOGICAL IMPACT OF A NUCLEAR EMERGENCY: PREPAREDNESS AND RESPONSE WITH THE FOCUS ON HEALTH.

Available experience from Chernobyl and Fukushima clearly demonstrate that nuclear emergencies may result in low and very low exposure levels, at which psychological and social effects among the affected population will dominate over the actual biological effects of ionising radiation. International protection standards and guidelines request, that both radiological and non-radiological health consequences have to be considered in preparedness and response to an actual emergency and there is a need to broaden the radiation protection system's philosophy beyond the metrics of radioactivity and radiation dose. During the past decade a number of multidisciplinary projects were set up with the aim of evaluating management options according to social, economic and ethical criteria, in addition to technical feasibility to achieve this goal. WHO and partners from the Inter-Agency Standing Committee Task Force on Mental Health and Psychosocial Support in Emergency Settings have developed a comprehensive framework and guidelines, which can be applied to any type of an emergency or disaster regardless of its origin. There is a need to include the available scientific expertise and the technical, managerial and personal resources to be considered within a similar 'decision framework' that will apply to radiation emergencies. Key areas of the required expertise needed to develop such a framework are radiation protection, medical support (especially primary care and emergency medicine, mental health support), social sciences (anthropology, psychology, ethics) and communications experts. The implementation of such a multidisciplinary concept in the operational world requires education and training well beyond the level currently available.

Main problems and suggested solutions for improving radiation protection in medicine in Ibero-American countries. Summary of an International Conference held in Madrid, 2016

During the International Conference on Radiation Protection in Medicine held in Bonn in 2012, several areas for improvement were identified, including specific actions related with justification, optimization, role of manufacturers, radiation protection education and training, strategic research, data collection on medical and occupational exposures, prevention of incidents and accidents, radiation safety culture, risk-benefit dialogue and implementation of the radiation safety standards. The outcomes of the Bonn Conference were summarized in the so-called ‘Bonn Call for Action’, identifying 10 priority actions to enhance RP in medicine. Trying to analyse the progress in the implementation of this ‘Call for Action’ in the Ibero-American region, several international organizations organized the ‘Ibero-American Conference on Radiation Protection in Medicine’ (Conferencia Iberoamericana sobre Protección Radiológica en Medicina, CIPRaM) held in Madrid, in October 2016. CIPRaM was structured in eight thematic sessions dealing with: diagnostic and dental radiology, image guided interventional radiology, nuclear medicine, radiation therapy, health authorities and radiation protection regulators, professional associations of technologists and nurses, professional associations of medical physicists and radiation protection experts, and universities and researchers in radiation protection in medicine. This paper summarizes the main results of that Conference based on the consensus achieved about main problems, solutions, and indicators to evaluate the implementation of the proposed solutions.

Critical Issues in Radiation Protection Knowledge Management for Preserving Radiation Protection Research and Development Capabilities.

As a hub of domestic radiation protection capabilities, Oak Ridge National Laboratory's Center for Radiation Protection Knowledge has a mandate to develop and actuate a formal knowledge management (KM) effort. This KM approach exceeds recruitment and training efforts but focuses on formalized strategies for knowledge transfer from outgoing subject matter experts in radiation protection to incoming generations. It is envisioned that such an effort will provide one avenue for preserving domestic capabilities to support stakeholder needs in the federal government and the nuclear industry while continuing to lead and innovate in research and development on a global scale. However, in the absence of broader coordination within the United States, preservation of radiation protection knowledge continues to be in jeopardy in the absence of a dedicated KM effort.

Lessons learnt by IRSN about the involvement of experts towards the population in contaminated areas in Fukushima Prefecture.

Since November 2011, Institut de radioprotection et de sûreté nucléaire (IRSN) experts have participated in the International Commission on Radiological Protection's (ICRP) dialogue initiative for the rehabilitation of living conditions after the Fukushima accident. In 2013, IRSN and Centre d'étude sur l'Evaluation de la Protection dans le domaine Nucléaire (CEPN) launched a study to identify the main lessons that can be learned from these dialogues, and benefit French IRSN experts in the event of a postaccident situation. The main lesson is that in order to protect the inhabitants of contaminated areas efficiently, experts must work in cooperation with local actors to develop a co-expertise process. The availability of measurement devices for inhabitants is crucial to allow them to assess their own radiological situation. Measuring radioactivity makes it visible, and allows individuals to discuss the results in their communities and develop local projects to improve their daily life. Eventually, inhabitants create a practical radiological protection culture to manage their situation. However, helping people to protect themselves does not mean that authorities and experts have no responsibilities, and this calls for strong ethical principles such as not making decisions for people about their future. To be helpful, scientists need to understand that, as necessary as radiation protection is, it is not the only problem that inhabitants are facing and it cannot control people's lives. Radiation protection experts must commit themselves to be at the service of individuals and the community, and the issues they want to address.