Trends in ionizing radiation exposure of healthcare workers in France (2009-2019): the EXPERTS study

Abstract Background Health workers exposed to ionizing radiation (IR) account for +50% of workers exposed to artificial IR in France. Over the last 10 years, the use of IR in medicine has developed due to the introduction of new practices. The EXPERTS study aims to evaluate and characterize the trends in IR exposure of health workers in France between 2009 and 2019. Methods The study includes all health workers with at least one dosimetric record in the System for occupational dosimetry registration (SISERI) database for each of the years 2009, 2014, and 2019, in the 6 hospitals included in the study (in Paris & Bordeaux). Individual passive external doses, professional activity, age and gender were collected via SISERI and occupational medicine units. Doses were estimated from badges worn at chest level under the lead apron. Results 1,999 workers were included. Mean Hp(10) doses significantly decreased between 2009 and 2019 (-0.004 mSv/year; p < 0.05). Workers in Bordeaux hospitals were more exposed than those in Paris in 2009 and 2014, while trend was reversed in 2019 (p > 0.05). Doses in men were significantly higher than women's doses in 2009 and 2014 (p < 0.02), but were similar in 2019 (p = 0.99). Physicians had the highest mean IR doses between 2009 and 2019 (0.14mSv ±1.09), and more specifically surgeons and cardiologists, but their exposure tended to decrease in recent years. Radiological technologists have similar mean doses (0.14mSv ±0.38), relatively stable over the study period - the most exposed in the nuclear medicine unit (0.60mSv ±0.58). Conclusions IR exposure of health workers in France decreased significantly between 2009 and 2019, despite an increase in practices using IR - this decrease was partly recorded in orthopaedic surgeons. This may be related to radiation protection rules' application. However, badges may not always be worn properly. This study could be extended to other healthcare centres to study local specificities and to adapt radiation protection policies Key messages Despite the increase in medical practices using ionising radiations (IR), the average exposure of health workers to IR has decreased over the 10 last year, mainly in Bordeaux hospitals. Differences in average IR exposure were found by occupation, gender, health care units, and hospitals. Policies should use these results to promote radiation protection rules.