Many areas of human activity use radioactive sources; this is particularly the case with diagnostic and therapeutic activities. This activity may lead to the production of radioactive waste and effluent.

Sealed sources are mainly used for radiotherapy (telegammatherapy and brachytherapy) and for measurement. Given their characteristics (usually radionuclides with periods of several years and high activity levels) these sources must be recovered by their supplier once they are no longer needed, or by their manufacturer in the event of defaulting by the supplier. Decree 2002-460 of 4 April 2002 reinforced the sealed source recovery requirements previously adopted by the CIREA. These sealed sources are not likely to produce radioactive effluent in normal conditions of use and storage.

The use of unsealed sources in nuclear medicine, biomedical and industrial research is the reason for production of radioactive solid waste and liquid effluent: small laboratory equipment items used to prepare sources (tubes, gloves, etc.), medical equipment used for administration (syringes, needles, cotton swabs, compresses which could be soiled with biological products, etc.), remains of meals consumed by patients who had received diagnostic or therapeutic doses, and so on. The radioactive liquid effluents also come from source preparation (liquid radioactive residues, contaminated material rinsing water, scintillating products used to count certain radionuclides, and so on), as well as from the patients who naturally eliminate the radioactivity administered to them.

To the radioactive risk can be added the chemical and infectious risks, in particular in the biomedical field. The infectious risk is due to pathogens (viruses, bacteria, parasites) contained in certain waste and effluent produced by the health care activities. If this risk is to be controlled, then specific handling rules must be followed and appropriate packaging used, failing otherwise it nosocomial diseases (secondary infections contracted in the health care establishments) are possible.

Faced with this problem of health care waste contaminated by radionuclides, which appeared with the growth of nuclear medicine, the public authorities have initiated a process of supervision of the activities and information of both patients and practitioners concerning good practices to be observed in managing this waste. First, a circular from the Minister for Health (2007/323 of 9 July 2001) therefore clarified the provision of the 30 November 1981 order on the conditions for the use of artificial radionuclides used in unsealed sources for medical purposes. This circular established recommendations for management and disposal of hospital radioactive effluent. Since then, the Ministry for the Environment (DPPR) in 2003 sent the managers of landfills and incineration plants recommendations stating what to do if the alarms are triggered on the radioactivity detection gates now installed in all such installations. The Minister for Health issued a new article on 21 January 2004 instructing nuclear medicine practitioners to advise their patients returning home on how to properly dispose of any radioactive waste they may produce. After publication of this ministerial order, a working group was set up to harmonise practices and accompany the dissemination of these new measures.

The disposal of radioactive effluent and waste produced when handling radioactive sources must comply with the provisions of point 1.2 of this chapter, in particular circular 2001/323 of 9 July 2001.

An order concerning waste and effluent produced outside BNIs must be issued to implement article R 1333-12 of the Public Health Code. A working group coordinated by the ASN was set up in September 2004 to make a particularly close review of how the infectious and radioactive risk is dealt with in waste and effluent management, as well as of the regulatory requirements to be established. This working group comprises representatives from the health authorities (DGS, DDASS), from public health and research institutions (Paris public hospitals, Paris municipal hygiene laboratory, INSERM, etc.) and private pharmaceutical laboratories.