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European Governance in nuclear issues
Decommissioning of Nuclear Installations Transport of Radioactive Material |
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Radiation Protection
A comprehensive culture of radiation protection and safety in medicine has been progressively developing throughout the European Union with regard to the medical use of ionising radiation and has been integrated into the various branches of diagnosis and treatment. The European Commission has contributed to this evolution with the establishment of legal requirements for the radiation protection of persons undergoing medical examinations or treatment. The establishment of the Directive 84/466/EURATOM on health protection of individuals against the dangers of ionising radiation in relation to medical exposures, the so called "Patient Directive" (PAD84) was one of the milestones of these European initiatives. Since 1984, the use of ionising radiation in medical practice has continued to develop, the number of installations to increase and the application to diversify. This together with the scientific and technical progress, urged the European Commission to revise Directive 84/466/EURATOM. The revised Medical Exposure Directive (MED97) 97/43/EURATOM was approved by the Council on 30 June 1997. The protection of offspring of pregnant and breast-feeding patients needs particular consideration for several reasons. The unborn child and small children are particularly vulnerable to ionising radiation. As well as other risks, there is a risk of malformation and mental retardation for the unborn child and for both the unborn child and small children there is a risk of radiation induced cancer which may be three times as high as for the average population (ICR91). The potential benefit of the examination or the treatment involving ionising radiation will in most cases be for the mother and only indirectly for the unborn child, whereas it will incur a risk. This is contradictory to the normal situation where one person, namely the patient, incurs the risk but also derives the benefit of the examination or treatment. It is the aim of the Commission to give some guidance to member states on the instructions and treatment needed for pregnant and breast-feeding women who can be considered as a particular subgroup of patients For this reason the Commission consulted the group of health experts established by the Article 31 of the Euratom Treaty. This group of experts created a working party with a mandate to develop such a guidance in order to facilitate the application of the MED. The present guidance was approved by the group of Article 31 experts during its session of 8 & 9 June 1998, taking into account comments made at the international workshop on the implementation of the MED in Madrid on 27 April 1998. This guidance is addressed to prescribers, to practitioners responsible for diagnosis or treatment, to nurses, to medical physicists and other professional staff who are in contact with the patient, e.g. such as midwives and gynaecologists. Furthermore the report will be of interest to authorities. Therefore this guidance has by definition a limited scope and certainly does not claim to be an exhaustive scientific report dealing with every aspect of the protection of the offspring. The document is structured as follows: A chapter entitled ‘Biological effects of ionising radiation in unborn children and infants’ gives general information on the risk of exposure to ionising radiation and how to put it into perspective. The second chapter called ‘Options for the medical practitioner concerning female patients’ provides guidance on how to avoid or to minimise detriment to the unborn child and to the breast-fed child. Three annexes and a schematic overview summarising different steps to be followed in the case of exposure of a female of childbearing age complete the guide. The first annex summarises a number of typical questions from mothers or mothers-to-be and gives examples of informative posters, the second gives dosimetric quantities and the third presents a number of typical absorbed doses to the unborn child. Finally, reference documents are listed.
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