12 Areas Covered

2. 12 Areas Covered 1. Biological and Health Effects of Ionising Radiation 2. Measurement and Dosimetry 3. Radiation Protection System Development and Implementation 4. Stakeholder Engagement and Involvement 5. Non-Ionising Radiation 6. Planned Exposure Situations: Industry and Research 7. Planned Exposure Situations: Medicine 8. Planned Exposure Situations: Radioactive Waste Management 9. Emergency Exposure Situations 10. Existing Exposure Situations 11. Protection of the Environment 12. Fukushima

3. Area 1: Biological and Health Effects of Ionising Radiation

4. Area 1: Biological and Health Effects of Ionising Radiation The Current State of Knowledge • The level of risk of cancer at low doses/dose-rates is uncertain, although epidemiological studies indicate that it is small, but not zero. • Experimental evidence indicates that the biological response to radiation at low doses may be different from that at high doses, and that tissue response may be as (if not more) important as cell response.

5. Area 1: Biological and Health Effects of Ionising Radiation Challenges for the Coming Years • Non-cancer effects at low doses/dose-rates are growing in importance • cataracts now included in radiological protection • evidence for an excess risk of blood circulatory disease is growing and will have to be carefully assessed in terms of radiological protection • The linear no-threshold (LNT) dose-response model for cancer at low doses/dose-rates is still appropriate for radiological protection. • We can expect important new evidence on low dose/dose-rate effects from epidemiological and experimental studies in the near future.

6. Area 2: Measurement and Dosimetry

7. Area 2: Measurement and Dosimetry The Current State of Knowledge • 25% of all contributions to the Congress were in the Measurement and Dosimetry section! • Computational adult reference phantoms are being used increasingly in numerical dosimetry. These are now of variable size, weight and increasing reality. • Dose conversion coefficients for external radiation of workers based on ICRP 103 are published (ICRP 116). • Continuous progress in techniques, methods and application in all fields of dosimetry (external, internal, retrospective and numerical).

8. Area 2: Measurement and Dosimetry Challenges for the Coming Years • Eye lens dosimetry: need for convergence on instrumentation and for harmonization of procedures, emerging from a consensus in understanding the scope and characteristics of the issue in real circumstances. • Evaluation of dose coefficients for intakes of radio-nuclides for workers and for the public (age-dependent). • Application of realistic computational phantoms in radiation protection dosimetry, radiation medicine and risk assessments. • Further international harmonization of procedures and standards of dosimetry for: • Patients and • radiation protection. • Review of operational quantities for external exposures. • Complexity of dosimetric quantities used in radiation protection should be reviewed.

9. Area 3: Radiation Protection System

10. Area 3: Radiation Protection System Development and Implementation The Current State of Knowledge • Evolution and implementation / Regulation • Involvement of stakeholders for the elaboration of ICRP recommendations • Integration of new recommendations in new international BSS (IAEA, EU) • A search for harmonization of regulatory requirements between countries • Education and Training / RP Culture • Huge development of RP training schemes for RP professionals and other workers concerned by RP • Development of accreditation systems for RP professionals in various fields (instrumentation, medical, nuclear,..) • Elements contributing to the development of RP culture are well identified • Actions are undertaken by regulatory bodies, professional associations, networks to disseminate RP culture in various fields (industry, medical, public,…)

11. Area 3: Radiation Protection System Development and Implementation Challenges for the Coming Years • Evolution and implementation / Regulation • Integration of lessons learned from Fukushima in RP system • How to better involve the relevant stakeholders according to exposure situations (medical, public, Norm,..) • Effective national regulatory infrastructure is still needed in many countries • Education and Training / RP Culture • Setting E&T programmes in countries where they are missing • Prepare early enough the next generations • Take advantage of new technologies : eg. use of e-learning • Dissemination of RP culture guidelines from IRPA • Develop practical RP culture for the public

12. Area 4: Engaging with Society

13. Area 4: Engaging with SocietyThe Current State of Knowledge • Stakeholder engagement can be a valuable decision making or aiding tool for the radiation protection profession • The radiation protection professionals and organizations need new skills in order to implement effective stakeholder engagement • Affected people, including patients, and populations benefit greatly when the radiation protection profession implements stakeholder engagement to identify and address their issues • Many Countries are taking action to expand students’ knowledge of radiation • Use of the latest communications technologies (e.g., social media, webcasts) is enhancing participation and the transfer of knowledge and information within the profession and with stakeholders • The IRPA “Guiding Principles for Radiation Protection Professionals on Stakeholder Engagement” are sound guidance to promote stakeholder participation

14. Area 4: Engaging with SocietyChallenges for the Coming Years • Collecting and sharing lessons learned and best practices in the conduct of stakeholder engagement that upholds stakeholder dignity • Enhancing the use and effectiveness of radiation protection professionals and their employers by their gaining greater knowledge and experience in stakeholder engagement • Including and emphasizing the need for stakeholder engagement during emergency planning, particularly for post emergency activities during recovery and remediation • Expanding the experience gained in teaching students about radiation to a broader spectrum of society • Taking action to expand the use of the latest communications technology to enhance the efficiency and effectiveness of the profession • Expanding the implementation and use of the IRPA Guiding Principles for Stakeholder Engagement by the Associate Societies and radiation protection professionals

15. Area 5: Non-Ionising Radiation

16. Area 5: Non-Ionising Radiation The Current State of Knowledge Static magnetic fields • Adverse health effects not observed up to the maximum exposure levels currently attainable in practice Time-varying EMF • Acute effects and corresponding exposure thresholds are well established • Accurate numerical and measurement dosimetry • Carcinogenicity classification - possibly carcinogenic Optical radiation • UVR-induced damage to DNA is well established • Photochemical injury to retina and corresponding thresholds identified • Thermally induced injury mechanism well understood and thresholds established

17. Area 5: Non-Ionising Radiation Challenges for the Coming Years Static magnetic fields • Larger database of exposure conditions and effects (monitoring) required Time-varying EMF • Replication/validation of studies suggesting effects below the exposure guidelines • Identification of plausible interaction mechanisms for such effects • Improved numerical dosimetry (particularly for children’s exposure) • Epidemiology of mobile phone users (cohort studies) • Studies (epidemiological and biological ) on children exposed to RF • Characterization of exposure conditions due to emerging technologies • Extrapolation across different frequencies and for different sources of exposure Optical radiation • Exposure of internal tissues (e.g. for medical diagnostics) • Better definition of effective retinal spot size for collimated laser beams and radiation from special devices • Better definition of the threshold for health effects of IR exposure of the eye

18. Area 6: Planned Exposure Situations - Industry and Research

19. Area 6: Planned Exposure Situations - Industry and ResearchThe Current State of Knowledge Decommissioning • Development and implementation of specific RP programs for the dismantling of facilities (NPPs, Research facilities, laboratories,…): starting from site characterization towards decommissioning NORM • Significant progress has been made in identifying relevant industries and the RP issues • A more coherent international focus, and wider agreement on common exemption criteria (although these may not work for all scenarios) Industry and Research • RP framework for practices is well-established, and is effectively implemented in most cases • Increased use of ALARA tools for bench-marking and self-assessment • Industrial radiography remains an area of concern

20. Area 6: Planned Exposure Situations - Industry and ResearchChallenges for the Coming Years Decommissioning • Improve international experience exchange on radiation protection during decommissioning • Integrate lessons learned from decom. into the design of new facilities NORM • Need to ensure a graded, proportional approach to regulation, and greater international clarity and consistency • Waste management strategies and disposal options remain a priority. Industry and Research • Need a continued focus on the security requirements for sources, and in particular, how to implement these in SMEs, education and research • Need a new approach to improving RP standards in industrial radiography

21. Area 7: Planned Exposure Situations - Medical

22. Area 7: Planned Exposure Situations - MedicalThe Current State of Knowledge • Awareness & concern regarding the radiation risks associated with the expanding use of CT technology is growing. • The development & use of radiation safety audits & patient dosimetry programmes within hospitals is expanding, though is still very variable between countries.. • Diagnostic reference levels have now been developed in many countries, though not all. • Patients and their representatives are becoming more aware and interested in radiation safety issues. • Development of new therapeutic and diagnostic techniques has put demands on both dosimetry methods and optimisation strategies.

23. Area 7: Planned Exposure Situations: Medical Challenges for the Coming Years • Continuing epidemiology studies to assess risks from diagnostic X-ray procedures, particularly CT • Maintaining a robust system of justification for medical irradiation, particularly for paediatric patients, CT and screening programmes • Sharing & learning from experiences of errors & accidents particularly within radiotherapy and the use of high activity sources • Ensuring that dosimetry methods and optimisation strategies keep up with rapid developments in technology • Controlling & monitoring staff doses, particularly regarding changes in dose limit for the eye • Ensuring effective communication with stakeholders, particularly patients & equipment manufacturers

24. Area 8: Planned Exposure Situations - Radioactive Waste Management

25. Area 8: Planned Exposure Situations - Radioactive Waste Management The Current State of Knowledge • Optimization of protection received the most emphasis during development of ICRP recommendations on RP in geological disposal • Scope of new ICRP recommendations covers both humans and the environment • Best option is to optimize RP systems during early years of disposal system development • General trend to develop simple and pragmatic approaches to clearance and exemption criteria • The toolkits of models and methods for exposure assessments and safety cases exist • Stakeholder involvement models have been developed and applied in some countries with various levels of success

26. Area 8: Planned Exposure Situations - Radioactive Waste ManagementChallenges for the Coming Years • Ensuring oversight on closed geological facilities after operational phase • Need for countries to work together on international legislation and uniform standards (for instance UK and Nordic countries on North Sea NORM standards) • Obtaining enough site and facility specific information to use those tools to help make practical decisions (e.g. on facility siting, design and operation) • Stakeholder Involvement: How to respond to what you have heard, and have you really heard what they have said

27. Area 9: Emergency Exposure Situations

28. Area 9: Emergency Exposure SituationsThe Current State of Knowledge • The approach for emergency management and response as recommended in ICRP-60 is adequately implemented. • New events producing radiological emergency situations (such as loss of radioactive source control, malicious acts against nuclear facilities or radioactive sources) have been incorporated in the system • Accurate tools for source term and consequence estimate, assessment and follow up are available, and have wide international consensus for the methodologies used • Probabilistic methods are being introduced to improve these tools as effective help for decision making by emergency managers • Co-operation through international organizations, and bilateral agreements have been identified as key elements because of possible trans-boundary consequences and possible support needs from some countries • Extensive experience from medical consequences from radiation accidents has been gained, and adequate guidance for management of medical consequences is available • Mechanisms exist for experience and lessons learned from nuclear and radiological accidents feedback, both at national and international level. Experience and lessons learned from emergencies in other sectors are also considered. Emergency exercises are key to incorporating experience.

29. Area 9: Emergency Exposure SituationsChallenges for the Coming Years • Taking actions to implement in an internationally harmonized way new ICRP recommendations (ICRP-103), especially reference levels and optimization criteria • Including consideration of Fukushima events, source term and consequences, and their implications for emergency planning, event mitigation and consequence management • Engaging stakeholders in all emergency planning, management and response activities, in particular local stakeholders for immediate response measure planning and implementation • Emphasizing the need to develop and implement harmonized criteria and guidance for recovery phase after emergency • Enhancing communications management during emergency, considering current situation of world-wide live follow up of accidents through media and the internet. • Continuing research and development for radio-protective drugs as well as tools for quick dose and radiation damage assessment, and incorporating these into medical response criteria and guidance

30. Area 10: Existing Exposure Situations

31. Area 10: Existing Exposure SituationsThe Current State of Knowledge NORM • is present everywhere, and practically all countries have NORM problems • can contribute significantly to human and environmental exposures • Many countries have nuclear legacy sites and large contaminated territories Legacy Sites and Consumer Products • The radioactive contamination can persist in the environment which means: • People in affected areas are living with the problem for generations • Countermeasures, remediation and communication strategies must evolve with time and environmental/societal changes • Radioactive material is also found in consumer products and there is a lack of international regulation and harmonisation. • Complying with dose limits is particularly challenging for astronauts on long space flights Radon • Epidemiological evidence that radon causes lung cancer in both smokers and non-smokers • Much higher absolute risk for smokers, but the relative risk is the same for smokers and non-smokers • Most Rn-induced lung cancers occur at low to moderate concentrations • Knowledge about the efficiency of different prevention techniques is available

32. Area 10: Existing Exposure SituationsChallenges for the Coming Years NORM • How to use the concept of planned vs existing exposure situations on NORM • Challenges in choosing the right parameters for dose calculations + harmonisation. • How to deal with the large volumes of NORM, radioactive waste, and mixed wastes Legacy Sites and Consumer Products • How to develop adequate regulations to deal with nuclear legacy and ensure independent regulators and efficient supervision world-wide? • Risk assessments should be ‘as simple as possible, as complex as necessary’: more guidance needed. • There is a clear need to establish international trade regulation on radioactivity in consumer products. Accident Recovery • pre-disaster preparedness work to build resilience for the late phase recovery period • Communication with the public and stakeholder involvement has to be a long-term commitment • Need to better share information on NORM and nuclear legacy site regulation and management Radon • There may be other diseases induced by Rn, eg. childhood leukemia • Need proper measurement protocols necessary also for short term measurements • Consistent dosimetric approach (DCF, mSv, WLM), specifically for worker exposures • National Action Plans for Rn reduction • Training of building professionals

33. Area 11: Protection of the Environment

34. Area 11: Protection of the EnvironmentThe Current State of Knowledge • Databases have been assembled, in international collaboration, that relate to transfer, exposure and effects (this includes robust dosimetry and consideration of RBE) • Data gaps exist, with regard to: • Population dynamics at ecosystem level caused by indirect effects • Specific ecosystems • Generic protection systems are available • Such systems are being implemented to support Environmental Impact assessments, to inform stakeholders, and to provide a basis for informed decision-making

35. Area 11: Protection of the EnvironmentChallenges for the Coming Years • Develop the system for environmental radiation protection to (examples): • Provide means to assess priorities (and exempt where and when possible) • Adapt the system for environmental RP to different exposure situations • Guide data collection for protection purposes (specific environments, organisms, exposure pathways, facilities, etc.) • Understand the ecosystem context • Provide the means for incorporating Environmental RP in EISs • Respond to, and interact with, stakeholders – to be able to take more informed decisions

36. Area 12: Fukushima

37. Area 12: FukushimaThe Current State of Knowledge Current Status of Affected Lands • About 200 Km2 between 1 and 20 mSv/a • About 70 Km2 between 20 and 50 mSv/a • About 25 Km2 greater than 50 mSv/a • About 14000 people still under living restrictions

38. Area 12: Fukushima Challenges for the Coming Years • Revisit emergency planning approaches • Large-scale economic consequences • Beyond design basis accidents • Need improve preparedness • “Harmonisation” of numeric criteria? • coordination of emergency information and decisions • availability of resources (e.g. monitoring and measurement) • Need to focus more on recovery preparedness • Need to clarify RP System • The transition between emergency and recovery phase • Protection standards for workers in emergency situations • Collective dose/projected risks; quantities and units; limits, reference levels • Need to focus on public trust in authorities

39. THANKS!