Practical recommendations to occupational physicians for medical monitoring and dose assessment of internal exposure of nuclear workers to radionuclides

Introduction
In France, 64000 workers of Basic Nuclear Facilities are occupationally exposed to a risk of internal contamination with radioactive material. Their follow-up is ensured by approximately 450 occupational physicians. These occupational physicians need a reference guide to harmonize their practice.

Methods
The development of a guide of recommendations for clinical practice has been done following the methodology suggested by the National Authority for Health (HAS) which is an agency under the supervision of the French Ministry of Health.

Results
The aim of this guide is to allow the occupational physicians:
• to set up monitoring programs adapted to the risk of exposure, in routine or special circumstances,
• to assess the dose from bioassay data,
• to answer the workers'concern about the individual risk when a dose is evaluated.

Discussion
A working group made up of occupational physicians, biological pharmacists and experts in internal dosimetry was set up in 2004, on the initiative of occupational physicians from various Basic Nuclear Facilities , to discuss and to list the difficulties in dose assessment for cases of internal contamination, in order to harmonize their related practices. In 2008, the group started to draft a guide of recommendations, promoted by the French Society of Occupational Medicine (SFMT), which could be used as a reference by professionals concerned with this risk. We present, herein, the editorial work method and different stages.