ASN Report 2017

247 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 NOUVELLE-AQUITAINE In 2017, the Bordeaux University Hospital notified ASN of 2 significant radiation protection events in brachytherapy and in contact radiotherapy which were provisionally rated level 2 on the ASN-SFRO scale. In both these cases, the dose administered to the patients was significantly higher than the prescribed dose and could potentially cause moderate alteration of an organ or function, therefore regular medical monitoring is required. ASN conducted an inspection at the Bordeaux University Hospital dedicated to these events in order to verify effective implementation of the corrective actions announced by the hospital. Tightened monitoring will also be ensured during scheduled inspections in 2018. With regard to occupational radiation protection, ASN considers that the regulatory requirements are correctly applied in the radiotherapy and brachytherapy departments. Fluoroscopy-guided interventional practices ASN inspected 25 centres practising fluoroscopy-guided interventional procedures in the Nouvelle-Aquitaine region in 2017. These inspections were carried out as much in the operating theatre as in facilities dedicated to cardiology, neuroradiology or vascular radiology. With regard to patient radiation protection, ASN observes that the optimisation of doses delivered to the patients is generally satisfactory in the structures dedicated to the performance of fluoroscopy-guided interventional procedures, but insufficiently applied in the operating theatre, due in particular to the absence of radiographers and medical physicists, and the surgeons’ lack of knowledge of the technical possibilities of optimisation offered by the equipment used. In addition, the surgeons are insufficiently trained in patient radiation protection. ASN does nevertheless take positive note that procedures are put in place to monitor patients having undergone long, high-exposure treatments in the dedicated facilities. One significant event concerning patient radiation protection was reported to ASN in 2017. With regard to occupational radiation protection, ASN observes shortcomings in the designation of radiation protection expert- officers by private practitioners. The regulatory provisions concerning dosimetric monitoring (especially of the extremities), medical monitoring and the training of exposed workers are still poorly applied in the operating theatres. The use of collective protective equipment, which is satisfactory in the dedicated facilities, must be further improved in the operating theatres. ASN continued to verify implementation of the provisions of ASN resolution 2013-DC-0349 of 4th June 2013 setting the design rules for premises in which X-ray generators are used. It observes that the majority of operating theatres have undertaken compliance procedures (studies and additional work where necessary), but the situation can be further improved. Nuclear medicine ASN performed 6 scheduled inspections in nuclear medicine departments in the Nouvelle-Aquitaine region in 2017. Two commissioning inspections were moreover carried out for the opening of a new PET (Positron Emission Tomography) sector in Pau and the transfer of the scintigraphy activity of the Saint-Augustin Clinic in Bordeaux to new premises. The new facilities provide the opportunity for ASN to verify, from the new premises design stage, that the provisions of ASN resolution 2014-DC-0463 of 23rd October 2014 relative to the design and operation of nuclear medicine facilities have been taken into account. ASN also verifies compliance with these requirements during its inspections. It considers that the requirements are met on the whole. Nevertheless, application of the requirements relative to the ventilation of rooms accommodating patients receiving Internal Targeted Radiotherapy (ITR) treatment must be improved. ASN considers that patient and worker radiation protection is on the whole ensured correctly in the nuclear medicine departments. ASN takes positive note of the transparency of the nuclear medicine departments in the reporting of ESRs. In effect, 19 ESRs were reported in 2017, compared with 8 in 2016. The majority of these events resulted from organisational or human causes – usually an error in the preparation of the radiopharmaceutical or a patient identity error when giving the injection. With regard to protection of the general public and the environment, ASNobserves that the difficulties in themanagement of radioactive effluents persist, particularly the effluents produced by patients hospitalised in ITR rooms. One significant event concerning the leak of a pipe carrying contaminated urine was reported to ASN in 2017; the event had no impact outside the centre. Constant vigilance must be exercised in the monitoring andmaintenance of the pipes carrying these radioactive effluents to prevent the occurrence of such events. 1.3 Radiation protection in the industrial and research sectors Industrial radiography ASN carried out 18 inspections of industrial radiography activities in fixed facilities or on worksites in 2017. Further to the significant radiation protection event that occurred in 2015 in an X-ray radiography bunker of an agency of Apave Sud-Europe in Colomiers (Haute-Garonne département), rated level 2 on the INES scale, ASN attaches particular importance to the monitoring of fixed facilities in which X-ray generators are used. 7 inspections on this theme were thus carried out in 2017, including 5 in enterprises which were licensed but had never yet been inspected by ASN. With regard to industrial radiography in fixed facilities, ASN observed unacceptable shortcomings in certain enterprises in 2017 concerning the administrative situation of their activity; these situations were only brought into compliance further to the ASN inspections. ASN will remain extremely vigilant in this respect in 2018. The enterprises must make further progress in the evaluation of the risks to which workers and the public are exposed, in the analysis of jobs and work environments and the conformity of the facilities with regulatory requirements concerning their design, particularly regarding their signalling. ASN does nevertheless note that the radiation protection