Background: Geographical variation in health care services challenges the basic principle of fair allocation of health care resources. This study aimed to investigate geographical variation in the use of X-ray, CT, MRI and Ultrasound examinations in Norway, the contribution from public and private institutions, and the impact of accessibility and socioeconomic factors on variation in examination rates.
The objective of the present work was to determine current levels and recent nationwide trends in radiological examination frequency, as well as to update corresponding collective effective dose estimates. Examination frequencies were obtained from radiology management systems at all hospitals and private radiology enterprises across Norway in terms of number of examination codes. During the last decade, the overall examination frequency increased by 16% to 910 per 1000 inhabitants, excluding nuclear imaging and dental radiology. The largest increase in examination frequency occurred in MRI (10-fold increase), followed by CT (more than doubling) and mammography (nearly 70% increase). The contribution to collective effective dose from radiological examinations was estimated to 4960 man Sv or 1.09 mSv per inhabitant; representing a 40% increase from 1993 to 2002. CT contribution to collective effective dose was estimated to account for 59% of the total as opposed to 30% in the previous survey.
None of the children was exposed to doses known to cause deterministic effects. However, since the threshold for radiation-induced damage is not known with certainty, alternative modalities such as US and MRI should be used whenever possible.
The personal dosimetry laboratory at the Norwegian radiation protection authority utilises a two-element dosemeter card for measuring Hp(10) and Hp(0.07), in a Harshaw dosemeter holder type 8814. Energy and directional responses for photons and betas for this holder have been assessed, as well as for the new Harshaw holder type 8891. The energy response characteristics for the 12-1250 keV photon energy range, in terms of TL output per unit Hp(10) and Hp(0.07) have been evaluated. The maximum over-response to under-response ratio for the Hp(10) element was found to be 1.46 for the new type 8891 holder, as compared to 1.55 for the older type 8814. The new holder also displays a more favourable directional response for this element. For the Hp(0.07) element, no significant differences with regard to energy or directional responses were found. Selecting radiation energy for absolute calibration of the Hp(10) and Hp(0.07) elements are discussed.
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