When the Ministry of Health, Labor and Welfare conducted the first exposure management survey of medical institutions nationwide, about 30% of medical institutions distributed the required number of dosimeters that doctors usually wear during surgery and examinations. It has become clear that the exposure management in the medical field is not thorough, such as not being done.
As medical care has become more sophisticated and opportunities to use radiation in surgery and examinations have increased, the exposure of doctors and nurses has become a problem, so the Ministry of Health, Labor and Welfare conducted the first survey on the management system at 8373 medical institutions nationwide. I got an answer from the surplus.
According to this, when performing surgery or examinations that handle radiation, it is usually required by law to attach dosimeters to two or more parts of the body such as the chest and neck, but two or more dosimeters are distributed in the survey. When I checked if it was done, I found that 33.3% of medical institutions did not distribute the required number.
In addition, when asked multiple answers about how to make the dosimeter properly installed, 21.0% answered that they did not make it known.
In addition, exposure measurements are required even when workers who normally do not enter the area that handles radiation enter temporarily, but when asked in multiple answers about such management, 15.2% of medical institutions said that they did not control it. I answered.
Tomotake Natsui, Deputy Director of the Ionizing Radiation Workers Health Measures Office of the Ministry of Health, Labor and Welfare, said, "Although the problem of radiation exposure management has been pointed out for some time, the problem has been confirmed again. I want to work hard on this. "
Regarding the exposure of medical workers, the average number of medical workers who have been exposed to radiation exceeding the national administrative guidance standard is more than 260 in the 10 years up to FY2019, according to the total of private dosimetry institutions. It has become a problem, and experts have pointed out that it is necessary to accurately grasp the situation.
The person in charge of the country
From the results of the survey conducted by the Ministry of Health, Labor and Welfare this time, the issues of the radiation exposure management system in the medical field became clear.
For example, when hiring a new person who worked at another medical institution to perform radiation work, it is supposed to check the past exposure dose, but when asked how to grasp it with multiple answers, 15.7 % Answered that they did not know.
Tomotake Natsui, assistant director of the Ionizing Radiation Workers Health Measures Office of the Ministry of Health, Labor and Welfare, said, "Evaluation and measurement of exposure dose is basic, and it is a serious result that one-third of medical institutions could not do it. Immediate improvement In addition, the medical institution has a solid management system so that medical staff will not be unable to wear a dose meter due to "troublesomeness" during treatment or examination. It will be necessary to make it. "
After that, "It is necessary for the national government to grasp the process of inspection by medical institutions, confirming problems, and leading to improvement, and to create opportunities for medical institutions themselves to confirm whether the situation is being observed on a regular basis. There is, "he said, and will continue to investigate.
Expert "Continuing efforts to demand thorough management"
Professor Naoki Yoshida of the University of Occupational and Environmental Health, who is familiar with the problem of radiation exposure management, said, "In the medical field, patient care is prioritized and exposure management is not often implemented. I think it's gone by without questioning it. "
Regarding the results of the national survey, "This time, it became clear what areas medical institutions need to improve. It is thought that this trend will lead to the next step, and now is the turning point. It is in an important position. "
In the future, "The Ministry of Health, Labor and Welfare will continue to make improvements by repeating surveys such as questionnaires and responding to medical institutions with the recognition that they have not been able to do so. I think that is required, "he continued, emphasizing that efforts to require medical institutions to ensure thorough management are indispensable.
Actual conditions of radiation use and countermeasures
According to the Ministry of Health, Labor and Welfare and experts, the use of radiation that can see through the body is increasing as medical care becomes more sophisticated.
It is used not only in radiology but also in various clinical departments such as cardiology, neurosurgery, and orthopedics.
Under these circumstances, workers such as doctors and nurses may be exposed to radiation during surgery and examinations.
For example, when an organ such as the bile duct is projected with radiation for examination, the radiation is applied to the patient lying on the bed from the top of the device.
From the image of the spread of radiation, it can be seen that the radiation that hits the patient is diffused into the room.
Even with a shielding curtain around the patient, radiation leaks through the gaps, and nearby healthcare professionals such as doctors and nurses cannot avoid some exposure.
The Ministry of Health, Labor and Welfare is aware of these radiation exposure problems for medical workers, and in recent years has taken measures.
For example, last year, when medical institutions purchased eyeglasses and curtains to reduce radiation exposure, we conducted a subsidy of up to 1 million yen, which is half the cost.
In addition, he said that he conducted online training for 400 medical institutions nationwide last year and informed the person in charge that it was necessary to make a plan to reduce the exposure dose and provide education to medical staff. That is.
This time, the Ministry of Health, Labor and Welfare has decided to continue the survey to grasp the situation, saying that the actual situation of the site could be grasped more accurately from the first survey of the management system.
In addition, we would like to put more effort into the training that we have conducted so far to convey the risks of radiation exposure and the importance of countermeasures, and to thoroughly implement the management system.
What is the actual exposure of healthcare workers?
Data also reveal the problem of exposure to health care workers.
According to national rules, when the value of "effective dose", which indicates the effect of whole body exposure, exceeds 20 millisieverts per year, the national government will give administrative guidance to medical institutions.
Looking at the aggregated data of doses such as medical staff compiled by four private dosimetry organizations every year, the average number of medical workers exceeding this standard value for the 10 years up to 2019 is 265.2. did.
Of these, an average of 12.4 people exceeded 50 millisieverts, which is even more severe than administrative guidance and violates the law.
It has been pointed out that radiation exposure in the medical field is even more serious than these data.
This time, a survey by the Ministry of Health, Labor and Welfare revealed the actual situation of inadequate management, such as the fact that dosimeters were not properly distributed to doctors, but reports from other research institutes also revealed such deficiencies in the management system. I am.
An unannounced survey of 1348 healthcare workers conducted last year by a research group at the University of Occupational and Environmental Health found that 60% of doctors did not wear dosimeters.
Experts point out that due to poor management, more healthcare workers may actually be exposed than the data.
One of the group who conducted the survey, Takashi Moritake, an associate professor at the University of Occupational and Environmental Health, said, "It can be said that there are few aggregated results of private companies with an average of 200 or more people over 20 mm receiving administrative guidance per year. I think I am. "