LES ACTIVITÉS NUCLÉAIRES : RAYONNEMENTS IONISANTS ET RISQUES POUR LA SANTÉ ET L’ENVIRONNEMENT account the involvement of management teams, OEF from healthcare facilities, treatment planning, and the adequacy of resources in relation to the missions and projects implemented by the centres. Each year, a typology of significant radiation protection events is identified and used as a guideline to assess risk management by the centres. At the same time, a questionnaire entitled “Information relating to the operation of the radiotherapy department” was developed and distributed to all centres with the aim of better assessing whether staffing resources are aligned with the centres’ workforce requirements. The data collected annually from this questionnaire will be used to guide ASNR’s inspection programme. An initial informationgathering exercise was carried out in 2025. Although the RNAs are given advance notice of the majority of routine inspections (see chapter 3), unannounced inspections may be carried out. Seven unannounced inspections were carried out in 2025 (1 in FGIP, 3 in conventional, 1 in radiotherapy and 2 in CT scanning – see point 2.1.3). Furthermore, inspections may be carried out in the commissioning context when installing new Medical Devices (MDs) or for new facilities, and when investigating ESRs. 1.5 Significant radiation protection events It is mandatory for ASNR to be notified of ESRs pursuant to the Public Health code (Articles L. 1333‑13, R. 1333‑21 and 22 and the French Labour Code (Article R. 4451‑74 – see chapter 3, point 3.3). In the medical field, ESRs have been notified to ASNR since 2007. Following analysis, these notifications provide Operational Experience Feedback to professionals, with a view to the continuous improvement of radiation protection. An on-line services portal has been provided at teleservices.asn.fr to enable all the medical professionals to file their notifications on line. This notification portal is integrated in the adverse public health events reporting portal managed by the Ministry responsible for health. Depending on the type of event reported, the notification is sent automatically to ASNR (regional division and Department of ionising radiation and health – DIS), to the ARS for all events concerning the patient and to the ANSM for events relating to medical device vigilance or drug safety monitoring. The methods of notification and of codifying the significant events notification criteria defined in ASN Guide No. 11 are soon to be updated. The ASN-SFRO scale for rating events concerning patients undergoing radiotherapy or brachytherapy treatment remains unchanged. The aim of this scale, developed in collaboration with the French Society for Radiation Oncology (SFRO), is to inform the public about radiation protection events affecting patients in the course of a radiotherapy or brachytherapy treatment, taking into account, in addition to the confirmed consequences, the potential effects of the event and the number of patients exposed (see chapter 3). In addition to this, the incident notifications are published on asnr.fr. In order to meet its obligation to communicate to healthcare professionals the lessons learned from the analysis of events likely to affect the health of the persons mentioned in Article L. 1333-13, when these events are relevant to the radiation protection of patients (Article R. 1333-74 of the Public Health Code), ASNR regularly produces several information media: ∙“Learning from experience sheets” further to an ESR to rapidly inform the medical professionals potentially concerned in order to prevent the event from occurring in another centre; ∙“Patient safety - Paving the way for progress” bulletins, published since March 2011. This bulletin offers a thematic presentation of the good practices of medical departments and the recommendations developed by the professional organisations of the discipline concerned and the health and radiation protection institutions; ∙Circular letters addressed to the RNAs to draw their attention to particular points that have caused ESRs, to disseminate the lessons learned from these events and/or to make known its recommendations on the subject. To produce the first two types of information media, ASNR is assisted by two multidisciplinary Working Groups (WGs) in the fields of radiotherapy and imaging respectively. Documents of this type are published on the ASNR website in the section “Espace professionnels”, sub-section “Retour d’expérience”. The circulars are published in the sections devoted to each medical activity, under the sub-section “Lettres circulaires”. All of these communication media, over and beyond fulfilling ASNR’s obligation, are produced with particular care in order to promote the engagement of medical professionals and encourage the sharing of lessons learned from their OEF. Refer to point 2.7 below for further information on the work of these WGs. Nuclear based medical activity Routine frequency External-beam radiotherapy Every 4 years Brachytherapy Every 4 years Diagnostic nuclear medicine Every 5 years Out-patient nuclear medicine for therapeutic purposes (for example, iodine < 800 MBq, synoviortheses, etc.) Every 4 years Therapeutic nuclear medicine with complex therapies using iodine > 800 MBq, lutetium-177, yttrium-90 and hospitalisation Every 3 years High-risk fluoroscopy-guided interventional practices Approximately every 5 years(*) Computed tomography (emergencies or paediatrics with radiation protection risks) Sampling: about twenty installations per year * Depending on ASNR’s knowledge of the radiation protection situation of the facilities, on the basis in particular of the inspections carried out when issuing a registration. TABLE 2 Inspection frequency by nuclear-based medical activity ASNR Report on the state of nuclear safety and radiation protection in France in 2025 197 01 05 02 03 04 09 06 10 07 11 13 08 12 A / Z
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