Conclusions and recommendations from the 17th Workshop of the European ALARA Network ‘ALARA in emergency exposure situations’

Abstract

The European ALARA Network regularly organises workshops on topical issues in radiation protection. In light of the Fukushima accident, the most recent workshop questioned the application of the ALARA principle in emergency exposure situations. This memorandum presents the conclusions and recommendations of this workshop. One of the outcomes is that the process of optimisation in emergency exposure situations should be flexible enough to be able to modify or refine decisions over the course of an accident. In the urgent phase, decisions must be made in a very time-constrained environment, based on scarce, uncertain and sometimes unreliable information. In this phase, optimisation and protection strategies are therefore developed and applied on the basis of conservative assumptions or 'reasonably foreseeable worst-case scenario' which could lead to an overestimation of the consequences. In the intermediate phase, knowledge of the situation improves, and more time is available to make the decision. This is reflected by adopting a less conservative approach, and transitioning to a more appropriate optimisation adapted as effectively as possible to the various exposure situations. When the situation is eventually stabilized (transition phase), there is time to shape the measures taken previously to reflect local conditions in the affected territories. In every phase, consideration should be given to the stakeholders, so that their needs and requirements can be incorporated as effectively as possible.

Simulated nuclear contamination scenario, solid cancer risk assessment, and support to decision

“…3A and 3B may positively impact the response team's strategy with respect to sex and age appearing as an additional occupational risk factor. Thus, depending on the location determined for a task to be performed, the team members could be selected by taking into account such specifi c vulnerabilities aiming at reduced occupational risk in accordance with the As Low As Reasonably Achievable (ALARA) principle [33]. Figure 3C shows that the contribution of age and sex loses strength as the sites of interest are increasingly further away from GZ.…”

ALADA Dose Optimization in the Computed Tomography of the Temporal Bone: The Diagnostic Potential of Different Low-Dose CT Protocols

“…Institutional Review Board Statement: Ethical review and approval were waived for this study, as "studies with cadavers donated by a bequest of the deceased to the Division of Clinical and Functional Anatomy of the medical University of Innsbruck no ethics committee approval is required by Austrian law." The study was conducted under the regulations defined in [13,14].…”

“…Fortunately, modern CT technology allows for low-dose (LD) exposures and short scanning times. As a consequence, the reduction of radiation exposure to the level of "as low as reasonably achievable" (ALARA) has become a major task in radiology [13]. Briefly, the ALARA principle comprises measures to reduce exposure (i.e., scanning) time, enhance the distance to the radioactive source and to shield with appropriate materials.…”

Computed tomography with low-dose radiation versus standard-dose radiation for diagnosing fractures: systematic review and meta-analysis

“…12 Thus, there is a growing awareness of the need to use the lowest possible radiation dose level that is capable of providing appropriate diagnostic information, also known as the ALARA principle (As Low As Reasonably Achievable). 9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24] CT is the gold standard for diagnosing fractures, 10,[25][26][27] characterizing them in greater detail, identifying hidden fractures and showing incomplete union. 27,28 In musculoskeletal radiology, lowdose CT has shown good results in studies with pre and postoperative scoliosis evaluations, as well as in diagnosing lytic injuries and fractures in patients with multiple myeloma.…”