French Population Exposure to Ionizing Radiation from Diagnostic Medical Procedures in 2007

Abstract

VThe objective of this study was to update the 2002 data on medical exposure of the French population to ionizing radiation. It is based on 2007 data and only includes exposures from diagnostic procedures: conventional radiology, computed tomography, nuclear medicine, and diagnostic interventional radiology. Relevant data concerning the nature and frequencies of the examinations were obtained from two main sources: the national health insurance data for private practice and representative surveys in public hospitals for public practice. An ''average'' effective dose was assessed for each type of examination using principally dosimetric data collected to update the French diagnostic reference levels and professional guidance. The results showed that 74.6 million examinations were performed in 2007, leading to an average effective dose per inhabitant equal to 1.3 mSv per year. Conventional radiology and CT represented 63% and 10.1% of the examinations and 26.1% and 58.0% of the effective dose, respectively. The annual number of examinations per inhabitant was constant between 2002 and 2007 (about 1.2 examinations). However, the corresponding average effective dose per inhabitant increased by 57%, from 0.83 to 1.3 mSv per year. This increased dose was due mostly to a growing number of CT and nuclear medicine examinations. As recommended by the European Commission, studies should be conducted every 5 y to survey the evolution of medical exposure of the French population. Furthermore, specific studies should be conducted to evaluate whether this estimated increase in dose delivered for diagnostics is related to an increase in the medical benefit. Health Phys. 102(6):670Y679; 2012

Exposure of the Swiss population to computed tomography

“…UNSCEAR [1] estimates the CT dose contribution for developed countries (health level I) to 47% during the period of the study (1997–2007), while recent works reported in six European countries and the USA indicate CT dose contributions ranging from 46% up to 80% of the total collective dose for the years 2006 to 2008 [7-13]. In parallel to the widespread of CT, there has been an increasing concern at the international level on the radiological risk associated the use of this radiological modality especially in paediatrics reflected in scientific literature [14].…”

The risk of cancer attributable to diagnostic medical radiation: Estimation for France in 2015

“…To account for temporal variations in the number and types of IR procedures performed, we assumed that CT scans and interventional radiology procedures were not used before 1980, and that the frequency of these procedures increased linearly until 2007. With respect to X‐ray procedures, we assumed that from 1980 to 2007 the number of X‐ray procedures decreased linearly, so that the total frequency of diagnostic external IR procedures (X‐rays, CT scans and interventional radiology combined) was constant …”

“…With respect to X-ray procedures, we assumed that from 1980 to 2007 the number of X-ray procedures decreased linearly, so that the total frequency of diagnostic external IR procedures (X-rays, CT scans and interventional radiology combined) was constant. 6,11,[14][15][16] Estimation of lifetime cumulative organ dose exposures from internal medical ionizing radiation (nuclear medicine). The age-and sex-specific average annual radiation doses delivered to each organ from diagnostic nuclear medicine procedures were estimated by combining age-and sex-specific diagnostic test frequencies and their respective effective doses.…”

“…Between 2002 and 2012, the mean annual dose of radiation received by the French population from diagnostic radiological procedures almost doubled, from 0.83 mSv to 1.6 mSv, partly due to a 12% increase in the use of computed tomography (CT) scans . Although the individual IR dose usually delivered from medical diagnostic procedures is small, the number of people undergoing these procedures is large, corresponding to 75 million examinations in France in 2007 . Exposure to diagnostic medical IR represented 35% of the total non‐therapeutic IR exposure in France in 2015, being one of the highest exposures to diagnostic medical IR in Europe…”

“…5 Although the individual IR dose usually delivered from medical diagnostic procedures is small, the number of people undergoing these procedures is large, corresponding to 75 million examinations in France in 2007. 4,6 Exposure to diagnostic medical IR represented 35% of the total nontherapeutic IR exposure in France in 2015, 7 being one of the highest exposures to diagnostic medical IR in Europe. 8 In order to quantify the impact on cancer risk of diagnostic IR procedures and the associated dose, our study estimated the number of new cancer cases in adults in France in 2015 attributable to lifetime exposure to IR from diagnostic imaging procedures.…”