The transposition of above-mentioned directive 97/43/Euratom into French legislation has led to a legislative and statutory framework geared to radiation protection for patients, whereas in the past this issue used to be a confidential subject handled exclusively by the medical practitioner carrying out the procedure. The new regulatory framework, created in March 2003, was completed at the end of 2005. At the same time medical practitioners have engaged major initiatives to ease implementation of this new device, promoting the establishment of good practices for procedures involving the use of ionising radiation.

Radiation protection for persons exposed for medical purposes is now based on two regulatory principles: justification of the procedures and optimisation of exposure, which are under the responsibility of both the practitioners prescribing medical imaging examinations entailing exposure to ionising radiation and the practitioners carrying out these procedures. They cover all the diagnostic and therapeutic applications of ionising radiation, including radiological examinations requested for screening, occupational health, sports medicine and in a medico-legal setting.

A written exchange of information between the prescribing practitioner and the practitioner carrying out the procedure exposing the patient should justify the benefit of the exposure for each procedure. This "individual" justification is required for each procedure. However it will be based on a general justification of medical procedures using ionising radiation, set out in good practices guides currently finalised by the various learned societies.

As an example, under the principle of justification, the use of radioscopy appliances without image intensification was prohibited in 2003 (article R. 1333-58 of the Public Health Code); the procedures for decommissioning these appliances were specified in the order of 17 July 2003. Establishments operating a total number of 35 installations of this type have confirmed that their equipment is no longer in use and has been scrapped.

Prescription and procedure guides for the performance of medical procedures involving exposure to ionising radiation

Articles R. 1333-70 and R. 1333-71 of the Public Health Code respectively refer to the publication of "prescription of routine procedures and examinations" guides (also called "indication guides") and "performance of procedures involving exposure to ionising radiation" guides (called "procedure guides"). Under the impetus of the departments reporting to the Ministry for Health (DGSNR since 2002), the professionals represented by their learned societies, including the French radiotherapy and oncology society (SFRO), the French radiology society (SFR), the French biophysics and nuclear medicine society (SFBMN), the French medical radio-physics society (SFPM), have set up the necessary working frameworks for drafting these guides. As applicable, DGSNR coordinates or supports this work, or is simply kept informed. The progress of the various guides is presented in the following table.

* Currently being updated

Table giving progress of prescription and performance guides for medical procedures involving exposure to ionising radiation