Towards Building a National Infrastructure in Radiation Safety

After being the member of IAEA in 2008, Nepal has been receiving the extended technical co-operation from the IAEA. Currently, a draft Nuclear Law has been prepared and approved by the Council of Ministers (16/09/2011) and is under the review of the Nepal Law Commission. Developing and establishing the national infrastructure is one of the major co-operation areas which Nepal and IAEA have agreed upon. Safe Use of Radiation is the primary aim of this co-operation.

Suresh Poudel

For disease diagnosis and radiation therapy, ionizing radiation is used. So to comply with the aim of the co-operation, it is necessary to focus on the quality control and radiation safety at hospitals and workplace. Nevertheless Nepal does not have a clear record of the number of radiation health professionals (i.e. Radiologists, Oncologists, Medical Physicists, Technologists, Technicians, Radiographers, nurses and others). Also there is no official record about the exact number of the operating radiological facilities, number and types of diagnostic and therapy machines using ionizing radiation. Conditions of workplace are still unknown. Lately there has been some development towards the baseline study of radioactive sources, and other basic studies in this area. In July 2010, a report “Status of Radioisotopes in Nepal- A Survey for the preparation of Inventory” was published as an initiative towards archiving information about the radioisotopes in the country. It was a positive development to create a database of radioactive sources. This report has been crucial in documentation of radioactive sources.

Widmark et al(2012) performed another study titled “Occupational Radiation Exposure in Health Care Facilities” to show the picture of occupational radiation safety in Nepal . In this study it has been mentioned that there are 11 computed radiography units, 12 mammography units, 30 CT units and more than 900 X-ray units are in operation. And in therapy, one gamma camera, three brachy equipments, three linacs, three simulators, four cobalt-60 machines are in operation in 5 hospitals. One big private hospital will come in operation soon with some additional facilities like IMRT, and nuclear medicine unit. In another study, Lamsal (2012) wrote a report about his reflection of attending “International Workshop on Radiation Risk Communication in Pediatric Imaging”. This report is basically his personal experience of and learning from the conference. However, it has included the different facet of radiation safety in Nepal. Also the report has discussed about the problems of achieving the quality assurance in imaging and also tried to shed information on radiation safety issues in Nepal.

On the other hand, Nuclear Law will be effective only if it is properly designed and effectively implemented in its implementation stage. But in every step of its design and also in implementation phase, it needs an adequate supply of information and expertise. As there is limited number of study undertaken till date which may make the literature insufficient for proper outcome of the Law. It is very challenging for the government to design a sound Nuclear Law with limited information, literature, expertise and insight of the true situation of the country. But it should not stop it for bring the Law as it would provide the basic guidelines for the use of ionizing radiation in medicine.

There are separate professional organizations for each group of professionals. Nepalese Radiological organization such as Nepal Nuclear Society, Nepal Radiological Society, Nepal Radiologist Association, Nepalese Association of Medical Physicists, Nepal Radiological Technology Student’s Society can play vital role in creating the database of the respective radiological health professionals. What government can do with these organizations is to ask such them to regularly supply the required data, primarily about their numbers, skills, trainings etc. On other words, the situation of these professionals in health care market.

Likewise for creating the database of the equipment used in diagnosis and radiotherapy, government can call the diagnostic equipment user for the voluntary registration of their devices in its early stage and then go for the mandatory registration. Since the number of radiotherapy facilities is very few in number, it can conduct survey to generate the information about the situation of devices there. It can be the initial step towards accounting the equipment used in diagnostic and therapy.Personal dose monitoring is rarely done in diagnostic facility with an exception at some private hospital. However, it is performed in radiotherapy but there are challenges like shortage of monitoring device, calibration in time and dose reporting.  Even in the cases where the personnel have devices, s/he may lack skills to handle it due to lack of knowledge and training.

In this context it has been essential for the government to initiate the collection and hence preservation of data related to the radiation health professionals, equipment related to diagnostic and radio therapy, organize training, workshop, radiation safety awareness programs now and has to come up with a long term planning to ensure radiation safety in Nepal.  This will help to ensure quality control and safe use of ionizing radiation in Nepal.  And hence it will add a brick towards building a national infrastructure in Radiation Safety.

The writer is a member of Bangladesh Medical Physics Society and a student of Gono Bishwobidyalay,  Savar, Dhaka, Bangladesh.