ASN Report 2017

233 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 HAUTS-DE-FRANCE The initiative of placing the patient treatment process under strict quality assurance procedures, after having progressed strongly in the past years, must now be maintained over time through lasting and resilient systems which can withstand changes of environment and organisation in a context of rapidly evolving techniques. Radiotherapy is effectively a field that increasingly calls upon innovative technologies which bring, among other things, greater precision in treatments (stereotactic treatments, for example). ASN asks that in-depth reflection be carried out on the appropriation of these technologies by the teams of the departments on a project management basis and with the support of adequate human and technical resources. ASN will continue to give priority to good integration of these prerequisites in 2018. Fluoroscopy-guided interventional practices ASN observes an ever-increasing use of fluoroscopy-guided interventional practises and that they have evolved considerably in the last few years, bringing significant radiation exposure risks for medical teams and patients alike, particularly during long or repeated procedures. ASN carried out 8 inspections in the Hauts-de-France region in 2017 in fluoroscopy-guided interventional practices in the operating theatre, particularly for cardiac surgery procedures. ASN sees progress, particularly in the increased provision of human and material resources, such as the time allocated to the Radiation Protection Expert-Officer, the use of physicists or the purchase of personal protective equipment, thanks to heightened awareness of the radiological risks. Further efforts must nevertheless be made to effectively meet the commitments made to ASN further to preceding inspections. Improvements are required in particular in 1) the effective wearing of dosimeters, more specifically by the practitioners who often minimise the exposure risk, particularly for the extremities and the lens of the eye, 2) training in occupational and patient radiation protection, 3) the optimisation of doses delivered to patients by putting in place appropriate and updated protocols, and 4) the coordination of prevention measures. Nuclear medicine ASN conducted 5 inspections in nuclear medicine in 2017, including one commissioning inspection of a new technical platform and one unannounced inspection. These inspections reveal greater integration of occupational and patient radiation protection in the practices of the departments, correlated in particular with the involvement of the Radiation Protection Expert-Officers. They moreover confirm an improvement, albeit slower than ASN expected, in the integration of certain regulatory provisions. Progress is expected in the internal technical radiation protection controls, in the coordination of prevention measures with practitioners and outside contractors, and in the compliance with the requirements of ASN resolution relative to the design of the premises. Among the reported events, 4 concern a problem associated with the preparation and administration of radiopharmaceuticals. Lastly, several department redevelopment projects to be implemented in 2018 were presented to ASN. Computed Tomography ASN’s inspections in computed tomography facilities in 2017 concerned four centres in the Hauts-de-France region. The relatively satisfactory situation in this area remains fairly stable. In the course of its oversight actions ASN has found that although the rules concerning the radiation protection of workers and patients are now applied in general, improvements must still be made, particularly with regard to exposure of the extremities in interventional practices, and to equipment quality control and the optimisation of protocols for certain categories of patients. Greater traceability of application of the principle of procedure justification is also required. Lastly, ASN notes that managing facilities through Economic Interest Groupings (EIG) combining teams from the public and private sectors can bring beneficial synergies. 1.3 Radiation protection in the industrial, research and veterinary sectors Industrial radiography In 2017, 10 inspections were carried out in industrial radiography, including 4 inspections of agencies and 2 of own-account users. ASN observes continued improvement in the organisation of radiation protection and the monitoring of workers within companies, even if particular vigilance is still required in conducting worksites, especially in the management of work areas. With regard to the agency inspections, ASN focused in particular on the radiography bunkers. Measures are required to ensure compliance with the standards in effect and should enable worksite inspections to be focused solely on parts that cannot be readily transported. Since 2009, ASN, in partnership with DIRECCTE (Regional Directorate for Enterprises, Competition, Consumption, Work and Employment) and CARSAT (Retirement and Occupational Health Insurance Fund), has instituted a charter of good practices in industrial radiography for the Hauts-de-France region. The aim of this charter is to optimise the use of ionising radiation in this area of activity; at present it has been signed by 19 companies (ordering customers and service providers) who have undertaken to limit the committed doses further than the levels required by the regulations. Universities and laboratories or research centres The research units in the Hauts-de-France region use a wide variety of ionising radiation sources (sealed and unsealed sources, electric generators); nevertheless, the radiation risks in these units remain low. ASN’s oversight duties led to the performance of two inspections in 2017 on the subjects of occupational radiation protection and the management of radioactive sources and waste. ASN considers that in the majority of research units, radiation protection has on the whole been improving for several years. The management and the procedures for removing the sources and stored radioactive waste found in certain universities are still major issues, as they were in 2016.