LES ACTIVITÉS NUCLÉAIRES : RAYONNEMENTS IONISANTS ET RISQUES POUR LA SANTÉ ET L’ENVIRONNEMENT At present, only 63% of the interventional radiology departments and 60% of the operating theatres have rooms conforming to the requirements of the above-mentioned ASN resolution 2017- DC-0591 of 13 June 2017 setting the technical fitting out rules and have drawn up a conformity report. These percentages have varied little over the last five years. The centres still mention financial difficulties and technical difficulties in particular in meeting the signalling requirements in the restricted areas, particularly with the emergence of new technologies that make electrical network modifications necessary. In accordance with article 12 of ASN resolution DC-0704-2021 of 4 February 2021, the RNA is granted a transitional period in which to submit an application for registration covering all interventional activities: two years where the establishment performs intracranial interventional procedures, four years where it performs cardiology or spinal interventional procedures without intracranial activity, and six years where it performs neither intracranial, cardiology nor spinal procedures. Thus, establishments whose activities fall within a timeframe of four years or less must now be covered by a registration scheme, while those falling within the six-year timeframe remain temporarily under the declaration scheme. ASNR reminds that registration applications should be submitted approximately six months in advance to allow sufficient time for a thorough review of the applications. 2.4.3.1 Radiation protection of medical professionals ASNR considers the level of radiation protection for workers to be satisfactory. Improvements have been noted in both operating theatres and interventional imaging departments, although shortcomings remain in the training of professionals in occupational radiation protection. In fact, the finding concerning the lack of training of the medical professionals in occupational radiation protection in 2025 is identical to the preceding years. This is a recurrent issue, particularly in operating theatres, where only 21% of the medical personnel (as opposed to 30% in interventional imaging departments) and 34 % of the paramedical personnel (compared with 53% in interventional imaging departments) are trained. Although this percentage is higher than in 2024, the level of training in occupational radiation protection remains a subject of concern to which employers should devote particular attention. ASNR observes in 2025, as in 2024, significant use of Radiation Protection Organisations (RPOs), either as a specialised contributor to assist an internal RPE-O, or as an RPA. The use of RPOs can partly explain the difficulties in training the personnel due to the lower organisational flexibility of outsourced training sessions. Furthermore, calling upon an RPO necessitates supervision of this service with strong internal mobilisation and an interlocutor who is capable of following through with the radiation protection questions, because the on-site presence of the RPO’s personnel is often very limited. Without close involvement of the centres, the RPO’s will use standardised documents that ignore the departments’ particularities. Furthermore, these documents are often poorly understood or even unknown to the teams, who have difficulties in assimilating them. Yet compliance with and assimilation of the occupational radiation protection requirements is dependent on a high degree of involvement of the people who ensure in particular the correct implementation of radiological zoning, the radiation protection verifications and the occupational radiation protection training courses. ASNR also took coercive and sanctioning measures against an RPE. In 2024, ASN informed the Public Prosecutor, pursuant to Article 40 of the Criminal Procedure Code, of matters identified during an inspection that could constitute the offences of forgery and use of forged documents relating to a forged conformity report for an operating theatre in a healthcare facility. The Public Prosecutor upheld this report and opened an investigation, which was entrusted to the Central Office for Combating Offences against the Environment and Public Health (OCLAESP). As a result of the investigation, the RPE-O concerned from the relevant RPO was sentenced to a ten-month suspended prison term. Coordinating prevention measures with outside contractors, including private practitioners, is also an area for progress in interventional imaging departments and operating theatres alike. The percentage of inspected departments having formalised prevention measures with all their outside contractors through a prevention plan varies between 17 and 31% for the 2021‑2025 period. In 2025, only 31% of the inspected centres had formalised these measures. Yet knowledge of the risks linked to ionising radiation and of the appropriate prevention measures for the situations encountered, particularly by private practitioners, is a prerequisite for ensuring their radiation protection and that of other professionals. In 77% of the operating theatres inspected in 2025, the medical personnel have dosimetric monitoring devices available in sufficient quantity and appropriate for their types of exposure. This situation has regressed since 2024, where 71% of the inspected centres provided appropriate dosimetry equipment. ASNR also notes that the analysis of dosimetric results by RPE-Os has improved over the past five years, enabling poor practices to be identified and addressed, both in interventional imaging departments and in operating theatres. In 2025, 83% of interventional imaging departments and 80% of operating theatres analysed dosimetric results, compared with 69% for both interventional imaging departments and operating theatres in 2021. Lastly, as in 2024, the inspections of private practitioners revealed non-conformities concerning training, dosimetric monitoring and the assessment of occupational risks for these professionals and their employees. They provided the opportunity to remind the private practitioners of employers’ obligations to prevent both their own and their employees’ occupational risks linked to exposure to ionising radiation. Radiation protection technical verifications ASNR notes that the verification programme for work equipment and radiation protection instrumentation is drawn up and implemented in 59% of the interventional imaging departments and 65% of the operating theatres. When nonconformities had been identified, they had been corrected or were in the course of being corrected on the date of inspection in 75% of the cases. 2.4.3.2 Radiation protection of patients Of the departments performing FGIPs inspected in 2025, 84% call upon a medical physicist and have a POPM describing the organisation for involving a medical physicist, whose duties and times of presence on site are defined according to the centre’s activities. ASNR notes an improvement over the period 20212025, when the rate was 52% in 2021. Recourse to outside contractors for medical physics services continues to expand in private sector centres and public hospitals alike. The outsourcing of medical physics duties is largely delegated to special advisors who intervene on site as and when required. ASNR points out that close collaboration between healthcare professionals and the medical physicist and regular presence of the physicist in the departments lead to optimised use of the equipment, with the setting up of protocols adapted to the procedures, recording of delivered doses and evaluation with regard to the locally-defined dosimetric reference levels. ASNR notes that the external medical physicists working under a service contract are rarely present on the sites, including when the presence of a medical physicist is required by the regulations, for example during medical device acceptance tests and the setting up of optimised protocols under article 10 of ASN resolution 2021-DC-0704. ASNR has noted for several years that the outsourcing of medical physics services, when not properly structured, can lead to 216 ASNR Report on the state of nuclear safety and radiation protection in France in 2025
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