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Content archived on 2024-04-15

EVALUATION OF THE RADIATION DOSES AND RISKS ASSOCIATED WITH DIAGNOSTIC X-RAY EXAMINATIONS IN BRITAIN

Objective

THIS CONTRACT COVERS TWO PROJECTS THAT INVOLVE THE COLLECTION AND ANALYSIS OF DATA CONCERNING MEDICAL X-RAY EXAMINATIONS IN THE UK TO IMPROVE THE ASSESSMENT OF INDIVIDUAL AND COLLECTIVE DOSES AND RISKS.
Studies conducted have included:
the analysis of somatic doses and risks from routine X-ray procedures in British hospitals;
the assessment of the contribution of computed tomography to the collective dose from diagnostic radiology in Britain.

Information on the organ doses and energy imparted to patients was used to estimate the somatic risks from common types of X-ray examination.
The collective doses and risks from diagnostic radiology in Britain were evaluated for comparison with other sources of radiation and with other European countries and techniques were identified are responsible for high patient doses.

The data on organ doses received by patients and on the frequency of examinations enabled the calculation of collective effective dose equivalents.
The patient age and sex data for different types of X-ray examination were used to calculate the reduction in opportunity for the expression of long term radiogenic cancers and genetic effects for patients. Log normal distributions for the pattern of cancer incidence with time after exposure were combined with current life expectancy data for people of different ages, to predict reduction factors for somatic effects in patients. Values of about 0.7 for leukaemia and 0.5 for solid cancers were typical for most types of examination. Child expectancy data as a function of age and sex were used to predict similar reduction factors for genetic effects and a typical value of about 0.2 was found. When combined with appropriate risk factors for the induction of fatal cancers and nonfatal cancers, and genetic effects the average individual risks for X-ray examinations were obtained.

Radiology practice and patient doses in France, Italy and Britain were compared. Some apparent differences in national criteria for the justification and optimisation of X-ray examinations were found. The wide distributions in patient doses for nominally the same type of examination have been studied further. Analyses of selected percentile values of these distributions demonstrates that dramatic reductions in the range of doses observed can be achieved by rejecting only a few per cent of the observed values at the extremes of the distributions. Interhospital variations in radiographic techniques and patient doses have so far revealed only the use of rare earth screens as a consistent contributor to lower doses.

Information was obtained on the pattern of use of computerised tomography (CT) scanners in Britain, on the number of patients undergoing each type of procedure and on the doses typically received by patients during those procedures.

With this continually increasing availability of scanners accompanied by regular reductions in scan times as the equipment has been improved, CT examinations are rapidly becoming more frequent and more extensive and are already making a major contribution to the collective population dose from diagnostic radiology in most European Community countries. To assess the situation in the United Kingdom a national survey has been carried out to establish the extent of CT activity and to study the associated levels of patient dose. This survey has been undertaken in conjunction with similar studies by other contractors to the Commission of European Communities (CEC) Radiation Protection Programme in Germany, France and Italy. New dosimetry techniques have been jointly developed that for the first time allow reliable estimates of organ doses to patients from CT examinations that are essential for assessing the radiation protection aspects of CT. By adopting a common dosimetry protocol reasonable comparisons can be made between CT practice and patient protection in the different member states.
1. ANALYSIS OF SOMATIC DOSES AND RISKS FROM ROUTINE X-RAY PROCEDURES IN BRITISH HOSPITALS.
2. ASSESSMENT OF THE CONTRIBUTION OF COMPUTED TOMOGRAPHY TO THE COLLECTIVE DOSE FROM DIAGNOSTIC RADIOLOGY IN BRITAIN.

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NATIONAL RADIOLOGICAL PROTECTION BOARD (NRPB)
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