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In the second quarter of 2015, ASN undertook a
tightened inspection of the University Hospital Centre
of Besançon (CHRUB) on account of significant changes
in its radiotherapy organization, concerning both
technical aspects (implementation of new practices)
and organisational aspects (department relocating and
grouping), and because this centre is one of the least
advanced in fulfilling the obligations concerning quality
assurance in radiotherapy and radiation protection in
the operating theatre.
Seven ASN inspectors were thus mobilised for three
days in May 2015 to assess the effectiveness of the
actions undertaken by the CHRUB to improve radiation
protection of medical staff and patients in radiotherapy
and in interventional practices. These inspections showed
ASN that the personnel hadmade great efforts to improve
radiation protection. Several deviations discovered during
the preceding inspections had been corrected, particularly
with regard to the radiation protection of medical staff
in rooms dedicated to interventional radiology. ASN
nevertheless noted that greater operational coordination
was required in the actions contributing to the radiation
protection of medical staff and patients in the oncology
and imaging units.
In 2015, five significant events concerning radiotherapy
patients were reported further to errors in performance
of the examination, three of which were rated level 1 on
the ASN-SFRO scale. ASN considers that radiotherapy
centres must be more attentive to the updating of their
procedures when material or organisational changes
arise.
Interventional practices
ASN devoted particular attention in 2015 to centres
that use image intensifiers in the operating theatre, and
carried out seven inspections in this area (see chapter 9,
point 1.1.2). Further improvements can be made in the
deployment of radiation protection measures and two
of the inspected centres have made no progress with
respect to the previous years.
With regard to radiation protection of health professionals,
the centres have become aware of the role and importance
of the Person Competent in Radiation protection (PCR),
but the time the PCRs are allocated to carry out their
duties is still too short. Significant progress has been
noted in the use of dosimeters. On the other hand,
improvements can still be made in the use of protective
equipment by practitioners, inworking practices analyses
and in radiation protection training.
With regard to patient radiation protection, ASN
has observed progress in the involvement of medical
physicists and overall compliance with the obligation
to ensure quality control of the devices used. Further
progress is required in the optimisation of doses delivered
to patients, more specifically by training the physicians
in the use of the imaging devices.
Only one significant event concerning a health
professional failing to wear a dosimeter was notified
to ASN in 2015.
Nuclear medicine
ASN issued four licenses in nuclear medicine in 2015,
three of whichwere on account of significant organisational
changes in the departments. The three inspections carried
out confirmed the significant improvements in the radiation
protection of patients and medical staff which began in
2014. As regards patient radiationprotection, the delivered
doses are below the diagnostic reference levels in the very
large majority of cases and the involvement of a medical
physicist inquality control verifications has become general
practice. With regard to radiation protection of health
professionals, a good level of involvement of PCRs has
been noted. The lines of progress concern the depth of the
analysis of working practices and conditions, radiological
zoning and establishing procedures to prevent errors in
the administration of radiopharmaceuticals.
The radiation protection culture in nuclearmedicine units
is good and they detect anomalies that occur and draw
lessons from them. Eleven significant events were notified
to ASN in 2015, which represents half the notified events
in themedical field. Nearly half of these events concerned
patient radiation protection and resulted from errors in
the performance of an examination. This highlights the
importance of having an organisation for the safety of
treatments in healthcare services.
Conventional radiology
In 2015, ASNcarried out an inspection campaign focusing
on 16 conventional radiology centres in Bourgogne
and Franche-Comté. All the centres carry out the risk
assessment for delimiting controlled areas and the
working environment analyses for the classification of
exposed workers. Virtually all the exposed personnel
wear passive dosimeters and are monitored by an
occupational physician at the regulatory frequency. The
internal radiationprotection controls are effectively carried
out at the regulatory frequency, but 66% of the centres
do not have external controls performed. Training in
the radiation protection of workers and patients can
be improved in 75% of the centres. ASN’s final opinion
is that the situation of more than 80% of the radiology
centres inspected is fairly satisfactory.
1.2 Radiation protection in
the industrial and research sectors
Industrial radiography
ASN carried out six inspections in this field in 2015, one
of which targeted a contractor company. The inspectors
endeavoured to devote equal attention to the radiography
conditions in protected bunkers and onworksites. ASN
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CHAPTER 08 :
REGIONAL OVERVIEW OF NUCLEAR SAFETY AND RADIATION PROTECTION
ASN report on the state of nuclear safety and radiation protection in France in 2015