Analysis of medical exposure levels of the Russian Federation population in 2023 using the updated form No. 3–DOZ

   Introduction: To successfully address the challenges of optimizing radiation protection during medical exposure, it is essential to have information on patient exposure levels and the structure of diagnostic radiology in medical organizations across the Russian Federation.

   Materials and Methods: The primary source of data on patient exposure levels and the structure of diagnostic radiology is the Form No. 3-DOZ, a part of the Unified state statistical monitoring system for controlling and recording individual radiation doses of citizens.

   The aim of this study was to comprehensively evaluate the results of completing Form No. 3-DOZ for 2023.
   The study utilized data from the Form No. 3-DOZ at the level of the constituent entities of the Russian Federation, obtained from the Federal Database on Individual Radiation Doses of Citizens during medical diagnostic X-ray radiological procedures.

   Results and Discussion: The collective dose from medical exposure among the adult population increased by 34 % in 2023 compared to 2022. The most significant increases in the collective doses were observed for radiographic (81 %), radionuclide (49 %), and interventional (57 %) procedures. For the first time in the past five years, the increase in collective doses for X-ray radiological procedures was not accompanied by a corresponding increase in the number of procedures, indicating a rise in average and individual effective doses for patients. The average effective dose per resident of the Russian Federation due to medical exposure in 2023 increased by more than one and a half times: 1.12 mSv compared to 0.86 mSv in 2022. The increase in collective doses for various types of diagnostic radiology is driven by the rise in average effective doses for different X-ray radiological procedures across regions of the Russian Federation. The greatest variations in average effective doses were observed for radiographic procedures (an increase of up to 2.5 times in 2023 compared to 2022).

   Conclusion: These changes in average effective doses may be attributed to errors in calculating effective doses and completing the Form No. 3-DOZ, as well as to objective changes in the equipment fleet and/or protocols for conducting X-ray procedures. At the same time, several regions of the Russian Federation reported anomalously low average effective doses. To identify the reasons for abnormally high and/or low effective doses during diagnostic radiology procedures, it is necessary to develop and test a methodology for verifying the data submitted in the Form No. 3-DOZ.

1. Results of Radiation and Hygiene Certification in the Subjects of the Russian Federation for 2022 (Radiation and Hygiene Passport of the Russian Federation). Moscow: Rospotrebnadzor; 2023. 134 p. (In Russian).

2. ICRP Publication 103. The 2007 Recommendations of the International Commission on Radiological Protection : translation from English. Ed. by MF Kiselev, NK Shandala. Moscow: «Alana»; 2009. 312 p. (In Russian).

3. International Atomic Energy Agency. Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards. GSR Part 3. Vienna: IAEA; 2015. 518 p. (In Russian).

4. Radiation protection and safety in medical uses of ionizing radiation. Specific safety guide SSG-46. IAEA, Vienna; 2018. 340 p.

5. Onischenko GG, Popova AYu, Romanovich IK, Vodovatov AV, Bashketova NS, Istorik OA, et al. Modern principles of the radiation protection from sources of ionizing radiation in medicine. Part 2: Radiation risks and development of the system of radiation protection. Radiatsionnaya Gygiena = Radiation Hygiene. 2019;12(2): 6-24. (In Russian). DOI: 10.21514/1998-426X-2019-12-2-6-24.

6. Vodovatov A, Chipiga L, Druzhinina P, Shatsky I, Petryakova A, Sarycheva S, et al. Update of the federal governmental statistical surveillance form No 3-DOZ: “Data on patient doses from medical X-ray examinations”— Part 2 (FORM completion Recommendations). Digital Diagnostics. 2023;4(3): 322−339. (In Russian). DOI: 10.17816/DD530656. EDN: XLHQWW.

7. Vodovatov A, Romanovich I, Alekhnovich A, Biblin A, Akhmatdinov R, Druzhinina P, et al. Ensuring Radiation Safety of Patients in the Russian Federation During Diagnostic Medical Radiation: Current State, Problems, and Solutions. Medical Physics. 2024;(4): 33-49. (In Russian). DOI: 10.52775/1810-200X-2024-104-4-33-49.