Changes

===Protecting pediatric patients===

Children are more sensitive to radiation exposure than adults. Depending on their age, organ, and tumour type, children are reported to be, on average, two to three times more sensitive to radiation than adults, and the younger the infants or children, the more radiosensitive they are at high doses. So, the potential risks of ionising radiation in paediatric patients need to be considered. Physicians should exercise caution when using ionising radiation to image or treat children. In nuclear medicine, a lower administered activity than that would be used for an adult may be used; acceptable images could still be obtained as the size of a child is typically smaller than that of an adult.

 

For [[diagnostic radiology]], the following should be taken into consideration: (1) select the most optimised imaging protocol based on the patient’s age and size; (2) repeat imaging, or phases (e.g. CT), need to be justified relative to the importance of the additional information being gained vs the additional radiation dose; and (3) only image the indicated area. [[ICRP Publication 121]] Radiological Protection in Paediatric Diagnostic and Interventional Radiology and ‘Image Gently’ (www.imagegently.org) provide more details. It is worthwhile to note that where applicable, non-ionizing radiation imaging modalities may be considered.

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===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). Working procedures should require key decisions to be subject to independent confirmation ([[ICRP Publication 86]]). 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 and [[ICRP Publication 98]] Radiation Safety Aspects of Brachytherapy for Prostate Cancer using Permanently Implanted Sources, and that for ion beam therapy can be found in [[ICRP Publication 127]] Radiological Protection in Ion Beam Radiotherapy and [[ICRP Publication 112]] Preventing Accidental Exposures from New External Beam Radiation Therapy Technologies.