Legal basic and aspects of regulation of the diagnostic reference level (DRL) in Indonesia

Diagnostic and interventional radiology facilities are among the supporting facilities in establishing the diagnosis of a disease in a hospital or others health facility. Diagnostic radiology is an activity related to the use of facilities for diagnostic purposes. Every use of nuclear power, including x-rays, which are sources of ionizing radiation, must follow radiation protection and safety principles. One of the principles of radiation protection and safety is optimization. Ionizing radiation given to patients in diagnostic and interventional radiological activities must also follow the rules or guidelines provided by the standards of radiation protection and safety principles. One practical tool in carrying out the optimization measures in radiation protection and safety is the Diagnostic Reference Level (DRL) level. To ensure and strive for the licensees to meet the optimization principle, BAPETEN establishes laws and regulations that must be implemented and complied with by the permit holder to utilize ionizing radiation. The principle of optimization in radiation protection and safety is one of the radiation safety requirements that must be fulfilled by permit holders as mandated in article 21, article 34, and article 35 in Government Regulation (GR) Number 33 Year 2007 [1] concerning Ionizing Radiation Safety and Radioactive Source Security. Medical practitioners must use the level of medical exposure guidance when carrying out the diagnostic and interventional radiological procedures to optimize protection for patients. Licensees play an important role in making and submitting patient dosage record reports for the benefit of optimization in radiation protection and safety. When establishing this level of diagnostic guidance or DRL, the licensees must be based on patient dosage records for patients who have performed diagnostic and interventional radiological examinations. Patient dosage records must always be done to ensure that the examination is in accordance with the established operational procedures. In addition, recording the patient’s dose also needs to be done in order to evaluate the examination and evaluation procedures if under certain conditions, the administration of doses to patients is too high or too low. If, during an examination, a high dose is obtained, it is necessary to investigate and consider the use of a high dose. Another second thing that will receive the effects or effects of the DRL determination is related to the profession of medical physicists. The medical physicist profession gets the mandate from BAPETEN to deliver and supervise reports related to patient dosage records. These patient dosage records will be used as a basis for the preparation and establishment of DRL or diagnostic guidance levels.