Medical and radiation safety experts from around the world have issued a renewed global warning—and a roadmap for action—calling for stronger radiation protection in medicine as new technologies rapidly reshape healthcare.
The appeal, known as the Bonn+ Call for Action, was outlined at the International Conference on Radiation Protection in Medicine: X Ray Vision, convened by the International Atomic Energy Agency (IAEA) at its headquarters in Vienna in December 2025, and co-sponsored by the World Health Organization (WHO) and the Pan American Health Organization (PAHO).
Bonn+ updates and modernizes the landmark 2012 Bonn Call for Action, which helped align countries around patient safety and radiation protection standards. The new framework responds to a transformed medical landscape—defined by artificial intelligence, digital systems, automation, and rapidly expanding use of diagnostic and therapeutic radiation.
Radiation Use Is Expanding—So Are the Risks
Radiation is now used in medicine more than 10 million times every day worldwide, across hospitals, outpatient centres, and rural clinics. Advances in imaging, interventional radiology, and radiation therapy have dramatically improved diagnosis and treatment—but experts warn that safety systems have not kept pace everywhere.
In many countries, regulation of medical radiation devices and clinical practices remains limited or uneven, while emerging technologies introduce new and poorly understood exposure risks.
“We are all now more aware of the opportunities—and responsibilities—to reinforce safety for patients, professionals and caregivers,” said Karine Herviou, IAEA Deputy Director General and Head of the Department of Nuclear Safety and Security, closing the conference.“Our shared goal is to ensure radiation is used only when justified, optimized for safety, and never at the expense of patient protection.”
Integrating Safety into Clinical Practice
Conference participants emphasized that radiation protection must be embedded into everyday clinical decision-making, not treated as a regulatory afterthought.
“We need to fully integrate radiation protection into clinical care,” said Mary Coffey of Trinity College Dublin, Conference President. “We must ensure that we don’t compromise safety and quality for quantity, even as access to imaging and treatment expands.”
More than 650 participants from over 120 countries attended the conference, including clinicians, regulators, researchers, patient advocates, and medical device specialists—highlighting the global scale and cross-sector urgency of the issue.
What Bonn+ Adds—and What Comes Next
The Bonn+ Call for Action builds on the original framework while addressing new realities, including:
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The growing role of artificial intelligence and automation in imaging and treatment
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Data-driven clinical decision-making and algorithm-guided diagnostics
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Expanding use of radiation technologies in low-resource and unevenly regulated settings
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The need for stronger professional training, device oversight, and patient engagement
The IAEA will continue supporting countries through safety standards, training programmes, expert missions, fellowships, and technical assistance, helping translate Bonn+ principles into national practice.
“The immediate challenge is achieving shared ownership of Bonn+ across all involved organizations,” said Ola Holmberg, Head of the IAEA Radiation Protection of Patients Unit and Scientific Secretary of the conference.“This must be a collaborative effort—not only in shaping the framework, but in making it work on the ground.”
Why It Matters
As medical radiation becomes more powerful, more precise—and more ubiquitous—experts warn that patient safety cannot rely on legacy safeguards. Bonn+ positions radiation protection as a core pillar of digital health governance, ensuring innovation delivers benefit without unintended harm.
The success of Bonn+ will depend on rapid uptake by governments, regulators, health systems, professional bodies, and technology developers—before gaps in protection widen further.