Using disability-adjusted life years measure for characterization of radiation risk from fluoroscopy

Abstract

Medical diagnostics procedures involving the use of ionising radiation is one of the most intensively developing areas in medical diagnostics. At the same time, medical exposure of patients has a number of fundamental differences from other routine situations of planned exposure. As a rule, medical exposure is acute, and radiation doses in some types of examinations exceed the level of natural and man-made exposure associated with normal operation of radiation facilities. In such a situation, risk differentiation is of great importance, taking into account the different radiosensitivity of individual sex and age groups of patients. Radiation risks should be taken into account both when prescribing examinations involving the use of ionising radiation and when analysing the benefit-harm ratio associated with their application to specific patients. Another reason why risk assessment is an urgent task is the need to inform patients and/or their legal representatives about the health risks associated with the carrying out of examinations, including radiation risks. Within the framework of the present work, the risks associated with fluoroscopic examinations were assessed. To characterise the risk we used the DALY indicator, which is more and more frequently used in risk assessment, reflecting the possible number of lost years of healthy life as a result of radiation exposure during the study. The aim of the work was to calculate DALY values for different sex and age groups of patients from the Russian population  during fluoroscopic examinations. To achieve this aim, the method of estimating the number of healthy life years lost due to exposure to ionising radiation, which was developed in the course of the research work, was used. The paper presents the results of calculating DALY values for three types of fluoroscopic examinations. This work represents the next step in the direction of harmonisation of radiation risk assessment methodology with the methodologies of risk assessment of other nature. One of the directions of using the calculation results is the development of methodological approaches to the calculation of sex- and age-dependent risk coefficients associated with medical exposure of patients. The analysis of the obtained results showed that the contribution of oncological diseases to the total radiation harm in older men was significantly higher than in women.