Definition of a disability weight for human exposure to ionizing radiation and its application to the justification of medical exposure.

Objectives: To establish a link between radiation dosimetry and disability-adjusted life-years (DALY) with the aim of quantifying the justification of medical exposures.

Methods: The health detriment, defined as lifetime loss of DALY at age of exposure to ionizing radiation for a US-European population was calculated. A simple model of the relationship was fitted to the results.

Duty of candour and clinically significant accidental or unintended exposures: revisiting the definition of moderate harm for patient safety incidents involving ionizing radiation.

Objective: To explore a quantitative interpretation of the term 'moderate harm' as applied to the triggering of the duty of candour associated with clinically significant accidental and unintended exposures to ionizing radiation.

Methods: Current definitions of 'moderate harm' were matched to the lay descriptions of disease and injury states used in the calculation of detriment as disability-adjusted life years (DALY) by the World Health Organization, to obtain a value of detriment associated with 'moderate harm'. Published conversion factors between effective dose and DALY were used to calculate the effective dose associated with the same detriment.

Increasing the public awareness of justification.

One of the requirements of the UK Ionising Radiation (Medical Exposure) Regulations 2017 is that all medical exposures must be justified before the exposure can proceed. One of the main elements of justification is a determination that the medical benefits from the exposure will exceed the associated radiation detriment. The field of medical exposure to ionising radiation is in the rare position of having this explicit legal requirement for net benefit.

Comparing benefit and detriment from medical diagnostic radiation exposure using disability-adjusted life years: towards quantitative justification.

Justification of medical radiation exposure is one of the main elements of radiation protection for patients. For a medical exposure to proceed, the benefit from the procedure must have been determined to be greater than the detriment. It is rare, however, that justification can be stated quantitatively as a ratio of benefit to detriment, or as a net benefit, and this is particularly true for medical diagnostic exposures associated with non-fatal diseases where survival statistics do not apply.

Application of ALARP cost-benefit analysis to hospital-based radiation protection.

The UK Ionising Radiations Regulations 2017 require employers to restrict radiation doses to their employees and the public to be as low as reasonably practicable (ALARP). This article looks at the boundary between what might be considered to be reasonable and unreasonable in protecting staff and the general public in the field of hospital-based diagnostic radiology. Guidance on cost-benefit analysis in support of ALARP has been used to formulate relationships for the estimation of the cost at which a radiation protection intervention is no longer ALARP.