Essentials of the system of radiological protection.

The system of radiological protection (the 'System') developed by the International Commission on Radiological Protection (ICRP) is built on nearly a century of efforts of numerous scientists and practitioners working together internationally. It rests on three enduring pillars: science, ethics, and experience. These pillars support the three fundamental principles that shape radiological protection strategies: justification, optimisation, and application of dose limits. Of note, optimisation of protection must be understood as a flexible and context-sensitive process, which allows identification of the appropriate level of protection, not simply the lowest dose, taking into account economic, societal and environmental factors. The System has proven effective in protecting workers, patients, members of the public, and the environment in all exposure situations. Effects of high doses, where acute injuries to healthy tissue occur, are rarely observed, and mostly due to accidental situations except for unavoidable side effects of radiotherapy. At low doses, the System is supported by application of the linear-no-threshold model. This model enables prudent (that is, carefully considered given existing uncertainties) policy decisions and estimation of risks at low doses by extrapolation from epidemiological data observed at medium and high radiation doses, acknowledging uncertainty without ignoring potential harm.