MODERN PECULIARITIES OF THE MEDICAL EXPOSURE LEVELS FORMING OF THE TATARSTAN REPUBLIC POPULATION DURING X-RAY PROCEDURES IMPLEMENTATION

The purpose. The purpose of the investigation is an assessment of the peculiarities of forming and registration of the collective doses of patients and the population of the Tatarsatan Republic (RT) from medical exposure and the development of measures for optimization of this radiation factor.

Materials and methods. The analysis is based on the forms of the Federal statistical observation № 3-DOZ «Data on the exposure doses to patients obtained during medical radiological examination» (form № 3-DOZ) and radiation-hygienic passports of RT for the period from 2006 to 2013.

The results. Annually in RT there is an increase of the number of performed X-ray procedures, which reached the value of 6279696 (1.64 procedures per resident per year) in 2013. During the reporting period (from 2006 to 2013) the structure of the performed X-ray procedures has also changed. It is observed that the percentage of fluorography procedures in the overall structure decreased from 41.3% to 31.3% at the same time the level of absolute value of annually performed fluorography procedures is stable. There is an increase in the absolute number of radiographic procedures performed during the period from 2578754 to 4072810 X-rays per year, that is 1.58 times higher. Absolute and relative values related to X-ray fluoroscopy examinations decreased from 1.1% to 0.7%. In contrast, the absolute number of annually performed X-ray computed tomography examinations (CT) has increased over the period by 3.3 times and percentage of CT in overall structure of X-ray procedure is 2.7%. The number of special investigations has increased in 2.1 times, but the relative value remained at average level of 0.4% on general background of the increasing of X-ray activity in the region. This fact influenced the change in the radiation-hygienic indexes of medical radiation exposure of the population of RT. According to №3-DOZ forms and radiation-hygienic passports of the territories, the levels of the annual collective effective dose from medical exposure to the patients and population increases in the period from 2006 to 2012. The structure of the medical exposure has been significantly changed. If the dominant role in the formation of the annual collective effective dose in 2006 performed the fluorography procedures (609.17 person-Sv; 34.03% in the structure of the total collective dose from medical exposure), then the primary importance passed to СТ in 2013 (748.18 person-Sv; 50.04%). The article considers the peculiarities of the formation and recording of exposure doses to patients when performing various types of x-ray procedures.

Conclusion. The widespread use of the digital technologies of producing and processing of the X-ray images, an adjust instrumental control and registration of patient exposure doses, routine control of operational parameters of the equipment used for the fluorographic, X-ray and fluoroscopic procedures allowed to objectify and reduce correspondent indicators of the collective effective exposure doses to patients and population. There exists the reserve for organizational, technical measures for the further reduction of patient exposure doses during the performance of the routine X-ray procedures, namely the standardization of the performed examinations, further transition to the digital X-ray technologies of the image obtaining. The use of calculation methods of the patient dose registration continues to provide the significant influence on the statistical reporting when the performing of CT and special examinations. Taking into account the fact that CT provides the greatest contribution to the annual collective effective dose in the region in recent years (more than 50%, the first place in the structure of medical exposure), and special examinations of a high clinical efficient, are also accompanied by a significant radiation exposure it is necessary to apply the measures fore the objectification of the exposure doses for these types of examinations in order to develop scientifically justified measures to reduce adverse effects on the exposed population categories.

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