LES ACTIVITÉS NUCLÉAIRES : RAYONNEMENTS IONISANTS ET RISQUES POUR LA SANTÉ ET L’ENVIRONNEMENT differ depending on whether they concern diagnostic or therapeutic procedures. Until 2024, the frequency of inspections was set at fiveyearly intervals for departments performing diagnostic examinations only, four-yearly intervals for departments performing diagnostic examinations and outpatient therapies (iodine administered at activities below 800 megabecquerels (MBq), radiosynoviorthesis, etc.), and three-yearly intervals for departments performing complex therapies using iodine at activities above 800 MBq, lutetium-177 or yttrium-90 (with or without hospitalisation in a radiation-proof room). Since 2025, these frequencies have changed to take into account the reform of healthcare licenses, which has separated nuclear medicine departments into two categories (level A and level B) on the basis of their risks. Consequently, level-B nuclear medicine departments are inspected every three years whereas level-A departments are inspected every five years (see point 1.3.3). With regard to the radiation protection risks, the ASNR inspections focus on radiation protection of workers (organisation of radiation protection, delimiting restricted areas, ambient dosimetry, personnel dosimetry) and patients (analysis of DRLs, quality control of medical devices, control of dispensing of RPDs,) and source management (circuit followed by unsealed sources, from delivery to disposal, such as the delivery reception premises, storage tanks and effluent discharges). In 2025, 75 nuclear medicine departments were inspected, representing 29% of the facilities. As in previous years, during these inspections, the centres inspected mentioned staffing problems, particularly with radiographers (recruitment difficulties, high turnover), and difficulties in recruiting practitioners in certain regions. The progressive reform of the healthcare licences also raises the question of whether there are enough radiopharmacists, as they must now assist the level-A nuclear medicine departments. Given the development of ITR, the number of medical physicists is also a focus of attention. ASNR pays particular attention to assessing whether centres have adequate resources, particularly in connection with new projects and increasing activity, as well as the competency sign-off of newly recruited professionals and, where applicable, their authorisation to undertake new practices. ASNR continued its inspection campaign on non-contamination monitoring, in order to assess how the risk of contamination is controlled by RNAs. After three centres in 2024, five new centres have been inspected. The atmospheric and surface contamination measurements were taken using air samplers and contamination meters and by laboratory analysis of smear samples. The measurement and sampling points were determined by the ASNR experts based on the plans of the department and its activities on the day the measurements were taken. They concerned both key places in the department and measurement points in adjacent rooms (preinjection waiting room, corridor in a non-restricted area, etc.). The first returns from these measurement campaigns indicate generally good control of the contamination risk in the departments inspected. The analysis reports are then communicated to the RNA so that they can be taken into account when defining measurement points that will be subject to statutory verifications. An OEF review of these campaigns will be conducted to share methodologies for defining measurement points and to define the criteria on which such inspections could be scheduled from time to time in the future. 2.3.3.1 Radiation protection of nuclear medicine professionals From the radiological viewpoint, the personnel are subjected to a risk of external exposure – in particular on the fingers – due to the handling of certain radionuclides (case with fluorine-18, iodine-131, gallium-68, yttrium-90, radium-223 and actinium-225) when preparing and injecting RPDs, and a risk of internal exposure through accidental intake of radioactive substances (for example, technetium-99). The findings from inspections carried out in 2025 reveal a degree of stability in compliance with radiation protection requirements for workers, although the overall picture remains mixed depending on the areas inspected (see Graph 6). The monitoring and analysis of occupational exposures are considered more satisfactory than in the facilities inspected in 2024, with 87% of the departments inspected in 2025 complying with these requirements, compared with only 77% in the previous year, and approaching the average level observed over the period 2020–2024 (90%). Better compliance was observed in departments performing therapeutic activities (95% of the 22 departments inspected on this topic in 2025). The updating of radiation protection training for professionals has slowed following the sharp increase observed in the previous year (73% of the departments inspected had all the professionals concerned trained within the previous three years, compared with 78% in 2024 and 59% in 2023). The other shortcomings identified concern failures to verify the risk of atmospheric contamination or surface contamination in areas adjacent to premises where radionuclides are handled, as well as verification of work equipment and sealed sources. The marked decline in compliance observed for these latter requirements since 2023 has been confirmed. Only 62% of the departments inspected were able to demonstrate that all sources and equipment had been verified at the required regulatory frequency. Furthermore, only 59% of the departments inspected had carried out compliance work further to the nonconformities identified at the last verifications. The level of compliance is improving, but there is still room for improvement in the case of departments involved in therapy (68%). The second area for improvement, also recurrent, is the coordination of the prevention measures with outside contractors, with only 39% of the nuclear medicine departments having drawn up a prevention plan with all their outside contractors, consistent with the observations of previous years (36% in 2024 and 41% in 2023). On the other hand, the designation of a Radiation Protection Expert-Officer (RPE-O) within the nuclear medicine department is well established (an appointment issued by the employer in all departments inspected), and the delineation of regulated areas reached a higher level in 2025, with 89% of the departments inspected having correctly delineated these areas in light of the verifications carried out (compared with 80% in 2024 and an average of 80% over the period 2020–2024). 2.3.3.2 Radiation protection of nuclear medicine patients The improvement in the optimisation approach that emerged the previous year has been confirmed, with 89% of the departments deploying a complete DRL management system, compared with 82% in 2024 and an average of 70% over the period 2020-2024 (see Graph 7), even if difficulties are still observed from time to time, to the extent that some departments have no optimisation approach whatsoever. Management of the third-party quality controls of MDs remains at a satisfactory level since, in 2025 as in 2024, 89% of the inspected departments had carried out the quality controls on all their MDs at the required regulatory frequency (see Graph 7). This rate reached 100% for the 22 departments audited for therapy. Since the successive publications of ASN resolutions 2019-DC-0660 and 2021-DC-0708 setting quality assurance obligations resolutions setting out quality assurance obligations for medical imaging and therapeutic procedures respectively, inspectors have observed encouraging progress reflecting the commitment and investment of nuclear medicine departments in the deployment of QSMS. However, the areas examined in greater depth in the departments inspected in 2025 on the therapy topic reveal performance that remains inadequate, whether in terms of oversight of the risk management process (only 24% of these departments assess the implementation and effectiveness of their QSMS every two years, communicate the results of that assessment to the person responsible for the nuclear activity and update their action programmes accordingly) or prospective risk management (only 38% of these departments ASNR Report on the state of nuclear safety and radiation protection in France in 2025 209 01 05 02 03 04 09 06 10 07 11 13 08 12 A / Z
RkJQdWJsaXNoZXIy NjQ0NzU=