Ann ICRP. 2007;37(6):1-63. doi: 10.1016/j.icrp.2008.08.001.
This report was prepared to underpin the Commission's 2007 Recommendations with regard to the medical exposure of patients, including their comforters and carers, and volunteers in biomedical research. It addresses the proper application of the fundamental principles (justification, optimisation of protection, and application of dose limits) of the Commission's 2007 Recommendations to these individuals. With regard to medical exposure of patients, it is not appropriate to apply dose limits or dose constraints, because such limits would often do more harm than good. Often, there are concurrent chronic, severe, or even life-threatening medical conditions that are more critical than the radiation exposure. The emphasis is then on justification of the medical procedures and on the optimisation of radiological protection. In diagnostic and interventional procedures, justification of procedures (for a defined purpose and for an individual patient), and management of the patient dose commensurate with the medical task, are the appropriate mechanisms to avoid unnecessary or unproductive radiation exposure. Equipment features that facilitate patient dose management, and diagnostic reference levels derived at the appropriate national, regional, or local level, are likely to be the most effective approaches. In radiation therapy, the avoidance of accidents is a predominant issue. With regard to comforters and carers, and volunteers in biomedical research, dose constraints are appropriate. Over the last decade, the Commission has published a number of documents that provided detailed advice related to radiological protection and safety in the medical applications of ionising radiation. Each of the publications addressed a specific topic defined by the type of radiation source and the medical discipline in which the source is applied, and was written with the intent of communicating directly with the relevant medical practitioners and supporting medical staff. This report consolidates that advice.
本报告旨在为委员会2007年关于患者（包括其陪护人员和护理人员）以及生物医学研究志愿者的医疗照射的建议提供支持。它论述了委员会2007年建议中的基本原则（正当性、防护最优化和剂量限值的应用）对这些人员的正确应用。对于患者的医疗照射，应用剂量限值或剂量约束并不合适，因为这样的限值往往弊大于利。通常存在并发的慢性、严重甚至危及生命的病症，这些病症比辐射照射更为关键。因此重点在于医疗程序的正当性以及放射防护的最优化。在诊断和介入程序中，程序的正当性（针对特定目的和个体患者）以及与医疗任务相称的患者剂量管理，是避免不必要或无意义辐射照射的适当机制。有助于患者剂量管理的设备特性以及在适当的国家、区域或地方层面得出的诊断参考水平，可能是最有效的方法。在放射治疗中，避免事故是一个主要问题。对于陪护人员和护理人员以及生物医学研究志愿者，剂量约束是合适的。在过去十年中，委员会已发布了一些文件，提供了与电离辐射医学应用中的放射防护和安全相关的详细建议。每份出版物都针对由辐射源类型和应用该源的医学学科所界定的特定主题编写，目的是直接与相关医疗从业者和辅助医务人员进行沟通。本报告整合了这些建议。
