The “As Low As Reasonably Achievable” (ALARA) principle: a brief historical overview and a bibliometric analysis of the most cited publications

Abstract

The “As Low As Reasonably Achievable” (ALARA) principle is largely followed in the radiology field. The current article provided a historical overview on the evolution and development of the ALARA principle and its related concepts. Meanwhile, the scientific impact of papers dealing with the ALARA principle was largely unknown. The current study aimed to identify the body of literature dealing with the ALARA principle, which of them were cited the most, and which of their references were cited the most. The Web of Science database hosted by Clarivate Analytics was accessed. Relevant papers were identified and analyzed. The search identified 979 relevant publications. Six journals (Health Physics, Pediatric Radiology, Radiation Protection Dosimetry, Transactions of the American Nuclear Society, Fusion Engineering and Design, and American Journal of Roentgenology) have accounted for nearly one-fifth of these publications. The most cited publications and references mainly related to two patient groups, children and pregnant women. It is important to adhere to the ALARA principle whenever a decision is made to irradiate a patient, because the exact effect of radiation on the patient health is not yet totally understood and predictable.