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Tao XG, Curriero FC, Mahesh M. Low Dose Radiation and Solid Tumors Mortality Risk. J Occup Environ Med 2024; 66:e230-e237. [PMID: 38527177 DOI: 10.1097/jom.0000000000003099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
BACKGROUND US nuclear capable shipyard workers have increased potential for occupational radiation exposure. OBJECTIVE The aim of the study is to examine solid tumor mortality risks at low doses. METHOD 437,937 workers working from 1957 to 2004 at eight US shipyards were studied. RESULTS Radiation workers with a median life-time dose at 0.82 mSv had a significantly lower solid tumor mortality risk (relative risk [RR]: 0.96, 95% confidence interval [CI]: 0.94-0.98) than nonradiation workers. Among 153,930 radiation workers, the RRs of solid tumors increased with increasing dose categories without statistical significance. The dose category >0-<25 mSv had significantly lower RR (0.95, 95% CI: 0.91-0.99) versus 0 dose and the excess relative risk was 0.05/100 mSv (95% CI: 0.01-0.08). CONCLUSIONS Solid tumor risk might increase with radiation dose, but not linearly at low doses. Actual mortality risk may be dependent on dose received.
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Affiliation(s)
- Xuguang Grant Tao
- From the Division of Occupational and Environmental Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland (T.G.X.); Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (F.C.C.), and the Russell H. Morgan Department of Radiology and Radiological Science and Division of Cardiology Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland (M.M.)
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Guo Z, Zhou G, Hu W. Carcinogenesis induced by space radiation: A systematic review. Neoplasia 2022; 32:100828. [PMID: 35908380 PMCID: PMC9340504 DOI: 10.1016/j.neo.2022.100828] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022]
Abstract
The carcinogenic risk from space radiation has always been a health risk issue of great concern during space exploration. In recent years, a large number of cellular and animal experiments have demonstrated that space radiation, composed of high-energy protons and heavy ions, has shown obvious carcinogenicity. However, different from radiation on Earth, space radiation has the characteristics of high energy and low dose rate. It is rich in high-atom-number and high-energy particles and, as it is combined with other space environmental factors such as microgravity and a weak magnetic field, the study of its carcinogenic effects and mechanisms of action is difficult, which leads to great uncertainty in its carcinogenic risk assessment. Here, we review the latest progress in understanding the effects and mechanisms of action related to cell transformation and carcinogenesis induced by space radiation in recent years and summarize the prediction models of cancer risk caused by space radiation and the methods to reduce the uncertainty of prediction to provide reference for the research and risk assessment of space radiation.
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Affiliation(s)
- Zi Guo
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, Jiangsu, PR China
| | - Guangming Zhou
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, Jiangsu, PR China.
| | - Wentao Hu
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou 215123, Jiangsu, PR China.
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Sutou S. Low-dose radiation from A-bombs elongated lifespan and reduced cancer mortality relative to un-irradiated individuals. Genes Environ 2018; 40:26. [PMID: 30598710 PMCID: PMC6299535 DOI: 10.1186/s41021-018-0114-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/13/2018] [Indexed: 02/06/2023] Open
Abstract
The US National Academy of Sciences (NAS) presented the linear no-threshold hypothesis (LNT) in 1956, which indicates that the lowest doses of ionizing radiation are hazardous in proportion to the dose. This spurious hypothesis was not based on solid data. NAS put forward the BEIR VII report in 2006 as evidence supporting LNT. The study described in the report used data of the Life Span Study (LSS) of A-bomb survivors. Estimation of exposure doses was based on initial radiation (5%) and neglected residual radiation (10%), leading to underestimation of the doses. Residual radiation mainly consisted of fallout that poured down onto the ground along with black rain. The black-rain-affected areas were wide. Not only A-bomb survivors but also not-in-the-city control subjects (NIC) must have been exposed to residual radiation to a greater or lesser degree. Use of NIC as negative controls constitutes a major failure in analyses of LSS. Another failure of LSS is its neglect of radiation adaptive responses which include low-dose stimulation of DNA damage repair, removal of aberrant cells via stimulated apoptosis, and elimination of cancer cells via stimulated anticancer immunity. LSS never incorporates consideration of this possibility. When LSS data of longevity are examined, a clear J-shaped dose-response, a hallmark of radiation hormesis, is apparent. Both A-bomb survivors and NIC showed longer than average lifespans. Average solid cancer death ratios of both A-bomb survivors and NIC were lower than the average for Japanese people, which is consistent with the occurrence of radiation adaptive responses (the bases for radiation hormesis), essentially invalidating the LNT model. Nevertheless, LNT has served as the basis of radiation regulation policy. If it were not for LNT, tremendous human, social, and economic losses would not have occurred in the aftermath of the Fukushima Daiichi nuclear plant accident. For many reasons, LNT must be revised or abolished, with changes based not on policy but on science.
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Ulsh BA. A critical evaluation of the NCRP COMMENTARY 27 endorsement of the linear no-threshold model of radiation effects. ENVIRONMENTAL RESEARCH 2018; 167:472-487. [PMID: 30138826 DOI: 10.1016/j.envres.2018.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 07/31/2018] [Accepted: 08/03/2018] [Indexed: 06/08/2023]
Abstract
Regulatory policy to protect the public and the environment from radiation is universally based on the linear, no-threshold model (LNT) of radiation effects. This model has been controversial since its inception over nine decades ago, and remains so to this day, but it has proved remarkably resistant to challenge from the scientific community. The LNT model has been repeatedly endorsed by expert advisory bodies, and regulatory agencies in turn adopt policies that reflect this advice. Unfortunately, these endorsements rest on a foundation of institutional inertia and numerous logical fallacies. These include most significantly setting the LNT as the null hypothesis, and shifting the burden of proof onto LNT skeptics. Other examples include arbitrary exclusion of alternative hypotheses, ignoring criticisms of the LNT, cherry-picking evidence, and making policy judgements without foundation. This paper presents an evaluation of the National Council on Radiation Protection and Measurements' (NCRP) Commentary 27, which concluded that recent epidemiological studies are compatible with the continued use of the LNT model for radiation protection. While this report will likely provide political cover for regulators' continued reliance on the LNT, it is a missed opportunity to advance the scientific discussion of the effects of low dose, low dose-rate radiation exposure. Due to its Congressionally chartered mission, no organization is better positioned than the NCRP to move this debate forward, and recommendations for doing so in future reviews are provided.
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Affiliation(s)
- Brant A Ulsh
- M. H. Chew & Associates, 7633 Southfront Rd, Ste. 170, Livermore, CA 94551-8211, United States.
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Shibamoto Y, Nakamura H. Overview of Biological, Epidemiological, and Clinical Evidence of Radiation Hormesis. Int J Mol Sci 2018; 19:E2387. [PMID: 30104556 PMCID: PMC6121451 DOI: 10.3390/ijms19082387] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 12/19/2022] Open
Abstract
The effects of low-dose radiation are being increasingly investigated in biological, epidemiological, and clinical studies. Many recent studies have indicated the beneficial effects of low doses of radiation, whereas some studies have suggested harmful effects even at low doses. This review article introduces various studies reporting both the beneficial and harmful effects of low-dose radiation, with a critique on the extent to which respective studies are reliable. Epidemiological studies are inherently associated with large biases, and it should be evaluated whether the observed differences are due to radiation or other confounding factors. On the other hand, well-controlled laboratory studies may be more appropriate to evaluate the effects of low-dose radiation. Since the number of such laboratory studies is steadily increasing, it will be concluded in the near future whether low-dose radiation is harmful or beneficial and whether the linear-no-threshold (LNT) theory is appropriate. Many recent biological studies have suggested the induction of biopositive responses such as increases in immunity and antioxidants by low-dose radiation. Based on recent as well as classical studies, the LNT theory may be out of date, and low-dose radiation may have beneficial effects depending on the conditions; otherwise, it may have no effects.
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Affiliation(s)
- Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan.
| | - Hironobu Nakamura
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan.
- Department of Radiology, Saito Yukokai Hospital, Osaka 567-0085, Japan.
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Cardarelli JJ, Ulsh BA. It Is Time to Move Beyond the Linear No-Threshold Theory for Low-Dose Radiation Protection. Dose Response 2018; 16:1559325818779651. [PMID: 30013457 PMCID: PMC6043938 DOI: 10.1177/1559325818779651] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/18/2018] [Accepted: 05/01/2018] [Indexed: 02/03/2023] Open
Abstract
The US Environmental Protection Agency (USEPA) is the primary federal agency responsible for promulgating regulations and policies to protect people and the environment from ionizing radiation. Currently, the USEPA uses the linear no-threshold (LNT) model to estimate cancer risks and determine cleanup levels in radiologically contaminated environments. The LNT model implies that there is no safe dose of ionizing radiation; however, adverse effects from low dose, low-dose rate (LDDR) exposures are not detectable. This article (1) provides the scientific basis for discontinuing use of the LNT model in LDDR radiation environments, (2) shows that there is no scientific consensus for using the LNT model, (3) identifies USEPA reliance on outdated scientific information, and (4) identifies regulatory reliance on incomplete evaluations of recent data contradicting the LNT. It is the time to reconsider the use of the LNT model in LDDR radiation environments. Incorporating the latest science into the regulatory process for risk assessment will (1) ensure science remains the foundation for decision making, (2) reduce unnecessary burdens of costly cleanups, (3) educate the public on the real effects of LDDR radiation exposures, and (4) harmonize government policies with the rest of the radiation scientific community.
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Fournier L, Cléro E, Samson E, Caër-Lorho S, Laurier D, Leuraud K. Impact of considering non-occupational radiation exposure on the association between occupational dose and solid cancer among French nuclear workers. Occup Environ Med 2017; 75:199-204. [PMID: 29055886 DOI: 10.1136/oemed-2017-104341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 08/25/2017] [Accepted: 10/05/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The French nuclear worker cohort allows for the assessment of cancer risk associated with occupational radiation exposure, but workers are also exposed to medical and environmental radiation which can be of the same order of magnitude. This study aims to examine the impact of non-occupational radiation exposures on the dose-risk analysis between occupational radiation exposure and cancer mortality. METHODS The cohort included workers employed before 1995 for at least one year by CEA, AREVA NC or EDF and badge-monitored for external radiation exposure. Monitoring results were used to calculate occupational individual doses. Scenarios of work-related X-ray and environmental exposures were simulated. Poisson regression was used to quantify associations between occupational exposure and cancer mortality adjusting for non-occupational radiation exposure. RESULTS The mean cumulative dose of external occupational radiation was 18.4 mSv among 59 004 workers. Depending on the hypotheses made, the mean cumulative work-related X-ray dose varied between 3.1 and 9.2 mSv and the mean cumulative environmental dose was around 130 mSv. The unadjusted excess relative rate of cancer per Sievert (ERR/Sv) was 0.34 (90% CI -0.44 to 1.24). Adjusting for environmental radiation exposure did not substantially modify this risk coefficient, but it was attenuated by medical exposure (ERR/Sv point estimate between 0.15 and 0.23). CONCLUSIONS Occupational radiation risk estimates were lower when adjusted for work-related X-ray exposures. Environmental exposures had a very slight impact on the occupational exposure risk estimates. In any scenario of non-occupational exposure considered, a positive but insignificant excess cancer risk associated with occupational exposure was observed.
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Affiliation(s)
- Lucie Fournier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - Enora Cléro
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - Eric Samson
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - Sylvaine Caër-Lorho
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - Dominique Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - Klervi Leuraud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
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Mortazavi SMJ, Doss M. Comments on “Solid Cancer Incidence among the Life Span Study of Atomic Bomb Survivors: 1958-2009” (Radiat Res 2017; 187:513–537). Radiat Res 2017. [DOI: 10.1667/rr4811.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- SMJ Mortazavi
- Department of Diagnostic Imaging, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111
- Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohan Doss
- Department of Diagnostic Imaging, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111
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Laurier D, Richardson DB, Cardis E, Daniels RD, Gillies M, O'Hagan J, Hamra GB, Haylock R, Leuraud K, Moissonnier M, Schubauer-Berigan MK, Thierry-Chef I, Kesminiene A. The International Nuclear Workers Study (Inworks): A Collaborative Epidemiological Study to Improve Knowledge About Health Effects of Protracted Low-Dose Exposure. RADIATION PROTECTION DOSIMETRY 2017; 173:21-25. [PMID: 27885078 DOI: 10.1093/rpd/ncw314] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INWORKS is a multinational cohort study, gathering 308 297 workers in the nuclear industry in France, the United Kingdom and the United States of America, with detailed individual monitoring data for external exposure to ionising radiation. Over a mean duration of follow-up of 27 y, the number of observed deaths was 66 632, including 17 957 deaths due to solid cancers, 1791 deaths due to haematological cancers and 27 848 deaths due to cardiovascular diseases. Mean individual cumulative external dose over the period 1945-2005 was 25 mSv. Analyses demonstrated a significant association between red bone marrow dose and the risk of leukaemia (excluding chronic lymphocytic leukaemia) and between colon dose and the risk of solid cancers. INWORKS assembled some of the strongest evidence to strengthen the scientific basis for the protection of adults from low dose, low-dose rate, exposures to ionising radiation.
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Affiliation(s)
- Dominique Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 91190 Fontenay-aux-Roses, France
| | - David B Richardson
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | | | - Robert D Daniels
- National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Michael Gillies
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, UK
| | - Jackie O'Hagan
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, UK
| | - Ghassan B Hamra
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Richard Haylock
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE-CRCE), Chilton, UK
| | - Klervi Leuraud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 91190 Fontenay-aux-Roses, France
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Sacks B, Meyerson G, Siegel JA. Epidemiology Without Biology: False Paradigms, Unfounded Assumptions, and Specious Statistics in Radiation Science (with Commentaries by Inge Schmitz-Feuerhake and Christopher Busby and a Reply by the Authors). BIOLOGICAL THEORY 2016; 11:69-101. [PMID: 27398078 PMCID: PMC4917595 DOI: 10.1007/s13752-016-0244-4] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/07/2016] [Indexed: 01/30/2023]
Abstract
Radiation science is dominated by a paradigm based on an assumption without empirical foundation. Known as the linear no-threshold (LNT) hypothesis, it holds that all ionizing radiation is harmful no matter how low the dose or dose rate. Epidemiological studies that claim to confirm LNT either neglect experimental and/or observational discoveries at the cellular, tissue, and organismal levels, or mention them only to distort or dismiss them. The appearance of validity in these studies rests on circular reasoning, cherry picking, faulty experimental design, and/or misleading inferences from weak statistical evidence. In contrast, studies based on biological discoveries demonstrate the reality of hormesis: the stimulation of biological responses that defend the organism against damage from environmental agents. Normal metabolic processes are far more damaging than all but the most extreme exposures to radiation. However, evolution has provided all extant plants and animals with defenses that repair such damage or remove the damaged cells, conferring on the organism even greater ability to defend against subsequent damage. Editors of medical journals now admit that perhaps half of the scientific literature may be untrue. Radiation science falls into that category. Belief in LNT informs the practice of radiology, radiation regulatory policies, and popular culture through the media. The result is mass radiophobia and harmful outcomes, including forced relocations of populations near nuclear power plant accidents, reluctance to avail oneself of needed medical imaging studies, and aversion to nuclear energy-all unwarranted and all harmful to millions of people.
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Affiliation(s)
- Bill Sacks
- />Center for Devices and Radiological Health, U.S. Food and Drug Administration, Green Valley, AZ USA
| | - Gregory Meyerson
- />Department of English, North Carolina Agricultural and Technical State University, Greensboro, NC USA
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