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account all the exposure pathways (hands and internal
exposure);
•
training of all the exposed personnel in occupational
radiation protection, particularly medical personnel,
with the required regulatory frequency;
•
tightenedmedical monitoring of themedical personnel;
•
performance of comprehensive internal technical controls
of radiation protection and the ambient environment,
in compliance with the regulatory frequencies;
•
the utilisation of a contamination meter at each exit
from the unit;
•
the coordination of preventionmeasures when outside
contractors are required to work in controlled areas,
with the preparation of a risk prevention plan.
The attention of the units is drawn to the fact that
ASN resolution 2014-DC-0463 has done away with
the negative pressure requirements for radionuclide
handling rooms. Consequently, containment is now
based exclusively on the radiation-proof enclosure,
hence the importance of using the gloves attached to
the radiation-proof enclosure.
5.5.2 Radiation protection of patients in nuclear
medicine
Radiation protection measures are properly taken into
account with regard to:
•
the principle of justification of nuclear medicine
procedures for diagnostic or therapeutic purposes
with prior approval by a nuclear medicine physician
of any nuclear medicine procedure request;
•
the use of a medical physicist;
•
the preparation of medical physics organisation plans
by the centres;
•
the training of paramedical staff in the radiation
protection of patients;
•
transmission to IRSN of dosimetric data to participate
in the development of the Diagnostic Reference Levels
(DRL);
•
the inclusion of dosimetric information in themedical
procedure reports;
•
the production of protocols for themedical procedures
performed.
The units must continue to make efforts with regard to:
•
the training of medical staff in the radiation protection of
patients, and ensuring the traceability of their training;
•
exploitation of the dosimetric data transmitted to IRSN
for the purpose of exposure optimisation;
•
performance of external quality controls;
•
formalising the methods of performing maintenance
and quality controls;
•
pregnancy screening of women of child-bearing age
before conducting nuclear medicine procedures.
5.5.3 Protection of the general public
and the environment
During this 2012-2014 period, the following points were
considered to be positive findings:
•
the establishing of a waste and effluents management
plan, even if it does not cover all the points requested
by ASN resolution 2008-DC-0095 of 29th January
2008 relative to contaminated effluents and waste;
•
the installation of decay tanks and systems delaying
the discharge of contaminated liquid effluents coming
from the units into the public network;
•
the traceability of the verifications of waste and effluents
contaminated by radionuclides.
On the other hand, few units obtained an authorisation
to discharge non-domestic effluents into the sewerage
networks in application of Article L. 1331-10 of the Public
HealthCode. ASN recommendations should be available
in 2016 to facilitate delivery of these authorisations by
the sewerage network administration services.
5.5.4 Summary
The points considered unsatisfactory in the assessment
for the 2012-2014 periodwill be reassessed in the coming
years by the inspectors. Since 2014, three priority subjects
have been undergoing detailed inspections:
•
management of contaminated effluents after the analysis
of significant radiation protection events. Greater
attention is paid to the knowledge, identification and
monitoring of pipes carrying radioactive effluents and
to the formalising of a response protocol in the event
of leakage;
•
the use of automatons for the preparation and/or
injection of doses. The units are questioned on protocol
quality assurance and protective measures regarding
administration of the radiopharmaceutical;
•
the radiation protectionmeasures associated with the
use of targeted internal radiotherapy rooms with the
provision of work equipment, the existence of access
instructions, the conditions and means of protection
during the transport of sources outside the nuclear
medicine unit.
The tightened oversight of the above three points will
be continued in 2016. Furthermore, the compliance
of the units with ASN resolution 2014-DC-0463 of
22nd October 2014 will be assessed by the inspectors,
given that the majority of the requirements are already
in force.
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CHAPTER 09:
MEDICAL USES OF IONISING RADIATION
ASN report on the state of nuclear safety and radiation protection in France in 2015