Evolution of radiation protection for medical workers.

Within a few months of discovery, X-rays were being used worldwide for diagnosis and within a year or two for therapy. It became clear very quickly that while there were immense benefits, there were significant associated hazards, not only for the patients, but also for the operators of the equipment. Simple radiation protection measures were implemented within a decade or two and radiation protection for physicians and other operators has continued to evolve over the last century driven by cycles of widening uses, new technologies, realization of previously unidentified effects, development of recommendations and regulations, along with the rise of related societies and professional organizations. Today, the continue acceleration of medical radiation uses in diagnostic imaging and in therapeutic modalities not imagined at the turn of this century, such as positron emission tomography, calls for constant vigilance and flexibility to provide adequate protection for the growing numbers of medical radiation workers.

Twelfth Annual Warren K. Sinclair Keynote Address--the Influence of the NCRP on Radiation Protection in the United States: Guidance and Regulation.

The Warren K. Sinclair Keynote Address for the 2015 Annual Meeting of the National Council on Radiation Protection and Measurements (NCRP) describes the Council's influence in the development of radiation protection guidance in the United States since its founding in 1929 as the U.S. Advisory Committee on X-Ray and Radium Protection. The National Bureau of Standards (NBS) was the coordinating agency for the Advisory Committee, and its reports were published as NBS handbooks. In 1946, the Advisory Committee was renamed the National Committee on Radiation Protection and remained so until NCRP was chartered by the U.S. Congress in 1964. In 1931, the U.S. Advisory Committee on X-Ray and Radium Protection proposed the first formal standard for protecting people from radiation sources as NBS Handbook 15 and issued the first handbook on radium protection, NBS Handbook 18. Revised recommendations for external exposure were issued in 1936 and for radium protection in 1938 and remained in force until 1948. Throughout its 86 y history, the Council and its predecessors have functioned as effective advisors to the nation on radiation protection issues and have provided the fundamental guidance and recommendations necessary for the regulatory basis of the control of radiation exposure, radiation-producing devices, and radioactive materials in the United States.

Capturing opportunities and meeting challenges in radiation protection.

This summary of the 2014 Annual Meeting of the National Council on Radiation Protection and Measurement (NCRP) captures the opportunities presented during the Warren K. Sinclair Keynote Address, the Lauriston S. Taylor Lecture, and the six scientific sessions including the subsequent questions and answers. It captures the important issues that emerge in these opportunities and discusses the challenges that they bring to radiation protection. These opportunities arise in the basic sciences; in operational areas such as emerging technologies, preparing for the improbable but possible event, industry and medicine; and in education, communication and policy. The challenges include identifying the most important aspects of radiation protection and measurement, prioritizing them in accordance with the NCRP mission, and gaining support for the activities of the NCRP to address these issues in the fulfillment of its charter.

Role of the International Radiation Protection Association.

Global concerns over energy supply and climate change have given rise to an increase in uranium prospecting, mining and extraction. The changing world economy is spreading the use of advanced nuclear and radiation-related technologies to many parts of the world, giving rise to global initiatives on nuclear energy and operation of nuclear fuel cycle facilities. The emerging global nuclear safety regime promotes and encourages high standards of radiation safety worldwide. These developments call for increasing capacity and capabilities in radiation protection expertise and continue to present both challenges and opportunities to the International Radiation Protection Association (IRPA), an association of 46 societies representing 58 countries with an individual membership of approximately 17,000. IRPA's objectives include: (1) assisting the development of competent radiation protection programs; (2) fostering the exchange of scientific and technical information through its international and regional congresses; (3) promoting the scientific and professional recognition of the radiation protection expert; and (4) supporting continuing education programs at each IRPA congress. IRPA has adopted a Code of Ethics and Guiding Principles for the Conduct of Stakeholder Engagement. Recently work began to develop guidance for maintaining and improving current levels of radiation protection and transferring this culture to future radiation protection professionals. These IRPA projects are developed through the Associate Society Forum discussions that are held at each IRPA international and regional congress. Finally, IRPA maintains a close working relationship with various international organizations and is also represented on the Inter-Agency Committee on Radiation Safety.

Radiation protection principles of NCRP.

The current recommendations of the National Council on Radiation Protection and Measurements (NCRP) relative to ionizing radiation are based on radiation protection principles that developed historically as information about radiation effects on human populations became available. Because the NCRP Charter states that the NCRP will cooperate with the International Commission on Radiological Protection (ICRP), the basic principles and recommendations for radiation protection of the NCRP are closely coupled with those of the ICRP. Thus, the fundamental principles of justification, optimization, and dose limitation as initially stated in ICRP Publication 26 have been adopted and applied by the NCRP in its recommendations. ICRP and NCRP recommendations on dose limitation for the general public and for occupationally exposed individuals are based on the same analyses of radiation risk, and, while similar, there are differences reflecting the aspects of radiation application and exposure circumstances unique to the United States. The NCRP has recently extended its guidance to address exposure to individuals engaged in space activities. Several reports have been issued or are in preparation to provide recommendations on dose limitation and the development of radiation safety programs to apply the radiation protection principles in space activities. The biological basis for these recommendations is provided in these and accompanying NCRP reports. Recommendations for the application of basic radiation protection principles have been made in many reports over the years. Those that are most current appear in approximately 50 reports published in the last 15 y. These address radiation safety practices in industrial and medical institutions, control of radionuclides in the environment, protection of the public, and assessment of radiation risk. Some of the aspects of these recommendations will be discussed. Current recommendations related to radiation safety practice are based on the principles and dose limits specified in Report No. 116. The limits are based on estimates of the risk of fatal cancer and an assessment of the risk that should be tolerated by workers who are occupationally exposed and by the general public. These levels of risk are related to other risks that individuals accept in their lives. Looking to the future, one might consider other directions that the NCRP could take in developing radiation safety recommendations that are still based upon the stated principles, such as relating dose to loss of life expectancy instead of fatal cancer risk. It may also be that the principles of justification, optimization, and dose limitation should be reconsidered. For example, the NCRP may make recommendations about the relationship of radiation dose to various biological effects or outcomes and the resulting estimates of risk, but not specify dose limits. This would relieve the NCRP of the necessity to speculate about acceptable risks. One can also imagine that the principle of justification could be applied not only to the introduction of a new source of radiation, but also to the removal of an existing source of radiation, i.e., the idea of justifying decontamination efforts. It is clear that as we move into the 21st century there will be a continuing need for the NCRP to identify the principles upon which radiation protection is to be based and to provide guidance on the application of those principles for the many beneficial uses of radiation and radioactive materials in society.