ASN Report 2017

217 ASN report on the state of nuclear safety and radiation protection in France in 2017 Chapter 08  - Regional overview of nuclear safety and radiation protection BRETAGNE In August 2017, ASN issued a resolution making the taking of samples from the reactor block subject to prior ASN consent. ASN is also examining the periodic safety review guidance file. Lastly, EDF will transmit a new complete decommissioning file in July 2018. 1.2 Radiation protection in the medical field External-beam radiotherapy Three external-beam radiotherapy accelerator replacements were registered for Bretagne in 2017. The change in equipment is accompanied by the development of new techniques (primarily stereotaxy) which lead to new risks. Three of the eight external-beam radiotherapy centres in Bretagne were inspected in 2017. Risk management and the implementation of new treatment techniques were verified in depth. Following a phase of consolidation of the quality approach, the inspections in 2017 confirm that the sites are now all resolutely engaged in a phase of quality management and continuous improvement. Although the “quality” objectives are regularly updated by the centres’ respective governing bodies, their monitoring and assessment can still be improved in some cases. The risks induced by the new techniques are integrated in the a priori risk analysis with the putting in place of new requirements or defence barriers. However, deadlines and the people responsible for their implementation are not always specified. The organisation for detecting and analysing adverse events is effective on the whole and contributes to the development of the risk analysis. A total of 12 significant patient radiation protection events were notified to ASN in 2017, and 4 of them were rated level 4 on the ASN-SFRO scale. After analysing the events, improvement measures have been implemented but their effectiveness is still insufficiently assessed in some centres. Lastly, despite the efforts made over the last few years to recruit medical physicists, dosimetrists and physical measurement technicians enabling all the centres to comply with the skills presence requirements during treatment time slots, most of the centres should define their medical physics needs more precisely. Interventional practices Oversight of interventional practices has figured among the priority objectives of the Nantes division since 2014 1 . Despite the effort made over the last few years in the number of inspections and their prioritisation, the division has not yet inspected each centre at least once, emphasis having been placed on monitoring the sites presenting the most serious radiation protection implications. However, to raise radiation protection awareness within the centres and to reinforce the prioritisation approach, a survey was carried out in 2017 with the centres that had never been inspected and with a few centres that have a very low level of activity in this area 1 . 62 inspections carried out in the Bretagne – Pays de la Loire regions in the 2014-2017 period, out of a total of 77 centres (82 sites). but whose practices nevertheless were considered to merit monitoring in view of the findings of the first inspection. This initiative moreover allowed the volume of activity of these centres to be updated and the two sites which in the first survey had declared they did not carry out fluoroscopy-guided interventional procedures to be identified. This instrument was also used to refine the targeting of the inspections on the 2018 schedule. In 2017, ASN inspected 3 of the 37 institutions identified by the division. Among these inspected institutions, the Brest University Hospital has made steady progress over the years, underpinned in particular by the strong involvement of the various professionals, including within the medical community, thanks to which the professional practices audits have more specifically allowed an objective review of the deviations detected by ASN and the implementation of appropriate measures to correct them. This being said, the findings for the institution inspected for the first time in 2017 – relatively similar to the findings for first-time inspected institutions in previous years – reveal considerable room for improvement in worker and patient radiation protection. For the third institution inspected in 2017, closer monitoring shall be implemented in view of the little progress observed with regard to the serious radiation protection implications associated with intensive cardiology- related activities. Nuclear medicine Two inspections were carried out in 2017 before new facilities started operating, due in one case to the addition of a Positron Emission Tomography (PET) scanner, and in the other to the relocating of a PET unit in new premises. The number of significant radiation protection event notifications remains relatively stable (up from 3 events in 2016 to 4 in 2017). Computed Tomography Two centres were inspected in 2017. The inspections focused more particularly on patient radiation protection, which is implemented satisfactorily in these centres. The personnel concerned are correctly trained, the facility quality controls have been carried out and patient dose optimisation protocols have been established. The medical monitoring of workers, the coordination of the resources of private practitioners and outside companies and the periodic refreshing of occupational radiation protection training, still constitute the three areas for improvement in occupational radiation protection. 1.3 Radiation protection in the industrial sector Industrial radiography ASNcarried out 4 inspections concerning industrial radiography in Bretagne in 2017, of which 2 were on gamma radiography