radhydРадиационная гигиенаRadiatsionnaya Gygiena = Radiation Hygiene1998-426X2409-9082NIIRG10.21514/1998-426X-2024-17-1-97-110radhyd-1021Research ArticleОбзорыReviewsРадиационные аварии в лучевой и радионуклидной диагностике и терапии: сравнение российских и международных подходов к терминологии и классификацииRadiation accidents in X-ray and radionuclide diagnostics and therapy: comparison of Russian and international approaches to the terminology and classificationhttps://orcid.org/0000-0002-5191-7535ВодоватовА. В.VodovatovA. V.

Водоватов Александр Валерьевич – кандидат биологических наук, ведущий научный сотрудник, заведующий лабораторией радиационной гигиены медицинских организаций Санкт-Петербургского научно-исследовательского института радиационной гигиены имени профессора П.В. Рамзаева; доцент кафедры общей гигиены Санкт-Петербургского государственного педиатрического медицинского университета

197101, ул. Мира 8, Санкт-Петербург

Aleksandr V. Vodovatov – Ph.D., Head of Laboratory, Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev;  docent, Saint-Petersburg State Pediatric Medical University

Mira Str., 8, Saint-Petersburg, 197101

vodovatoff@gmail.comhttps://orcid.org/0000-0001-9153-3061ЧипигаЛ. А.ChipigaL. A.

Чипига Лариса Александровна – кандидат технических наук, научный сотрудник лаборатории радиационной гигиены медицинских организаций Санкт-Петербургского научно-исследовательского института радиационной гигиены имени профессора П.В. Рамзаева;  научный сотрудник Российского научного центра радиологии и хирургических технологий имени академика А.М. Гранова; доцент кафедры ядерной медицины и радиационных технологий Национального медицинского исследовательского центра им. В.А. Алмазова

Санкт-Петербург

Larisa A. Chipiga – Ph.D., research fellow, Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev;  research fellow, A.M. Granov Russian Scientific Center of Radiology and Surgical Technologies of the Ministry of Health; docent, Almazov National Medical Research Centre 

Saint-Petersburg

https://orcid.org/0000-0002-0640-7368РыжовС. А.RyzhovS. A.

Рыжов Сергей Анатольевич – вице-президент Ассоциации медицинских физиков России; начальник отдела радиационной безопасности и медицинской физики Национального медицинского исследовательского центра детской гематологии, онкологии и иммунологии имени Дмитрия Рогачева; научный сотрудник Научно-практического клинического центра диагностики и телемедицинских технологий 

Москва

Sergey A. Ryzhov – vice president, Association of Medical Physicists in Russia; research fellow, Research and Practice Center of Diagnostics and Telemedicine Technologies; head of the radiation safety and medical physics department, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

 Moscow

https://orcid.org/0000-0003-2663-9091ПетряковаА. В.PetryakovaA. V.

Петрякова Анастасия Валерьевна – младший научный сотрудник лаборатории радиационной гигиены медицинских организаций Санкт-Петербургского научно-исследовательского института радиационной гигиены имени профессора П.В. Рамзаева; инженер по радиационной безопасности Городской больницы № 40 Курортного района

Санкт-Петербург

Anastasia V. Petryakova – acting junior researcher, Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev; radiation safety engineer, Saint-Petersburg City Hospital No. 40

Saint-Petersburg

https://orcid.org/0000-0002-3139-2479БиблинА. М.BiblinA. M.

Библин Артем Михайлович – старший научный сотрудник, руководитель Информационно-аналитического центра 

 Санкт-Петербург

Artem M. Biblin – senior research fellow, head of Information-analytical center

Saint-Petersburg

https://orcid.org/0000-0001-7310-9718ГорскийГ. А.GorskyG. A.

Горский Григорий Анатольевич – кандидат медицинских наук, заместитель директора по инновационной работе Санкт-Петербургского научно-исследовательского института радиационной гигиены имени профессора П.В. Рамзаева; доцент кафедры гигиены условий воспитания, обучения, труда и радиационной гигиены Северо-Западного государственного медицинского университета им. И.И. Мечникова

Санкт-Петербург

Grigory A. Gorsky – Ph.D., Deputy Director of the Innovation work, Saint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev

Saint-Petersburg

Санкт-Петербургский научно-исследовательский институт радиационной гигиены имени профессора П.В. Рамзаева, Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека; Санкт-Петербургский государственный педиатрический медицинский университетРоссияSaint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing; Saint-Petersburg State Pediatric Medical UniversityRussian FederationСанкт-Петербургский научно-исследовательский институт радиационной гигиены имени профессора П.В. Рамзаева, Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека; Российский научный центр радиологии и хирургических технологий имени академика А.М. Гранова; Национальный медицинский исследовательский центр им. В.А. АлмазоваРоссияSaint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing; A. Granov Russian Scientific Center of Radiology and Surgical Technologies of the Ministry of Health; Almazov National Medical Research Centre of the Ministry of HealthRussian FederationАссоциация медицинских физиков России; Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии имени Дмитрия Рогачева; Научно-практический клинический центр диагностики и телемедицинских технологий Департамента здравоохранения города МосквыРоссияAssociation of Medical Physicists of Russia; Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Health; Research and Practical Clinical Centre of Diagnostics and Telemedicine Technologies of Moscow Healthcare DepartmentRussian FederationСанкт-Петербургский научно-исследовательский институт радиационной гигиены имени профессора П.В. Рамзаева, Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека; Городская больница №40 Курортного районаРоссияSaint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing; The City Hospital No 40 of the Kurortny DistrictRussian FederationСанкт-Петербургский научно-исследовательский институт радиационной гигиены имени профессора П.В. Рамзаева, Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человекаРоссияSaint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance of Consumer Rights Protection and Human WellbeingRussian FederationСанкт-Петербургский научно-исследовательский институт радиационной гигиены имени профессора П.В. Рамзаева, Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека; Северо-Западный государственный медицинский университет им. И.И. МечниковаРоссияSaint-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing; I. Mechnikov North Western State Medical UniversityRussian Federation20242104202417197110Copyright © Водоватов А.В., Чипига Л.А., Рыжов С.А., Петрякова А.В., Библин А.М., Горский Г.А., 20242024Водоватов А.В., Чипига Л.А., Рыжов С.А., Петрякова А.В., Библин А.М., Горский Г.А.Vodovatov A.V., Chipiga L.A., Ryzhov S.A., Petryakova A.V., Biblin A.M., Gorsky G.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.radhyg.ru/jour/article/view/1021

Внедрение новых методов ядерной медицины, лучевой диагностики и терапии с использованием медицинских источников ионизирующего излучения неизбежно приводит к росту числа и видов аварийных (нештатных) ситуаций. В международной практике в последние годы особое внимание уделяется вопросам предотвращения радиационных аварий и происшествий при медицинском облучении. При этом основной акцент сделан на аварийном облучении (переоблучении) пациентов в рентгеновской и радионуклидной диагностике и терапии. Данные подходы в отечественных нормативно-методических документах реализованы ограниченно и формально. Основное внимание уделяется крупномасштабным техногенным радиационным авариям, а аварийные (нештатные) ситуации при медицинском облучении незаслуженно игнорируются. Целью работы являлся анализ терминологии и классификации радиационных аварий и происшествий при медицинском облучении в Российской Федерации и зарубежных странах для разработки предложений по совершенствованию подходов к их классификации в рамках переработки действующих нормативно-методических документов. Результаты работы показали, что необходимо актуализировать отечественные подходы к определению и классификации радиационных аварий в медицине с учетом специфики медицинского облучения. Для этого целесообразно ввести различные уровни аварийных (нештатных) ситуаций, отличающиеся друг от друга масштабами воздействия и последствий для пациентов, персонала и населения. С учетом отсутствия проработанных сценариев аварийных (нештатных) ситуаций в отечественных нормативно-методических документах, такую градацию возможно заимствовать из международных регулирующих документов при условии ее адаптации под специфику и реалии отечественной системы здравоохранения.

Introduction of new methods of nuclear medicine, X-ray diagnostics and therapy using medical sources of ionizing radiation inevitably leads to an increase in the number and types of accidents (abnormal situations). In international practice in recent years, special attention has been paid to the prevention of radiation accidents and incidents from medical exposure. The main focus is put on accidental exposure (overexposure) of patients in X-ray and radionuclide diagnostics and therapy. These approaches are implemented in Russian regulatory and methodological documents in a limited and formal way. The main attention is paid to large-scale technogenic radiation accidents, and accidents (abnormal situations) from medical irradiation are undeservedly ignored. The aim of the work was to analyze the terminology and classification of radiation accidents and incidents from medical exposure in the Russian Federation and foreign countries to develop proposals to improve approaches to their classification within the framework of revision of existing regulatory and methodological documents. The results of the work indicate that it is necessary to actualize Russian approaches to the definition and classification of radiation accidents in medicine considering the specifics of medical exposure. For this purpose, it is advisable to introduce different levels of accidents (abnormal situations), differing from each other by the scale of impact and consequences for patients, workers and public. Considering the absence of elaborated scenarios of accidents (abnormal situations) in Russian regulatory and methodological documents, such gradation can be borrowed from international regulatory documents provided that it is adapted to the specifics and realities of the Russian health care system

радиационная авариярадиационное происшествиемедицинское облучениепациентыперсоналradiation accidentradiation incidentmedical exposurepatientsstaffРабота выполнена в рамках отраслевой программы Роспотребнадзора «Разработка и научное обоснование комплекса мер по обеспечению радиационной защиты в ядерной медицине» а также в рамках НИР «Научное развитие медико-технологических и организационных аспектов обеспечения радиационной безопасности при оказании медицинской помощи», (№ ЕГИСУ: №123031500006-9) в соответствии с Приказом от 21.12.2022 г. № 1196 «Об утверждении государственных заданий, финансовое обеспечение которых осуществляется за счет средств бюджета города Москвы государственным бюджетным (автономным) учреждениям подведомственным Департаменту здравоохранения города Москвы, на 2023 год и плановый период 2024 и 2025 годов» Департамента здравоохранения города МосквыThe work was performed as a part of the program of Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being “Development and scientific justification of a set of measures to ensure radiation protection in nuclear medicine” and within the framework of the research work «Scientific development of medical-technological and organizational aspects of radiation safety in the provision of medical care», (No. EGISU: №123031500006-9) in accordance with the Order of 21.12.2022 № 1196 «On approval of state tasks, financial support of which is carried out at the expense of the budget of the city of Moscow to state budgetary (autonomous) institutions subordinate to the Department of Health of the city of Moscow, for 2023 and the planning period of 2024 and 2025 years» of the Department of Health of the city of Moscow.ReferencesIAEA Safety Standards Series. 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The authors declare that there are no conflicts of interest present.