Medical diagnostic exposure in the Russian Federation: regulatory problems and proposals for their solution

The analysis of trends in levels of radiation exposure of the public in the Russian Federation in recent years indicates a steady increase in patient doses from medical exposure. To maintain the necessary level of radiation protection of patients, the system of regulatory support of radiation safety for medical exposure in the Russian Federation needs to be updated and adapted to the current state of Russian X-ray diagnostics and therapy. The aim of this study was to substantiate the revision of the regulatory and legal framework in the field of radiation safety for medical exposure. For this purpose, international and Russian approaches to the provision of radiation safety for medical exposure were compared; the main problems were identified and proposals for their solution were formulated. Within the framework of this work, the analysis of international and national regulatory documents in the field of radiation safety, regulating the requirements for limitation, justification and optimization for medical exposure was performed. Based on the results of the analysis, the main directions of improvement of the national system of radiation safety for medical exposure were identified: establishment of interdepartmental interaction between Rospotrebnadzor, Ministry of Health and Roszdravnadzor to create an integrated approach to radiation safety for medical exposure; improvement of the system of registration and accounting of patient doses; improvement of approaches to assessment of radiation detriment (risk) for patients undergoing radiological procedures. A scheme for distribution of powers to ensure radiation protection of patients between Rospotrebnadzor, the Ministry of Health and Roszdravnadzor has been proposed. Some of the proposals were implemented in SanPiN 2.6.4115-25 “Sanitary and Epidemiological Requirements in the Field of Radiation Safety of the Population when Handling Sources of Ionizing Radiation.”