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Meng Q, Zaharieva EK, Sasatani M, Kobayashi J. Possible relationship between mitochondrial changes and oxidative stress under low dose-rate irradiation. Redox Rep 2021; 26:160-169. [PMID: 34435550 PMCID: PMC8405122 DOI: 10.1080/13510002.2021.1971363] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Objectives: High dose-rate ionizing radiation (IR) causes severe DSB damage, as well as reactive oxygen species (ROS) accumulation and oxidative stress. However, it is unknown what biological processes are affected by low dose-rate IR; therefore, the molecular relationships between mitochondria changes and oxidative stress in human normal cells was investigated after low dose-rate IR.Methods: We compared several cellular response between high and low dose-rate irradiation using cell survival assay, ROS/RNS assay, immunofluorescence and western blot analysis.Results: Reduced DSB damage and increased levels of ROS, with subsequent oxidative stress responses, were observed in normal cells after low dose-rate IR. Low dose-rate IR caused several mitochondrial changes, including morphology mass, and mitochondrial membrane potential, suggesting that mitochondrial damage was caused. Although damaged mitochondria were removed by mitophagy to stop ROS leakage, the mitophagy-regulatory factor, PINK1, was reduced following low dose-rate IR. Although mitochondrial dynamics (fission/fusion events) are important for the proper mitophagy process, some mitochondrial fusion factors decreased following low dose-rate IR.Discussion: The dysfunction of mitophagy pathway under low dose-rate IR increased ROS and the subsequent activation of the oxidative stress response.
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Affiliation(s)
- Qingmei Meng
- Department of Interdisciplinary Environment, Graduate School of Human and Environmental Sciences, Kyoto University, Yoshidanihonmatsucho, Sakyo-ku, Kyoto, Japan
| | - Elena Karamfilova Zaharieva
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine (RIRBM), Hiroshima University, Hiroshima, Japan
| | - Megumi Sasatani
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine (RIRBM), Hiroshima University, Hiroshima, Japan
| | - Junya Kobayashi
- Department of Interdisciplinary Environment, Graduate School of Human and Environmental Sciences, Kyoto University, Yoshidanihonmatsucho, Sakyo-ku, Kyoto, Japan
- Department of Radiological Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
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Boice JD, Held KD, Shore RE. Radiation epidemiology and health effects following low-level radiation exposure. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2019; 39:S14-S27. [PMID: 31272090 DOI: 10.1088/1361-6498/ab2f3d] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Radiation epidemiology is the study of human disease following radiation exposure to populations. Epidemiologic studies of radiation-exposed populations have been conducted for nearly 100 years, starting with the radium dial painters in the 1920s and most recently with large-scale studies of radiation workers. As radiation epidemiology has become increasingly sophisticated it is used for setting radiation protection standards as well as to guide the compensation programmes in place for nuclear weapons workers, nuclear weapons test participants, and other occupationally exposed workers in the United States and elsewhere. It is known with high assurance that radiation effects at levels above 100-150 mGy can be detected as evidenced in multiple population studies conducted around the world. The challenge for radiation epidemiology is evaluating the effects at low doses, below about 100 mGy of low-linear energy transfer radiation, and assessing the risks following low dose-rate exposures over years. The weakness of radiation epidemiology in directly studying low dose and low dose-rate exposures is that the signal, i.e. the excess numbers of cancers associated with low-level radiation exposure, is so very small that it cannot be seen against the very high background occurrence of cancer in the population, i.e. a lifetime risk of incidence reaching up to about 38% (i.e. 1 in 3 persons will develop a cancer in their lifetime). Thus, extrapolation models are used for the management of risk at low doses and low dose rates, but having adequate information from low dose and low dose-rate studies would be highly desirable. An overview of recently conducted radiation epidemiologic studies which evaluate risk following low-level radiation exposures is presented. Future improvements in risk assessment for radiation protection may come from increasingly informative epidemiologic studies, combined with mechanistic radiobiologic understanding of adverse outcome pathways, with both incorporated into biologically based models.
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Affiliation(s)
- J D Boice
- National Council on Radiation Protection and Measurements, Bethesda, Maryland, United States of America. Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
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Tang FR, Loganovsky K. Low dose or low dose rate ionizing radiation-induced health effect in the human. JOURNAL OF ENVIRONMENTAL RADIOACTIVITY 2018; 192:32-47. [PMID: 29883875 DOI: 10.1016/j.jenvrad.2018.05.018] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 05/28/2018] [Indexed: 06/08/2023]
Abstract
The extensive literature review on human epidemiological studies suggests that low dose ionizing radiation (LDIR) (≤100 mSv) or low dose rate ionizing radiation (LDRIR) (<6mSv/H) exposure could induce either negative or positive health effects. These changes may depend on genetic background, age (prenatal day for embryo), sex, nature of radiation exposure, i.e., acute or chronic irradiation, radiation sources (such as atomic bomb attack, fallout from nuclear weapon test, nuclear power plant accidents, 60Co-contaminated building, space radiation, high background radiation, medical examinations or procedures) and radionuclide components and human epidemiological experimental designs. Epidemiological and clinical studies show that LDIR or LDRIR exposure may induce cancer, congenital abnormalities, cardiovascular and cerebrovascular diseases, cognitive and other neuropsychiatric disorders, cataracts and other eye and somatic pathology (endocrine, bronchopulmonary, digestive, etc). LDIR or LDRIR exposure may also reduce mutation and cancer mortality rates. So far, the mechanisms of LDIR- or LDRIR -induced health effect are poorly understood. Further extensive studies are still needed to clarify under what circumstances, LDIR or LDRIR exposure may induce positive or negative effects, which may facilitate development of new therapeutic approaches to prevent or treat the radiation-induced human diseases or enhance radiation-induced positive health effect.
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Affiliation(s)
- Feng Ru Tang
- Singapore Nuclear Research and Safety Initiative, National University of Singapore, 138602, Singapore.
| | - Konstantin Loganovsky
- Radiation Psychoneurology Department, Institute of Clinical Radiology, State Institution "National Research Centre for Radiation Medicne, National Academy of Medical Sciences of Ukraine", 53 Melnikov Str., Kyiv, 04050, Ukraine
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Kocher DC, Apostoaei AI, Hoffman FO, Trabalka JR. Probability Distribution of Dose and Dose-Rate Effectiveness Factor for use in Estimating Risks of Solid Cancers From Exposure to Low-Let Radiation. HEALTH PHYSICS 2018; 114:602-622. [PMID: 29697512 PMCID: PMC5922807 DOI: 10.1097/hp.0000000000000838] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
This paper presents an analysis to develop a subjective state-of-knowledge probability distribution of a dose and dose-rate effectiveness factor for use in estimating risks of solid cancers from exposure to low linear energy transfer radiation (photons or electrons) whenever linear dose responses from acute and chronic exposure are assumed. A dose and dose-rate effectiveness factor represents an assumption that the risk of a solid cancer per Gy at low acute doses or low dose rates of low linear energy transfer radiation, RL, differs from the risk per Gy at higher acute doses, RH; RL is estimated as RH divided by a dose and dose-rate effectiveness factor, where RH is estimated from analyses of dose responses in Japanese atomic-bomb survivors. A probability distribution to represent uncertainty in a dose and dose-rate effectiveness factor for solid cancers was developed from analyses of epidemiologic data on risks of incidence or mortality from all solid cancers as a group or all cancers excluding leukemias, including (1) analyses of possible nonlinearities in dose responses in atomic-bomb survivors, which give estimates of a low-dose effectiveness factor, and (2) comparisons of risks in radiation workers or members of the public from chronic exposure to low linear energy transfer radiation at low dose rates with risks in atomic-bomb survivors, which give estimates of a dose-rate effectiveness factor. Probability distributions of uncertain low-dose effectiveness factors and dose-rate effectiveness factors for solid cancer incidence and mortality were combined using assumptions about the relative weight that should be assigned to each estimate to represent its relevance to estimation of a dose and dose-rate effectiveness factor. The probability distribution of a dose and dose-rate effectiveness factor for solid cancers developed in this study has a median (50th percentile) and 90% subjective confidence interval of 1.3 (0.47, 3.6). The harmonic mean is 1.1, which implies that the arithmetic mean of an uncertain estimate of the risk of a solid cancer per Gy at low acute doses or low dose rates of low linear energy transfer radiation is only about 10% less than the mean risk per Gy at higher acute doses. Data were also evaluated to define a low acute dose or low dose rate of low linear energy transfer radiation, i.e., a dose or dose rate below which a dose and dose-rate effectiveness factor should be applied in estimating risks of solid cancers.
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Affiliation(s)
- David C Kocher
- *Oak Ridge Center for Risk Analysis, Inc., 102 Donner Drive, Oak Ridge, TN 37830; †Deceased
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5
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Abstract
Hormesis can be explained by evolutionary adaptation to the current level of a factor present in the natural environment or to some average from the past. This pertains also to ionizing radiation as the natural background has been decreasing during the time of the life existence. DNA damage and repair are normally in a dynamic balance. The conservative nature of the DNA repair suggests that cells may have retained some capability to repair damage from higher radiation levels than that existing today. According to this concept, the harm caused by radioactive contamination would tend to zero with a dose rate tending to a wide range level of the natural radiation background. Existing evidence in favor of hormesis is substantial, experimental data being partly at variance with results of epidemiological studies. Potential bias, systematic errors, and motives to exaggerate risks from low-dose low-rate ionizing radiation are discussed here. In conclusion, current radiation safety norms are exceedingly restrictive and should be revised on the basis of scientific evidence. Elevation of the limits must be accompanied by measures guaranteeing their observance.
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Affiliation(s)
- S V Jargin
- Peoples' Friendship University of Russia, Moscow, Russian Federation
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6
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Jargin SV. Re: The high price of public fear of low-dose radiation. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2017; 37:797-799. [PMID: 28675752 DOI: 10.1088/1361-6498/aa7c69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Sergei V Jargin
- People's Friendship University of Russia, Clementovski per 6-82, 115184 Moscow, Russia
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Krestinina LY, Kharyuzov YE, Epiphanova SB, Tolstykh EI, Deltour I, Schüz J, Akleyev AV. Cancer Incidence after In Utero Exposure to Ionizing Radiation in Techa River Residents. Radiat Res 2017; 188:314-324. [PMID: 28715276 DOI: 10.1667/rr14695.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Health effects of in utero exposure to ionizing radiation, especially among adults, are still unclear. The aim of this study was to analyze cancer risk in a cohort of subjects exposed in utero due to releases of nuclear waste into the Techa River in the Southern Urals, taking into account additional postnatal exposure. Analysis for solid cancer was based on 242 cases among 10,482 cohort members, accumulating 381,948 person-years at risk, with follow-up from 1956-2009, while analysis for hematological malignancies was based on 26 cases among 11,070 persons, with 423,502 person-years at risk, with follow-up from 1953-2009. Mean doses accumulated in soft tissues and in red bone marrow during the prenatal period were 4 mGy and 30 mGy, respectively. Additional respective mean postnatal doses received by cohort members were 11 and 84 mGy. Poisson regression analysis was used to estimate the excess relative risk (ERR) of cancer incidence related to in utero and postnatal doses. No association was observed for in utero exposure with solid cancer risk [ERR per 10 mGy: -0.007; 95% confidence interval (CI): <-0.107; 0.148] or with hematological malignancy risk (ERR/10 mGy: -0.011; 95% CI: <-0.015; 0.099). However, ERR of solid cancer increased significantly with increasing postnatal dose (ERR/10 mGy: 0.11; 95% CI: 0.04; 0.22). The very wide confidence intervals in these ERR results are similar to those of studies performed on the LSS cohort and the offspring of the Mayak Female Worker Cohort, as well as case-control studies of effects after in utero medical exposure. There were limitations of this study, with decreased statistical power, due to the low prenatal doses received by most of the cohort members, the small number of cancer cases and the absence of cohort members over the age of 59 years (living cohort members had reached 49-59 years of age). Further aging of the cohort and extension of the follow-up period will enhance the statistical power of this study in the future. There is a shortage of cohort studies reporting on the effects of prenatal radiation exposure, as well as information on chronic exposure during the prenatal period. Therefore, further research of this unique cohort will be a useful addition to the published literature on this subject, and a valuable means of elucidating the long-term effects of low-dose radiation exposure in the fetus.
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Affiliation(s)
- L Yu Krestinina
- a Urals Research Center for Radiation Medicine (URCRM), Chelyabinsk, Russian Federation
| | - Yu E Kharyuzov
- a Urals Research Center for Radiation Medicine (URCRM), Chelyabinsk, Russian Federation
| | - S B Epiphanova
- a Urals Research Center for Radiation Medicine (URCRM), Chelyabinsk, Russian Federation
| | - E I Tolstykh
- a Urals Research Center for Radiation Medicine (URCRM), Chelyabinsk, Russian Federation
| | - I Deltour
- b Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - J Schüz
- b Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - A V Akleyev
- a Urals Research Center for Radiation Medicine (URCRM), Chelyabinsk, Russian Federation
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Correction of confidence intervals in excess relative risk models using Monte Carlo dosimetry systems with shared errors. PLoS One 2017; 12:e0174641. [PMID: 28369141 PMCID: PMC5378348 DOI: 10.1371/journal.pone.0174641] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 03/13/2017] [Indexed: 11/19/2022] Open
Abstract
In epidemiological studies, exposures of interest are often measured with uncertainties, which may be independent or correlated. Independent errors can often be characterized relatively easily while correlated measurement errors have shared and hierarchical components that complicate the description of their structure. For some important studies, Monte Carlo dosimetry systems that provide multiple realizations of exposure estimates have been used to represent such complex error structures. While the effects of independent measurement errors on parameter estimation and methods to correct these effects have been studied comprehensively in the epidemiological literature, the literature on the effects of correlated errors, and associated correction methods is much more sparse. In this paper, we implement a novel method that calculates corrected confidence intervals based on the approximate asymptotic distribution of parameter estimates in linear excess relative risk (ERR) models. These models are widely used in survival analysis, particularly in radiation epidemiology. Specifically, for the dose effect estimate of interest (increase in relative risk per unit dose), a mixture distribution consisting of a normal and a lognormal component is applied. This choice of asymptotic approximation guarantees that corrected confidence intervals will always be bounded, a result which does not hold under a normal approximation. A simulation study was conducted to evaluate the proposed method in survival analysis using a realistic ERR model. We used both simulated Monte Carlo dosimetry systems (MCDS) and actual dose histories from the Mayak Worker Dosimetry System 2013, a MCDS for plutonium exposures in the Mayak Worker Cohort. Results show our proposed methods provide much improved coverage probabilities for the dose effect parameter, and noticeable improvements for other model parameters.
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9
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Seong KM, Seo S, Lee D, Kim MJ, Lee SS, Park S, Jin YW. Is the Linear No-Threshold Dose-Response Paradigm Still Necessary for the Assessment of Health Effects of Low Dose Radiation? J Korean Med Sci 2016; 31 Suppl 1:S10-23. [PMID: 26908982 PMCID: PMC4756336 DOI: 10.3346/jkms.2016.31.s1.s10] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/17/2015] [Indexed: 12/17/2022] Open
Abstract
Inevitable human exposure to ionizing radiation from man-made sources has been increased with the proceeding of human civilization and consequently public concerns focus on the possible risk to human health. Moreover, Fukushima nuclear power plant accidents after the 2011 East-Japan earthquake and tsunami has brought the great fear and anxiety for the exposure of radiation at low levels, even much lower levels similar to natural background. Health effects of low dose radiation less than 100 mSv have been debated whether they are beneficial or detrimental because sample sizes were not large enough to allow epidemiological detection of excess effects and there was lack of consistency among the available experimental data. We have reviewed an extensive literature on the low dose radiation effects in both radiation biology and epidemiology, and highlighted some of the controversies therein. This article could provide a reasonable view of utilizing radiation for human life and responding to the public questions about radiation risk. In addition, it suggests the necessity of integrated studies of radiobiology and epidemiology at the national level in order to collect more systematic and profound information about health effects of low dose radiation.
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Affiliation(s)
- Ki Moon Seong
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Songwon Seo
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Dalnim Lee
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Min-Jeong Kim
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Seung-Sook Lee
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Sunhoo Park
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
| | - Young Woo Jin
- Laboratory of Radiation Exposure & Therapeutics, National Radiation Emergency Medical Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea
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Davis FG, Krestinina LY, Preston D, Epifanova S, Degteva M, Akleyev AV. Solid Cancer Incidence in the Techa River Incidence Cohort: 1956–2007. Radiat Res 2015; 184:56-65. [DOI: 10.1667/rr14023.1] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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11
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Ainsbury EA, Moquet J, Rothkamm K, Darroudi F, Vozilova A, Degteva M, Azizova TV, Lloyd DC, Harrison J. What radiation dose does the FISH translocation assay measure in cases of incorporated radionuclides for the Southern Urals populations? RADIATION PROTECTION DOSIMETRY 2014; 159:26-33. [PMID: 24736296 DOI: 10.1093/rpd/ncu118] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The fluorescence in situ hybridisation (FISH) technique is now well established for retrospective dosimetry in cases of external radiation exposure that occurred many years ago. However, the question remains as to whether FISH provides valid estimates of cumulative red bone marrow radiation doses in cases of incorporation of radionuclides or combined external and internal exposures. This question has arisen in connection with the interpretation of results of dose assessments for epidemiological studies of plutonium workers at the Russian Mayak plant and of members of the public exposed to strontium radioisotopes and external radiation as a result of discharges from Mayak to the Techa River. Exposures to penetrating external radiation result in fairly uniform irradiation of body tissues, and hence similar doses to all tissues, for which FISH dosimetry can provide a reliable measure of this whole body dose. However, intakes of radionuclides into the body by inhalation or ingestion may result in retention in specific organs and tissues, so that the distribution of dose is highly heterogeneous. For radionuclides emitting short-range radiations (e.g. alpha particles), this heterogeneity can apply to dose delivery within tissues and between cells within tissues. In this paper, an attempt is made to address the question of what FISH measures in such circumstances by considering evidence regarding the origin and lifetime dynamics of lymphocyte subsets in the human body in relation to the localised delivery of dose from the internal emitters (90)Sr and (239)Pu, which are of particular interest for the Southern Urals Mayak and Techa River populations, and for which most evidence is available in these populations. It is concluded that the FISH translocation assay can be usefully applied for detecting internal and combined external gamma and internal doses from internally deposited (90)Sr, albeit with fairly large uncertainties. The same may be true of (239)Pu, as well as other radionuclides, although much work remains to be done to establish dose-response relationships.
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Affiliation(s)
| | - Jayne Moquet
- Public Health England (PHE) CRCE, Chilton, Didcot, Oxfordshire OX11 0RQ, UK
| | - Kai Rothkamm
- Public Health England (PHE) CRCE, Chilton, Didcot, Oxfordshire OX11 0RQ, UK
| | - Firouz Darroudi
- Department of Toxicogenetics, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Alexandra Vozilova
- Urals Research Center for Radiation Medicine (URCRM), Chelyabinsk, Russian Federation
| | - Marina Degteva
- Urals Research Center for Radiation Medicine (URCRM), Chelyabinsk, Russian Federation
| | - Tamara V Azizova
- Southern Urals Biophysics Institute (SUBI), Chelyabinsk, Russian Federation
| | - David C Lloyd
- Public Health England (PHE) CRCE, Chilton, Didcot, Oxfordshire OX11 0RQ, UK
| | - John Harrison
- Public Health England (PHE) CRCE, Chilton, Didcot, Oxfordshire OX11 0RQ, UK
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Boice JD. Implications of radiation dose and exposed populations on radiation protection in the 21st century. HEALTH PHYSICS 2014; 106:313-328. [PMID: 24378509 DOI: 10.1097/hp.0000000000000024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Radiation is in the public eye because of Fukushima, computed tomography examinations, airport screenings, and possible terrorist attacks. What if the Boston Marathon pressure cooker had also contained a radioactive source? Nuclear power may be on the resurgence. Because of the increasing uses of radiation, the increases in population exposures, and the increasing knowledge of radiation effects, constant vigilance is needed to keep up with the changing times. Psychosocial disorders associated with the inappropriate (but real) fear of radiation need to be recognized as radiation detriments. Radiation risk communication, radiation education, and communication must improve at all levels: to members of the public, to the media, to other scientists, and to radiation professionals. Stakeholders must continue to be involved in all radiation protection initiatives. Finally, we are at a crisis as the number of war babies (me) and baby boomers (you?) who are also radiation professionals continues its rapid decline, and there are few in the pipeline to fill the current and looming substantial need: "The old road is rapidly agin'" (Dylan). NCRP has begun the WARP initiative-Where Are the Radiation Professionals?-an attempt to rejuvenate the pipeline of future professionals before the trickle becomes tiny drops. A Workshop was held in July 2013 with government agencies, military, private sector, universities, White House representatives, and societies to develop a coordinated and national action plan. A "Manhattan Project" is needed to get us "Back to the Future" in terms of the funding levels that existed in years past that provided the necessary resources to train, engage, and retain (a.k.a., jobs) the radiation professionals needed for the nation. If we don't keep swimmin' (Disney's Nemo) we'll "sink like a stone" (Dylan).Introduction of Implications of Radiation Dose and Exposed Populations (Video 2:06, http://links.lww.com/HP/A25).
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Affiliation(s)
- John D Boice
- *National Council on Radiation Protection and Measurements, 7910 Woodmont Avenue, Suite 400, Bethesda, MD 20814-3095; †Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, TN 37240
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Krestinina LY, Davis FG, Schonfeld S, Preston DL, Degteva M, Epifanova S, Akleyev AV. Leukaemia incidence in the Techa River Cohort: 1953-2007. Br J Cancer 2013; 109:2886-93. [PMID: 24129230 PMCID: PMC3844904 DOI: 10.1038/bjc.2013.614] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 08/31/2013] [Accepted: 09/16/2013] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Little is known about leukaemia risk following chronic radiation exposures at low dose rates. The Techa River Cohort of individuals residing in riverside villages between 1950 and 1961 when releases from the Mayak plutonium production complex contaminated the river allows quantification of leukaemia risks associated with chronic low-dose-rate internal and external exposures. METHODS Excess relative risk models described the dose-response relationship between radiation dose on the basis of updated dose estimates and the incidence of haematological malignancies ascertained between 1953 and 2007 among 28 223 cohort members, adjusted for attained age, sex, and other factors. RESULTS Almost half of the 72 leukaemia cases (excluding chronic lymphocytic leukaemia (CLL)) were estimated to be associated with radiation exposure. These data are consistent with a linear dose response with no evidence of modification. The excess relative risk estimate was 0.22 per 100 mGy. There was no evidence of significant dose effect for CLL or other haematopoietic malignancies. CONCLUSION These analyses demonstrate that radiation exposures, similar to those received by populations exposed as a consequence of nuclear accidents, are associated with long-term dose-related increases in leukaemia risks. Using updated dose estimates, the leukaemia risk per unit dose is about half of that based on previous dosimetry.
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Affiliation(s)
- L Y Krestinina
- Urals Research Center for Radiation Medicine, Epidemiology Laboratory, 68-a, Vorovsky Street, Chelyabinsk 454076, Russia
| | - F G Davis
- University of Illinois at Chicago, School of Public Health, Division of Epidemiology/Biostatistics, 1603 West Taylor Street, Chicago, IL 60612, USA
| | - S Schonfeld
- International Agency for Research on Cancer, Section of Environment and Radiation, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France
- National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, 6120 Executive Boulevard, Bethesda, MD 20892, USA
| | - D L Preston
- Hirosoft International Company, 1335 H Street, Eureka, CA 95501, USA
| | - M Degteva
- Urals Research Center for Radiation Medicine, Epidemiology Laboratory, 68-a, Vorovsky Street, Chelyabinsk 454076, Russia
| | - S Epifanova
- Urals Research Center for Radiation Medicine, Epidemiology Laboratory, 68-a, Vorovsky Street, Chelyabinsk 454076, Russia
| | - A V Akleyev
- Urals Research Center for Radiation Medicine, Epidemiology Laboratory, 68-a, Vorovsky Street, Chelyabinsk 454076, Russia
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Krestinina LY, Akleyev AV. Reply to "On the low-dose radiation exposure in the Techa River Cohort and mortality from circulatory diseases" by Jargin (2013). RADIATION AND ENVIRONMENTAL BIOPHYSICS 2013; 52:421-423. [PMID: 23733008 DOI: 10.1007/s00411-013-0476-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 05/18/2013] [Indexed: 06/02/2023]
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15
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Jargin SV. On the low-dose-radiation exposure in the Techa River Cohort and mortality from circulatory diseases. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2013; 52:419-420. [PMID: 23733007 DOI: 10.1007/s00411-013-0475-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 05/18/2013] [Indexed: 06/02/2023]
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16
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Martineau-Beaulieu D, Lanthier L. Low-dose ionising radiation from medical imaging in patients hospitalised in Internal Medicine. Intern Med J 2013; 42:547-53. [PMID: 22152026 DOI: 10.1111/j.1445-5994.2011.02640.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Medical imaging is responsible for increasing exposure to low-dose ionising radiation in the general population. The extent of exposure in specific patient populations remains to be determined. AIM We sought to determine the level of exposure in patients hospitalised in General Internal Medicine. METHODS In this retrospective cohort study, we searched the Centre Informatisé de Recherche Évaluative en Services et Soins de Santé database for adult patients hospitalised in General Internal Medicine from 1 January 2008 to 31 December 2008. We collected data on demographics, co-morbidities, and radiological and nuclear imaging. We used data from the literature to calculate an estimated annual effective dose for each patient and searched for factors associated with higher exposure. RESULTS One thousand one hundred eighty-seven (1187) patients were hospitalised at least once during the study period. The median age was 69 years (interquartile range 56-81) and 636 (53.6%) were men. The median annual effective dose of the whole cohort was 8.7 mSv/year. Patients aged between 55 and 80 years were exposed to a higher median effective dose compared with their younger and older counterparts (P < 0.001). Patients with cardiac, pulmonary, peripheral arterial and neoplastic disease were at higher risk of exposure to high and very high annual effective dose (P < 0.01). Patients with longer hospitalisations were at higher risk of exposure to high and very high annual effective dose (P < 0.01). CONCLUSION Patients hospitalised on a General Internal Medicine ward are exposed to three times more ionising radiation than the general population.
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Affiliation(s)
- D Martineau-Beaulieu
- Department of Medicine, Internal Medicine Division, Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, Quebec, Canada
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Das Roy L, Giri S, Singh S, Giri A. Effects of radiation and vitamin C treatment on metronidazole genotoxicity in mice. Mutat Res 2013; 753:65-71. [PMID: 23416157 DOI: 10.1016/j.mrgentox.2013.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Revised: 01/26/2013] [Accepted: 02/05/2013] [Indexed: 10/27/2022]
Abstract
The impact of exposure to low dose radiation (LDR) on human health is not clear. Besides, cross adaptation or sensitization with pharmaceutical agents may modify the risk of LDR. In the present study, we analyzed the interaction of radiation and metronidazole (MTZ) in inducing chromosome aberration (CA) and micronucleus (MN) in the bone marrow cells of Balb/C mice in vivo. Further, we evaluated the efficacy of vitamin C to reduce MTZ induced genotoxicity. We found that 10, 20 and 40mg/kg of MTZ induced dose dependent increase in the frequency of CA (r=0.9923, P<0.01) as well as MN (r=0.9823, P<0.05) in polychromatic erythrocytes. However, MTZ did not affect the ratio of polychromatic erythrocytes to normochromatic erythrocytes indicating lack of cytotoxicity. Supplementation with vitamin C prior to MTZ treatment significantly reduced the frequency of CA (P<0.001) as well as MN (P<0.001). Radiation (0.5Gy) exposure prior to MTZ treatment produced a less than additive (for CA) to additive (for MN) effects. However, radiation exposure following MTZ treatment produced additive (for CA) and synergistic (for MN) effects. Further, vitamin C pre-treatment also reduced the genotoxicity indices following the combined treatment of MTZ and radiation. Our findings suggest that MTZ may sensitize bone marrow cells to radiation exposure and enhances genotoxicity. We recommend more studies on the interaction of LDR and marketed pharmaceuticals to minimize possible harmful outcomes through appropriate precautionary measures.
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Affiliation(s)
- Lopamudra Das Roy
- Department of Life Science & Bioinformatics, Assam University, Silchar, India
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Tolstykh EI, Degteva MO, Peremyslova LM, Shagina NB, Vorobiova MI, Anspaugh LR, Napier BA. Reconstruction of long-lived radionuclide intakes for Techa riverside residents: 137Cs. HEALTH PHYSICS 2013; 104:481-498. [PMID: 23532077 DOI: 10.1097/hp.0b013e318285bb7a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Radioactive contamination of the Techa River (Southern Urals, Russia) occurred from 1949-1956 due to routine and accidental releases of liquid radioactive wastes from the Mayak Production Association. The long-lived radionuclides in the releases were Sr and Cs. Contamination of the components of the Techa River system resulted in chronic external and internal exposure of about 30,000 residents of riverside villages. Data on radionuclide intake with diet are used to estimate internal dose in the Techa River Dosimetry System (TRDS), which was elaborated for the assessment of radiogenic risk for Techa Riverside residents. The Sr intake function was recently improved, taking into account the recently available archival data on radionuclide releases and in-depth analysis of the extensive data on Sr measurements in Techa Riverside residents. The main purpose of this paper is to evaluate the dietary intake of Cs by Techa Riverside residents. The Cs intake with river water used for drinking was reconstructed on the basis of the Sr intake-function and the concentration ratio Cs-to-Sr in river water. Intake via Cs transfer from floodplain soil to grass and cows' milk was evaluated for the first time. As a result, the maximal Cs intake level was indicated near the site of releases in upper-Techa River settlements (8,000-9,000 kBq). For villages located on the lower Techa River, the Cs intake was significantly less (down to 300 kBq). Cows' milk was the main source of Cs in diet in the upper-Techa River region.
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Affiliation(s)
- E I Tolstykh
- Urals Research Center for Radiation Medicine, Vorovskogo 68 a, 454076 Chelyabinsk, Russian Federation.
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Krestinina LY, Epifanova S, Silkin S, Mikryukova L, Degteva M, Shagina N, Akleyev A. Chronic low-dose exposure in the Techa River Cohort: risk of mortality from circulatory diseases. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2013; 52:47-57. [PMID: 23124827 DOI: 10.1007/s00411-012-0438-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 10/21/2012] [Indexed: 06/01/2023]
Abstract
The aim of the present study was to analyze the mortality from circulatory diseases for about 30,000 members of the Techa River cohort over the period 1950-2003, and to investigate how these rates depend on radiation doses. This population received both external and internal exposures from (90)Sr, (89)Sr, (137)Cs, and other uranium fission products as a result of waterborne releases from the Mayak nuclear facility in the Southern Urals region of the Russian Federation. The analysis included individualized estimates of the total (external plus internal) absorbed dose in muscle calculated based on the Techa River Dosimetry System 2009. The cohort-average dose to muscle tissue was 35 mGy, and the maximum dose was 510 mGy. Between 1950 and 2003, 7,595 deaths from circulatory diseases were registered among cohort members with 901,563 person years at risk. Mortality rates in the cohort were analyzed using a simple parametric excess relative risk (ERR) model. For all circulatory diseases, the estimated excess relative risk per 100 mGy with a 15-year lag period was 3.6 % with a 95 % confidence interval of 0.2-7.5 %, and for ischemic heart disease it was 5.6 % with a 95 % confidence interval of 0.1-11.9 %. A linear ERR model provided the best fit. Analyses with a lag period shorter than 15 years from the beginning of exposure did not reveal any significant risk of mortality from either all circulatory diseases or ischemic heart disease. There was no evidence of an increased mortality risk from cerebrovascular disease (p > 0.5). These results should be regarded as preliminary, since they will be updated after adjustment for smoking and alcohol consumption.
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Schonfeld SJ, Krestinina LY, Epifanova S, Degteva MO, Akleyev AV, Preston DL. Solid cancer mortality in the techa river cohort (1950-2007). Radiat Res 2013; 179:183-9. [PMID: 23289384 PMCID: PMC3613701 DOI: 10.1667/rr2932.1] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Our understanding of cancer risk from ionizing radiation is largely based on studies of populations exposed at high dose and high dose rates. Less certain is the magnitude of cancer risk from protracted, low-dose and low-dose-rate radiation exposure. We estimated the dose-response relationship for solid cancer mortality in a cohort of 29,730 individuals who lived along the Techa River between 1950 and 1960. This population was exposed to both external γ radiation and internal (90)Sr, (137)Cs and other radionuclides after the release of radioactive waste into the river by the Mayak Radiochemical Plant. The analysis utilized the latest individualized doses from the Techa River Dosimetry System (TRDS) 2009. We estimated excess relative risks (ERRs) per Gy for solid cancer mortality using Poisson regression methods with 95% confidence intervals (CIs) and P values based on likelihood ratio tests. Between 1950 and 2007, there were 2,303 solid cancer deaths. The linear ERR/Gy = 0.61 (95%; CI 0.04-1.27), P = 0.03. It is estimated that approximately 2% (49.7) of solid cancers deaths were associated with the radiation exposure. Our results, based on 2,303 solid cancer deaths and more than 50 years of follow-up, support an increased risk of solid cancer mortality following protracted radiation exposure from the Techa River contamination. The wide confidence interval of our estimate reflects the challenges of quantifying and describing the shape of the dose-response relationship in the low dose range. Nevertheless, the risk estimates provide important information concerning health risks from whole-body radiation exposure that can occur from accidents that result in wide-scale environmental contamination.
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Affiliation(s)
- S J Schonfeld
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
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21
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Akiba S. Cancer Risk Associated with Low-dose and Low-dose-rate Ionizing Radiation Exposure. Genes Environ 2013. [DOI: 10.3123/jemsge.2013.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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22
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Beyea J. DNA damage after continuous irradiation: findings in mice compared with human epidemiologic data. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:a383-a384. [PMID: 23026205 PMCID: PMC3491950 DOI: 10.1289/ehp.1205564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Kepros JP, Opreanu RC, Samaraweera R, Briningstool A, Morrison CA, Mosher BD, Schneider P, Stevens P. Whole body imaging in the diagnosis of blunt trauma, ionizing radiation hazards and residual risk. Eur J Trauma Emerg Surg 2012; 39:15-24. [PMID: 26814919 DOI: 10.1007/s00068-012-0201-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 06/06/2012] [Indexed: 02/06/2023]
Abstract
Ever since the introduction of radiographic imaging, its utility in identifying injuries has been well documented and was incorporated in the workup of injured patients during advanced trauma life support algorithms [American College of Surgeons, 8th ed. Chicago, 2008]. More recently, computerized tomography (CT) has been shown to be more sensitive than radiography in the diagnosis of injury. Due to the increased use of CT scanning, concerns were raised regarding the associated exposure to ionizing radiation [N Engl J Med 357:2277-2284, 2007]. During the last several years, a significant amount of research has been published on this topic, most of it being incorporated in the BEIR VII Phase 2 report, published by the National Research Council of the National Academies [National Academy of Sciences, Washington DC, 2006]. The current review will analyze the scientific basis for the concerns over the ionizing radiation associated with the use of CT scanning and will examine the accuracy of the typical advanced trauma life support work-up for diagnosis of injuries.
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Affiliation(s)
- J P Kepros
- Department of Surgery, College of Human Medicine, Michigan State University, 1215 East Michigan Avenue, Suite 655, Lansing, MI, 48912, USA. .,Trauma and Surgical Critical Care, Sparrow Hospital, Lansing, MI, USA.
| | - R C Opreanu
- Department of Surgery, College of Human Medicine, Michigan State University, 1215 East Michigan Avenue, Suite 655, Lansing, MI, 48912, USA.
| | - R Samaraweera
- Department of Radiology, Sparrow Hospital, Lansing, MI, USA
| | - A Briningstool
- Emergency Department, Sparrow Hospital, Lansing, MI, USA
| | - C A Morrison
- Department of Surgery, College of Human Medicine, Michigan State University, 1215 East Michigan Avenue, Suite 655, Lansing, MI, 48912, USA.,Trauma and Surgical Critical Care, Sparrow Hospital, Lansing, MI, USA
| | - B D Mosher
- Department of Surgery, College of Human Medicine, Michigan State University, 1215 East Michigan Avenue, Suite 655, Lansing, MI, 48912, USA.,Trauma and Surgical Critical Care, Sparrow Hospital, Lansing, MI, USA
| | - P Schneider
- Department of Surgery, College of Human Medicine, Michigan State University, 1215 East Michigan Avenue, Suite 655, Lansing, MI, 48912, USA.,Trauma and Surgical Critical Care, Sparrow Hospital, Lansing, MI, USA
| | - P Stevens
- Trauma and Surgical Critical Care, Sparrow Hospital, Lansing, MI, USA
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Lemburg SP, Roggenland D, Nicolas V, Heyer CM. Interventional radiology at the meetings of the German Radiological Society from 1998 to 2008: evaluation of structural changes and radiation issues. Insights Imaging 2012; 3:101-9. [PMID: 22696003 PMCID: PMC3292639 DOI: 10.1007/s13244-011-0138-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Revised: 10/11/2011] [Accepted: 10/19/2011] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES Evaluation of structural changes and the weight given to radiation exposure of interventional radiology (IR) contributions at the Congress of the German Radiological Association from 1998 to 2008. METHODS All IR abstracts were evaluated for type of contribution, design, imaging modality, and anatomic region. Weight given to radiation exposure was recorded as general statement, main topic and/or dose reduction. Statistical analysis included calculation of absolute/relative proportions of subgroups and ANOVA regression analyses. RESULTS Out of 9,436 abstracts, 1,728 (18%) were IR-related. IR abstracts significantly rose to a maximum of 200 (20%) in 2005 (P = 0.048). While absolute numbers of scientific contributions declined, educational contributions significantly increased (P = 0.003). Computed tomography (CT) and magnetic resonance imaging (MRI) were the main IR imaging modalities, with growing use of CT (P = 0.021). The main body regions were vessels (45%) and abdomen (31%). Radiation exposure was addressed as a general statement in 3% of abstracts, as a main topic in 2%, and for dose reduction in 1%, respectively. During the study interval a significant growth of dose reduction abstracts was observed (P = 0.016). CONCLUSIONS IR emerged as a growing specialty of radiology, with a significant increase in educational contributions. Radiation exposure was rarely in the focus of interest but contributions relating to dose reduction demonstrated a significant growth during the study period. Main Messages • Interventional radiology emerged as a growing specialty at the German radiological congress. • Significant increments of educational and prospective research contributions could be observed. • Despite a significant trend towards computed tomography, radiation exposure of IR was rarely in the focus of interest. • Contributions related to dose reduction demonstrated a significant growth during the study period.
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Affiliation(s)
- Stefan P Lemburg
- Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Ruhr-University of Bochum, Buerkle-de-la-Camp Platz 1, 44789, Bochum, Germany
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Cortical bone resorption rate in elderly persons: Estimates from long-term in vivo measurements of 90Sr in the skeleton. Arch Gerontol Geriatr 2012; 54:e411-8. [DOI: 10.1016/j.archger.2011.06.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 06/07/2011] [Accepted: 06/29/2011] [Indexed: 01/02/2023]
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Linet MS, Slovis TL, Miller DL, Kleinerman R, Lee C, Rajaraman P, Berrington de Gonzalez A. Cancer risks associated with external radiation from diagnostic imaging procedures. CA Cancer J Clin 2012; 62:75-100. [PMID: 22307864 PMCID: PMC3548988 DOI: 10.3322/caac.21132] [Citation(s) in RCA: 220] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The 600% increase in medical radiation exposure to the US population since 1980 has provided immense benefit, but increased potential future cancer risks to patients. Most of the increase is from diagnostic radiologic procedures. The objectives of this review are to summarize epidemiologic data on cancer risks associated with diagnostic procedures, describe how exposures from recent diagnostic procedures relate to radiation levels linked with cancer occurrence, and propose a framework of strategies to reduce radiation from diagnostic imaging in patients. We briefly review radiation dose definitions, mechanisms of radiation carcinogenesis, key epidemiologic studies of medical and other radiation sources and cancer risks, and dose trends from diagnostic procedures. We describe cancer risks from experimental studies, future projected risks from current imaging procedures, and the potential for higher risks in genetically susceptible populations. To reduce future projected cancers from diagnostic procedures, we advocate the widespread use of evidence-based appropriateness criteria for decisions about imaging procedures; oversight of equipment to deliver reliably the minimum radiation required to attain clinical objectives; development of electronic lifetime records of imaging procedures for patients and their physicians; and commitment by medical training programs, professional societies, and radiation protection organizations to educate all stakeholders in reducing radiation from diagnostic procedures.
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Affiliation(s)
- Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-7238, USA.
| | - Thomas L Slovis
- Chief, Pediatric Radiology, Department of Radiology, Children's Hospital of Michigan, Detroit, MI
| | - Donald L Miller
- Acting Chief, Diagnostic Devices Branch, Division of Mammography Quality and Radiation Program Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD
| | - Ruth Kleinerman
- Epidemiologist, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Choonsik Lee
- Investigator, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Preetha Rajaraman
- Investigator, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Amy Berrington de Gonzalez
- Senior Investigator, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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Boice JD. Radiation epidemiology: a perspective on Fukushima. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2012; 32:N33-N40. [PMID: 22395193 DOI: 10.1088/0952-4746/32/1/n33] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
For nearly 100 years, epidemiologic studies of human populations exposed to ionising radiation have provided quantitative information on health risks. High dose deterministic (tissue reaction) effects result when sufficient numbers of functioning cells are killed, such as in bone marrow depression that can lead to death. Lower dose stochastic effects are probabilistic in nature and include an increased risk of cancer later in life and heritable genetic defects, although genetic conditions in the children of irradiated parents have yet to be convincingly demonstrated. Radiation studies are of diverse populations and include not only the Japanese atomic bomb survivors, but also patients treated with radiation for malignant and non-malignant disease; patients exposed for diagnostic purposes; persons with intakes of radionuclides; workers occupationally exposed; and communities exposed to environmental and accidentally released sources of radiation. Much is known about radiation and its risks. The major unanswered question in radiation epidemiology, however, is not whether radiation causes cancer, but what the level of risk is following low dose (<100 mSv) or low dose rate exposures. Paracelsus is credited with first articulating that the 'poison is in the dose', which for radiation epidemiology translates as 'the lower the dose, the lower the risk' and, an important corollary, the lower the dose, the greater the difficulty in detecting any increase in the number of cancers possibly attributable to radiation. In contrast to the Chernobyl reactor accident, the Fukushima reactor accident has to date resulted in no deterministic effects and no worker deaths. Estimates to date of population doses suggest very low uptakes of radioactive iodine which was a major determinant of the epidemic of thyroid cancer following childhood exposures around Chernobyl. The estimates to date of population doses are also much lower (and the distribution much narrower) than the doses for which cancer excesses have been detected among atomic bomb survivors after 60 years of follow-up. Studies of populations exposed to low doses are also limited in their ability to account for important lifestyle factors, such as cigarette smoking and medical x-ray exposures, which could distort findings. Studies of the Fukushima population should be and are being considered for reassurance and health care reasons. Apart from as regards the extreme psychological stress caused by the horrific loss of life following the tsunami and the large-scale evacuation from homes and villages, such studies have limited to no chance of providing information on possible health risks following low dose exposures received gradually over time--the estimated doses (to date) are just too small.
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Affiliation(s)
- John D Boice
- Department of Medicine, Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt School of Medicine, Nashville, TN, USA.
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Cancer risks from low dose exposure to ionising radiation – Is the linear no-threshold model still relevant? Radiography (Lond) 2012. [DOI: 10.1016/j.radi.2011.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Degteva MO, Shagina NB, Vorobiova MI, Anspaugh LR, Napier BA. Reevaluation of waterborne releases of radioactive materials from the Mayak Production Association into the Techa River in 1949-1951. HEALTH PHYSICS 2012; 102:25-38. [PMID: 22134076 DOI: 10.1097/hp.0b013e318228159a] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Mayak Production Association was the first site for the production of weapons-grade plutonium in Russia. Early operations led to the waterborne release of radioactive materials into the small Techa River. Residents living downstream used river water for drinking and other purposes. The releases and subsequent flooding resulted in deposition of sediments along the shoreline and on floodplain soil. Primary routes of exposure were external dose from the deposited sediments and ingestion of 90Sr and other radionuclides. Study of the Techa River Cohort has revealed an increased incidence of leukemia and solid cancers. Epidemiologic studies are supported by extensive dose-reconstruction activities that have led to various versions of a Techa River Dosimetry System (TRDS). The correctness of the TRDS has been challenged by the allegation that releases of short-lived radionuclides were much larger than those used in the TRDS. Although the dosimetry system depends more upon measurements of 90Sr in humans and additional measurements of radionuclides and of exposure rates in the environment, a major activity has been undertaken to define more precisely the time-dependent rates of release and their radionuclide composition. The major releases occurred during 1950-1951 in the form of routine releases and major accidental releases. The reevaluated amount of total release is 114 PBq, about half of which was from accidents that occurred in late 1951. The time-dependent composition of the radionuclides released has also been reevaluated. The improved understanding presented in this paper is possible because of access to many documents not previously available.
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Affiliation(s)
- M O Degteva
- Urals Research Center for Radiation Medicine, Chelyabinsk, Russian Federation.
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Vozilova AV, Shagina NB, Degteva MO, Edwards AA, Ainsbury EA, Moquet JE, Hone P, Lloyd DC, Fomina JN, Darroudi F. Preliminary FISH-Based Assessment of External Dose for Residents Exposed on the Techa River. Radiat Res 2012; 177:84-91. [DOI: 10.1667/rr2485.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kleinerman R, Mabuchi K, Linet M. Research Symposium on Radiation and Cancer Honors Dr. Elaine Ron. Radiat Res 2011. [DOI: 10.1667/rrol03.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Tolstykh EI, Shagina NB, Degteva MO, Anspaugh LR, Napier BA. Does the cortical bone resorption rate change due to 90Sr-radiation exposure? Analysis of data from Techa Riverside residents. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2011; 50:417-430. [PMID: 21523463 DOI: 10.1007/s00411-011-0363-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 04/09/2011] [Indexed: 05/30/2023]
Abstract
The Mayak Production Association released large amounts of (90)Sr into the Techa River (Southern Urals, Russia) with peak amounts in 1950-1951. Techa Riverside residents ingested an average of about 3,000 kBq of (90)Sr. The (90)Sr-body burden of approximately 15,000 individuals has been measured in the Urals Research Center for Radiation Medicine in 1974-1997 with use of a special whole-body counter (WBC). Strontium-90 had mainly deposited in the cortical part of the skeleton by 25 years following intake, and (90)Sr elimination occurs as a result of cortical bone resorption. The effect of (90)Sr-radiation exposure on the rate of cortical bone resorption was studied. Data on 2,022 WBC measurements were selected for 207 adult persons, who were measured three or more times before they were 50-55 years old. The individual-resorption rates were calculated with the rate of strontium recirculation evaluated as 0.0018 year(-1). Individual absorbed doses in red bone marrow (RBM) and bone surface (BS) were also calculated. Statistically significant negative relationships of cortical bone resorption rate were discovered related to (90)Sr-body burden and dose absorbed in the RBM or the BS. The response appears to have a threshold of about 1.5-Gy RBM dose. The radiation-induced decrease in bone resorption rate may not be significant in terms of health. However, a decrease in bone remodeling rate can be among several causes of an increased level of degenerative dystrophic bone pathology in exposed persons.
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Affiliation(s)
- Evgenia I Tolstykh
- Urals Research Center for Radiation Medicine, Vorovskogo 68a, 454076, Chelyabinsk, Russian Federation.
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Ogata H. A review of some epidemiological studies on cancer risk from low-dose radiation or other carcinogenic agents. RADIATION PROTECTION DOSIMETRY 2011; 146:268-271. [PMID: 21715412 DOI: 10.1093/rpd/ncr167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
It is extremely difficult to assess cancer risks accurately due to health effects of low-dose radiation exposure or other carcinogens based on epidemiological studies. For the detection of minute increases of the risk at low-level exposure, most of epidemiological studies lack statistical power, and they involve various complicated confounding factors. This paper reports on a literature survey of epidemiological studies published since 2000 on cancer risks associated with low-dose radiation and other carcinogens to gather major epidemiological data. Integrated risk indices were derived from those data by using, where possible, statistical models. Regarding risk assessment of low-dose radiation exposure, it is important to lower the degree of uncertainty arising from risk estimation. Risk assessment of low-dose radiation exposure could be scientific evidence when uncertainty is considered in comparing carcinogenic risks of radiation with those of other carcinogens.
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Affiliation(s)
- Hiromitsu Ogata
- Center for Information Research, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama 351-0197, Japan.
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Tolstykh EI, Degteva MO, Peremyslova LM, Shagina NB, Shishkina EA, Krivoshchapov VA, Anspaugh LR, Napier BA. Reconstruction of long-lived radionuclide intakes for Techa riverside residents: strontium-90. HEALTH PHYSICS 2011; 101:28-47. [PMID: 21617390 DOI: 10.1097/hp.0b013e318206d0ff] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Releases of radioactive materials from the Mayak Production Association in 1949-1956 resulted in contamination of the Techa River; a nuclide of major interest was 90Sr, which downstream residents consumed with water from the river and with milk contaminated by cows' consumption of river water and contaminated pasture. Over the years, several reconstructions of dose have been performed for the approximately 30,000 persons who make up the Extended Techa River Cohort. The purpose of the study described here was to derive a revised reference-90Sr-intake function for the members of this cohort. The revision was necessary because recently discovered data have provided a more accurate description of the time course of the releases, and more is now known about the importance of the pasture grass-cow-milk pathway for the members of this cohort. The fundamental basis for the derivation of the reference-90Sr-intake function remains the same: thousands of measurements of 90Sr content in bone with a special whole-body counter, thousands of measurements of beta-activity of front teeth with a special tooth-beta counter, and a variety of other measurements, including post mortem measurements of 90Sr in bone, measurements of 90Sr in cow's milk, and measurements of beta activity in human excreta. Results of the new analyses are that the major intake started in September 1950 and peaked somewhat later than originally postulated. However, the total intake for adult residents has not changed significantly. For children of some birth years, the intake and incorporation of Sr in bone tissue have changed substantially.
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Affiliation(s)
- E I Tolstykh
- Urals Research Center for Radiation Medicine, Vorovskogo 68 a, 454076 Chelyabinsk, Russian Federation.
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Felter SP, Conolly RB, Bercu JP, Bolger PM, Boobis AR, Bos PMJ, Carthew P, Doerrer NG, Goodman JI, Harrouk WA, Kirkland DJ, Lau SS, Llewellyn GC, Preston RJ, Schoeny R, Schnatter AR, Tritscher A, van Velsen F, Williams GM. A proposed framework for assessing risk from less-than-lifetime exposures to carcinogens. Crit Rev Toxicol 2011; 41:507-44. [DOI: 10.3109/10408444.2011.552063] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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36
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Shore RE. Implications of radiation epidemiologic data for risk assessment and radiation protection. HEALTH PHYSICS 2011; 100:306-308. [PMID: 21595078 DOI: 10.1097/hp.0b013e3182050493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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37
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Cumulative Effective Dose Associated With Radiography and CT of Adolescents With Spinal Injuries. AJR Am J Roentgenol 2010; 195:1411-7. [DOI: 10.2214/ajr.10.4616] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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38
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Preston DL, Krestinina LY, Sokolnikov ME, Ron E, Davis FG, Ostroumova EV, Gilbert ES. How much can we say about site-specific cancer radiation risks? Radiat Res 2010; 174:816-24. [PMID: 21128806 DOI: 10.1667/rr2024.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Studies of Mayak workers and people who lived along the Techa River have demonstrated significant associations between low-dose-rate radiation exposure and increased solid cancer risk. It is of interest to use the long-term follow-up data from these cohorts to describe radiation effects for specific types of cancer; however, statistical variability in the site-specific risk estimates is large. The goal of this work is to describe this variability and provide Bayesian adjusted risk estimates. We assume that the site-specific estimates can be viewed as a sample from some underlying distribution and use Bayesian methods to produce adjusted excess relative risk per gray estimates in the Mayak and Techa River cohorts. The impact of the adjustment is compared to that seen in similar analyses in the atomic bomb survivors. Site-specific risk estimates in the Mayak and Techa River cohorts have large uncertainties. Unadjusted estimates vary from implausibly large decreases to large increases, with a range that greatly exceeds that found in the A-bomb survivors. The Bayesian adjustment markedly reduced the range of the site-specific estimates for the Techa River and Mayak studies. The extreme variability in the site-specific risk estimates is largely a consequence of the small number of excess cases. The adjusted estimates provide a useful perspective on variation in the actual risks. However, additional work on interpretation of the adjusted estimates, extension of the methods used in describing effect modification, and making more use of prior knowledge is needed to make these methods useful.
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Affiliation(s)
- D L Preston
- Hirosoft International, Eureka, California, USA.
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Eidemüller M, Ostroumova E, Krestinina L, Epiphanova S, Akleyev A, Jacob P. Comparison of mortality and incidence solid cancer risk after radiation exposure in the Techa River Cohort. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2010; 49:477-490. [PMID: 20461395 DOI: 10.1007/s00411-010-0289-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Accepted: 04/17/2010] [Indexed: 05/29/2023]
Abstract
In the present paper, analysis of solid cancer mortality and incidence risk after radiation exposure in the Techa River Cohort in the Southern Urals region of Russia is described. Residents along the Techa River received protracted exposure to ionizing radiation in the 1950s due to the releases of radioactive materials from the Mayak Production Association. The current follow-up through December 2003 includes individuals exposed on the Techa riverside within the Chelyabinsk and Kurgan oblasts using mortality data, and within the Chelyabinsk oblast using incidence data. The analysis was performed by means of the biologically based two-stage clonal expansion (TSCE) model and conventional excess relative risk models. For the mortality and incidence cohorts, central estimates of the excess relative risk per dose of 0.85 Gy(-1) (95% CI 0.36; 1.38) and 0.91 Gy(-1) (95% CI 0.35; 1.52) were found, respectively. For both the mortality and incidence cohorts, the best description of the radiation risk was achieved with the same TSCE model including a lifelong radiation effect on the promotion rate of initiated cells. An increase in the excess risk with attained age was observed, whereas no significant change of risk with age at exposure was seen. Direct comparison of the mortality and incidence cohorts showed that the excess relative risk estimates agreed very well in both cohorts, as did the excess absolute risk and the hazard after correction for the different background rates.
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Affiliation(s)
- M Eidemüller
- Helmholtz Zentrum München, Institute of Radiation Protection, 85764 Neuherberg, Germany.
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40
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Dauer LT, Brooks AL, Hoel DG, Morgan WF, Stram D, Tran P. Review and evaluation of updated research on the health effects associated with low-dose ionising radiation. RADIATION PROTECTION DOSIMETRY 2010; 140:103-136. [PMID: 20413418 DOI: 10.1093/rpd/ncq141] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
While radiation health risks at low doses have traditionally been estimated from high-dose studies, we have reviewed recent literature and concluded that the mechanisms of action for many biological endpoints may be different at low doses from those observed at high doses; that acute doses <100 mSv may be too small to allow epidemiological detection of excess cancers given the background of naturally occurring cancers; that low-dose radiation research should use holistic approaches such as systems-based methods to develop models that define the shape of the dose-response relationship; and that these results should be combined with the latest epidemiology to produce a comprehensive understanding of radiation effects that addresses both damage, likely with a linear effect, and response, possibly with non-linear consequences. Continued research is needed to understand how radiobiology and epidemiology advances should be used to effectively model radiation worker risks.
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Affiliation(s)
- Lawrence T Dauer
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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41
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Boice JD, Hendry JH, Nakamura N, Niwa O, Nakamura S, Yoshida K. Low-Dose-Rate Epidemiology of High Background Radiation Areas. Radiat Res 2010; 173:849-54. [DOI: 10.1667/rr2161.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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42
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Krestinina L, Preston DL, Davis FG, Epifanova S, Ostroumova E, Ron E, Akleyev A. Leukemia incidence among people exposed to chronic radiation from the contaminated Techa River, 1953-2005. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2010; 49:195-201. [PMID: 20012750 PMCID: PMC6276792 DOI: 10.1007/s00411-009-0257-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Accepted: 11/26/2009] [Indexed: 05/05/2023]
Abstract
Beginning in 1950, people living on the banks of the Techa River received chronic low-dose-rate internal and external radiation exposures as a result of releases from the Mayak nuclear weapons plutonium production facility in the Southern Urals region of the Russian Federation. The Techa River cohort includes about 30,000 people who resided in riverside villages sometime between 1950 and 1960. Cumulative red bone marrow doses range up to 2 Gy with a mean of 0.3 Gy and a median of 0.2 Gy. Between 1953 and 2005, 93 first primary cases of leukemia, including 23 cases of chronic lymphatic leukemia (CLL), were ascertained among the cohort members. A significant linear dose-response relationship was seen for leukemias other than CLL (P < 0.001), but not for CLL. The estimated excess relative risk per Gy is 4.9 (95% confidence interval (CI): 1.6; 14.3) for leukemias other than CLL and less than 0 (95% upper bound 1.4) for CLL.
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Affiliation(s)
- Lyudmila Krestinina
- Urals Research Center for Radiation Medicine, 68-a, Vorovsky St., 454076, Chelyabinsk, Russia.
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Jacob P, Rühm W, Walsh L, Blettner M, Hammer G, Zeeb H. Is cancer risk of radiation workers larger than expected? Occup Environ Med 2009; 66:789-96. [PMID: 19570756 PMCID: PMC2776242 DOI: 10.1136/oem.2008.043265] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2009] [Indexed: 11/03/2022]
Abstract
Occupational exposures to ionising radiation mainly occur at low-dose rates and may accumulate effective doses of up to several hundred milligray. The objective of the present study is to evaluate the evidence of cancer risks from such low-dose-rate, moderate-dose (LDRMD) exposures. Our literature search for primary epidemiological studies on cancer incidence and mortality risks from LDRMD exposures included publications from 2002 to 2007, and an update of the UK National Registry for Radiation Workers study. For each (LDRMD) study we calculated the risk for the same types of cancer among the atomic bomb survivors with the same gender proportion and matched quantities for dose, mean age attained and mean age at exposure. A combined estimator of the ratio of the excess relative risk per dose from the LDRMD study to the corresponding value for the atomic bomb survivors was 1.21 (90% CI 0.51 to 1.90). The present analysis does not confirm that the cancer risk per dose for LDRMD exposures is lower than for the atomic bomb survivors. This result challenges the cancer risk values currently assumed for occupational exposures.
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Affiliation(s)
- P Jacob
- Hemholtz Zentrum München, Institute of Radiation Protection, D-85764 Neuherberg, Germany.
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Abstract
Although the Japanese atomic bomb study and radiotherapy studies have clearly documented cancer risks from high-dose radiation exposures, radiation risk assessment groups have long recognized that protracted or low exposures to low-linear energy transfer radiations are key radiation protection concerns because these are far more common than high-exposure scenarios. Epidemiologic studies of human populations with low-dose or low dose-rate exposures are one approach to addressing those concerns. A number of large studies of radiation workers (Chernobyl clean-up workers, U.S. and Chinese radiological technologists, and the 15-country worker study) or of persons exposed to environmental radiation at moderate to low levels (residents near Techa River, Semipalatinsk, Chernobyl, or nuclear facilities) have been conducted. A variety of studies of medical radiation exposures (multiple-fluoroscopy, diagnostic (131)I, scatter radiation doses from radiotherapy, etc.) also are of interest. Key results from these studies are summarized and compared with risk estimates from the Japanese atomic bomb study. Ideally, one would like the low-dose and low dose-rate studies to guide radiation risk estimation regarding the shape of the dose-response curve, DDREF (dose and dose-rate effectiveness factor), and risk at low doses. However, the degree to which low-dose studies can do so is subject to various limitations, especially those pertaining to dosimetric uncertainties and limited statistical power. The identification of individuals who are particularly susceptible to radiation cancer induction also is of high interest in terms of occupational and medical radiation protection. Several examples of studies of radiation-related cancer susceptibility are discussed, but none thus far have clearly identified radiation-susceptible genotypes.
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Affiliation(s)
- Roy E Shore
- Radiation Effects Research Foundation, 5-2 Hijiyama Koen, Minami-ku, Hiroshima 732-0815, Japan.
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Locke PA. Incorporating information from the U.S. Department of Energy low-dose program into regulatory decision-making: three policy integration challenges. HEALTH PHYSICS 2009; 97:510-515. [PMID: 19820461 DOI: 10.1097/hp.0b013e3181b18737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The U.S. Department of Energy (U.S. DOE) sponsors a research program aimed at gaining a better understanding of how low-dose radiation affects cellular functioning and progression toward disease. There have been calls to incorporate into regulatory decision-making the scientific information that this program has produced. After a discussion of the evolution of radiation protection law and the weight-of-evidence approach that agencies employ, this paper offers some preliminary thoughts about how to approach this complex and important policy question. Three implementation challenges are identified and discussed. The first implementation challenge involves explaining low-dose effects in a systems biology model. The second challenge arises when issues of population susceptibility are juxtaposed against molecular and mechanistic studies, such as those that make up much of the U.S. DOE low-dose program. The third challenge concerns integrating the results of radiation epidemiology, especially epidemiologic studies among cohorts that are exposed to low dose and low-dose rate radiation, with the results of U.S. DOE low-dose studies.
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Affiliation(s)
- Paul A Locke
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room W7032G, Baltimore, MD 21205, USA.
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Abstract
PURPOSE Epidemiologic studies of persons exposed to ionising radiation offer a wealth of information on cancer risks in humans. The Life Span Study cohort of Japanese A-bomb survivors, a large cohort that includes all ages and both sexes with a wide range of well-characterised doses, is the primary resource for estimating carcinogenic risks from low linear energy transfer external exposure. Extensive data on persons exposed for therapeutic or diagnostic medical reasons offer the opportunity to study fractionated exposure, risks at high therapeutic doses, and risks of site-specific cancers in non-Japanese populations. Studies of persons exposed for occupational and environmental reasons allow a direct evaluation of exposure at low doses and dose rates, and also provide information on different types of radiation such as radon and iodine-131. This article summarises the findings from these studies with emphasis on studies with well-characterised doses. CONCLUSIONS Epidemiologic studies provide the necessary data for quantifying cancer risks as a function of dose and for setting radiation protection standards. Leukaemia and most solid cancers have been linked with radiation. Most solid cancer data are reasonably well described by linear-dose response functions although there may be a downturn in risks at very high doses. Persons exposed early in life have especially high relative risks for many cancers, and radiation-related risk of solid cancers appears to persist throughout life.
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Affiliation(s)
- Ethel S Gilbert
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland 20892, USA.
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Current utilization and radiation dose from computed tomography in patients with trauma*. Crit Care Med 2009; 37:1336-40. [DOI: 10.1097/ccm.0b013e31819d6739] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Breast cancer incidence following low-dose rate environmental exposure: Techa River Cohort, 1956-2004. Br J Cancer 2008; 99:1940-5. [PMID: 19002173 PMCID: PMC2600704 DOI: 10.1038/sj.bjc.6604775] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
In the 1950s, the Mayak nuclear weapons facility in Russia discharged liquid radioactive wastes into the Techa River causing exposure of riverside residents to protracted low-to-moderate doses of radiation. Almost 10,000 women received estimated doses to the stomach of up to 0.47 Gray (Gy) (mean dose=0.04 Gy) from external gamma-exposure and (137)Cs incorporation. We have been following this population for cancer incidence and mortality and as in the general Russian population, we found a significant temporal trend of breast cancer incidence. A significant linear radiation dose-response relationship was observed (P=0.01) with an estimated excess relative risk per Gray (ERR/Gy) of 5.00 (95% confidence interval (CI), 0.80, 12.76). We estimated that approximately 12% of the 109 observed cases could be attributed to radiation.
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Degteva MO, Bougrov NG, Vorobiova MI, Jacob P, Yeter Göksu H. Evaluation of anthropogenic dose distribution amongst building walls at the Metlino area of the upper Techa River region. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2008; 47:469-479. [PMID: 18648838 DOI: 10.1007/s00411-008-0183-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2008] [Accepted: 07/06/2008] [Indexed: 05/26/2023]
Abstract
This paper presents the results of an effort to evaluate anthropogenic doses in bricks from old buildings located on the banks of the Techa River. The river area was contaminated in 1949-1956 as a result of radioactive waste releases by the Mayak plutonium facility (Southern Urals, Russia). Absorbed doses were determined by luminescence measurements of quartz extracted from the near-surface layers of bricks sampled in 1991-1997 from three remained buildings (a mill, a granary and a church). These buildings are located in the former residence area of Metlino, which was the settlement located closest to the release site (residents of Metlino were relocated from the contaminated river in 1956). The measured anthropogenic dose in the three buildings was found to be comparable: minimum values were equal to 0.5-0.9 Gy and maximum values amounted to about 3-4 Gy. Unfortunately, the geometry of gamma-exposure of the brick samples changed significantly in 1956 as a result of creation of an artificial reservoir downstream of the Metlinsky pond. Since luminescence data provide absorbed dose in the investigated samples accumulated over the whole period of irradiation, for interpretation of the data obtained it is important to know the exposure geometry for the period of maximal exposure, which was in the early 1950s. In 2005, archival data describing configuration of contaminated water streams and shorelines (which were the main sources of gamma-irradiation) were published. Comparison of these data with the results of the luminescence study presented here showed that the bricks with the highest thermoluminescence (TL)-based doses faced contaminated shores and were located close to them. In contrast, the bricks with lower values of measured dose were opposite to contaminated shores and/or being shielded. This demonstrates that the luminescence method allowed reconstruction of the anthropogenic dose distribution in the former settlement center. The obtained results suggest new options for further luminescence studies in Metlino aimed at the reconstruction of the external exposures of the affected population.
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Affiliation(s)
- Marina O Degteva
- Urals Research Center for Radiation Medicine, 68-a Vorovsky Street, 454076 Chelyabinsk, Russia.
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50
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Puskin JS. Response to Dr. Simmons. Radiat Res 2008. [DOI: 10.1667/rr1391b.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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