The full ALARA principle includes "as low as reasonably achievable" taking social and economic factors into consideration. The International Commission on Radiological Protection advises a conventional cost benefit approach (e.g., cost per monetized averted stochastic effects or years of life saved) to consider economic factors. Given small incremental radiation dose reductions to patients, workers, or the public that may be realized in medical settings and the correspondingly small changes to theoretical stochastic effects, a conventional cost benefit approach is less than ideal. This is illustrated in the case studies presented in this paper. Alternate approaches, such as cost per unit of radiation dose averted (e.g., $/μSv averted), cancer induction/fatality probabilistic thresholds, or thresholds relative to natural background radiation may be alternate options. However, the decision regarding what is a "safe" level of radiation and what are reasonable costs to make it "safer" are driven by societal values and may vary from jurisdiction to jurisdiction.

中文翻译：

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医疗环境辐射防护的经济考虑——是时候采用新范式了吗？

完整的 ALARA 原则包括考虑社会和经济因素的“合理可达到的最低水平”。国际放射防护委员会建议采用传统的成本效益方法（例如，避免随机效应的货币化成本或挽救生命的年数）来考虑经济因素。考虑到在医疗环境中可能实现的对患者、工作人员或公众的辐射剂量小幅增量减少以及理论随机效应相应的小变化，传统的成本效益方法并不理想。本文提供的案例研究对此进行了说明。替代方法，例如每单位避免的辐射剂量的成本（例如，$/μSv 避免）、癌症诱发/死亡概率阈值或相对于自然背景辐射的阈值可能是替代选择。然而，关于什么是“安全”辐射水平以及使其“更安全”的合理成本是多少的决定是由社会价值观驱动的，并且可能因管辖区而异。