title: Lessons learned from events notified to the French Nuclear Safety Authority during the period 2007-13 in the medical field.
abstract: The analysis of events is crucial for accident prevention. In 2007, ASN set up a system for the notification of radiation protection events. The majority of them concern the exposure of patients undergoing therapeutic or diagnostic procedures and, to a lesser extent, occupational exposures and the management of radioactive effluents. The most significant events concern interventional radiological procedures and nuclear medicine, in which there are exceedances of mandatory dose limits and staff contaminations, respectively. Deterministic effects in patients were observed following interventional procedures and in nuclear medicine. Many events involve leakage of radioactive effluents and highlight the need to improve the monitoring and maintenance of radioactive effluent facilities. The causes are mainly of organisational and human origin. The lessons learned emphasise the importance of the role of medical physicists and radiation protection officers and the need to implement quality and risk management measures and to conduct clinical audits.
authors.affiliation: ASN - French Nuclear Safety Authority, 15 rue Louis Lejeune, Montrouge 92541, France carole.rousse@asn.fr.
authors.forename: Carole
authors.initials: C
authors.lastname: Rousse
authors.affiliation: ASN - French Nuclear Safety Authority, 15 rue Louis Lejeune, Montrouge 92541, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Cillard
authors.affiliation: ASN - French Nuclear Safety Authority, 15 rue Louis Lejeune, Montrouge 92541, France.
authors.forename: Aurelie
authors.initials: A
authors.lastname: Isambert
authors.affiliation: ASN - French Nuclear Safety Authority, 15 rue Louis Lejeune, Montrouge 92541, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Valero
mesh_terms: D005602:France / Q000453:epidemiology; D006801:Humans; D019221:Mandatory Reporting; D019300:Medical Errors / Q000706:statistics & numerical data*; D011159:Population Surveillance / Q000379:methods*; D011835:Radiation Protection / Q000706:statistics & numerical data*; D018788:Radioactive Hazard Release / Q000706:statistics & numerical data*