Ionizing radiation is used extensively in medicine; worldwide, about 2000 million diagnostic X ray examinations and 32 million nuclear medicine procedures are carried out annually, and of about 10 million new cancer patients each year, 40-50 % receive radiotherapy (UNSCEAR 2000). Moreover, it is hoped that the use of radiation in medicine will increase, as the benefits for patients are enormous - far exceeding the risks. In the 2000 report of the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), it was stated that medical applications of ionizing radiation represented by far the largest man-made source of ionizing radiation exposure.
According to the International Commission on Radiological Protection (ICRP), there is considerable scope for dose reduction in diagnostic radiology and simple, low-cost measures are available for reducing doses without loss of diagnostic information. At the same time, while new diagnostic equipment and techniques bring new benefits, some of the procedures involve the delivery of relatively high radiation exposures to patients. In addition, a number of radiation injuries in interventional radiology and accidental exposures in radiotherapy have been reported (ICRP, IAEA). These facts have focused attention on the need to improve the radiological protection of patients in diagnostic and interventional radiology, nuclear medicine and radiotherapy.
The Agency is authorized by its Statute to 'establish standards of safety for protection of health and to provide for the application of these standards'. The safety standards that are applicable to this website are the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (the BSS). The BSS specifically address the radiological protection of patients by placing requirements on responsibilities and training, justification, optimization (design and operational considerations, including calibration, clinical dosimetry and quality assurance), guidance levels, and investigation of accidental medical exposure.
The Agency, in responding to the importance of this issue, organized, in collaboration with other International Organizations and Professional Bodies, the International Conference on the Radiological Protection of Patients in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy, which was held in March 2001 in Málaga, Spain. The findings and recommendations of this Conference included a request to the Agency to formulate an action plan based on the findings of the Conference for future work relating to the radiological protection of patients.
The International Action Plan on the Radiological Protection of Patients was prepared and approved by the Agency's governing bodies in 2002. The objective of the International Action Plan is to make progress in patient safety as a whole.
In striving to meet the objectives of the International Action Plan, the benefits of, and the needs for, medical uses of radiation should be recognized and radiological protection of the patient should be promoted without limiting the medical benefits. It should be ensured that radiological protection is an integral part of medical practice.
Radiological protection programmes in medicine must allow the exposure to be sufficient to obtain adequate diagnostic information and to provide effective treatment. To this end, quality assurance (QA) systems are essential. Radiological safety regulations and guidance should not impair medical care; they should focus on performance and allow for flexibility in achieving the desired outcomes.
Health professionals involved in the processes of diagnosis and treatment are the critical link. Training them properly and ensuring intensive information exchange among them are therefore probably the most cost-effective ways of achieving patient safety. The involvement of international organizations and professional bodies is crucial to implementing the actions and achieving the goals outlined in the Action Plan. The number of health professionals to be reached by the information exchange is very large. For this reason the Action Plan includes an action on using mechanisms for widely disseminating information related to the protection of the patient. This is the purpose of this website.
International Organizations and Professional Bodies
- World Health Organization (WHO)
- Pan American Health Organization (PAHO)
- European Commission
- United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR)
- International Organization for Standardization (ISO)
- International Commission on Radiological Protection (ICRP)
- International Commission on Radiation Units & Measurements (ICRU)
- International Electrotechnical Commission (IEC)
- European Society for Therapeutic Radiology and Oncology (ESTRO)
- International Organization for Medical Physics (IOMP)
- International Radiation Protection Association (IRPA)
- International Society of Radiographers and Radiological Technologists (ISRRT)
- International Society of Radiology (ISR)
- World Federation of Nuclear Medicine and Biology (WFNMB)
References
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INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION, Radiological Protection and Safety in Medicine, ICRP Publication 73, Pergamon Press, Oxford and New York (1997).
- INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION, Avoidance of Radiation Injuries from Medical Interventional Procedures, ICRP Publication 85, Volume 30/2, Pergamon Press, Oxford and New York (2001).