International action plan on the radiation protection of patients.

Realising that the major part of radiation protection efforts had been directed for over half a century at radiation protection of workers, and that there are major issues in relation to medical exposure, which contributes to over 95 % of the dose to the global population from man-made sources, with increasing individual patient doses in diagnostic examinations, unnecessary or inappropriate examinations and continued accidents in radiotherapy, the International Atomic Energy Agency established an International Action Plan (IAP) in 2002 in cooperation with international organisations and professional bodies. The achievements of the IAP, which include harmonised training material, guidance documents, a number of publications, a website on radiation protection of patients (http://rpop.iaea.

Radiation effects in fluoroscopically guided cardiac interventions--keeping them under control.

It would appear that a significant number of cardiologists are unaware that skin injuries ranging from erythema to telangiectasia or even dermal necrosis can be caused by the procedures they perform. Conditions that have been reported to be associated with radiation-induced skin injuries include: the high values of the exposure factors required with thick patients; prolonged or multiple procedures; elevated radiosensitivity of some patients (ataxia telangiectasia); connective tissue disease and diabetes mellitus. The total number of reported severe injuries worldwide so far is 100-200, or over 200 when all degrees of skin injuries are included, but the real number may be substantially larger since initial symptoms often appear only weeks after the procedure and the cardiologist may not be notified, unless a procedure for systematic follow up is in place.