# The vital role of radiation protection research in Europe's future: a PIANOFORTE white paper

Jacqueline Garnier-Laplace, Jean Christophe Gariel, Filip Vanhavere, Florian

Rauser, Andrzej Wojcik, Elizabeth Ainsbury, Simon Bouffler, Marie

Davídková, Tomasz Kalita, Christoph Hoeschen

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## ► To cite this version:

Jacqueline Garnier-Laplace, Jean Christophe Gariel, Filip Vanhavere, Florian Rauser, Andrzej Wojcik, et al.. The vital role of radiation protection research in Europe's future: a PIANOFORTE white paper. Journal of Radiological Protection, 2025, 45 (2), pp.023001. 10.1088/1361-6498/adc7c0 hal-05385148

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MEMORANDUM

# The vital role of radiation protection research in Europe's future: a PIANOFORTE white paper

Jacqueline Garnier-Laplace<fnref n="1" />,*, Jean-Christophe Gariel<fnref n="1" />, Filip Vanhavere<fnref n="2" /> ID, Florian Rauser<fnref n="3" /> ID, Andrzej Wojcik<fnref n="4" /> ID, Elizabeth Ainsbury<fnref n="5" /> ID, Simon Bouffler<fnref n="5" /> ID, Marie Davídková<fnref n="6" /> ID, Tomasz Kalita<fnref n="7" /> and Christoph Hoeschen<fnref n="8" /> ID

E-mail: jacqueline.garnierlaplace@asnr.fr

Keywords: radiation protection research, health and environmental policies, sustainability

## Abstract

Radiation protection is a cornerstone of public health, occupational safety, patient welfare, and environmental stewardship. A strong emphasis on radiation protection is necessary to contribute to the well-being of citizens, to innovation and sustainable growth across Europe, and to meet the challenges by application of new technologies, and emerging threats. While the use of ionising radiation and radioactive substances underpins significant advancements in medicine, nuclear and non-nuclear industry, it also poses risks that must be carefully defined and managed in environmental and health policies. Effective radiation protection knowledge and know-how help balance the benefits and risks of ionising radiation use, empowering European society to harness its potential safely. Neglecting investment in radiation protection research could lead to increased risks, delayed innovation, and risk-disproportionate radiation protection policy and regulation frameworks, hindering Europe's progress and resilience. This white paper argues for sustained investment in radiation protection research, in the follow-up of the dedicated PIANOFORTE pan-European partnership (2022–2029). In the context of the 10th Framework Programme of Research and Innovation and its related EURATOM's part, this should be achieved with a funding envelop for radiation protection research of ca. 75 M€ through a PIANOFORTE-like partnership, including actions related to infrastructure and education and training. Such investment forms an essential component of Europe's strategy for competitiveness, security, and quality of life, including quality of environmental resources and natural capital, notably but not only in the context of the energy transition. Key challenges related to occupational exposure, medical diagnostics and treatments, emergency preparedness and response, exposure to natural sources of radiation and environmental protection underscore the need for comprehensive research to support evidence-based policy decisions, harmonised regulations and safe, sustainable and integrated practices that address protection of both human and environmental health.

## 1. The importance of continued investment in radiation protection research

Fit-for-purpose radiation protection is essential for protecting public health, workers, patients, and the environment, as well as for fostering industrial and medical innovation in Europe [1]. The significance of these needs is underscored by key yearly based figures in Europe, such as 1 million dose-monitored nuclear

<footnote n="1">¹ Autorité de Sûreté Nucléaire et de Radioprotection (ASNR), Fontenay-aux-Roses, France</footnote>

<footnote n="2">² Belgian Nuclear Research Centre SCK CEN, Boeretang, Mol 2400, Belgium</footnote>

<footnote n="3">³ Bundesamt für Strahlenschutz (BfS), Salzgitter, Germany</footnote>

<footnote n="4">⁴ MBW Department, Stockholm University, Stockholm, Sweden</footnote>

<footnote n="5">⁵ UK Health Security Agency, Didcot, United Kingdom</footnote>

<footnote n="6">⁶ National Radiation Protection Institute, Praha 4, Czech Republic</footnote>

<footnote n="7">⁷ Narodowe Centrum Badań i Rozwoju (NCBR), Warsaw, Poland</footnote>

<footnote n="8">⁸ Otto-von-Guericke University, Magdeburg, Germany</footnote>

<footnote>* Author to whom any correspondence should be addressed.</footnote>
workers, 500 million radiographs, 55 million CT-Scan, 10 million nuclear medicine imaging procedures, 50% of cancer patients treated by radiotherapy, about 1 in 10 lung cancer cases in Europe attributable to residential radon [2].

Beyond medical and occupational exposure, radiation protection research also plays a crucial role in addressing environmental and industrial challenges. The nuclear energy revival heightens safety considerations, while managing the many legacy sites of former uranium mining and milling across Europe is still needed. A range of non-nuclear industries (geothermal energy, oil and gas, and rare earth element mining) also faces significant risks related to naturally occurring radioactive materials (NORMs). Furthermore, in an increasingly uncertain geopolitical landscape, the potential risks associated with nuclear military conflict must also be factored into long-term radiation protection strategies. Continued research investment is essential for addressing these evolving challenges, ensuring the safe and sustainable use of radiation technologies across all sectors.

While exposure to ionising radiation carries inherent risks, scientific advances using ionising radiation and radioactive substances have greatly reduced these risks, while at the same time driving substantial progress in medicine and technology, leading to sustainable growth. Yet, questions remain about the acceptable levels of risk that the society is willing to assume as well as how the risk should be governed in a participatory manner in a way that maintains public trust and social cohesion. Through scientifically grounded policies and public and stakeholder involvement, the EU Member States can respond to societal needs and effectively manage radiation-related risks associated with both natural and artificial sources, and benefit from the safest possible use of ionising radiation while avoiding costs resulting from unnecessary protection measures.

PIANOFORTE [3], the European partnership for research in radiation protection (2022–2029), with the combined expertise of its 108 partners across 26 countries, provides evidence-based insights and outcomes from research projects in the multi- and trans-disciplinary area of radiation protection, that foster sound policy discussions in many fields, robust and risk-proportionate regulation as well as better practice or implementation. Through the prioritisation of research topics and the mechanism of open calls, the European partnership drives momentum in the radiation protection research community, which in turn contributes to the provision of scientific expertise and create a lot of benefits. Together with facilitating access to infrastructures and developing education and training strategies, investment in radiation protection research responds to pertinent and emerging societal needs and empowers society to safely harness the benefits of nuclear science and all technologies that may lead to increased radiation exposures, for current and future generations.

In brief, radiation protection research provides a science-based foundation influencing both European and global policies that subsequently guide national regulations and allow for developing safe practices for protecting people and the environment from deleterious effects of ionising radiation, without limiting the societal benefits of nuclear science and technologies. In addition to this, radiation protection research impacts and shapes the diverse range of daily activities of all radiation protection professionals in academic, governmental, regulatory and industrial entities (e.g. reusing radioactive materials/by-products from NORM industries within the framework of a circular economy and/or sustainable practices, using and managing ionising radiation and radiopharmaceuticals in hospitals, protecting the public and workers from artificial and naturally-occurring radiation exposure, planning emergency responses, strengthening preparedness for recovery from a nuclear or radiological accident, monitoring and protecting the environment, maintaining radiation safety in nuclear power plants and adapting it to new reactor designs or fusion facilities). Ensuring sustained and substantial funding for this research is critical to maintaining scientific expertise, preserving key competences, and fostering the development of human resources in the field. This investment is essential to achieve the following goals, each of which being of equal importance:

* Enhance public health and protection of the environment, as well as occupational health, not least because understanding and mitigating the health risks associated with medical, occupational, and environmental radiation exposure (including legacy contamination, enhanced natural radioactivity, and ionising radiation applications in industry and research) eventually protects individuals from radiation-related health issues, optimising the benefit-to-risk ratio in diagnostics, cancer therapies, and other medical applications for various diseases, and reducing the burden of disease attributable to radiation exposures (thereby avoiding healthcare costs). While individual risks are small, radiation exposure remains a public health issue, as millions of people each running a small risk collectively constitute a significant public health concern.

* Support and advance radiation protection research to drive industrial innovation including new technologies and Artificial Intelligence applications because advancements in technologies that use ionising radiation, such as those in the medical technologies and space exploration industries, rely on research to ensure
safe application and foster public confidence based on insights and evidence from research across the con-
tinuum of technology readiness levels. Radiation protection research and its results also plays a critical role
in assisting Member States in the selection of energy sources for climate change mitigation in the context of
the energy transition and the net zero agenda.

* Prepare for emergencies because continuous efforts strengthen infrastructure and emergency response systems effectively (including e.g. crisis training, radiation monitoring efforts) to handle radiological and nuclear incidents/accidents. Importantly, research in radiation protection contributes to all necessary capabilities by advancing monitoring techniques and analytical methods. The evolving risk landscape—driven by technological changes, geopolitical tensions, climate-related disasters, and the potential for combined or unexpected threats—demands improved readiness. Strengthening these systems is crucial to minimising the societal and environmental impact of such crises and ensuring long-term resilience.

Despite the importance of radiation protection research, this field often struggles to secure national funding, as few countries have dedicated funding bodies for radiation research (for instance, proposals on low-dose effects and health risks are typically assessed alongside broader life sciences topics, where their significance is often overlooked due to a lack of specialised expertise among reviewers—a challenge that also extends to peer-reviewed journal evaluations).

Without sustained support, radiation protection research will remain uncompetitive at the national level, making a joint European effort essential to maintaining progress. While one could argue that maintaining the current level of scientific knowledge and robustness in radiation protection would suffice, assuming the international system of radiation protection is already fit-for-purpose, the main reason for continued radiation protection research is the constant emergence of new applications and insights. This dynamic evolution necessitates ongoing research to ensure that radiation protection measures remain effective and up to date. The lack of investment could result in outdated protocols, reduced preparedness for radiological or nuclear emergencies and other chemical, biological, radiological, nuclear, explosive (CBRN-E) issues, and diminished global leadership in addressing emerging challenges from advanced nuclear technologies. The withdrawal of EURATOM funding could further dismantle established collaborations like those formed through the successive Euratom (co)funded initiatives (e.g. CONCERT [4], Radonorm [5], PIANOFORTE) as well as by MEENAS [6], leading to a loss of accumulated expertise. Proactively supporting this field ensures not only the development of safe, more efficient systems but also the protection of future generations from radiation hazards.

## 2. Strategic alignment with the European Commission's agenda (2024–2029)

In PIANOFORTE, an open, yearly adopted research prioritisation process enables to rank research needs thanks to the implementation of a powerful multi-stakeholder engagement mechanism. These current and future research priorities align with the European Commission's strategic goals for competitiveness, security, and quality of life [7]. The following aspects illustrate the relevance of continued research investment, focusing on their potential interactions and contribution to the six Horizon Europe clusters defining as broad themes of the programme.

### 2.1. Quality of life (human and ecosystem health)

The 3 first bullets are in line with Horizon Europe Cluster 1 on Health. They address nuclear medicine, safety of patients and medical staff, radiopharmaceuticals; the last bullet aligns with Horizon Europe Cluster 6 related to food, bioeconomy, natural resources, agriculture and environment. Like Cluster 1, it also emphasises health across the lifespan, as well as the environmental and social determinants of health.

* Reducing uncertainties in health risk estimates for both patients and medical staff and contributing to the safe use of ionising radiation in the medical field, especially in cancer treatment is a vital topic. This extends to innovation such as Flash or microbeam therapy and other emerging beam applications in radiotherapies, diagnostics (allowing better structural and molecular information) and nuclear medicine (including use of new tracers and radiopharmaceuticals), interventional radiology, vectorised radiotherapy and theranostic approaches, to better inform the risks-benefits balance of diagnosis and treatment, taking into account individual responses to radiation exposure. Combining radiopharmaceuticals with other treatments, is also a growing area of interest.

* Contributing to Europe's leadership in radiopharmaceuticals and medical technology by complementary radiation protection research on the safe and effective use of radiopharmaceuticals and novel diagnostic and therapeutic technologies, including artificial intelligence approaches and tools. This extends to the development of related clinical protocols, ensuring both enhanced patient care and the protection of healthcare
professionals. Lessons from initiatives like the 'EU's Beating Cancer Plan' [8] highlight the importance of comprehensive health strategies that integrate radiation protection aspects.

* Improving the basic knowledge in different adverse health effects (cancer and non-cancer pathogenesis) resulting from exposure to ionising radiation at low doses and low dose rates remains unchanged high priority for research. While leveraging new technologies such as artificial intelligence, advanced computational big data techniques, 'omics' approaches, and the 'Adverse Outcome Pathway' framework can enhance insights, these tools are only as effective as the quality of the data they rely on. Therefore, generating high-quality, meaningful data remains essential to ensure AI-driven advancements in radiation research are both valid and impactful. Low-dose research is crucial not only for understanding disease mechanisms but also for identifying therapeutic targets, developing early detection strategies, and refining radiation protection guidelines. Since many of the diseases linked to radiation exposure are widespread public health concerns, advancing this research has significant societal benefits. Additionally, a clearer understanding of dose-response relationships is essential for establishing well-founded radiation protection strategies, ensuring effective risk management while avoiding unnecessary overprotection.

* Addressing environmental radiation-related issues like exposure to radon and other naturally occurring radionuclides, remediation of legacy sites (e.g. NORM sites, areas affected by accidents), or empowering circular economy with radioactive residues, has become increasingly complex. Industrial sectors dealing with NORM require sustained expertise in risk assessment, communication, and management to prevent misinformation that could lead to economic and transboundary challenges, potentially hindering the sustainable development of industries crucial for new technologies. Additionally, climate change and increasing combined exposures (radiation, hazardous physical stressors, and chemical substances) heighten these risks. Strengthening public awareness and education is essential to empower communities to recognise and be able to put radiation risks into perspective with other risks in a changing environmental landscape. Eventually these efforts contribute to the management of these risks.

## 2.2. Security

The three topics below are in line with Horizon Europe Cluster 3 on civil security: all of them related to emergency preparedness and response including CBRN-E risks, and questions of societal resilience and governance.

* A coordinated approach to counter threats related to CBRN-E risks is essential, particularly in the current context of geopolitical instability. Research enhances the EU's readiness and response capabilities to nuclear threats and disasters. It supports Member States to strengthen the resilience of their societal vital functions in such extremely complex situations as armed conflict for example. This requires a comprehensive approach that addresses cross-border harmonisation, coordination between radiation protection and public health sector-specific issues, integrated approaches for emergency and post-emergency phases, non-radiological aspects (e.g. mental health and psychosocial consequences), risk communication, and social challenges.

* Developing robust strategies for joint procurement and stockpiling of medical protective actions, including those for radiation emergencies, is vital for strengthening healthcare system resilience.

* Ensuring synergy between radiation protection research for civilian safety and research funded for European armed forces—particularly through the European Defence Fund—is essential. Establishing a controlled dual-use research framework in health and protection of populations could facilitate this integration.

## 2.3. Competitiveness, risk-informed society, choice of energy sources for climate change mitigation

The five topics below are in line with Horizon Europe Cluster 4 on Digital, Industry and Space: radiation protection in space, nuclear industry and emerging nuclear technologies including their potential risks and benefits.

* The different choices and implementation of solutions to mitigate the impact of climate change need to be informed based on state-of-the-art expertise in the Member States. Radiation protection research complements in that way the achievement of Horizon Europe's objectives inter alia in the context of the energy transition and the move towards a more circular economy. As new energy designs or technologies (e.g. small modular reactors, fusion facilities) and sustainable practices emerge, including the reuse of materials containing low levels of radioactivity, it is essential to develop comprehensive knowledge and methodologies to assess potential risks, and ensure regulatory compliance at a European scale. This comprehensive approach helps safeguard both human health and the environment while enabling innovation in energy and resource management.

* Due to the rapid progress in nuclear science and technology, combined with the flowering of artificial intelligence-driven methods and tools (enabling e.g. big data mathematical processes), alongside with
advances in cellular technologies (e.g. ‘omics’), the development of radiation protection with modern approaches has become more than ever a critical and urgent societal issue.

* The expansion of technologically-driven sectors like space exploration necessitates enhanced protection against cosmic radiation. An improved understanding of the biological effects of different radioactive particles, such as protons and heavy ions will not only improve the safety and effectiveness of space missions, but also advance medical treatments on earth.

* The rapid advancement of technologies involving ionising radiation underscores the need to maintain and enhance expertise in risk assessment, risk communication and risk management as well as exploring novel ways of interacting and engaging with citizens on the topics related to radiation protection. Without these efforts, public understanding may be vulnerable to misinformation, potentially leading to the rejection of sustainable development pathways. To address this, sustained support for research in radiation protection is essential.

* Investment in research and development in radiation protection is also of paramount importance for the sustainability of the energy transition for the next generation; education and training must be stepped up in line with the ICRP Vancouver call for action [9] and provide the highest level of competence on the European continent for decades to come.

### 3. Addressing the budgetary challenges

Despite the crucial role of radiation protection research, the recent report by the Euratom Scientific and Technical Committee issued in October 2023 [10] highlights a concerning decline in budget allocations for the fission programme, which includes radiation protection. Through its key message number 6, the report urged Member States to reconsider their contributions to align with EU Framework Programme trends as follows: « ...Even more worrying, the budget for the present fission programme (2021–2025) was reduced by 30% compared to its immediate predecessor when, during the same period, Horizon Europe’s was increased by 22%. Member States should consider a substantial increase to the budget of the Euratom Programme to bring it in line with the trend of EU Framework Programmes and ambitious climate policy targets.”

To ensure Europe’s leadership in radiation protection, at least 75 M€ of EC funding through a PIANOFORTE-like partnership is essential to coordinate transdisciplinary research under the next framework programme within the EURATOM Treaty. This estimate is based on the EC’s contribution to major Euratom research projects under Horizon 2020 (2014–2020) (67 M€) and Horizon Europe (2021–2027) (48 M€) [11, 12]. To ensure continuity, the approach is to restore the H2020 baseline and adjust it by ~15%, leading to an estimated 75 M€ dedicated to radiation protection research over the 10th framework programme. This funding is needed to support both long-term and short-term projects that advance critical research and innovation in this field. Without it, attracting young researchers and experts and maintaining essential expertise will become increasingly difficult. Facing the multidisciplinary fields’ radiation protection encompasses, this raises the question of how the EURATOM work programme, through instruments like partnerships, can effectively balance its focus across medical applications, energy and non-energy applications, emergency preparedness, along with the equitable distribution of funding.

A potential solution lies in fostering stronger collaboration between EURATOM and other European research sectors (e.g. health, civil security, integrated human well-being and ecosystem health, including research on radiation’s impact on biodiversity and ecosystems). This could include establishing joint initiatives within both EURATOM and the relevant cluster to align priorities and share resources, developing cross-sector funding pools to provide researchers with access to financial support from both programmes, and creating unified data repositories where both sectors can share and access new research findings. These approaches would enhance synergy, optimise funding, and ensure more comprehensive advancements for Europe.

### 4. Call to action

A unified commitment from the European Commission, Member States, and stakeholders is necessary to prioritise and sustain radiation protection research. We advocate for a consistent funding allocation of about 75 M€ of EC funding for the next EU Framework Programme in Euratom, enhancing Europe’s ability to lead globally in this critical area. This investment in radiation protection research would:

* Strengthen research efforts and foster cooperation between institutions;

* Contribute to the protection of European citizens and to protection of nature;

* Boost sustainable economic growth;

* Enable effective responses to emerging threats and challenges.
PIANOFORTE organisations acknowledged in the dedicated section have been officially mandated by their respective governments to represent the Programme Owners and Managers (POMs) of their Member State. Additionally, key European research platforms actively participate in the partnership, contributing to the definition of research priorities. These inputs, alongside with the POM ones, play a crucial role in shaping the governance of the Open Calls and drive the direction and the progress of research in all aspects of radiation protection. All together, recognised for their high level of expertise and significant contributions to advancing radiation protection research., call for a unified commitment from the European Commission, Member States, and stakeholders to prioritise and sustain collaborative, stakeholder-driven radiation protection research, supported by a stable and consistent EU funding framework.

## Data availability statement

No new data were created or analysed in this study.

## Acknowledgments

PIANOFORTE Beneficiaries endorsing this white paper include:

* the Programme Owners and Managers (POMs) of their Member State with the Authority of Nuclear Safety and Radiation Protection (ASNR) in France, the Federal Office for Radiation Protection (BfS) in Germany, Stockholm University (SU) in Sweden, SURO vvi (National Radiation Protection Institute) in Czechia Institute of Atomic Physics (IFA) in Romania, National Center for Public Health and Pharmacy (NNGYK) in Hungary, Tartu Ülikool (UTARTU) in Estonia, Glowny Instytut Gornictwa (GIG) in Poland, National Center for Scientific Research ‘DEMOKRITOS’ (NCSRD) in Greece, University of Eastern Finland (UEF) in Finland, Centre for Energy, Environmental and Technological Research (CIEMAT) in Spain, Narodowe Centrum Badan I Rozwoju (NCBR) in Poland, Istituto Superiore di Sanità (ISS) in Italy, Energiatudományi Kutatóközpont (EK) in Hungary, Jožef Stefan Institute (JSI) in Slovenia, Commissariat à l'énergie atomique et aux énergies alternatives (CEA) in France, Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA) in Italy, Danish Emergency Management Agency, Ministry of Defence (DEMA-MoD) in Denmark, Helmholtz-Zentrum Dresden-Rossendorf EV (HZDR) in Germany, Greek Atomic Energy Commission (EEAE) in Greece, Institute for Medical Research and Occupational Health (IMROH) in Croatia, Portuguese Environment Agency (APA) in Portugal, Instituto Superior Técnico (IST) in Portugal, National Institute for Public Health and the Environment (RIVM) in the Netherlands, Swedish Radiation Safety Authority (SSM) in Sweden, Istituto Nazionale di Fisica Nucleare (INFN) in Italy, Natsionalen Tsentar Po Radiobiologiya I Radiatsionna Zashtita (NCRRP) in Bulgaria, Urad Verejneho Zdravotnictva Slovenskej Republiky (UVZSR) in Slovakia, Ministero dell'Università e della Ricerca (MUR) in Italy, Environmental Protection Agency (EPA) in Ireland, Saechsisches Staatsministerium Fur Wissenschaft, Kultur Und Tourismus (SMWK) in Germany, and Latvijas Zinatnes Padome (LZP) in Latvia.

* the European research platforms MELODI (Association MELODI on low dose radiation risk research), EURADOS (European Radiation Dosimetry Group), NERIS (European platform on preparedness for nuclear and radiological emergency response and recovery), ALLIANCE (the European Alliance on Radioecology), SHARE (European Platform for Social Sciences and Humanities Research Relating to Ionizing Radiation), and EURAMED (European Alliance for Medical Research and Radiation Protection).

PIANOFORTE partnership has received funding from the European Union's 'EURATOM' research and innovation programme under the Number 101061037 Grant Agreement.

## ORCID iDs

Jacqueline Garnier-Laplace https://orcid.org/0000-0002-3486-147X

Filip Vanhavere https://orcid.org/0000-0003-3813-0858

Florian Rauser https://orcid.org/0009-0005-0740-0490

Andrzej Wojcik https://orcid.org/0000-0002-3951-774X

Elizabeth Ainsbury https://orcid.org/0000-0001-8076-6978

Simon Bouffler https://orcid.org/0000-0003-1883-919X

Marie Davídková https://orcid.org/0000-0003-1057-3091

Christoph Hoeschen https://orcid.org/0000-0002-4240-1107
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