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→Preventing accidents in radiation therapy
===Preventing accidents in radiation therapy===
Accident prevention in radiation therapy should be an integral part of the design of equipment and premises, and of the working procedures. Radiation therapy equipment should be designed to reduce operator errors by automatically rejecting demands outside the design specification. Radiation therapy equipment should be calibrated after installation or any modification and should be routinely checked by a standard test procedure that will detect significant changes in performance ([[ICRP Publication 86]] Prevention of Accidents to Patients Undergoing Radiation Therapy). <ref name="Pub086"/> Working procedures should require key decisions to be subject to independent confirmation ([[ICRP Publication 86]]). <ref name="Pub086"/> In radiation therapy, the avoidance of accidents is the predominant issue. A review of such accidents and advice for accident prevention is found in [[ICRP Publication 86]]; specific advice for brachytherapy can be found in [[ICRP Publication 97]] Prevention of High-dose-rate Brachytherapy Accidents <ref name="Pub097">[[ICRP Publication 97]] Prevention of High-dose-rate Brachytherapy Accidents. Ann. ICRP 35(2), 2005.</ref> and [[ICRP Publication 98]] Radiation Safety Aspects of Brachytherapy for Prostate Cancer using Permanently Implanted Sources<ref name="Pub098">[[ICRP Publication 98]] Radiation Safety Aspects of Brachytherapy for Prostate Cancer using Permanently Implanted Sources. Ann. ICRP 35(3), 2005.</ref>, and that for ion beam therapy can be found in [[ICRP Publication 127]] Radiological Protection in Ion Beam Radiotherapy <ref name="Pub127">[[ICRP Publication 127]] Radiological Protection in Ion Beam Radiotherapy. Ann. ICRP 43(4), 2014.</ref> and [[ICRP Publication 112]] Preventing Accidental Exposures from New External Beam Radiation Therapy Technologies.<ref name="Pub112"/>
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===Special notes on the use of effective dose and dose measurements===
Effective dose was originally introduced so that all radiation exposures, external and internal, could be treated together in the control of occupational and public exposures, but it is also applicable to exposures in healthcare. Effective dose is used to inform decisions on justification of patient diagnostic and interventional procedures, planning requirement for research studies, and evaluation of accidental exposures. In each case, effective dose provides a measure of detriment. Effective dose can be used to classify different types of medical procedure into broad risk categories for the purpose of communicating risk levels to clinicians and patients. These applications rely on the validity of the linear-non-threshold (LNT) dose-response relationship. In addition, effective dose should not be used for individual or population-based cancer risk assessment as it does not consider individualized information. ICRP TG79 is preparing further advice on the use of effective dose in medicine as part of a task group report.