National Radiation Safety Committee

Transcription

1 National Radiation Safety Committee ANNUAL REPORT 2012

2 Report for the year-end 31 st December 2012 The National Radiation Safety Committee (NRSC), established in November 2007, is a statutory committee appointed by the CEO, HSE to advise him on matters pertaining to medical exposure of patients to ionising radiation, in accordance with Statutory Instrument (SI) 478 (2002). Extract from SI 478 (2002): The Radiation Safety Committee shall furnish the chief executive officer with an annual report and such other reports as the chief executive officer may require The Radiation Safety Committee shall monitor the population dosage for the health board functional area and will include their findings in an annual report. 2

3 Contents Page 1. Chairperson s Statement 4 2. Function of the National Radiation Safety Committee (NRSC) 5 3. Membership of the NRSC 6 4. Report of the Medical Exposures Radiation Unit (MERU) 9 5. Work of the NRSC and the MERU Meetings 5.2 National Clinical Audit, Patient Identification, Patient Consent, Imaging in Radiotherapy - update 5.3 Chiropractic Baseline Audit 5.4 Revision of the Basis Safety Standards (96/29/Euratom) and Medical Exposure (97/43/Euratom) directives - updates 5.5 Radiation Protection Manual 5.6 Patient Radiation Incidents 5.7 Population Dose from General X-Ray Scanning updates 6. Priorities for the NRSC and the MERU for Relevant documents 16 APPENDIX 1 17 Subcommittees Membership APPENDIX 2 18 MERU Patient Dose Information Chart 3

4 1. Chairperson s Statement I am pleased to introduce the fifth Annual Report of the National Radiation Safety Committee (NRSC) for year end 31st December The committee was established to advise the CEO, HSE on matters pertaining to the health protection of patients in relation to medical exposures to ionising radiation. This includes both public and private facilities. In 2012, the Committee continued to advise the delegated officer of the CEO, HSE and produced recommendations on the implementation of the requirements of SI 478/303/459 for The work is greatly supported by the Medical Exposures Radiation Unit (MERU), HSE and the achievements reflect the interest and commitment of stakeholders to continue to improve patient safety and apply best practice in the field of medical ionising radiation. The Committee has been encouraged by many national and HSE developments in 2012 and it is likely that the role and work of the NRSC will be realigned with these national developments in the years ahead, to provide a comprehensive national approach to patient safety. The Committee remains concerned at the continuing absence of an inspection and enforcement function activated in this legislation. The committee has advised the CEO, HSE on the need to advance this as a priority with the Competent Authority, the Department of Health. The committee has also recommended that the introduction of a unique patient identifier will be the single most effective way to record and accumulate patient doses, leading to better outcomes for patients. In the meantime, we are pleased to report on the notification of patient radiation incidents, chiropractic compliance, general x-ray population doses and other matters in this report. I would like to thank the members of the NRSC for their continued work and commitment and acknowledge the support of the CEO, HSE delegated officer, Dr. Philip Crowley and that of the MERU in effecting the advice of the committee through networking with all relevant stakeholders. During the first 5 year term of the NRSC, and under the same Chair, membership rotated to ensure continuity of work and expertise. I wish to take this opportunity also to wish my successor Chair and the revised Committee every success during the next term of office. The progress has been great.well done to the team that put it together. Dr. Sheelah Ryan, Chair National Radiation Safety Committee DATE May

5 2. Function of the National Radiation Safety Committee as outlined in SI 478 (2002) The National Radiation Safety Committee, established in November 2007, is the statutory committee that has been appointed by the CEO, HSE to advise him on matters pertaining to medical exposure of patients to ionising radiation. The committee consists of no more than 10 members, appointed by the CEO, HSE for a period not exceeding five years. The National Radiation Safety Committee is required to meet twice a year at a minimum and met three times in Role of the National Radiation Safety Committee: Advise the CEO, HSE, as appropriate, on measures or arrangements in installations that are necessary to protect the health and safety of patients, the general public or persons employed in the installations. Produce annual report. Receive reports on radiation incidents as required and advise where appropriate. Establish population dose level, i.e., the total population exposure to ionising radiation in liaison with Radiological Protection Institute of Ireland. Issue Guidance Notes where applicable. Review relevant new clinical risk practices to ensure that the exposure and outcome for the patient is in line with international best practice and provide advice where applicable. Offer guidance and support to the sub committees as required. Gather lifetime data on equipment and an assurance that each piece is recorded as being maintained. Receive reports from the clinical auditor and inspectors. Monitor radiation diagnostic reference levels as established by the Medical and Dental Councils. Any other appropriate matters that may arise. 5

6 3. Membership of the National Radiation Safety Committee Dr. Sheelah Ryan, Chair Dr. Ryan is a public health physician and a former Chief Executive Officer of the Western Health Board. She chaired the National Breast Screening Board and the National Cancer Screening Service Board since their inception until they were subsumed in to HSE in April She currently works as an advanced organisation development consultant. Dr Peter Finnegan Dr. Peter Finnegan graduated from UCD in After a two year period as General Practitioner he worked in Community Care and was a Senior Medical Officer and later a Director Community Care/ Medical Officer of Health. His main interest is Health Protection especially Infectious Diseases and Environmental Health. He is presently working in HSE Dublin NE as a Specialist in Public Health Medicine. Dr. Michael Casey Dr. Michael Casey completed his PhD studies in UCD in 1978 and started work in the Nuclear Medicine Department, St Vincent's University Hospital, Dublin. Subsequently he was involved in the provision of general medical physics services in St Vincent's and was promoted to the position of Chief Physicist in He has been Radiation Protection Advisor to the hospital since Eamonn Fitzgerald Eamonn Fitzgerald is Chief Executive of the Hermitage Medical clinic in Lucan, Co. Dublin. Eamonn has worked in the healthcare services sector for the past 18 years. Eamonn previously worked as the Deputy Chief Executive of St Vincent's Healthcare Group. He also worked in Beaumont Hospital. He holds an M.B.S. from the Smurfit Graduate School, UCD and a M.Sc. in Economics from Trinity College. Dr. David Fitzpatrick Dr David Fitzpatrick is a Consultant radiation oncologist based in St Luke s Hospital Dublin and St Luke s radiation oncology centre Beaumont hospital. He is chair of both the radiation protection committee and the Radiotherapy incident learning group in St Luke s radiation oncology network in Dublin. He is a member of the Faculty of Radiologists of The Royal College of Surgeons in Ireland, the education and training body for the medical specialty of Radiation oncology in Ireland He has trained in radiation oncology in Ireland and spent 2 years as a fellow in Princess Margaret Hospital, Toronto, Ontario, Canada from 2007 to

7 Dr Mary Hynes Dr. Hynes is a public health doctor and was Director of Public Health and later Regional Manager Acute Services in the former Western Health Board. Dr. Hynes was appointed to the new post of Assistant Director in the National Hospital Office with a brief for quality, risk and customer care. Currently Dr Hynes is Cancer Network Manager West, National Cancer Control Programme, Galway Dr. Tom Ryan Dr. Tom Ryan is the Director of Regulatory Services with the Radiological Protection Institute of Ireland. His role involves responsibility for the licensing and inspection of practices using ionising radiation in Ireland including those within the medical and dental sectors. He also has responsibility in the Radiological Protection Institute of Ireland for matters relating to radioactive waste and the security of radioactive materials. Tom is a member of the EURATOM Article 37 Expert Group, the European Commission's Standing Working Group and the Inter-Departmental High Level Group on radioactive waste. Catherine McKenna Catherine is a graduate of the College of Radiographers, London, with a career in Radiotherapy spanning more than thirty years. As Radiation Therapy Services Manager at St. Luke s Hospital Dublin she is responsible for the management and delivery of Radiotherapy Services. Catherine is a Director of the Board of St. Luke s Institute of Cancer Research (SLICR), and sits on both Radiotherapy Risk and Radiation Safety committees. She is a member of the Radiographers Registration Board (RRB), and is the current RSM chair on the Council of the Irish Institute of Radiographers and Radiation Therapists (IIRRT). Catherine is the National Cancer Control Programme s appointee as National Clinical Lead for Radiation Therapists. Dr Jane Renehan Dr Renehan is Principal Dental Surgeon in HSE Dublin North West. Dr Renehan has regional responsibility for planning and evaluation of Health & Safety, Radiation Safety, Quality & Audit, Continuing Professional Development (CPD), and Risk Management, in Dublin North East. She is joint chair of the Dental Radiation Safety Committee in Dublin North East / Mid Leinster. 7

8 Dr. Patricia Cunningham Is a Consultant Radiologist, practising in Our Lady s Hospital, Navan and Our Lady of Lourdes Hospital, Drogheda and sits on the National Radiation Safety Committee in this capacity. Dr. Cunningham is currently a Board member of the Faculty of Radiologists of The Royal College of Surgeons in Ireland, the education and training body for the medical specialty of Radiology in Ireland and chairs that organisation's Radiation Protection Committee which reports to the Faculty Board. She is the Irish Medical Council representative on the Board of the Radiological Protection Institute of Ireland. Dr. Cunningham is also a member of the Musculoskeletal Radiology Subcommittee of the European Congress of Radiology from Mr. Paddy Gilligan Paddy Gilligan is a principal medical physicist at the Mater Private Hospital where he has worked for over twenty years. He was a member of the HSE task force on the implementation of SI 478, Mr. Gilligan has chaired the Medical Physics Expert subgroup for the national radiation safety committee. He has recently become the chair of the population dose subcommittee and sits on the dental subcommittee. He has been a board member of the RPII since 2006, chairing the Audit Committee since He is the medical physicist on the Faculty of Radiology Radiation Safety Committee. He previously sat on the Medical Council s Ionising Radiation Committee. 8

9 4. Report of the Medical Exposure Radiation Unit (MERU) The EU Directive on medical exposures (transposed in Irish law by Statutory Instrument 478(2002) and its amendments) requires that appropriate mechanisms are in place to protect all patients from the harmful effects of ionising radiation. This requires; Protocols for justification and optimisation of practice Clear accountability arrangements Clinical audit Quality assurance programmes Training and education Incident reporting Application of standards in practices and equipment The Medical Exposure Radiation Unit was established following the recommendation from the HSE Task Force on the Implementation of SI 478. Its primary tasks are to execute the regulatory responsibility of the CEO, HSE and to support the National Radiation Safety Committee s advisory role in implementing the provisions of SI 478. SI 478 (2002) assigns specific regulatory responsibility to the HSE: Establishment of the National Radiation Safety Committee. Conduct External Clinical Audit every five years. Receive the advice of the National Radiation Safety Committee and implement mechanisms for patient safety, such as regular incident reporting, production of guidelines. Produce an annual report on Population Dose from patient ionising radiation. Since its establishment, the unit has engaged extensively with stakeholders, statutory bodies and staff to advance the requirements of SI 478. The unit has an expert advisory team consisting of a Radiographer, Radiologist, Medical Physicist, Public Health Doctor and Dental Radiologist. 9

10 Main activities of the MERU: Conduct National Clinical Audit. Produce and publish annual population dose reports. Manage National Statutory Incident Reporting of patient radiation incidents. Maintain national database of all medical radiological equipment and holders in Ireland. Support the NRSC and implement its recommendations. Work with statutory bodies to produce, promote and monitor guidelines on practice. The work of the unit is regulatory in nature and results in a potential conflict of interest in that the HSE is regulator and provider of services. The HSE Task Force has recommended that the regulatory function moves to the Health Information and Quality Authority (HIQA) which has been agreed in principle with HIQA and the Department of Health and Children. EU Medical Directive 97/42 and 96/26 Basic Safety Standards Directive are being reviewed and incorporated in to one directive. Its transposition in to Irish law will require a review of current governance arrangements. It will require relevant Competent Authorities and Regulatory Bodies to work together for the best solution for regulation of Radiation Protection in Ireland. The role of Chiropractors in Ireland in the field of medical ionising radiation requires clarification. The RPII issues chiropractors with a licence that entitles them to hold x-ray equipment (SI 125). At present, under Irish law, Chiropractors are not entitled to refer patients for ionising radiation procedures. In 2012, chiropractors cooperated with the national baseline audit of radiological practices. The results are published on the HSE website. The unit is very appreciative of the significant input by statutory and professional bodies such as the Radiological Protection Institute of Ireland, the Department of Health and Children, the Health Information and Quality Authority, the Medical Council, the Dental Council and the Faculty of Radiologists to advance the common agenda. In addition, the guidance of the advisors to the unit and the NRSC and its subcommittees has been the key to the success of all the advancements made. Ciara Norton Medical Exposure Radiation Unit DATE April

11 5. Work of the National Radiation Safety Committee (NRSC) and Medical Exposure Radiation Unit (Medical Exposure Radiation Unit) Meetings 2012 The National Radiation Safety Committee met 3 times in In 2012 six members retired from the committee. The maximum length for membership of the NRSC is five years. Six of the committee members reached their 5 year term in 2012 and required replacement. The following members retired from the committee in 2012; Dr. Sheelah Ryan replaced by Mr. Pat Harvey. Mr. Eamonn Fitzgerald replaced by Mr. Michael Redmond. Mr. Tom Ryan replaced by Dr. Stephen Fennell. Dr. Jane Renehan replaced by Dr. Andrew Bolas. Dr. Mary Hynes replaced by Dr. Mary Browne. Dr. Michael Casey replaced by Mr. Paddy Gilligan. We would like to take this opportunity to thank the retiring members for the expert advice and support they have given the NRSC over the past 5 years. Their commitment and professional approach has to be commended. We wish them every success in their future. We also wish to thank the new members for agreeing to be part of the committee and we believe that their expertise and commitment will continue the success of the NRSC. The meetings are also attended by the advisors to the Medical Exposure Radiation Unit and HIQA are invited as attendees, in an observer capacity. Much of the committee s work is delivered through the subcommittees which are established by it and chaired by a member of the National Radiation Safety Committee. The recommendations of the NRSC and its subcommittees are addressed to the delegated nominee of the CEO, HSE. The Medical Exposure Radiation Unit is responsible for the implementation of the advice and recommendations of the NRSC and its subcommittees, in addition to fulfilling the regulatory requirements placed on the CEO, HSE. A regular update from the subcommittees and the Medical Exposure Radiation Unit on the implementation of its recommendations is tabled for meetings of the National Radiation Safety Committee. A list of all subcommittees is provided in Appendix 1. 11

12 5.2 National Clinical Audit, Patient Identification, Patient Consent and Imaging in Radiotherapy There is a requirement to conduct national clinical audit as defined in Medical Ionising Radiation Statutory Instrument 478 (2002), which transposes the Medical Exposures Directive (97/42/Euratom) into national legislation. A compliance audit was conducted in Various guidance documents were produced by MERU and NRSC as a result of recommendations from this audit. The NRSC made a decision in 2011 to set up a Clinical Audit Sub Committee to review the legislative requirements and evidence base for topics on clinical audit. The sub committee undertook broad consultation and piloted a Clinical Audit questionnaire at a number of locations. In 2012 a Clinical Audit questionnaire was circulated to all Medical Radiological and Radiotherapy Practices. The return rate for replies to the audit was 91%. The results of the Audit are currently being analysed and a report will be available and circulated in The report will also be available on the MERU website. 5.3 Chiropractic Baseline Audit Under SI 478 all licence holders of radiological installations are subject to clinical audit every 5 years. The NRSC agreed in 2011 to conduct a baseline audit of chiropractors in Ireland. Although Chiropractors are not a registered profession in Ireland they are a registered profession in other jurisdictions, such as the UK. The NRSC recognises that, until the current situation with chiropractor s changes, interim measures need to be put in place to ensure chiropractic patients are protected from the potential harmful effects of medical ionising radiation. The chiropractor audit was circulated early in 2012 to all chiropractic practices operating a diagnostic radiology facility. The questionnaire referred to Clinical Audit, Protocols e.g. referral protocols, Activity in relation to exposures taken for 2010, X-Ray equipment type and details in relation to RPA/MPE. At present there are 19 chiropractic practices in Ireland operating a diagnostic radiology facility. One chiropractor has two separate diagnostic radiology facilities under one licence. There was a good level of participation in the survey considering this was the first audit carried out on chiropractors in Ireland. There was a return rate of 75%. After considerable consultation the report was finalised towards the end of The Report was published in early One very positive and encouraging piece of feedback from the audit is that virtually all practices appear to have written protocols with regard to safety, 12

13 justification and optimisation. One issue from the audit that has warranted further investigation is in relation to referral practices for chiropractors. There are nine recommendations in the report, three of which are high priority. The recommendations identified areas in which Chiropractors holding ionising radiation equipment can comply with current legislation and take the necessary actions in order to improve compliance and provide greater assurance that good quality assurance mechanisms are in place for the benefit of patient safety. The implementation of the recommendations by holders will be subject to audit. There still remains the anomaly that chiropractors are not recognised in current legislation in Ireland and it will not be possible for them to comply completely with SI478 until this matter has been resolved. The vast majority of chiropractors in Ireland do not hold ionising radiation equipment. These chiropractors may act as referrers for ionising radiation procedures but they were not included in this audit. The Medical Exposure Radiation Unit will consider a future audit of referral practices for ionising radiation procedures from all referrers, including chiropractic referrals. 5.4 Revision of the Basic Safety Standards (96/29/Euratom) and Medical Exposure (97/43/Euratom) directives implications for Medical Exposures Dr. Geraldine O Reilly was nominated on behalf of the Department of Health as the Irish representative on the European committee to review the Basic Safety Standards. Dr. O Reilly has attended meetings with European counterparts on a number of occasions throughout 2011 and Dr. Tom Ryan, RPII, and a former member of the National Radiation Safety Committee, HSE, has been seconded temporarily from January 2013 to chair the European Council s Atomic Questions Working Party and Ireland took up the European presidency in January The BSS document is due to be finalised in Radiation Protection Manual Following from the recommendations of the National Baseline Audit 2008, the National Radiation Safety Committee agreed that a Radiation Protection Manual be developed for use in all areas of Radiology. The manual incorporates Patient Radiation Protection requirements of the above mentioned legislation as far as is possible. The NRSC recommended that all holders hold a Radiation Protection Manual at their location and outlined suggestions for a Dental and Chiropractic Radiation Protection File. The aim of this manual is to provide a practical guide for staff working with ionising radiation to ensure safe practices, the best quality clinical care and prevent avoidable harm to patients undergoing medical ionising radiation procedures. This manual is designed to assist personnel involved with Medical Ionising Radiation to comply with national legislation and to apply best practice 13

14 guidelines in Radiation Protection. The manual is intended to complement the Radiation Safety Procedures or local rules. In 2012 the Manual was piloted in a number of locations and has again been reviewed by all stakeholders and relevant committees. The Manual is due for print 2013 and it will be circulated to all locations for use to complement their Radiation Safety Procedures and local Rules. 5.6 Patient Radiation Incidents A total of 47 notifiable patient radiation incidents were notified to the MERU in 2012, of which 12 were near misses. Out of the total number of incidents reported to the MERU 29(62%) were in Diagnostic Radiology and 18 (38%) were in Radiotherapy. There has been a very positive response rate to incident reporting. There was an increase of 10% in the number of patient radiation incidents reported to the MERU in 2012 compared to the previous year. This indicates that there was an increased awareness in reporting incidents and it is expected that this upward trend will continue... The incident reporting guidelines are currently under review to improve incident definitions and guidelines on reporting incidents. 5.7 Population Dose from General X-Ray Scanning Further review of the submitted data from 2011 took place in 2012 and a final report complete. The report is available on the HSE website. A patient dose information chart was compiled from all the data submitted for the Population Dose surveys conducted to date. The patient dose information chart will be circulated to all locations for display in their Radiological locations for display. See Appendix 2. 14

15 6 Priorities for the NRSC and the MERU for 2013 Regulation of Patient Radiation Transfer of SI478 to the appropriate regulatory authority and establishment of inspection function Unique Patient Identifier Introduction of service wide Unique Patient Identifier priority for patient safety monitoring National Radiation Safety Committee Service Committee and Subcommittees Renew membership and governance as required Provide advice and research to committee as requested Process advice and recommendations of committee that are governed by the CEO, HSE National Clinical Audit in Radiation Protection Report on National Audit and follow up recommendations Report Annual Population Radiation Dose Monitor Recommendations of Chiropractic Audit. Quantify radiation dose to patients from fluoroscopy and interventional radiology, subject to resources Validate information received to date Manage Statutory Incident Reporting in Patient Radiation Monitor incident reports Review and learn from incident reports Monitor compliance with incident reporting Improve Patient Radiation Safety Measure compliance in radiological services Establish national standards in patient radiation safety within the HSE Quality Improvement Tool (QPIT) Promote introduction of unique patient identifier Set Guidelines in Patient Radiation Safety Medical Physics Expert in Dentistry Introduce Radiation Protection Manual nationally. 15

16 7. Relevant Documents All documents available at: EC Directive 97/43 EURATOM Statutory Instrument (SI) 478 (2002) Statutory Instrument (SI) 303 (2007)/SI 459 (2010) HSE Task Force Report, 2007 National Baseline Audits in Radiology and Radiotherapy, 2008 Report of the Commission on Patient Safety and Quality Assurance (2008). European Commission Guidelines on Clinical Audit for Medical Radiological Practices (Diagnostic Radiology, Nuclear Medicine and Radiotherapy), 2009 (RP 159) General X Ray Audit Survey Report 2011/2012 Chiropractic baseline audit report 2012 Guidelines for Reporting Patient Safety Incidents from Medical ionising Radiation, 2010 Guidance on Responsibilities in Statutory Instrument 478 (2002), 2010 Clinical Audit in Medical Radiological Practices (Diagnostic Radiology, Radiotherapy and Nuclear Medicine) HSE/Faculty of Radiologists

17 Appendix 1 Subcommittees, 2011: The subcommittees of the NRSC have similar terms of reference to the NRSC and report to the NRSC. They provide additional expertise and advice on speciality-specific issues. National Radiation Dental Subcommittee Meetings in 2012: 1 meeting Membership in 2012: Eamonn Fitzgerald Chair, replaced by Michael Redmond Jane Renehan Terry Farrelly Eamon Croke Maurice Quirke Paddy Gilligan Tanya Kenny Paul Dowling Maurice Fitzgerald Andrew Bolas National Radiotherapy Subcommittee Meetings in 2012: 3 meetings Membership in 2012: Mary Hynes Chair, (due for replacement) Goran Bjelkengren Catherine McKenna Martin Sheridan Wil van der Putten David Fitzpatrick Tanya Kenny Martin Sheridan National Population Dose Subcommittee Meetings in 2012: 2 meetings Membership in 2012: Michael Casey Chair, replaced by Paddy Gilligan Michael Maher Noeleen Cunningham Lesley Malone Brendan McCoubrey Shane Foley Peter Finnegan Michael Maher Mandy Lewis Bernadette Moran National Clinical Audit Subcommittee Meetings in 2012: 3 meetings Membership in 2012: Mary Hynes Chair, (due for replacement) Louise Casey Max Ryan Catherine McKenna Martin Sheridan Neil O Donovan Bernadette Moran 17

18 Appendix 2 MERU Medical Exposure Radiation Unit INFORMATION ON PATIENT RADIATION DOSES, IRELAND Typical effective doses, equivalent periods of natural background radiation and lifetime fatal cancer risks from most common diagnostic medical exposures Ionising Radiation (typical effective dose in millisieverts(msv) (1) Equivalent Period of Natural Background Radiation (1) Lifetime Additional Risk of Fatal Cancer per Single Examination (3) Limbs and joints (except hip and knees) (0.0002mSv) Half an hour Almost 0 (1 in 100 million) Knees x-ray ( mSv) One hour Almost 0 (1 in 35 million) Teeth, intra-oral (0.005mSv) Less than a day 1 in 4 million Teeth, panoramic (0.019mSv) 2 days 1 in 1 million Chest PA x-ray (0.02mSv) 2 days 1 in 1 million Return airplane flight (0.027mSv) (1) 2 days 1 in 1 million Dublin Rome return Cervical spine AP + Lat x-ray (0.07mSv) 1 week 1 in 300,000 Pelvis AP x-ray (0.29mSv) 1 month 1 in 70,000 Abdomen AP x-ray (0.4mSv) 7 weeks 1 in 50,000 Mammogram screening (0.57mSv) 2 months 1 in 35,000 Lumbar Spine AP + Lat x-ray (0.57mSv) 2 months 1 in 35,000 Spine (Thoracic and Lumbar) (1.22mSv) 4 months 1 in 16,000 Nuclear Medicine 99mTc (1.32mSv) 5 months 1 in 15,000 Thyroid Scan CT Brain / Head (1.7mSv) 6 months 1 in 12,000 One year s natural (3.4mSv) 1 in 5,900 background radiation (Ireland) Nuclear Medicine 99mTc (3.54mSv) 1 year 1 in 5,700 Bone Scan Barium enema (4.6mSv) 1.4 years 1 in 4,500 Cardioangiography (6mSv) 1.5 years 1 in 3,500 CT of Chest / Thorax (7.3mSv) 2 years 1 in 2,800 CT of Abdomen and Pelvis (8.4mSv) 2.5 years 1 in 2,400 CT of Chest, Abdomen and (12.9mSv) 3.8 years 1 in 1,500 Pelvis Nuclear Medicine 131 I Thyroid Uptake Scan (47mSv) 14 years 1 in 450 Lifetime risk of cancer NOT caused by radiation (2) 1 in 3 1. Medical Exposure Radiation Unit Publications on CT, Dental, General and Nuclear Medicine Patient Radiation Doses, ; Radiation Doses Received by the Irish Population, RPII, National Cancer Registry of Ireland (NCRI) ( 3. Patient Dose Information, Public Health England website, ontopics/medicalradiation/medic_tedequivalent/ Published May 2013 MERU 18