The Future of Radiologoical Protection

		Consistency and Complementarity of Ethical Values Across the System and Practice of Radiological Protection Presented by Nicole Martinez, USA
		Author(s): Nicole Martinez 1, Friedo Zölzer 2 ( 1 Clemson University; 2 University of South Bohemia)

In 2018, the International Commission on Radiological Protection (ICRP) released Publication 138, which highlights the ethical values foundational to the system of radiological protection. Additional work, both within and beyond the ICRP, has proposed or recommended ethical values associated with applications of the system in different areas, perhaps most notably in medical, veterinary, and environmental radiological protection. There are also existing ethical frameworks not specifically related to radiological protection that are nonetheless relevant to its practice; for example, the Beauchamp and Childress principles of biomedical ethics are highly relevant when it comes to medical uses of radiation and radioactivity. At first glance, it may seem as if there are unique or isolated sets of ethical values that need to be applied depending on the circumstance. Yet while each area of application will indeed have its own unique aspects and associated value judgements, there are consistent and complementary relationships between these ethical values. This presentation highlights similarities and differences of proposals made for different contexts, with emphasis on medical, veterinary, and environmental radiological protection.

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		Summary of the Third SFRP/IRPA Workshop on the Application of the Concept of Tolerability Presented by Jean-François Lecomte, France
		Author(s): Jean-François Lecomte (IRSN, France)

Following the discussion during the IRPA 14 Congress in 2016 about the need to a greater visibility of the decision processes to a reasonable level of protection, the SFRP organised three workshops. The two first were face-to-face meetings in Paris in February 2017 and in October 2018. Their objective was to investigate the practical implementation of the optimised principle in three sectors: nuclear, medical, existing exposure situations (radon, radium, post-accident), based on case-studies and working groups. The main conclusion was that optimisation remains a challenge in all sectors and is a proactive and deliberative process to achieve a reasonable “compromise” with all informed stakeholders.

The third workshop, organised virtually in May 2021, was focused on the notion of tolerability (or non-tolerability) and its link with the notion of reasonableness for three topics: radon exposure, exposure from Naturally Occurring Radioactive Materials (NORM) and the dismantling of nuclear installations. Like the previous workshops, the work was based on case-studies and working groups. There were around 50 participants from 15 countries.

According to the so-called tolerable risk model set for practices by ICRP in its Publication 60 (1991), the range of a tolerable risk is between an unacceptable risk and an acceptable risk. In this model, set only for practices, now planned exposure situations, the boundary between a tolerable risk and an unacceptable risk is the compliance with the dose limits and the risk may be acceptable when the protection is optimised. In the ICRP Publication 138 (2018) on the ethical foundations of the system of radiological protection, the term tolerability is defined as: the degree or extent to which something can be endured.

The purpose of the 3rd SFRP/IRPA workshop was to investigate whether the model from Publication 60 is still valid and to try to answer some questions such as: what could be the boundary between tolerable and unacceptable in in diverse exposure situations? What is the rationale of the considered criteria? Who should set this criteria? How? When? What should be done if the situation is not tolerable? If actions are implemented to improve the situation, what process or criteria should be used to determine that the situation became acceptable? Etc. The aim of the presentation is to present the main conclusions drawn from the workshop.

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		The Need to Review Low-Dose Decision-Making in Radiation Protection Presented by Roger Coates, UK
		Author(s): Roger Coates (Private Individual, Member of UK Society for Radiological Protection)

The current approach in the system of protection, and the way in which it is implemented in regulatory practice, has resulted in the allocation of significant and disproportionate societal resources to reduce relatively low level exposures to even lower levels. The resulting exposure levels are often a fraction of the basic natural background level, and in particular are comparable to, or often significantly less than, the variability of natural background exposures due to individual decision-making, which the system of protection deems acceptable. There are arguments for a wider approach to decision-making at such low doses, recognising the uncertainties in radiation risk estimation and acknowledging the context that all human life takes place in a variable natural background radiation which generally dominates these lower dose exposures. Recommendations for such improvement in how decisions are made are presented.

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		Application of the Graded Approach for the Radiation Protection of Workers: Examples and Reflexions From European ALARA Networks Presented by Sylvain Andresz, France
		Author(s): Sylvain Andresz 1, Fernand Vermeersch 2, Nicolas Stritt 3 ( 1 Nuclear Evaluation Protection Centre, France; 2 SCK•CEN, Mol, Belgium; 3 Swiss Federal Office of Public Health, Switzerland)

The concept of the “graded approach” has become an essential part of the modern radiation protection. It has been introduced in recent ICRP publications (ex. Publications 122, 126, 132 and 142) for different exposure situations, but with various definitions. Another definition has been proposed later in the ICRPpedia.

In Europe, the graded approach has been transposed in the national laws from the Article 24 of the Euratom Directive 2013/59. In this context, the European ALARA Network (EAN) and the European Radiation Protection Authority Network (ERPAN) has set up in 2018 a brainstorming meeting to discuss the interpretation and the practical implementation of the graded approach for workers at workplace. After the meeting, the participants decided to launch a survey addressed to regulators and professionals via the EAN and ERPAN networks to collect more examples and additional points of view.

The objective of this contribution is to provide a synthesis of the analysis of the 20 cases study collected (in the medical field, existing exposure situations, etc.) and to bring to the light several topics about the implementation of the graded approach and notably those that could find echo in recent and current ICRP’s reflections, inter alia:

• No two similar graded approaches were collected, confirming that there is no harmonized procedure and the graded approach is currently shaped on case-by-case, fully depending on the sector and the circumstances. Despite the differences, a global scheme coming from the analysis of the cases study will be presented, a plausible basis for an harmonized graded approach. In addition, several good practices to ensure that the graded approach is comprehendible and functional will be presented.
• The benefits of the graded approach for radiation protection and notably its interest for achieving the reasonableness in the protection, e.g. in ensuring a better allocation of resources.
• The potential pitfalls when applying the graded approach and the specific issues to be aware of, including ethical ones.
• Several examples are showing that non-radiological criteria should be considered for the graduation, and can even dominate the decision, making the graded approach not necessarily “proportionate”. Moreover, by replacing the radiation protection in a global context, the graded approach is a concrete attempt to make use of the ‘holistic approach’.

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		Prospects on the ICRP Paradigm for Radiological Protection Presented by Abel Gonzalez, Argentina
		Author(s): Abel Julio González (Argentine Nuclear Regulatory Authority, Argentina)

The ICRP radiation protection is exceptional in its comprehensiveness and is internationally recognized; it ought to be preserved and tinkering with its basis should be avoided. Nonetheless, it needs to be refreshed to reflect inter alia novel scientific consensus on the epistemology of radiation effects and fresh societal demands on protection. Such updating would also allow echoing the many lessons on the application of ICRP recommendations, which were learned and reported in recent years.

The paper presents an analysis of professional and societal expectations on the future ICRP recommendations, including the following:

• The ethical foundations of the paradigm are scrutinized, as recent ICRP recommendations reflect the values on the paradigm but not necessarily its ethical basis; the need for incorporating the ethics of arête and the consequent principle about future and habitat are developed, reflecting changes incorporated in the radiation safety fundamentals established by international intergovernmental organizations.
• The implications for the paradigm of the recent UNSCEAR estimates on attribution of radiation health effects vis-à-vis inference of radiation risk are analysed.
• The repercussions of the recent changes on quantities are examined and the needs of further changes are studied; the differentiation between the paradigm uses of intensive versus extensive quantities will be described.
• The usually misunderstood LNT ‘model’ will be dissected, describing its need for practical radiation protection, particularly in the occupational exposure domain.
• The conundrum presented by various circumstances of protection against natural radiation exposure situations versus the traditional approaches of protection in ‘practices’ will be presented and potential solutions will be discussed.
• The current concept of ‘dose limit’ and its contradictory connotations will be discussed and potential clarifications will be suggested.
• The concept of ‘existing’ exposure situation will be argued vis-à-vis the concept of ‘extant’ exposure situation.
• The practical application of the paradigm in emergency exposure situations will be revisited.
• The need for specific recommendations on the application of ICRP recommendations on the scope of radiological protection will be considered.
• Legally binding obligations undertaken on occupational safety will be refreshed and their implications for the paradigm discussed.
• The issue of protection of patients will be revisited taking into account new developments in radiodiagnosis and radiotherapy.
• New demands for social licensing of human endeavours involving radiation exposure will be explored.

It is expected that the paper will be helpful for the ICRP in developing its future recommendations.

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