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CAR - Canadian Association of Radiologists

The Canadian Association of Radiologists is the national specialty association for radiologists, dedicated to medical imaging excellence in patient care

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Imagerie Sécuritaire Canada (CSI)

CSI-logo-web-500px

Veuillez noter que ce contenu n'est présentement disponible qu'en anglais.

À propos Comité directeur Notre communauté Risques liés à la radiation Initiatives internationales Les étoiles Canada Safe Imaging Ressources Actualités Nos coordonnées
À propos

À propos

Canada Safe Imaging (CSI) was formed in 2015 to address the need for a national strategy and action plan in Canada, to strengthen medical radiation protection in patients and foster a culture of radiation safety in healthcare in Canada.

CSI represents a collaborative undertaking between government agencies, professional associations, universities, colleges, national research institutions and hospitals. Within each sector, a multi-disciplinary approach has also been adopted, involving partners, researchers, technologists, medical and health physicists and other health care providers using or prescribing the use of radiation.

Canada Safety Imaging is part of a network of radiation safety campaigns worldwide under the auspices of the International Society of Radiology.

Mission

To provide Canadian contextualized guidelines and tools for patient radiation safety.

Responsibilities

  • Promote knowledge translation and adoption of and adherence to good radiation safety practices and standards as they relate to the Canadian medical environment;
  • Undertake future potential strategies and initiatives to enhance medical imaging radiation safety and care;
  • Shape and promote a strategic research agenda for radiation protection of patients in Canada

Context

Today’s medical imaging technologies provide unprecedented visibility into the body. As medical imaging technologies and techniques continue to evolve rapidly so has their utilization and subsequent exposure of patients to ionizing radiation.

Even if the technology has significantly improved and doses of radiation have decreased, the risk of exposure did not disappear and needs to be taken into consideration when tests using ionizing radiations are prescribed. As many things we take for granted, we don’t see any more the risks attached to the technology as it becomes part of our life. But there is a need to remain vigilant, raise awareness and educate healthcare professionals and population at large about the risks and benefits of ionizing radiations in medicine.

In 2012 the International Atomic Energy Agency (IAEA) and the World Health Organization (WHO) launched an initiative that was supported by 77 countries and 16 organizations, titled the “Bonn Call For Action,” which outlines ten major strategies for promoting radiation protection. In response, a new campaign was formed, which brings together many stakeholders to strengthen medical radiation protection across Canada following an inclusive approach. The delivery of health care is a provincial responsibility but a focused national strategy and a unified effort is needed to ensure radiation safety in medical imaging for all Canadians.

Canada Safe Imaging (CSI) was formed to address this need for a national strategy and action plan as it relates to radiation safety for medical imaging care in Canada.

Comité directeur

Comité directeur

The Executive Committee is composed of representatives of the major founding organizations.

David A. Koff,  Chair, CAR

David Wormald, CAMRT

Patrik Rogalla, CAR

Bassem Elshahat, COMP

Sandor Demeter

Helen Chen, University of Waterloo

Natalia Moyazed, Radiation Safety Institute of Canada

Notre communauté

Notre communauté

Organisations participantes 

  • Association des Radiologistes du Québec
  • Canada Health Infoway
  • Canadian Association of Medical Radiation Technologists
  • Canadian Association of Nuclear Medicine
  • Canadian Association of Radiologists
  • Canadian Cardiovascular Society
  • Canadian Interventional Radiology Association
  • Canadian Organization of Medical Physicists
  • Canadian Partnership Against Cancer (CPAC)
  • Centre d’Expertise Clinique en Radioprotection
  • Choosing Wisely
  • MEDEC
  • Ontario Association of Medical Radiation Sciences
  • Ordre des technologues en imagerie médicale et en radio-oncologie du Québec
  • Radiation Safety Institute of Canada
Risques liés à la radiation

Risques liés à la radiation

The BEIR report VII

Defines “low level” radiation as a range from near zero up to 100 milliSieverts (mSv)

  • 30-40 times annual natural background exposure
  • 10 times that of a CT Scan
  • 1000 times that of a chest X-Ray.

Linear No Threshold Theory

  • According to the Linear No Threshold (LNT) theory, the risk of developing a radiation induced cancer (stochastic effects) increases with increasing dose.
  • This model has been validated at higher acute radiation doses (>100mSv) from the atomic bomb survivors.
  • The dose level at which there is a significant risk is not known, but for radiationprotection purposes, it is assumed that there is a linear risk down to “0” dose.
  • For low dose exposures, less than 100 mSv per year, the risk profile is open to discussion.
  • Different dose risks models have been proposed, going from increased risks to benefits!
  • The Health Physics Society stated recently that the LNT theory cannot be used for risk cancer estimates.

ALARA Principle

  • Irrespective of the LNT debate we have to follow best practices and keep radiation exposures and doses “As Low As Reasonably Achievable”.
  • This is the ALARA principle which means making every effort to maintain exposures to ionizing radiation as far as below the dose limits as practical.
  • Taking into consideration the state of technology and the economics of improvements in relation to benefits to the public health and safety.
Initiatives internationales

Initiatives internationales

Bonn Call-for-Action

The International Atomic Energy Agency (IAEA) held the “International Conference on Radiation Protection in Medicine: Setting the Scene for the Next Decade” in Bonn, Germany, in December 2012, with the specific purpose of identifying and addressing issues arising in radiation protection in medicine.

The conference was co-sponsored by the World Health Organization (WHO), hosted by the Government of Germany and attended by 536 participants and observers from 77 countries and 16 organizations. An important outcome of the conference was the identification of responsibilities and a proposal for priorities for stakeholders regarding radiation protection in medicine for the next decade. This specific outcome is the Bonn Call-for-Action.

The aims of the Bonn Call for Action are to:

  1. Strengthen the radiation protection of patients and health workers overall;
  2. Attain the highest benefit with the least possible risk to all patients by the safe and appropriate use of ionizing radiation in medicine;
  3. Aid the full integration of radiation protection into health care systems;
  4. Help improve the benefit/risk-dialogue with patients and the public; and
  5. Enhance the safety and quality of radiological procedures in medicine.

The Bonn Call-for-Action highlights ten main actions, and related sub-actions, that were identified as being essential for the strengthening of radiation protection in medicine over the next decade. The actions are not listed in order of importance.

The ten main actions:

  1. Justification
  2. Protection and Safety
  3. Manufacturer’s role
  4. Education and training
  5. Research
  6. Global information
  7. Incidents and accidents
  8. Culture
  9. Benefit Risks dialogue
  10. Global requirements

The Bonn Call For Action 5 years later

In December 2017, the IAEA, in partnership with the WHO and the Pan-American Health Organization, hosted the International Conference on Radiation Protection in Medicine: Achieving Change in Practice in Vienna, Austria. The goal of this conference was to provide an overview of the actions and developments since the 2012 Bonn conference.

The conference, with 530 participants from 100 countries, five days of presentations and round tables, acknowledged the work performed in numerous jurisdictions around the world to promote the Bonn Call-for-Action and outlined what more should be done to enhance awareness and implementation.

 

ISRQSA

The International Society of Radiology Quality and Safety Alliance (ISRQSA)

The International Society of Radiology collaborates with the International Atomic Energy Agency (IAEA) and the World Health Organization (WHO) to focus on the implementation of the Bonn Call for Action and the International Radiation Basic Safety Standards (BSS). These standards have been first published by the IAEA in 1996, to establish basic requirements for protection against the risks associated with exposure to ionizing radiation and for the safety of radiation sources. They result from the collaboration between multiple international organizations and have been developed from widely accepted radiation protection and safety principles. They have been revised and updated in 2014 taking into account the most recent findings of the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) and the latest recommendations of the International Commission on Radiological Protection (ICRP).

The ISR Quality and Safety Alliance (ISRQSA) drives the ISR’s quality and safety agenda, and acts as a convener and facilitator for continental, regional and national radiation protection, quality and safety campaigns. These campaigns are led primarily by radiologists and supported by their regional societies of radiology. Most of them are multi-stakeholder organizations, with Medical Physicists and Radiographers on board, as promoted by Canada Safe Imaging. These campaigns include Image Wisely and Image Gently in the USA, EuroSafe Imaging, Canada Safe Imaging, AfroSafe Rad English and French, LatinSafe, Japan Safe, Arab Safe, AsiaSafe.

ISRQSA and WHO have worked on a 3 year work plan for 2019-2021 to promote WHO’s initiatives. Besides facilitating the implementation of the International Radiation BSS and the Bonn Call for Action, the plans also addresses focal areas such as justification of medical imaging, multidisciplinary/team approach in the use of medical radiation, radiation risk communication, radiation safety culture in healthcare and use of medical imaging in individual health assessment of asymptomatic persons.

The continental, regional, national initiatives

Les étoiles Canada Safe Imaging

Les étoiles Canada Safe Imaging

The CSI Executive Committee estimated that Canada would benefit from a system based on the EuroSafe Imaging Stars which identify and recognize imaging facilities that embody best practice in radiation protection (6). These facilities obtain stars on a scale from 1 to 5 based on their level of compliance with recommendations adapted from the Bonn Call for Action.

A Canadian version adapted to our healthcare environment will support the work already performed by Accreditation Canada in providing a more comprehensive tool to assess compliance with international recommendations and best practices.

The Canadian version has also five levels of stars and applicants will have to demonstrate that they fulfill a number of criteria for each level as outlined in table 2 and 3. The criteria have been divided in six sections: optimization, justification, quality and safety, education, research and regulatory compliance.

 

 

 

 

 

Ressources

Ressources

Questions about Radiation

The Free Information Service in Radiation Safety provided by the Radiation Safety Institute of Canada offers medical imaging professionals answers to patient and workplace safety questions, as well as answers to direct patient enquiries about imaging procedures’ exposures and their associated risks.

1 800 263 5803
[email protected]

A similar service is offered in French by the Centre d’Expertise Clinique en Radioprotection.

1 877 839 1217
[email protected]

 

General Information

Under construction

Actualités

News

 

Nos coordonnées

Nos coordonnées

[email protected]

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