Risk assessment of medical exposure in X-ray examinations of children

The use of the effective dose (the concept of which was developed for radiation protection of workers and public) and the nominal risk coefficients, averaged by sex and age, to assess the radiation risks of medical exposure has some significant limitations. Age and sex distribution of the staff and the entire population may be quite different from the sex and age distribution of patients undergoing medical exposure. Moreover, the structure of the age and sex of patients may be different for various medical examinations. There are simplified methods for evaluating individual risk for patients undergoing medical exposure. The methods are based on the effective dose evaluation and those take in to account age and gender. A more accurate assessment of lifetime risk of delayed stochastic effects for health of the patient is achieved by using the organ doses and the age and gender risk factors. The aim of this work was evaluation of the lifetime risk of long-term stochastic health effects for different gender and age groups of children undergoing various radiographic investigations by using organ doses and the age and gender risk factors, and subsequent classification in accordance with generally accepted international risk scale. Data from surveys of33 X-ray units in 29 specialized pediatric health care organizations in Russia were used in the work. Organ doses and patient’s effective doses were calculated on the basis of the defined for each x-ray machine typical modes for the 12 radiographic procedures (X-ray exam of the skull, chest, cervical spine, thoracic spine, lumbar spine–all in two projections – of the abdomen and pelvis – both in one projection)using a computer program PCXMC., Radiation risks for selected studies were estimated using the obtained organ doses and the age and gender risk factors calculated for the Russian population. The radiation risks were classified according to the international scale of the risks. It was found that the risk dependence on the sex and age is significant. For a number of examinations ,the gender dependence prevail; higher risks are intrinsic to female. For others examinations, a strong dependence on the age was revealed, such as an increase of the risk for the middle age group of children (10-14 years) compared to the younger and older groups.

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