ASN Report 2017

278 ASN report on the state of nuclear safety and radiation protection in France in 2017 Chapter 09  - Medical uses of ionising radiation 5.2 Some general indicators 5.2.1 Licenses and declarations In 2017, ASN issued: ཛྷ ཛྷ 5,286 acknowledgements of receipt of declarations of medical and dental diagnostic radiology devices; ཛྷ ཛྷ 634 licenses (for entry into service, renewal or cancellation), of which 56%were in computed tomography, 24% in nuclear medicine, 16% in external-beam radiotherapy and 4% in brachytherapy. 5.2.2 Dosimetry of health professionals According to the data collected in 2016 by IRSN, 227,980 people working in sectors using ionising radiation for medical and veterinary purposes were subject to dosimetric monitoring of their exposure. Medical radiology (50%) and dental care (22%) alone account for nearly 72% of the medical personnel exposed. More than 99% of the health professionals monitored in 2016 received an annual effective dose below 1 millisievert (mSv). No exceedance of the annual effective dose limit of 20 mSv was observed. Two cases in which the annual equivalent dose at the extremities (500 mSv) was exceeded were registered (in the radiology sector). The average annual individual dose calculated for people having received a dose exceeding the registration threshold is 0.33 mSv/year and is stable compared with the value for 2015. 1,821 persons were monitored (radiotoxicological and whole-body radiation measurement analyses) for a risk of internal exposure in 2016. An effective dose calculation was carried out for eight workers (four working in nuclear medicine and four in a radioimmunology laboratory, and in all eight cases the committed effective dose was less than 1 mSv. 5.2.3 Report on Significant Radiation protection Events Significant Radiation protection Events (ESR) have been notified to ASN since 2007. These notifications provide professionals with increasingly valuable experience feedback, helping to improve radiation protection in the medical field. In 2017, ASN published two bulletins on radiotherapy patient safety (No. 10 and  11) and two event analysis sheets (see points 5.3.3). Incident notices are also published on www.asn.fr . Since July 2015, radiotherapy departments can notify significant radiation protection events on line. This portal falls within the framework of the single vigilance portal created by the Ministry of Health. It was extended to cover the entire medical sector in april 2017. Since 2012, the number of ESR notifications stands at about 500 per year. In 2017, 568 ESRs in the medical sector were notified to ASN. This increase is primarily due to the notification of a larger number of ESRs in radiology (conventional and computed tomography) and, to a lesser extent, in nuclear medicine. It is probable that setting up the on-line service for notifying events to ASN has facilitated this procedure, particularly in the radiology sector. On the other hand, the number of ESR notifications concerning radiotherapy has dropped steadily since 2015. The Graphs below illustrate the breakdown of the number of ESRs in 2017 by sector and how they have evolved since 2007, along with the breakdown of events by notification criterion. About 80% of the notified events originate from either computed tomography (29%), radiotherapy (25%) or nuclear medicine (26%) departments. For the first time since 2007, when the ESR notification system was put in place, computed tomography is the area with the largest number of ESR notifications per year. NUMBER OF SIGNIFICANT EVENTS over the years 2010 2011 2012 2013 2014 2015 2016 2017 0 300 600 257 435 531 553 564 536 498 568 DISTRIBUTION OF SIGNIFICANT EVENTS by category in 2017 (%) DISTRIBUTION OF SIGNIFICANT EVENTS by activity in 2017 (%) Worker Interventional radiology External-beam radiotherapy Other activities or co-activities Brachytherapy Populations Conventional and dental radiology Patient Computed Tomography Environment Nuclear medicine 12.4 4.4 10.4 25.5 53.3 28.6 31.9 5.2 25.1 1.5 1.7