1. Christian Lefuare John Croft CEPN NRPB
Overview of Medical Occupational Exposure Issues in the European Countries
Christian Lefuare John Croft
CEPN NRPB

2. Broad Strands
Well established technology and professions
radiologists, radiographers, nurses etc
Cutting edge technology
equipment
procedures
widening scope of disciplines

3. Broad Strands
Well established technology and professions
radiologists, radiographers, nurses etc
Cutting edge technology
equipment
procedures
widening scope of disciplines
HOW DO WE PERFORM?

4. Occupational Exposure Review ( UNSCEAR )
0.8
2500
2000
0.6
Average
annual
individual
dose,
mSv
Monitored
workers,
x 103
1500
0.4
1000
0.2
500

5. Average Annual Individual Doses to “Measurably Exposed Workers”
Medical mSv
Education/Veterinary 1.0 mSv
Industrial mSv
Nuclear fuel cycle 3.1 mSv

6. Medical Sector Dose Data
E and SE Asia
Monitored
E Europe
Indian sub continent
Latin America
OECD (except USA)
Measurably
exposed
USA
Other
Total 1 2 3 4 5
UNSCEAR
Average annual individual doses, mSv

7. European Study of Occupational Exposure (ESOREX)
EU MS + Iceland, Norway & Switzerland
systems to register doses
numbers exposed & dose distributions
potential for harmonisation
ESOREX East: applicant countries
Bulgaria, Estonia, Hungary, Latvia, Lithuania, Poland & Slovak Republic

8. Occupationally Radiation Exposed Workers
Norway 80
Nos. of workers
Total 12,158 60
Collective doses
Total 3.6 man Sv % 40 20
Education,
Research,
Safety inspection
General
industry
Nuclear
Medicine

9. Occupationally Radiation Exposed Workers
Germany 80
Nos. of workers
Total 337,613 60
Collective doses
Total man Sv % 40 20
Education,
Research,
Safety inspection
General
industry
Nuclear
Medicine
Others
24188

10. Occupationally Radiation Exposed Workers
Spain 80
Nos. of workers
Total 67,836 60
Collective doses
Total man Sv % 40 20
Education,
Research,
Safety inspection
General
industry
Nuclear
Medicine

11. Occupationally Radiation Exposed WorkersUK 60
Nos. of workers
Total 48,502
Collective doses
Total man Sv 40 % 20
Education,
Research,
Safety inspection
General
industry
Nuclear
Natural
radioactivity
Medicine
Others

12. UK Anomaly
“Classified workers”
likely to receive >6 mSv
dose records, health surveillance
Central Index of Dose Information (CIDI)
“Non-classified workers”
large volume monitored and records kept

13. Occupational Exposure in Medicine, 1995
Measurably
exposed
No. in dose range, mSv
5-10
10-15
15-20
20-50
>50
Finland
Germany
Greece
Norway
Spain
2.32
1.02
2.48
1.60
0.55 46
338 74 75
279 13 62 25 27 55 5 18 9 14 36 8 10 20 14 27 3 8 1 6
ESOREX, 1998

14. Survey of Occupational Exposure
in Medicine in the UK
Category
No. in dose range, mSv
Average
annual
dose, mSv
0-5
5-10
10-15
15-20
>20
Diagnostic
Radiotherapy
Nuclear med.
Survey
UK total
10,619
2,916
883
14,418
39,950 4 3 7
<50 2
<10 2
<10 2 3 5
<10
0.08
0.33
0.09
0.1
ESOREX, 1998

15. UK Survey of Occupational Exposure in Diagnostic Radiology Departments
Category
No. in dose range, mSv
Average
annual
dose, mSv
0-5
5-10
10-15
15-20
>20
Radiologists
Cardiologists
Other clinicians
Radiographers
Nurses
Scientists/
technicians
Other staff
Total
999
458
656
5,024
2,276
631
575
10,619 2 1 4 1 2 1 2 1 2
0.19
0.26
0.04
0.05
0.07
0.08
ESOREX, 1998

16. UK Survey of Occupational Exposure in Radiotherapy Departments
Category
No. in dose range, mSv
Average
annual
dose, mSv
0-5
5-10
10-15
15-20
>20
Beam radiographers
Radiotherapists
Nurses - Theatre
Source technicians
Scientists/
technicians
Other staff
Total
864
242
481
646 64 16
251
352
2,916 1 2 3 1 3
0.06
0.23
0.05
0.10
0.15
0.01
0.08
Ward
Other
ESOREX, 1998

17. UK Survey of Occupational Exposure in Nuclear Medicine Departments
Category
No. in dose range, mSv
Average
annual
dose, mSv
0-5
5-10
>10
Pharmacists
Radiographers
Scientists/
technicians
Clinicians
Nurses
Other staff
Research workers
Total
168
262 86 54 73
109
131
883
0.35
0.53
0.29
0.18
0.61
0.06
0.07
0.33
ESOREX, 1998

18. Occupational Exposure in Non-nuclear
Industry - France, 1999
Category
No. in dose range, mSv
<1
1-6
6-20
20-50
>50
Radiology
Radiotherapy
Nuclear medicine
Non in vitro
Dental
Veterinary
Non-nuclear
industry
Occupation and PH
Others
Total
86,207
7,621
3,614
3,572
25,412
2,637
18,763
5,366
13,752
166,944
1,189
259
400 23
208 27
2,639 33 90
4,868
294 35 39 48 2
1,299 3 24
1,744 48 7 3 1 60
121 17 1 10 6 25
ESOREX, 1998

19. IAEA: Protecting Workers Against Exposure to Ionising Radiation
Generally well controlled
Problem of new areas
particularly interventional radiology
post graduate education
raising awareness
participation of Health Physicists

20. Format of Workshop
Focussed sessions
Working Groups
2 sessions
some suggested issues
Report back in final session
recommendations to EC etc.

21. are there issues where co-operative research would be useful ?
New technologies and procedures provide radiation protection challenges:
are there issues where co-operative research would be useful ?

22. Issues (2)
Data suggests varying levels of achievement:
Do Qualified experts and Radiation Protection Supervisors have a high enough profile within medical establishments both large and small ?

23. Issues (2)
Data suggests varying levels of achievement:
Do Qualified experts and Radiation Protection Supervisors have a high enough profile within medical establishments both large and small ?
If not; what can be done to improve matters ?

24. Issues (3)
There is often a link between the standard of control of patient exposure and occupational exposure.
Is that link widely recognised and if not, what initiatives to improve safety culture can be identified ?

25. Issues (4)
Training at al levels is a fundamental building block
Is RP covered to a sufficient extent in the professional training of mainstream medical occupations ?
If not, how can this be improved ?

26. Issues (4)
Training at al levels is a fundamental building block
New technologies etc. can lead to professions that are unfamiliar with RP becoming new users:
Are there adequate training arrangements ?

27. Issues (4)
Training at al levels is a fundamental building block
Update and refresher training is important:
are there sufficient facilities for this and could we make more use of e-technology to improve accessibility and availability ?

28. Issues (5)
How can we improve the feedback process so that we learn lessons from accidents and incidents ?
How can we make information available to the direct users, who may spread across diverse establishments ?

29. Issues (6)
Are there concerted actions that could improve the monitoring and control of extremity doses ?

30. Issues (7)
The production and distribution of radiopharmaceuticals involves a series of employers and provides the potential for doses that are a significant fraction of the dose limit.
Is there scope for improvement, and if so how should efforts be focussed ?