Estimation of the collective dose in the Portuguese population due to medical procedures in 2010

Abstract

In a wide range of medical fields, technological advancements have led to an increase in the average collective dose in national populations worldwide. Periodic estimations of the average collective population dose due to medical exposure is, therefore of utmost importance, and is now mandatory in countries within the European Union (article 12 of EURATOM directive 97/43). Presented in this work is a report on the estimation of the collective dose in the Portuguese population due to nuclear medicine diagnostic procedures and the Top 20 diagnostic radiology examinations, which represent the 20 exams that contribute the most to the total collective dose in diagnostic radiology and interventional procedures in Europe. This work involved the collaboration of a multidisciplinary taskforce comprising representatives of all major Portuguese stakeholders (universities, research institutions, public and private healthcare providers, administrative services of the National Healthcare System, scientific and professional associations and private service providers). This allowed us to gather a comprehensive amount of data necessary for a robust estimation of the collective effective dose to the Portuguese population. The methodology used for data collection and dose estimation was based on European Commission recommendations, as this work was performed in the framework of the European wide Dose Datamed II project. This is the first study estimating the collective dose for the population in Portugal, considering such a wide national coverage and range of procedures and consisting of important baseline reference data. The taskforce intends to continue developing periodic collective dose estimations in the future. The estimated annual average effective dose for the Portuguese population was of 0.080±0.017 mSv caput(-1) for nuclear medicine exams and of 0.96±0.68 mSv caput(-1) for the Top 20 diagnostic radiology exams.

Estimated collective effective dose to the population from nuclear medicine diagnostic procedures in Croatia: A comparison of 2010 and 2015

“…Though the major part of medical exposure comes from diagnostic X-rays, it has been shown that contribution of nuclear medicine (NM) diagnostic procedures in most developed countries is between 4% and 14% [4–6]. …”

European Guidelines for AP/PA chest X-rays: routinely satisfiable in a paediatric radiology division?

“…Optimal collimation reduces (scatter) radiation and improves image quality, especially contrast and resolution [20]. Although radiation doses for individual chest radiographs are considered low [15,21], both the collective dose applied due to the volume of examinations performed [22][23][24] and the individual patient dose from repeated chest X-rays can be notable.…”

Trends in thyroid cancer incidence and mortality in Portugal

“…Exposure to known risk factors such as radiation from diagnostic tests (Schonfeld et al, 2011), including the use of iodinated contrast agents (Baker and Bhatti, 2006) and medical imaging [dental radiography (Memon et al, 2010) and computed tomography scans (Baker and Bhatti, 2006)], radiotherapy for the treatment of the head and neck malignancies (Ron et al, 1995) and exposure to environmental ionizing radiation (Richardson, 2009), has been linked to thyroid cancer, and exposure to some of these factors has increased in the last decades (Mettler et al, 2008; United Nations Scientific Committee on the Effects of Atomic Radiation, 2010). In Portugal, specifically, estimates of radiodiagnosis in 2010 were twice those observed in 1992 (Serro et al, 1992;Teles et al, 2013). As thyroid cancer is much more common in women than men, a role of female hormones in thyroid cancer has been hypothesized; however, the evidence supporting a relation between reproductive factors such as age of menarche, menopause or number of pregnancies and this type of cancer (Rahbari et al, 2010) is still The mean number of cases per year is shown: for incidence, the number of cases from 3 years was used to increase the precision of estimates from Regional Cancer Registries with small numbers of cases (2007)(2008)(2009) was selected because it is the most recent period with data available from all Regional Cancer Registries); for mortality, the number of deaths from 8 years was used for each of the Portuguese regions (2004-2012 was selected to increase the precision of estimates for regions with very small numbers of cases).…”