RADIATION PROTECTION IN MEDICINE

RADIATION PROTECTION IN MEDICINE

Setting the Scene for the Next Decade

Proceedings of an International Conference

3?7 December 2012 Bonn, Germany

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RADIATION PROTECTION IN MEDICINE: SETTING THE SCENE FOR THE NEXT DECADE

The following States are Members of the International Atomic Energy Agency:

AFGHANISTAN ALBANIA ALGERIA ANGOLA ARGENTINA ARMENIA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BELARUS BELGIUM BELIZE BENIN BOLIVIA, PLURINATIONAL

STATE OF BOSNIA AND HERZEGOVINA BOTSWANA BRAZIL BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CENTRAL AFRICAN

REPUBLIC CHAD CHILE CHINA COLOMBIA CONGO COSTA RICA C?TE D'IVOIRE CROATIA CUBA CYPRUS CZECH REPUBLIC DEMOCRATIC REPUBLIC

OF THE CONGO DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC ECUADOR EGYPT EL SALVADOR ERITREA ESTONIA ETHIOPIA FIJI FINLAND FRANCE GABON GEORGIA

GERMANY GHANA GREECE GUATEMALA GUYANA HAITI HOLY SEE HONDURAS HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC OF IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KOREA, REPUBLIC OF KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC

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OMAN PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES POLAND PORTUGAL QATAR REPUBLIC OF MOLDOVA ROMANIA RUSSIAN FEDERATION RWANDA SAN MARINO SAUDI ARABIA SENEGAL SERBIA SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOUTH AFRICA SPAIN SRI LANKA SUDAN SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAJIKISTAN THAILAND THE FORMER YUGOSLAV

REPUBLIC OF MACEDONIA TOGO TRINIDAD AND TOBAGO TUNISIA TURKEY UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM OF

GREAT BRITAIN AND NORTHERN IRELAND UNITED REPUBLIC OF TANZANIA UNITED STATES OF AMERICA URUGUAY UZBEKISTAN VENEZUELA, BOLIVARIAN REPUBLIC OF VIET NAM YEMEN ZAMBIA ZIMBABWE

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PROCEEDINGS SERIES

RADIATION PROTECTION IN MEDICINE:

SETTING THE SCENE FOR THE NEXT DECADE

PROCEEDINGS OF AN INTERNATIONAL CONFERENCE ORGANIZED BY THE

INTERNATIONAL ATOMIC ENERGY AGENCY, HOSTED BY THE GOVERNMENT OF GERMANY, CO-SPONSORED BY THE WORLD HEALTH ORGANIZATION AND HELD IN BONN, GERMANY, 3?7 DECEMBER 2012

INTERNATIONAL ATOMIC ENERGY AGENCY VIENNA, 2015

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Printed by the IAEA in Austria September 2015 STI/PUB/1663

IAEA Library Cataloguing in Publication Data

Radiation protection in medicine : setting the scene for the next decade : proceedings of an International Conference, Bonn, 3?7 December 2012. -- Vienna : International Atomic Energy Agency, 2015. p. ; 24 cm. -- (Proceedings series, ISSN 0074?1884) STI/PUB/1663 ISBN 978?92?0?103914?9 Includes bibliographical references.

1. Medical radiology -- Safety measures -- Congresses. 2. Radiation -- Safety measures -- Congresses. 3. Nuclear medicine -- Safety measures -- Congresses. I. International Atomic Energy Agency. II. Series.

IAEAL15?00973

FOREWORD

The first international conference addressing radiation protection of patients triggered an International Action Plan that has since been guiding efforts in patient protection worldwide. The M?laga conference, held in March 2001, provided very broad international input on the status of radiation protection of patients at the time, and allowed accurate prediction of future trends. But recent years have witnessed significant increases in medical radiation uses, as well as developments in radiation protection, which need to be taken into account. For the first time in history, several countries are experiencing population doses from medical uses of radiation that exceed those from natural background radiation and have fully eclipsed those from other human sources.

There is no doubt that the application of ionizing radiation and radioactive substances in diagnostic, interventional and therapeutic procedures in medicine is beneficial for hundreds of millions of people each year. However, employing radiation in medicine has to involve carefully balancing the benefits of enhancing human health and welfare and the risks related to radiation exposure. There is a need for a holistic approach which includes partnership between national governments, civil society, international agencies, researchers, educators and professional associations aimed at identifying, implementing and advocating solutions; and leadership, harmonization and coordination of activities and procedures at an international level. Ionizing radiation in medicine involves the deliberate and direct exposure of humans, and there is a strong and continuing need to protect patients from unnecessary and unintended exposure, and also to protect medical staff, in particular, from incurring high doses.

Unnecessary exposure of patients can arise from medical procedures that are not justified for a specified objective, from the application of procedures to individuals whose condition does not warrant such intervention, and from medical exposures that are not appropriately optimized for the situation in which they are being used. Unintended exposure of patients and medical staff can arise from unsafe design or inappropriate use of medical technology. The number of occupationally exposed workers is much higher in medicine than in any other professional field, and individual occupational exposure varies widely among those involved in medical care.

Recent years have seen an increased recognition of the importance of communication with patients and patient organizations on medical radiation protection, as well as the value of openly sharing knowledge on adverse events involving medical radiation sources.

Considering these issues and taking account of current trends and developments, it became necessary to organize a conference to focus efforts

in this area for the next decade and to maximize the positive impact of future international work in radiation protection in medicine.

Thus, with the World Health Organization as co-sponsor, and the Government of Germany through the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety as host, the International Atomic Energy Agency organized the International Conference on Radiation Protection in Medicine: Setting the Scene for the Next Decade. The conference was held in Bonn, 3?7 December 2012, and aimed, in particular, to:

Indicate gaps in current approaches to radiation protection in medicine; Identify tools for improving radiation protection in medicine; Review advances, challenges and opportunities in the field of radiation

protection in medicine; Assess the impact of the International Action Plan for the Radiation

Protection of Patients, in order to prepare new international recommendations, taking into account newer developments.

The conference was attended by 536 participants and observers from 77 countries and 16 organizations. Eight topical sessions and four round table discussions were organized in a one-track programme that allowed all participants to follow all discussions. In addition, the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) and the European Commission (EC) hosted lunchtime breakout sessions to address state of the art developments in their respective areas of expertise. The following organizations also contributed to the briefing session: the Pan American Health Organization (PAHO), the International Organization for Medical Physics (IOMP), the International Radiation Protection Association (IRPA), the International Society of Radiology (ISR) and the International Society of Radiographers and Radiological Technologists (ISRRT).

To maximize stakeholder participation, contributed papers were summarized by invited experts and presented for the respective sessions and round table discussions, and authors had the additional option to present their work as posters. This resulted in the acceptance of 224 contributed papers that described developments and the results of research being undertaken in all continents of the world. Invited papers were presented for each session and round table discussion to form part of the bases for the ensuing discussion among all participants. At the concluding session, summaries of all discussions were presented, together with insight into relevant requirements stated in Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards (IAEA Safety Standards Series No. GSR Part 3) and perceptions of goals and challenges for the next decade.

An important outcome of the conference was the identification of responsibilities and proposal for priorities of stakeholders regarding radiation protection in medicine for the next decade. This is the Bonn Call for Action.

The aims of the Bonn Call for Action are: (a) to strengthen the radiation protection of patients and health workers overall; (b) to attain the highest benefit with the least possible risk to all patients by the appropriate use of ionizing radiation medicine; (c) to aid the full integration of radiation protection into health care systems; (d) to help improve the benefit?risk dialogue with patients and the public; and (e) to enhance the safety of technical operations in medicine.

The Bonn Call for Action highlights ten main actions, and related subactions, that were identified as being essential for the strengthening of radiation protection in medicine over the next decade. Action by all stakeholders is encouraged.

The IAEA gratefully acknowledges the support and generous hospitality extended to the conference participants by the German authorities. The IAEA officer responsible for this publication was O. Holmberg of the Division of Radiation, Transport and Waste Safety.

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