1
|
Little MP, Bazyka D, de Gonzalez AB, Brenner AV, Chumak VV, Cullings HM, Daniels RD, French B, Grant E, Hamada N, Hauptmann M, Kendall GM, Laurier D, Lee C, Lee WJ, Linet MS, Mabuchi K, Morton LM, Muirhead CR, Preston DL, Rajaraman P, Richardson DB, Sakata R, Samet JM, Simon SL, Sugiyama H, Wakeford R, Zablotska LB. A Historical Survey of Key Epidemiological Studies of Ionizing Radiation Exposure. Radiat Res 2024; 202:432-487. [PMID: 39021204 PMCID: PMC11316622 DOI: 10.1667/rade-24-00021.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/23/2024] [Indexed: 07/20/2024]
Abstract
In this article we review the history of key epidemiological studies of populations exposed to ionizing radiation. We highlight historical and recent findings regarding radiation-associated risks for incidence and mortality of cancer and non-cancer outcomes with emphasis on study design and methods of exposure assessment and dose estimation along with brief consideration of sources of bias for a few of the more important studies. We examine the findings from the epidemiological studies of the Japanese atomic bomb survivors, persons exposed to radiation for diagnostic or therapeutic purposes, those exposed to environmental sources including Chornobyl and other reactor accidents, and occupationally exposed cohorts. We also summarize results of pooled studies. These summaries are necessarily brief, but we provide references to more detailed information. We discuss possible future directions of study, to include assessment of susceptible populations, and possible new populations, data sources, study designs and methods of analysis.
Collapse
Affiliation(s)
- Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
- Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Oxford, OX3 0BP, UK
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | | | - Alina V. Brenner
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Vadim V. Chumak
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | - Harry M. Cullings
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Robert D. Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eric Grant
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 1646 Abiko, Chiba 270-1194, Japan
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany
| | - Gerald M. Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Dominique Laurier
- Institute for Radiological Protection and Nuclear Safety, Fontenay aux Roses France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Martha S. Linet
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Lindsay M. Morton
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | | | | | - Preetha Rajaraman
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - David B. Richardson
- Environmental and Occupational Health, 653 East Peltason, University California, Irvine, Irvine, CA 92697-3957 USA
| | - Ritsu Sakata
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Jonathan M. Samet
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Steven L. Simon
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Hiromi Sugiyama
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, UK
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16 Street, 2 floor, San Francisco, CA 94143, USA
| |
Collapse
|
2
|
Degenhardt Ä, Sreetharan S, Amrenova A, Adam-Guillermin C, Dekkers F, Dumit S, Frelon S, Horemans N, Laurier D, Liutsko L, Salomaa S, Schneider T, Hande MP, Wakeford R, Applegate KE. The ICRP, MELODI, and ALLIANCE workshop on effects of ionizing radiation exposure in offspring and next generations: a summary of discussions. Int J Radiat Biol 2024; 100:1382-1392. [PMID: 38284800 DOI: 10.1080/09553002.2024.2306335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/19/2023] [Accepted: 01/10/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE Task Group 121 - Effects of ionizing radiation exposure in offspring and next generations - is a task group under the Committee 1 of the International Commission on Radiological Protection (ICRP), approved by the Main Commission on 18th November 2021. The main goals of Task Group 121 are to (1) review and update the scientific literature of relevance to radiation-related effects in the offspring of parent(s) exposed to ionizing radiation in both human and non-human biota; (2) to assess preconceptional and intrauterine effects of radiation exposure and related morbidity and mortality; and, (3) to provide advice about the level of evidence and how to consider these preconceptional and postconceptional effects in the system of radiological protection for humans and non-human biota. METHODS The Task Group is reviewing relevant literature since Publication 90 'Biological effects after prenatal irradiation (embryo and fetus)' (2003) and will include radiation-related effects on future generations in humans, animals, and plants. This review will be conducted to account for the health effects on offspring and subsequent generations in the current system of radiological protection. Radiation detriment calculation will also be reviewed. Finally, preliminary recommendations will be made to update the integration of health effects in offspring and next generations in the system of radiological protection. RESULTS A Workshop, jointly organized by ICRP Task Group 121 and European Radiation Protection Research Platforms MELODI and ALLIANCE was held in Budapest, Hungary, from 31st May to 2nd June 2022. Participants discussed four important topics: (1) hereditary and epigenetic effects due to exposure of the germ cell line (preconceptional exposure), (2) effects arising from exposure of the embryo and fetus (intrauterine exposure), (3) transgenerational effects on biota, and (4) its potential impact on the system of radiological protection. CONCLUSIONS Based on the discussions and presentations during the breakout sessions, newer publications, and gaps on the current scientific literature were identified. For instance, there are some ongoing systematic reviews and radiation epidemiology reviews of intrauterine effects. There are newer methods of Monte Carlo simulation for fetal dosimetry, and advances in radiation genetics, epigenetics, and radiobiology studies. While the current impact of hereditary effects on the global detriment was reported as small, the questions surrounding the effects of radiation exposure on offspring and the next generation are crucial, recurring, and with a major focus on exposed populations. This article summarizes the workshop discussions, presentations, and conclusions of each topic and introduces the special issue of the International Journal of Radiation Biology resulting from the discussions of the meeting.
Collapse
Affiliation(s)
- Ämilie Degenhardt
- Division of Medical and Occupational Radiation Protection, German Federal Office for Radiation Protections (BfS), Neuherberg, Germany
| | | | - Aidana Amrenova
- French Institute for Radiological Protection and Nuclear Safety (IRSN), France
| | | | - Fieke Dekkers
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Sara Dumit
- Los Alamos National Laboratory, Radiation Protection Division, Los Alamos, NM, USA
| | - Sandrine Frelon
- French Institute for Radiological Protection and Nuclear Safety (IRSN), France
| | - Nele Horemans
- Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
| | - Dominique Laurier
- French Institute for Radiological Protection and Nuclear Safety (IRSN), France
| | | | - Sisko Salomaa
- Radiation and Nuclear Safety Authority (STUK), Finland
| | - Thierry Schneider
- Nuclear Protection Evaluation Centre (CEPN), Fontenay-aux-Roses, France
| | - Manoor P Hande
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, UK
| | - Kimberly E Applegate
- Department of Radiology (retired), University of Kentucky College of Medicine, Lexington, KY, USA
| |
Collapse
|
3
|
Carcel C, Haupt S, Arnott C, Yap ML, Henry A, Hirst JE, Woodward M, Norton R. A life-course approach to tackling noncommunicable diseases in women. Nat Med 2024; 30:51-60. [PMID: 38242981 DOI: 10.1038/s41591-023-02738-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/27/2023] [Indexed: 01/21/2024]
Abstract
Women's health has been critically underserved by a failure to look beyond women's sexual and reproductive systems to adequately consider their broader health needs. In almost every country in the world, noncommunicable diseases are the leading causes of death for women. Among these, cardiovascular disease (including heart disease and stroke) and cancer are the major causes of mortality. Risks for these conditions exist at each stage of women's lives, but recognition of the unique needs of women for the prevention and management of noncommunicable diseases is relatively recent and still emerging. Once they are diagnosed, treatments for these diseases are often costly and noncurative. Therefore, we call for a strategic, innovative life-course approach to identifying disease triggers and instigating cost-effective measures to minimize exposure in a timely manner. Prohibitive barriers to implementing this holistic approach to women's health exist in both the social arena and the medical arena. Recognizing these impediments and implementing practical approaches to surmounting them is a rational approach to advancing health equity for women, with ultimate benefits for society as a whole.
Collapse
Affiliation(s)
- Cheryl Carcel
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia.
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
| | - Sue Haupt
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
| | - Clare Arnott
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Mei Ling Yap
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- Liverpool and Macarthur Cancer Therapy Centres, South-West Sydney Local Health District, Sydney, New South Wales, Australia
- Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), South-Western Sydney Clinical School, Ingham Institute, UNSW, Sydney, New South Wales, Australia
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Amanda Henry
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, UNSW, Sydney, New South Wales, Australia
- Department of Women's and Children's Health, St George Hospital, Sydney, New South Wales, Australia
| | - Jane E Hirst
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Mark Woodward
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
| | - Robyn Norton
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
| |
Collapse
|
4
|
Benotmane MA, Trott KR. Epidemiological and experimental evidence for radiation-induced health effects in the progeny after exposure in utero. Int J Radiat Biol 2023; 100:1264-1275. [PMID: 38079348 DOI: 10.1080/09553002.2023.2283088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 08/30/2024]
Abstract
PURPOSE It has been known for many decades that radiation exposure of the developing embryo or fetus may cause two fundamentally different types of severe health effects: on the one hand, radiation may interfere with the normal intrauterine development, on the other hand, radiation may induce leukemia and cancer which become manifest in childhood. A large amount of epidemiological and experimental data has recently been presented which might be used to improve our understanding of underlying mechanisms and setting radiation protection standards. Yet, ecological studies in the populations exposed to increased levels of radiation in regions contaminated by radioactivity released from reactor accidents (Chernobyl, Fukushima) do not provide solid evidence which would contribute to this aim. On the other hand, well designed experimental studies demonstrated the multifactorial mechanisms which lead to different health effects after radiation exposure in utero. CONCLUSION There is no convincing evidence, neither from epidemiological nor experimental data of the existence of a dose threshold for developmental defects after radiation exposure in utero. This must be taken into account in the revision of rules and regulations of radiation protection in medicine.
Collapse
Affiliation(s)
| | - Klaus Ruediger Trott
- Department of Radiation Oncology, Technical University of Munich, Munich, Germany
| |
Collapse
|
5
|
Riser A, Perez M, Snead MC, Galang RR, Simeone RM, Salame-Alfie A, Rice ME, Sayyad A, Strid P, Yocca J, Meeker JR, Waits G, Hansen S, Hall R, Anstey E, Duane House L, Okoroh E, Zotti M, Ellington SR. CDC Division of Reproductive Health's Emergency Preparedness Resources and Activities for Radiation Emergencies: Public Health Considerations for Women's Reproductive Health. J Womens Health (Larchmt) 2023; 32:1271-1280. [PMID: 38051520 PMCID: PMC10980281 DOI: 10.1089/jwh.2023.0842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
Pregnant, postpartum, and lactating people, and infants have unique needs during public health emergencies, including nuclear and radiological incidents. This report provides information on the CDC Division of Reproductive Health's emergency preparedness and response activities to address the needs of women of reproductive age (aged 15-49 years), people who are pregnant, postpartum, or lactating, and infants during a radiation emergency. Highlighted preparedness activities include: (1) development of a quick reference guide to inform key questions about pregnant, postpartum, and lactating people, and infants during radiation emergencies; and (2) exercising the role of reproductive health experts during nuclear and radiological incident preparedness activities.
Collapse
Affiliation(s)
- Aspen Riser
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| | - Mirna Perez
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| | - Margaret Christine Snead
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| | - Romeo R. Galang
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| | - Regina M. Simeone
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| | - Adela Salame-Alfie
- National Center for Environmental Health, Division of Environmental Health Science and Practice, Atlanta, Georgia, USA
| | - Marion E. Rice
- National Center for Emerging and Zoonotic Infectious Diseases, Division of Parasitic Diseases and Malaria, Atlanta, Georgia, USA
| | - Ayeesha Sayyad
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Penelope Strid
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| | - Jessica Yocca
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| | - Jessica R. Meeker
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| | - Grayson Waits
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Sabrina Hansen
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| | - Rebecca Hall
- Office of Readiness and Response, Office of Science and Public Health Practice, Atlanta, Georgia, USA
| | - Erica Anstey
- National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity, and Obesity, and Population Health, Atlanta, Georgia, USA
| | - L. Duane House
- Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Atlanta, GA, USA
| | - Ekwutosi Okoroh
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| | - Marianne Zotti
- Association of Maternal and Child Health Programs (AMCHP) and Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sascha R. Ellington
- National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Atlanta, Georgia, USA
| |
Collapse
|
6
|
Jeong A, Moon SG, Han Y, Nam JW, Kim MK, Kim I, Kim YM, Park B. Comparison of Proportional Mortality Between Korean Atomic Bomb Survivors and the General Population During 1992-2019. J Korean Med Sci 2023; 38:e110. [PMID: 37012689 PMCID: PMC10070051 DOI: 10.3346/jkms.2023.38.e110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/28/2022] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Atomic bombs dropped on Hiroshima and Nagasaki in Japan in August 1945 were estimated to have killed approximately 70,000 Koreans. In Japan, studies on the health status and mortality of atomic bomb survivors compared with the non-exposed population have been conducted. However, there have been no studies related to the mortality of Korean atomic bomb survivors. Therefore, we aimed to study the cause of death of atomic bomb survivors compared to that of the general population. METHODS Of 2,299 atomic bomb survivors registered with the Korean Red Cross, 2,176 were included in the study. In the general population, the number of deaths by age group was calculated from 1992 to 2019, and 6,377,781 individuals were assessed. Causes of death were categorized according to the Korean Standard Classification of Diseases. To compare the proportional mortality between the two groups, the P value for the ratio test was confirmed, and the Cochran-Armitage trend test and χ² test were performed to determine the cause of death according to the distance from the hypocenter. RESULTS Diseases of the circulatory system were the most common cause of death (25.4%), followed by neoplasms (25.1%) and diseases of the respiratory system (10.6%) in atomic bomb survivors who died between 1992 and 2019. The proportional mortality associated with respiratory diseases, nervous system diseases, and other diseases among atomic bomb survivors was higher than that of the general population. Of the dead people between 1992 and 2019, the age at death of survivors who were exposed at a close distance was younger than those who were exposed at a greater distance. CONCLUSION Overall, proportional mortality of respiratory diseases and nervous system diseases was high in atomic bomb survivors, compared with the general population. Further studies on the health status of Korean atomic bomb survivors are needed.
Collapse
Affiliation(s)
- Ansun Jeong
- Department of Health Sciences, Hanyang University, Seoul, Korea
| | - Seong-Geun Moon
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Yunji Han
- Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Jin-Wu Nam
- Department of Life Science, Hanyang University College of Natural Sciences, Seoul, Korea
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Korea
| | - Mi Kyung Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Inah Kim
- Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Yu-Mi Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Korea.
| |
Collapse
|
7
|
Hamasaki K, Matsumoto T, Cologne J, Mukai M, Kodama Y, Noda A, Nakamura N. Translocations are induced in hematopoietic stem cells after irradiation of fetal mice. JOURNAL OF RADIATION RESEARCH 2023; 64:99-104. [PMID: 36420765 PMCID: PMC9855322 DOI: 10.1093/jrr/rrac078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/02/2022] [Indexed: 06/16/2023]
Abstract
Although mammalian fetuses have been suggested to be sensitive to radiation, an increased frequency of translocations was not observed in blood lymphocytes from atomic bomb (A-bomb) survivors who were exposed to the bomb in utero and examined as adults. Since experiments using hematopoietic cells of mice and rats confirmed this finding, it was hypothesized that either irradiated fetal hematopoietic stem cells (f-HSCs) cannot generate exchange-type chromosomal aberrations or cells bearing induced aberrations are eliminated before the animals reach adulthood. In the present study, pregnant mice (12.5-15.5 days post coitum [dpc]) were irradiated with 2 Gy of X-rays and long-term HSCs (LT-HSCs) were isolated 24 h later. Multicolor fluorescence in situ hybridization (mFISH) analysis of LT-HSC clones proliferated in vitro showed that nine out of 43 (21%) clones from fetuses and 21 out of 41 (51%) clones from mothers bore translocations. These results indicate that cells with translocations can arise in mouse f-HSCs but exist at a lower frequency than in the mothers 24 h after X-ray exposure. Thus, it seems likely that translocation-bearing f-HSCs are generated but subsequently disappear, so that the frequency of lymphocyte translocations may decrease and reach the control level by the time the animals reach adulthood.
Collapse
Affiliation(s)
- Kanya Hamasaki
- Corresponding author. Department of Molecular Biosciences, Radiation Effects Research Foundation, 5-2 Hijiyama-Park, Minami-ku, Hiroshima 732-0815, Japan, , Tel: +81-82-261-3131, Fax +81-82-263-7279
| | - Tomoko Matsumoto
- Department of Molecular Biosciences, Radiation Effects Research Foundation, 5-2 Hijiyama-Park, Minami-ku, Hiroshima 732-0815, Japan
| | - John Cologne
- Department of Statistics, Radiation Effects Research Foundation, 5-2 Hijiyama-Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Mayumi Mukai
- Department of Molecular Biosciences, Radiation Effects Research Foundation, 5-2 Hijiyama-Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Yoshiaki Kodama
- Department of Molecular Biosciences, Radiation Effects Research Foundation, 5-2 Hijiyama-Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Asao Noda
- Department of Molecular Biosciences, Radiation Effects Research Foundation, 5-2 Hijiyama-Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Nori Nakamura
- Department of Molecular Biosciences, Radiation Effects Research Foundation, 5-2 Hijiyama-Park, Minami-ku, Hiroshima 732-0815, Japan
| |
Collapse
|
8
|
Folkers C, Gunter LP. Radioactive releases from the nuclear power sector and implications for child health. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001326. [PMID: 36645750 PMCID: PMC9557777 DOI: 10.1136/bmjpo-2021-001326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/18/2022] [Indexed: 11/05/2022] Open
Abstract
Although radioactivity is released routinely at every stage of nuclear power generation, the regulation of these releases has never taken into account those potentially most sensitive-women, especially when pregnant, and children. From uranium mining and milling, to fuel manufacture, electricity generation and radioactive waste management, children in frontline and Indigenous communities can be disproportionately harmed due to often increased sensitivity of developing systems to toxic exposures, the lack of resources and racial and class discrimination. The reasons for the greater susceptibility of women and children to harm from radiation exposure is not fully understood. Regulatory practices, particularly in the establishment of protective exposure standards, have failed to take this difference into account. Anecdotal evidence within communities around nuclear facilities suggests an association between radiation exposure and increases in birth defects, miscarriages and childhood cancers. A significant number of academic studies tend to ascribe causality to other factors related to diet and lifestyle and dismiss these health indicators as statistically insignificant. In the case of a major release of radiation due to a serious nuclear accident, children are again on the frontlines, with a noted susceptibility to thyroid cancer, which has been found in significant numbers among children exposed both by the 1986 Chornobyl nuclear accident in Ukraine and the 2011 Fukushima-Daiichi nuclear disaster in Japan. The response among authorities in Japan is to blame increased testing or to reduce testing. More independent studies are needed focused on children, especially those in vulnerable frontline and Indigenous communities. In conducting such studies, greater consideration must be applied to culturally significant traditions and habits in these communities.
Collapse
|
9
|
Little MP, Brenner AV, Grant EJ, Sugiyama H, Preston DL, Sakata R, Cologne J, Velazquez-Kronen R, Utada M, Mabuchi K, Ozasa K, Olson JD, Dugan GO, Pazzaglia S, Cline JM, Applegate KE. Age effects on radiation response: summary of a recent symposium and future perspectives. Int J Radiat Biol 2022; 98:1-11. [PMID: 35394411 PMCID: PMC9626395 DOI: 10.1080/09553002.2022.2063962] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
One of the principal uncertainties when estimating population risk of late effects from epidemiological data is that few radiation-exposed cohorts have been followed up to extinction. Therefore, the relative risk model has often been used to estimate radiation-associated risk and to extrapolate risk to the end of life. Epidemiological studies provide evidence that children are generally at higher risk of cancer induction than adults for a given radiation dose. However, the strength of evidence varies by cancer site and questions remain about site-specific age at exposure patterns. For solid cancers, there is a large body of evidence that excess relative risk (ERR) diminishes with increasing age at exposure. This pattern of risk is observed in the Life Span Study (LSS) as well as in other radiation-exposed populations for overall solid cancer incidence and mortality and for most site-specific solid cancers. However, there are some disparities by endpoint in the degree of variation of ERR with exposure age, with some sites (e.g., colon, lung) in the LSS incidence data showing no variation, or even increasing ERR with increasing age at exposure. The pattern of variation of excess absolute risk (EAR) with age at exposure is often similar, with EAR for solid cancers or solid cancer mortality decreasing with increasing age at exposure in the LSS. We shall review the human data from the Japanese LSS cohort, and a variety of other epidemiological data sets, including a review of types of medical diagnostic exposures, also some radiobiological animal data, all bearing on the issue of variations of radiation late-effects risk with age at exposure and with attained age. The paper includes a summary of several oral presentations given in a Symposium on "Age effects on radiation response" as part of the 67th Annual Meeting of the Radiation Research Society, held virtually on 3-6 October 2021.
Collapse
Affiliation(s)
- Mark P. Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Eric J. Grant
- Radiation Effects Research Foundation, Hiroshima, Japan
| | | | | | - Ritsu Sakata
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - John Cologne
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - Raquel Velazquez-Kronen
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, OH, USA
| | - Mai Utada
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Kotaro Ozasa
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - John D. Olson
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Gregory O. Dugan
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Simonetta Pazzaglia
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l’Energia e lo Sviluppo Economico Sostenibile (ENEA), Rome, Italy
| | - J. Mark Cline
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | |
Collapse
|
10
|
Assessment of extremity occupational exposure at a nuclear medicine department. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2022. [DOI: 10.1016/j.jrras.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
11
|
Cologne J, Sugiyama H, Hamasaki K, Tatsukawa Y, French B, Sakata R, Misumi M. Chromosome aberrations among atomic-bomb survivors exposed in utero: updated analysis accounting for revised radiation doses and smoking. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2022; 61:59-72. [PMID: 35175360 PMCID: PMC8897374 DOI: 10.1007/s00411-021-00960-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 12/27/2021] [Indexed: 06/14/2023]
Abstract
A previous study of peripheral blood lymphocyte translocations around age 40 among atomic-bomb survivors exposed in utero revealed no overall association with radiation dose-despite a clear association between translocations and dose among their mothers-but the data suggested an increase at doses below 100 mGy with a definite peak. That analysis of the in utero-exposed survivors did not adjust for their subsequent smoking behavior, an established cause of chromosomal aberrations, or their subsequent exposures to medical irradiation, a potential mediator. In addition, atomic-bomb survivor radiation dose estimates have subsequently been updated and refined. We therefore re-estimated the dose response using the latest DS02R1 dose estimates and adjusting for smoking as well as for city and proximal-distal location at the time of exposure to the atomic bomb. Sex of the survivor, mother's age around the time of conception, and approximate trimester of gestation at the time of exposure were also considered as explanatory variables and modifiers. Precision of the estimated dose response was slightly lower due to greater variability near zero in the updated dose estimates, but there was little change in evidence of a low-dose increase and still no suggestion of an overall increase across the entire dose range. Adjustment for smoking behavior led to a decline in background number of translocations (the dose-response intercept), but smoking did not interact with dose overall (across the entire dose range). Adjustment for medical irradiation did not alter the association between dose and translocation frequency. Sex, mother's age, and trimester were not associated with number of translocations, nor did they interact with dose overall. Interactions with dose in the low-dose range could not be evaluated because of numerical instability.
Collapse
Affiliation(s)
- John Cologne
- Department of Statistics, Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan.
| | - Hiromi Sugiyama
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Kanya Hamasaki
- Department of Molecular Biosciences, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Yoshimi Tatsukawa
- Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ritsu Sakata
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Munechika Misumi
- Department of Statistics, Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan
| |
Collapse
|
12
|
Laine JE. War in Europe: health implications of environmental nuclear disaster amidst war. Eur J Epidemiol 2022; 37:221-225. [PMID: 35426580 DOI: 10.1007/s10654-022-00862-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/12/2022] [Indexed: 11/03/2022]
Abstract
Recent incidents at nuclear facilities in Ukraine related to the attacks from Russian forces highlight the fragility of nuclear power plants and other nuclear facilities in war and the very real potential for another environmental nuclear disaster and associated health risks in Europe. Nuclear catastrophes from war can occur from radioactive materials released from war threatened nuclear power plants and other nuclear facilities in war zones, in addition to the direct threat from the deployment of nuclear weaponry and can result in immediate and long-term health impacts. Despite historical nuclear catastrophic events, including the Chernobyl nuclear power plant accident and atomic bombings of Hiroshima and Nagasaki, and that for more than a century epidemiologists have studied the consequences of radiation exposures, there are still major unanswered questions regarding radiation risks and human health. Epidemiologists will need to continue to quantify the health effects from exposure to environmental radiation, including background radiation, and are able to contribute to conversations about reliance on nuclear energy and alternative energy futures. As a society we are compelled to rethink our ties to nuclear energy, especially with the potential of increasing reliance on nuclear power amid oil and gas crisis and considering climate change, nuclear warfare, including nuclear weapon testing, and the fragility of humanity and health to even low doses of radiation from these and other natural and unnatural sources.
Collapse
Affiliation(s)
- Jessica E Laine
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. .,MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom.
| |
Collapse
|
13
|
Little MP, Wakeford R, Bouffler SD, Abalo K, Hauptmann M, Hamada N, Kendall GM. Review of the risk of cancer following low and moderate doses of sparsely ionising radiation received in early life in groups with individually estimated doses. ENVIRONMENT INTERNATIONAL 2022; 159:106983. [PMID: 34959181 PMCID: PMC9118883 DOI: 10.1016/j.envint.2021.106983] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 10/16/2021] [Accepted: 11/13/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND The detrimental health effects associated with the receipt of moderate (0.1-1 Gy) and high (>1 Gy) acute doses of sparsely ionising radiation are well established from human epidemiological studies. There is accumulating direct evidence of excess risk of cancer in a number of populations exposed at lower acute doses or doses received over a protracted period. There is evidence that relative risks are generally higher after radiation exposures in utero or in childhood. METHODS AND FINDINGS We reviewed and summarised evidence from 60 studies of cancer or benign neoplasms following low- or moderate-level exposure in utero or in childhood from medical and environmental sources. In most of the populations studied the exposure was predominantly to sparsely ionising radiation, such as X-rays and gamma-rays. There were significant (p < 0.001) excess risks for all cancers, and particularly large excess relative risks were observed for brain/CNS tumours, thyroid cancer (including nodules) and leukaemia. CONCLUSIONS Overall, the totality of this large body of data relating to in utero and childhood exposure provides support for the existence of excess cancer and benign neoplasm risk associated with radiation doses < 0.1 Gy, and for certain groups exposed to natural background radiation, to fallout and medical X-rays in utero, at about 0.02 Gy.
Collapse
Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA.
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester M13 9PL, UK
| | - Simon D Bouffler
- Radiation Effects Department, UK Health Security Agency (UKHSA), Chilton, Didcot OX11 0RQ, UK
| | - Kossi Abalo
- Laboratoire d'Épidémiologie, Institut de Radioprotection et de Sûreté Nucléaire, BP 17, 92262 Fontenay-aux-Roses Cedex, France
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Strasse 38, 16816 Neuruppin, Germany
| | - Nobuyuki Hamada
- Radiation Safety Unit, Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo 201-8511, Japan
| | - Gerald M Kendall
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| |
Collapse
|
14
|
Rühm W, Laurier D, Wakeford R. Cancer risk following low doses of ionising radiation - Current epidemiological evidence and implications for radiological protection. MUTATION RESEARCH. GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2022; 873:503436. [PMID: 35094811 DOI: 10.1016/j.mrgentox.2021.503436] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 01/05/2023]
Abstract
Recent studies suggest that every year worldwide about a million patients might be exposed to doses of the order of 100 mGy of low-LET radiation, due to recurrent application of radioimaging procedures. This paper presents a synthesis of recent epidemiological evidence on radiation-related cancer risks from low-LET radiation doses of this magnitude. Evidence from pooled analyses and meta-analyses also involving epidemiological studies that, individually, do not find statistically significant radiation-related cancer risks is reviewed, and evidence from additional and more recent epidemiological studies of radiation exposures indicating excess cancer risks is also summarized. Cohorts discussed in the present paper include Japanese atomic bomb survivors, nuclear workers, patients exposed for medical purposes, and populations exposed environmentally to natural background radiation or radioactive contamination. Taken together, the overall evidence summarized here is based on studies including several million individuals, many of them followed-up for more than half a century. In summary, substantial evidence was found from epidemiological studies of exposed groups of humans that ionizing radiation causes cancer at acute and protracted doses above 100 mGy, and growing evidence for doses below 100 mGy. The significant radiation-related solid cancer risks observed at doses of several 100 mGy of protracted exposures (observed, for example, among nuclear workers) demonstrate that doses accumulated over many years at low dose rates do cause stochastic health effects. On this basis, it can be concluded that doses of the order of 100 mGy from recurrent application of medical imaging procedures involving ionizing radiation are of concern, from the viewpoint of radiological protection.
Collapse
Affiliation(s)
- W Rühm
- Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany.
| | - D Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - R Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, M13 9PL, UK
| |
Collapse
|
15
|
Balajee AS, Livingston GK, Escalona MB, Ryan TL, Goans RE, Iddins CJ. Cytogenetic follow-up studies on humans with internal and external exposure to ionizing radiation. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2021; 41:S578-S601. [PMID: 34233319 DOI: 10.1088/1361-6498/ac125a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
Cells exposed to ionizing radiation have a wide spectrum of DNA lesions that include DNA single-strand breaks, DNA double-strand breaks (DSBs), oxidative base damage and DNA-protein crosslinks. Among them, DSB is the most critical lesion, which when mis-repaired leads to unstable and stable chromosome aberrations. Currently, chromosome aberration analysis is the preferred method for biological monitoring of radiation-exposed humans. Stable chromosome aberrations, such as inversions and balanced translocations, persist in the peripheral blood lymphocytes of radiation-exposed humans for several years and, therefore, are potentially useful tools to prognosticate the health risks of radiation exposure, particularly in the hematopoietic system. In this review, we summarize the cytogenetic follow-up studies performed by REAC/TS (Radiation Emergency Assistance Center/Training site, Oak Ridge, USA) on humans exposed to internal and external radiation. In the light of our observations as well as the data existing in the literature, this review attempts to highlight the importance of follow-up studies for predicting the extent of genomic instability and its impact on delayed health risks in radiation-exposed victims.
Collapse
Affiliation(s)
- Adayabalam S Balajee
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Centre/Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, United States of America
| | - Gordon K Livingston
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Centre/Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, United States of America
| | - Maria B Escalona
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Centre/Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, United States of America
| | - Terri L Ryan
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Centre/Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, United States of America
| | - Ronald E Goans
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Centre/Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, United States of America
| | - Carol J Iddins
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Centre/Training Site, Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, United States of America
| |
Collapse
|
16
|
Applegate KE, Findlay Ú, Fraser L, Kinsella Y, Ainsbury L, Bouffler S. Radiation exposures in pregnancy, health effects and risks to the embryo/foetus-information to inform the medical management of the pregnant patient. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2021; 41:S522-S539. [PMID: 34380129 DOI: 10.1088/1361-6498/ac1c95] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
Generally, intentional exposure of pregnant women is avoided as far as possible in both medical and occupational situations. This paper aims to summarise available information on sources of radiation exposure of the embryo/foetus primarily in medical settings. Accidental and unintended exposure is also considered. Knowledge on the effects of radiation exposure on the developing embryo/foetus remains incomplete-drawn largely from animal studies and two human cohorts but a summary is provided in relation to the key health endpoints of concern, severe foetal malformations/death, future cancer risk, and future impact on cognitive function. Both the specific education and training and also the literature regarding medical management of pregnant females is in general sparse, and consequently the justification and optimisation approaches may need to be considered on a case by case basis. In collating and reviewing this information, several suggestions for future basic science research, education and training, and radiation protection practice are identified.
Collapse
Affiliation(s)
- Kimberly E Applegate
- Department of Radiology (retired), University of Kentucky College of Medicine, 800 Rose St, Lexington, KY 40536, United States of America
| | - Úna Findlay
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Chilton, Didcot, Oxon OX11 0RQ, United Kingdom
| | - Louise Fraser
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Chilton, Didcot, Oxon OX11 0RQ, United Kingdom
| | - Yvonne Kinsella
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Chilton, Didcot, Oxon OX11 0RQ, United Kingdom
| | - Liz Ainsbury
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Chilton, Didcot, Oxon OX11 0RQ, United Kingdom
| | - Simon Bouffler
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Chilton, Didcot, Oxon OX11 0RQ, United Kingdom
| |
Collapse
|
17
|
Laurier D, Rühm W, Paquet F, Applegate K, Cool D, Clement C. Areas of research to support the system of radiological protection. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2021; 60:519-530. [PMID: 34657188 PMCID: PMC8522113 DOI: 10.1007/s00411-021-00947-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/05/2021] [Indexed: 05/07/2023]
Abstract
This document presents the ICRP's updated vision on "Areas of Research to Support the System of Radiological Protection", which have been previously published in 2017. It aims to complement the research priorities promoted by other relevant international organisations, with the specificity of placing them in the perspective of the evolution of the System of Radiological Protection. This document contributes to the process launched by ICRP to review and revise the System of Radiological Protection that will update the 2007 General Recommendations in ICRP Publication 103.
Collapse
Affiliation(s)
- D Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - W Rühm
- Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany.
| | - F Paquet
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Cadarache, France
| | - K Applegate
- University of Kentucky College of Medicine, Lexington, KY, USA
| | - D Cool
- International Commission on Radiological Protection (ICRP) Vice-Chair, Charlotte, NC, USA
| | - C Clement
- International Commission on Radiological Protection (ICRP), Ottawa, ON, Canada
| |
Collapse
|
18
|
Wakeford R, Bithell JF. A review of the types of childhood cancer associated with a medical X-ray examination of the pregnant mother. Int J Radiat Biol 2021; 97:571-592. [PMID: 33787450 DOI: 10.1080/09553002.2021.1906463] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/11/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE For 65 years the interpretation of the statistical association between the risk of cancer in a child and a prior diagnostic X-ray examination of the abdomen of the pregnant mother has been debated. The objections to a direct cause-and-effect explanation of the association vary in their strength, but one of the most notable grounds for controversy is the finding from the first and largest case-control study reporting the association, the Oxford Survey of Childhood Cancers (OSCC), of an almost uniformly raised relative risk (RR) for nearly all of the types of cancer that are most frequent in children. Here we compare the antenatal X-ray associations found in the OSCC for different types of childhood cancer with the results of all other case-control and case-cohort studies appropriately combined in meta-analyses, and we also review the findings of the few cohort studies that have been conducted. CONCLUSIONS From the case-control/case-cohort studies other than the OSCC there are consistent and clear elevations of risk for all types of childhood cancer combined, all leukemia, and all cancers except leukemia combined. This compatibility of the findings of the OSCC with those of the combined other studies is less clear, or effectively absent, when some categories containing smaller numbers of incident cases/deaths are considered, but lack of precision of risk estimates due to sparse data presents inferential challenges, although there is a consistent absence of an association for bone tumors. Further, more recent studies almost certainly address lower intrauterine doses, with an anticipated decrease in estimated risks, which could be misleading when comparisons involve a limited number of studies that are mainly from later years, and a similar problem arises when having to employ all types of antenatal X-ray exposures for a study because data for abdominal exposures are absent. The problem of low statistical power is greater for cohort studies, and this, together with other shortcomings identified in the studies, limits the interpretational value of results. The findings of non-medical intrauterine exposure studies are constrained by sparse data and make a limited contribution to an understanding of the association. Certain aspects of the various studies require a need for caution in interpretation, but overall, the appropriate combination of all case-control/case-cohort studies other than the OSCC lends support to the inference that low-level exposure to radiation in utero proportionally increases the risk of the typical cancers of childhood to around the same level.
Collapse
Affiliation(s)
- Richard Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
| | - John F Bithell
- Department of Statistics, University of Oxford, Oxford, UK
| |
Collapse
|