Radiological mass screening within the Member States of the European Community

European Commission Directorate-General For The Information Society And Media Directorate-General For Research And Innovation Directorate-General For Employment Social Affairs And Inclusion

Description

Regulations, practices, effectiveness
Nuclear energy and safety
Health policy

Sujets

• Proceedings
• Health law
• Radiation protection
• Radioactive waste

Informations

• Publié par: EUROPEAN-COMMISSION-DIRECTORATE-GENERAL-FOR-THE-INFORMATION-SOCIETY-AND-MEDIA-DI
• Nombre de lectures: 17
• Langue: English
• Poids de l'ouvrage: 7 Mo

Extrait

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Commission of the European Communities
radiation protection 37
Radiological mass screening
within the Member States
of the European Community
Regulations, practices, effectiveness
Proceedings of a seminar
held in Luxembourg, 3-4 December 1985 -S
Commission of the European Communities
radiation protection — 37
Radiological mass screening
within the Member States
of the European Community
Regulations, practices, effectiveness
Proceedings of a seminar
held in Luxembourg, 3-4 December 1985
Jointly organized by:
Commission of the European Communities
Directorate-General 'Employment, Social Affairs and Education'
Health protection and public health l 'Science, Research and Development'
Radiation protection programme
Commissariat à l'Energie Atomique (CEA), France
Centre d'étude sur l'Evaluation de la Protection dans le
domaine Nucléaire (CEPN), France
Edited by
J. Lochard
(CEPN)
Directorate-General
Employment, Social Affairs and Education
Health and Safety Directorate
| MWjUi!Ţî>. Billie.
1987 lNC­'EUR11059 EN Published by the
COMMISSION OF THE EUROPEAN COMMUNITIES
Directorate-General
Telecommunications, Information Industries and Innovation
Bâtiment Jean Monnet
LUXEMBOURG
LEGAL NOTICE
Neither the Commission of the European Communities nor any person acting on
behalf of then is responsible for the use which might be made of the
following information
Cataloguing data can be found at the end of this publication
Luxembourg: Office for Official Publications of the European Communities, 1987
ISBN 92-825-7602-7 Catalogue number: CD-NA-11059-EN-C
© ECSC-EEC-EAEC, Brussels · Luxembourg, 1987
Printed in Belgium PREFACE
Under the Euratom Treaty it is the task of the Commission of the
European Community to ensure the health protection of workers and the
general public against the dangers of ionizing radiation. Dose limits
and the principals of radiation protection were first laid down in a
Council Directive of 1959, and have since been repeatedly adapted. The
specific problems ofnn of persons undergoing
medical examination or treatment are the subject of a seperate Council
Directive of 3 September 1984.* This directive specifies that "all
medical exposures must be medically justified and kept as low as
reasonably achievable".
The concept of justification is particularly critical in the case of
mass-screening activities. For some diseases with low prevalence the
radiological detriment to the population resulting from radiological g procedures might be greater than the individual benefit
of the diagnosis. In addition the costs of public health care are
rising in all Member States of the European Community and the
effectiveness of public health care programmes like mass-screening
must be carefully examined.
A technical workshop on practices and regulations in the field of
radiological mass-screening within the Member States (Luxembourg, 4-5
December 1984) and a seminar on the same subject, 3-4 r 1985) were therefore organized by the Commission of the
European Communities in cooperation with the Commissariat à l'énergie
Atomique, CEA, and the Centre d'étude sur l'évaluation de la
protection dans le domaine nucléaire, CEPN (France).
The workshop provided up-to-date information on effectiveness and cost
of radiological mass-screening programmes in the Member States. The
seminar provided the representatives of the national authorities
responsible for radiation protection, public health and occupational
medicine with an opportunity to discuss mass-screening pratices with
experts.
This publication contains the papers presented at the workshop and the
seminar. It gives an overview on the current pratices in radiological
mass-screening and it is hoped that it will help the responsible
authorities in the Public Health sector in their planning activities
and decision making.
* OJ No. L 265, 3.9.1984, p.1 The services of the Commission would Like to express their gratitude
to all who have actively taken part in these meetings and especially
Mr. LOCHARD (CEPN) and Mr. UZZAN (CEA) for their most valuable
contribution.
F. VAN HOECK E. BENNETT
Director Director
Biology, Radiation Protection Health and Safety
and Medical Research
IV -CONTENTS
Page
INTRODUCTION 1
PART 1 : SUMMARY REPORTS 9
Regulations and practices for systematic radiological screening within
countries of the European Community 11
C. Lefaure
Cost-effectiveness and radiological risk associated with mass chest screening 3
F.E. Stieve
Population screening for breast cancer in the European Community 43
F. de Waard
Screening for congenital dislocation of the hip. 5
H. Fendei
PART 2 : TECHNICAL REPORTS5
SECTION 1 : OVERVIEWS 57
Routine use of radiologic investigations : WHO recommendations 59
N.T. Racoveanu
Concepts of optimisation and justification. Consequences for
radiological mass screening 73
J.H.E. Carmichael
SECTION 2 : REGULATIONS AND PRACTICES 91
Belgium *
Practice and regulations of radiological chest screening in Denmark3
O. Berg, O. Hjardemaal
Practices and regulations for radiological man screening in the
Federal Republic of Germany 10
G. Hinz
Regulation and practice of X-ray screening in France 111
E. Bouvet, C. Weill, C. Lefaure
Greece *
Practice and regulations of radiological mass screening in Italy 129
P.L. Indovina, S. Romagnoli, M. Paganini Fioratti
Radiological mass screening in the Irish Republic 147
B. O'Donnell
* Report non available
V Luxembourg *
Radiological mass screening in the Netherlands 151
J. de Pater
Practices and regulations of radiological mass screening
in the United Kingdom 159
M.E. Abrams
SECTION 3 : MASS CHEST SCREENING 16
Cost-effectiveness and risk associated with radiological chest screening
programmes illustrated by the results of mass screening in
Bavaria/Federal Republic of Germany3
Th. Schmidt, F.E. Stieve
Cost-effectiveness and radiological risk from mass tuberculosis X-ray
screening in France 205
C. Le Gales, C. Lefaure, J. Lochard
Radiological tracking down of pulmonary tuberculosis in France :
investigation concerning 984 declared cases 23
A. Hirsch, C. Le Gales, C. Lefaure, F. Valuer
Mass chest radiography in Greece 24
C. Papavasiliou
X-ray chest mass screening for pulmonary tuberculosis in
the Friuli Venezia Giulia Region, Italy 251
V. Barbina, G. Contento, R. Padovani, G. Pitzalis, C. Nigris
Notes on a local study on effectiveness and risk of X-ray mass chest screening 267
V. Barbina, M. Leonardi
Mass chest screening in Luxembourg 277
P. Kayser
SECTION 4 : MAMMOGRAPHY SCREENING9
Breast cancer screening 281
A. Vandenbroucke
Radiation exposure and risk from mammography
M. Säbel
Alterations in age distribution of breast cancer patients over the last 20 years 303
E.M. Paterok
* Report non available
VI -Evaluation of costs and benefits of mammography screening for breast
cancer in the context of French resources 311
H. Bouhnik, J.L. Renaud-Salis, C. Maccia
Cost-effectiveness andradiologicalriskassociated with mammography
screening in Italy 343
S.Torna,G.Pino,S.Braghetti
Cost-effectivenessand radiationriskofbreastcancer screening 361
J.J.Rombach
Mammographyandmammographie screening in theUnitedKingdom:
practices,regulationsand radiation dosimetry 367
M. Fitzgerald
SECTION 5 : INFANTS' HIPDYSPLASIASCREENING379
The futility of the Roentgen-screeningofinfants for congenital
dislocation of the hip 381
H.Fendei,G.Fuhrmann, Κ. Schneider
Limitationsofcost-benefit evaluation of non-systematic radiological
screeningofcongenital dislocatable or dislocated hip in Germany 395
V.Weidtman,B.Von Heereman, F. Herrmann
Congenitalhipdislocation : radiological screening or diagnosis?415
G. Kalifa, C. Faure
Cost-effectiveness and risk associated with infants' hip dysplasia screening
in France 421
C.Maccia,C.Lefaure, F. Corlobe
Cost-effectivenessand risk associated with infants' hip radiological
screeninginItaly437
M.Pini,R.Perale
Annotationsoncost-effectiveness and risk associated with infants' hip
radiologicalscreening in the Netherlands451
P.Kramer
Screening for congenital dislocation of the hip in the newborn : the role
of clinical, ultrasonographic and radiographic examination 461
P.M. Dunn
AUTHOR INDEX 479
Workshop-List of participants 481
Seminar-Listof s487
- VII