1. HOW STAKEHOLDERS IN THE HEALTH SECTOR PERCEIVE THE ORGANIZATION OF RADIATION PROTECTION CONTROLS IN FRANCE
MENECHAL Ph. (SFRP) GAURON Ch.(INRS),
FRABOULET P. (AFPPE), KALIFA G. (Saint-Vincent de Paul Hospital), DE WILDE P. (Pitié-Salpétrière Hospital)

2. EXTERNAL ACTORS ASN AFSSAPS Work inspectorate DGS Health care facility
IRSN
Registered
organisms
CRAM

3. INTERNAL ACTORS
Manager
CHSCT (Hygiene, Safety and Working Conditions Committee)
Occupational physicians
Radiation Protection Competent Person (PCRP)
Physicists
Radiologists, radiographers
Biomedical engineers...

4. OCCUPATIONAL PHYSICIAN
a central actor in the French occupational health system
advises directly the employer and the workers about occupational risk management
prevents any harm to workers’ health condition due to work

5. OCCUPATIONAL PHYSICIAN
Works in collaboration with experts (physicists, PCRP…)
Assesses and improves radiological risk management
Deals with most problems concerning practices, training, management, devices

6. HOW DOES THE OCCUPATIONAL PHYSICIAN PERCEIVE RADIOPROTECTION CONTROLS?
Relies on sources of information from external controls
Dosimetric results
Workstation studies
Architectural conformities
Carries out medical visits
Internal actors’ role is essential
training actions, procedure controls, advice, equipment
incident investigation, feedback

7. The internal operational link of radiation protection system
PCRP
The internal operational link of radiation protection system
Works in collaboration with:
occupational physician
CHSCT
managers...
Acts as an adviser and as an expert

8. PCRP
Analyses the workplaces
Improves level of occupational expositions
Carries out training and spreads information
Manages risky situations
Enforces regulation
Gives technical advice
Performs active dosimetry, makes sure external controls are performed
Checks working situations

9. HOW DOES THE PCRP PERCEIVE EXTERNAL CONTROLS?
As an assessment of his job
As supporting and comforting his advice
As a means to dialogue with authorities
Limits to these external controls:
patient exposures controls
assessment of procedures and training levels
Importance of external + internal controls

10. RADIOGRAPHER
he is the last safeguard
he has essential knowledge
only radiographers are allowed to perform acts with ionising radiation
he receives regular training

11. RADIOGRAPHER
no contact with external actors
controls take into account mainly the compliance of medical devices and facilities
the regulatory external controls should take into account the training level of radiographers
receive advice from internal actors (PCRP and occupational physician)

12. THE RADIOLOGIST
Meeting point between the medical indication and the physical requirements
Specific training
Overall view of the different imaging technique
Real partner of clinicians,manufacturers and administators
Knowledge of the risks
RESPECT OF THE EURATOM97/43

13. these partners act also as «controllers»
THE RADIOLOGIST
PATIENTS
CLINICIANS
RADIOGRAPHERS
ADMINISTRATORS and or BUSINESSMEN
EXTERNAL REGULATORY BODIES
these partners act also as «controllers»
the patient being the «supreme judge»

14. MANAGER
He is in charge of workers’ safety
Coercive role of external controls
He gets a real idea of compliance level of facilities
Legal guarantee
Advice from internal experts is necessary (PCRP, occupational physician)

15. Conclusion
CONTROLS ARE APPROVED BY EVERY INTERNAL ACTORS AS A WAY OF KNOWLEDGE
EXTERNAL INSPECTIONS ARE NOT SUFFICIENT TO IMPROVE RADIATION PROTECTION
TECHNICAL COMPLIANCE LEVEL MUST BE COMPLETED BY A CONTROL OF THE MEN