Estimation of the collective effective dose to the population from medical x-ray examinations in Finland

The collective effective dose to the population from all x-ray examinations in Finland in 2005 was estimated. The numbers of x-ray examinations were collected by a questionnaire to the health care units (response rate 100 %). The effective doses in plain radiography were calculated using a Monte Carlo based program (PCXMC), as average values for selected health care units. For computed tomography (CT), weighted dose length product (DLPw) in a standard phantom was measured for routine CT protocols of four body regions, for 80 % of CT scanners including all types. The effective doses were calculated from DPLw values using published conversion factors. For contrast-enhanced radiology and interventional radiology, the effective dose was estimated mainly by using published DAP values and conversion factors for given body regions. About 733 examinations per 1000 inhabitants (excluding dental) were made in 2005, slightly less than in 2000. The proportions of plain radiography, computed tomography, contrast-enhanced radiography and interventional procedures were about 92, 7, 1 and 1 %, respectively. From 2000, the frequencies (number of examinations per 1000 inhabitants) of plain radiography and contrast-enhanced radiography have decreased about 8 and 33 %, respectively, while the frequencies of CT and interventional radiology have increased about 28 and 38 %, respectively. The population dose from all x-ray examinations is about 0,43 mSv per person (in 1997 0,5 mSv). About half of this is caused by CT (in 1997 only 20 %) although the relative number of CT examinations is only 7 %. The contribution by plain radiography is 19 %, interventional radiology 17 %, and contrast-enhanced radiology 14 %. It is concluded that CT examinations are the major source of the population dose, while interventional radiology gives about the same population dose as plain radiography. For plain radiography, body examinations cause the highest effective dose.