Electron paramagnetic resonance and fluorescence in situ hybridization-based investigations of individual doses for persons living at Metlino in the upper reaches of the Techa River

A comparative validation of biodosimetry and physical dosimetry techniques for possible triage applications in emergency dosimetry

Large-scale radiological accidents or nuclear terrorist incidents involving radiological or nuclear materials can potentially expose thousands, or hundreds of thousands, of people to unknown radiation doses, requiring prompt dose reconstruction for appropriate triage. Two types of dosimetry methods namely, biodosimetry and physical dosimetry are currently utilized for estimating absorbed radiation dose in humans. Both methods have been tested separately in several inter-laboratory comparison exercises, but a direct comparison of physical dosimetry with biological dosimetry has not been performed to evaluate their dose prediction accuracies. The current work describes the results of the direct comparison of absorbed doses estimated by physical (smartphone components) and biodosimetry (dicentric chromosome assay (DCA) performed in human peripheral blood lymphocytes) methods. For comparison, human peripheral blood samples (biodosimetry) and different components of smartphones, namely surface mount resistors (SMRs), inductors and protective glasses (physical dosimetry) were exposed to different doses of photons (0-4.4 Gy; values refer to dose to blood after correction) and the absorbed radiation doses were reconstructed by biodosimetry (DCA) and physical dosimetry (optically stimulated luminescence (OSL)) methods. Additionally, LiF:Mg,Ti (TLD-100) chips and Al₂O₃:C (Luxel) films were used as reference TL and OSL dosimeters, respectively. The best coincidence between biodosimetry and physical dosimetry was observed for samples of blood and SMRs exposed toγ-rays. Significant differences were observed in the reconstructed doses by the two dosimetry methods for samples exposed to x-ray photons with energy below 100 keV. The discrepancy is probably due to the energy dependence of mass energy-absorption coefficients of the samples extracted from the phones. Our results of comparative validation of the radiation doses reconstructed by luminescence dosimetry from smartphone components with biodosimetry using DCA from human blood suggest the potential use of smartphone components as an effective emergency triage tool for high photon energies.

Strengths and Weaknesses of Dosimetry Used in Studies of Low-Dose Radiation Exposure and Cancer

BACKGROUND

A monograph systematically evaluating recent evidence on the dose-response relationship between low-dose ionizing radiation exposure and cancer risk required a critical appraisal of dosimetry methods in 26 potentially informative studies.

METHODS

The relevant literature included studies published in 2006-2017. Studies comprised case-control and cohort designs examining populations predominantly exposed to sparsely ionizing radiation, mostly from external sources, resulting in average doses of no more than 100 mGy. At least two dosimetrists reviewed each study and appraised the strengths and weaknesses of the dosimetry systems used, including assessment of sources and effects of dose estimation error. An overarching concern was whether dose error might cause the spurious appearance of a dose-response where none was present.

RESULTS

The review included 8 environmental, 4 medical, and 14 occupational studies that varied in properties relative to evaluation criteria. Treatment of dose estimation error also varied among studies, although few conducted a comprehensive evaluation. Six studies appeared to have known or suspected biases in dose estimates. The potential for these biases to cause a spurious dose-response association was constrained to three case-control studies that relied extensively on information gathered in interviews conducted after case ascertainment.

CONCLUSIONS

The potential for spurious dose-response associations from dose information appeared limited to case-control studies vulnerable to recall errors that may be differential by case status. Otherwise, risk estimates appeared reasonably free of a substantial bias from dose estimation error. Future studies would benefit from a comprehensive evaluation of dose estimation errors, including methods accounting for their potential effects on dose-response associations.

Retrospective biodosimetry techniques: Focus on cytogenetics assays for individuals exposed to ionizing radiation

In the absence of physical data, biodosimetry tools are required for fast dose and risk assessment in the event of radiological or nuclear mass accidents or attacks to triage exposed humans and take immediate medical countermeasures. Biodosimetry tools have mostly been developed for retrospective dose assessment and the follow-up of victims of irradiation. Among them, cytogenetics analyses, to reveal chromosome damage, are the most developed and allow the determination of doses from blood samples as low as 100 mGy. Various cytogenetic tests have already allowed retrospective dose assessment of Chernobyl liquidators and military personnel exposed to nuclear tests after decades. In this review, we discuss the properties of various biodosimetry techniques, such as their sensitivity and limitations as a function of the time from exposure, using multiple examples of nuclear catastrophes or working exposure. Among them, chromosome FISH hybridization, which reveals chromosome translocations, is the most reliable due to the persistence of translocations for decades, whereas dicentric chromosome and micronuclei assays allow rapid and accurate dose assessment a short time after exposure. Both need to be adjusted through mathematical algorithms for retrospective analyses, accounting for the time since exposure and the victims' age. The goal for the future will be to better model chromosome damage, reduce the time to result, and develop new complementary biodosimetry approaches, such as mutation signatures.

Local bone-marrow exposure: how to interpret the data on stable chromosome aberrations in circulating lymphocytes? (some comments on the use of FISH method for dose reconstruction for Techa riverside Residents)

The method of fluorescence in situ hybridization (FISH) applied to peripheral blood T lymphocytes is used for retrospective dose estimation, and the results obtained from the analysis of stable chromosomal aberrations are usually interpreted as a dose accumulated in the red bone marrow (RBM). However, after local internal exposure of the RBM, doses derived from FISH were found to be lower than those derived from direct measurements of radionuclides accumulated in the bodies of exposed persons. These results were obtained for people residing near the Techa River contaminated by ^89,90Sr (beta-emitters) in 1949-1956 (Chelyabinsk Oblast, Russia). A new analysis has been performed of the combined results of FISH studies (n = 178) undertaken during 1994-2012 for persons living on the Techa Riverside. Analysis confirms the lower slope of the translocation yield per Gy (8.0 ± 0.7 × 10^-3) for Techa residents in comparison with FISH data for donors with external exposures (11.6 ± 1.6 × 10^-3, Tawn et al., Radiat Res 184(3):296-303, 2015). It was suggested that some portion of T cells remained unexposed, because they represented the descendants of T cell progenitors, which had migrated to the thymus before the start of ^89,90Sr intakes. To clarify this problem, the dynamics of T-cell Genera (TG), combining all descendants of specific T-cell progenitor reaching the thymus, was considered. Rates of TGs produced by RBM over different age periods of human life were estimated with the use of the mathematic model of T-cell homeostasis (Bains, Mathematical modeling of T-cell homeostasis. A thesis submitted for the degree of Doctor of Philosophy of the University College London. http://discovery.ucl.ac.uk/20159/1/20159.pdf , 2010). The rate of TG loss during the lifetime was assumed to be very small in comparison with production rate. The recirculation of mature T lymphocytes in contaminated RBM was taken into account. According to our model estimates, at the time of blood sampling, the fraction of exposed T lymphocytes (whose progenitors were irradiated) ranged from 20 to 80% depending on the donors' age at the start of exposure to ^89,90Sr. Dose to T lymphocytes, estimated from FISH studies, should be about 0.6-0.9 of RBM dose for residents of the upper Techa region and about 0.4-0.8 in the middle Techa region. Our results could explain the lower value of translocation yield per Gy obtained for Techa residents. The approaches for further model improvement and validation are discussed in this paper.

External dose reconstruction in tooth enamel of Techa riverside residents

This study summarizes the 20-year efforts for dose reconstruction in tooth enamel of the Techa riverside residents exposed to ionizing radiation as a result of radionuclide releases into the river in 1949-1956. It represents the first combined analysis of all the data available on EPR dosimetry with teeth of permanent residents of the Techa riverside territory. Results of electron paramagnetic resonance (EPR) measurements of 302 teeth donated by 173 individuals living permanently in Techa riverside settlements over the period of 1950-1952 were analyzed. These people were residents of villages located at the free-flowing river stream or at the banks of stagnant reservoirs such as ponds or blind river forks. Cumulative absorbed doses measured using EPR are from several sources of exposure, viz., background radiation, internal exposure due to bone-seeking radionuclides (⁸⁹Sr, ⁹⁰Sr/⁹⁰Y), internal exposure due to ¹³⁷Cs/^137mBa incorporated in soft tissues, and anthropogenic external exposure. The purpose of the present study was to evaluate the contribution of different sources of enamel exposure and to deduce external doses to be used for validation of the Techa River Dosimetry System (TRDS). Since various EPR methods were used, harmonization of these methods was critical. Overall, the mean cumulative background dose was found to be 63 ± 47 mGy; cumulative internal doses due to ⁸⁹Sr and ⁹⁰Sr/⁹⁰Y were within the range of 10-110 mGy; cumulative internal doses due to ¹³⁷Cs/^137mBa depend on the distance from the site of releases and varied from 1 mGy up to 90 mGy; mean external doses were maximum for settlements located at the banks of stagnant reservoirs (~500 mGy); in contrast, external doses for settlements located along the free-flowing river stream did not exceed 160 mGy and decreased downstream with increasing distance from the site of release. External enamel doses calculated using the TRDS code and derived from the EPR measurements were found to be in good agreement.

FISH analysis of translocations induced by chronic exposure to Sr radioisotopes: second set of analysis of the Techa River Cohort

Fluorescent in situ hybridisation analysis of stable translocations was performed for 26 residents living along the Techa River (Russia), who were predominantly (95%) exposed to ingested strontium radioisotopes ((89)Sr and (90)Sr) resulting in exposure of their red bone marrow (RBM). Analysis was conducted at the Urals Research Center for Radiation Medicine, Public Health England and Leiden University Medical Center. Each laboratory scored 1000 cells per donor, which resulted in ∼1000 genome equivalents (GE) per donor. The age-dependent spontaneous level of translocations for each donor was evaluated on the basis of data published by Sigurdson et al. (International study of factors affecting human chromosome. Mutat. Res. 2008;652: :112-121). Reconstruction of doses was performed with the 'Techa River Dosimetry System' developed in 2009. In the studied donors, the range of individual cumulated RBM dose was from 0.3 to 3.7 Gy. Analysis of the yield of stable translocations dependent on the individual RBM dose from (89,90)Sr showed a linear dose-response relationship of 0.007 ± 0.002 translocation/GE cell/Gy (R = 0.61, p = 0.001). This set of results was in a good agreement with the previous data reported for 18 donors by Vozilova et al. (Preliminary FISH-based assessment of external dose for residents exposed on the Techa River.

What radiation dose does the FISH translocation assay measure in cases of incorporated radionuclides for the Southern Urals populations?

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.

Concentrations of 90Sr in the tooth tissues 60 years after intake: results of TL measurements and applications for Techa River dosimetry

This article focuses on the study of (90)Sr in the tooth tissues of Techa riverside residents 60 years after intake. The Techa River was contaminated by radioactive wastes in the 1950s. Contamination of the river system, including water, bottom sediment, floodplain soil, and grass, depended on the distance from the source of releases. Therefore, the average (90)Sr intake was different in different settlements located downstream the river. An additional factor influencing (90)Sr accumulation in the teeth is the rate of tissue mineralization at the time of intake which depended on the donor's age at the time of releases. Measurements of (90)Sr concentration in various dental tissues (enamel, crown, and root dentin) of 166 teeth were performed about 60 years after the main intake using the method of thermoluminescence passive beta detection. The paper presents the current levels of tooth tissue contamination, and the tooth-to-tooth variability of (90)Sr concentration in tooth tissues was assessed for the tissues which were matured at the time of massive liquid radioactive waste releases into the Techa River. A model describing the expected levels of (90)Sr in matured dental tissues depending on age and intake has been elaborated for the population under study. The results obtained will be used for calculation of internal dose in enamel and for interpretation of tooth doses measured by means of the electron paramagnetic resonance method, among the population of the Techa River region.

Chronic radioisotope effects on residents of the Techa River (Russia) region: cytogenetic analysis more than 50 years after onset of exposure

This paper presents the results of a cytogenetic study conducted among residents of the Techa Riverside communities (Southern Urals, Russia) exposed in the early 1950s as a result of releases of liquid radioactive wastes from the Mayak plutonium-production facility. The study was performed 50-60 years after the beginning of the exposure for those individuals who were predominantly exposed to strontium radioisotopes ((89,90)Sr) through drinking contaminated river water and consumption of local foodstuff. Standard cytogenetic methods were used for evaluation of the frequency of unstable chromosome aberrations in exposed persons as well as in persons from the control group who were of similar age and sex, living in similar socio-economic conditions in non-contaminated territories of the Southern Urals. The exposure doses were reconstructed for the studied donors using the Techa River Dosimetry System developed in 2009. The doses of internal exposure from ingested radionuclides were evaluated using individual or family in vivo measurements of (90)Sr-body burden. Individual cumulative absorbed doses in red bone marrow (RBM) in the studied persons varied in the range of 0.01-4.4Gy. A significantly higher level of unstable chromosome aberrations (UCA) in T-cells was observed in the group of exposed individuals as compared to control group. The highest UCA level was detected in the individuals who were suspected of having chronic radiation syndrome.

Review of reconstruction of radiation incident air kerma by measurement of absorbed dose in tooth enamel with EPR

Electron paramagnetic resonance dosimetry with tooth enamel has been proved to be a reliable method to determine retrospectively exposures from photon fields with minimal detectable doses of 100 mGy or lower, which is lower than achievable with cytogenetic dose reconstruction methods. For risk assessment or validating dosimetry systems for specific radiation incidents, the relevant dose from the incident has to be calculated from the total absorbed dose in enamel by subtracting additional dose contributions from the radionuclide content in teeth, natural external background radiation and medical exposures. For calculating organ doses or evaluating dosimetry systems the absorbed dose in enamel from a radiation incident has to be converted to air kerma using dose conversion factors depending on the photon energy spectrum and geometry of the exposure scenario. This paper outlines the approach to assess individual dose contributions to absorbed dose in enamel and calculate individual air kerma of a radiation incident from the absorbed dose in tooth enamel.

EPR dosimetry with tooth enamel: A review

When tooth enamel is exposed to ionizing radiation, radicals are formed, which can be detected using electron paramagnetic resonance (EPR) techniques. EPR dosimetry using tooth enamel is based on the (presumed) correlation between the intensity or amplitude of some of the radiation-induced signals with the dose absorbed in the enamel. In the present paper a critical review is given of this widely applied dosimetric method. The first part of the paper is fairly fundamental and deals with the main properties of tooth enamel and some of its model systems (e.g., synthetic apatites). Considerable attention is also paid to the numerous radiation-induced and native EPR signals and the radicals responsible for them. The relevant methods for EPR detection, identification and spectrum analyzing are reviewed from a general point of view. Finally, the needs for solid-state modelling and studies of the linearity of the dose response are investigated. The second part is devoted to the practical implementation of EPR dosimetry using enamel. It concerns specific problems of preparation of samples, their irradiation and spectrum acquisition. It also describes how the dosimetric signal intensity and dose can be retrieved from the EPR spectra. Special attention is paid to the energy dependence of the EPR response and to sources of uncertainties. Results of and problems encountered in international intercomparisons and epidemiological studies are also dealt with. In the final section the future of EPR dosimetry with tooth enamel is analyzed.

Evaluation of anthropogenic dose distribution amongst building walls at the Metlino area of the upper Techa River region

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.

Minisatellite germline mutation rate in the Techa River population

Germline mutation at eight minisatellite loci has been studied among the irradiated families from the Techa River population and non-exposed families from the rural area of the Chelyabinsk and Kurgan Oblasts. The groups were matched by ethnicity, parental age, occupation and smoking habit. A statistically significant 1.7-fold increase in mutation rate was found in the germline of irradiated fathers, whereas maternal germline mutation rate in the exposed families was not elevated. Most of the minisatellite loci showed an elevated paternal mutation rate in the exposed group, indicating a generalised increase in minisatellite germline mutation rate in the Techa River population. These data suggest that the elevated minisatellite mutation rate can be attributed to radioactive exposure. The spectra of paternal mutation seen in the unexposed and exposed families were indistinguishable.

Development of an Improved Dose Reconstruction System for the Techa River Population Affected by the Operation of the Mayak Production Association

The Techa River Dosimetry System (TRDS) has been developed to provide estimates of dose received by approximately 30,000 members of the Extended Techa River Cohort (ETRC). Members of the ETRC were exposed beginning in 1949 to significant levels of external and internal (mainly from (90)Sr) dose but at low to moderate dose rates. Members of this cohort are being studied in an effort to test the hypothesis that exposure at low to moderate dose rates has the same ability to produce stochastic health effects as exposure at high dose rates. The current version of the TRDS is known as TRDS-2000 and is the subject of this paper. The estimated doses from (90)Sr are supported strongly by approximately 30,000 measurements made with a tooth beta-particle counter, measurements of bones collected at autopsy, and approximately 38,000 measurements made with a special whole-body counter that detects the bremsstrahlung from (90)Y. The median doses to the red bone marrow and the bone surface are 0.21 and 0.37 Gy, respectively. The maximum doses to the red bone marrow and bone surface are 2.0 and 5.2 Gy, respectively. Distributions of dose to other organs are provided and are lower than the values given above. Directions for future work are discussed.

Report from the techa river dosimetry review workshop held on 8-10 December 2003 at The State Research Centre Institute of Biophysics, Moscow, Russia

Large releases of fission products into the Techa River, in the Southern Urals, occurred in 1950 and 1951, during the early years of operation of the Mayak Production Association (Mayak PA), which produced plutonium for nuclear weapons. Increases of leukemia and of solid cancers with radiation dose have been noted in the population of about 30,000 people who lived in the settlements downstream of the site of the radioactive releases; that population has been studied for several decades by Russian scientists, notably in the framework of cooperation with American and European scientists. The radiation doses are currently estimated by means of the Techa River Dosimetry System-2000 (TRDS-2000). Recently, a scientist from Mayak PA has suggested in several publications that the doses calculated using TRDS-2000 might be underestimated substantially. A special international Workshop, held in Moscow on 8-10 December 2003, aimed to resolve some of the pressing issues related to the determination of the external and internal doses received by the Techa River population and to give recommendations on the further development of methodologies used for dose reconstruction. The authors of this article were selected by the organizers of the Workshop to draw the conclusions of the meeting. They express the view that, while the dose reconstruction system TRDS-2000 is basically sound, additional work is needed and the results of any epidemiological studies making use of TRDS-2000 should be qualified as preliminary, pending resolution of several issues. The most important of these issues is the re-evaluation of the activities released, using additional information that could be obtained with the help of Mayak experts. Other specific suggestions aiming to improve the dose reconstruction methodology for the Techa River cohort, i.e., continued measurements of accumulated dose in environmental samples and human tissues, validation of external dose estimates with thermoluminescence measurements of bricks and with electron paramagnetic resonance measurements of teeth, estimation of individual doses instead of group doses, detailed account of the contributions to dose of medical examinations and of other releases from the Mayak complex, and careful assessment of the uncertainties, were made by the meeting participants.

Protracted radiation exposure and cancer mortality in the Techa River Cohort

In the 1950s many thousands of people living in rural villages on the Techa River received protracted internal and external exposures to ionizing radiation from the release of radioactive material from the Mayak plutonium production complex. The Extended Techa River Cohort includes 29,873 people born before 1950 who lived near the river sometime between 1950 and 1960. Vital status and cause of death are known for most cohort members. Individualized dose estimates have been computed using the Techa River Dosimetry System 2000. The analyses provide strong evidence of long-term carcinogenic effects of protracted low-dose-rate exposures; however, the risk estimates must be interpreted with caution because of uncertainties in the dose estimates. We provide preliminary radiation risk estimates for cancer mortality based on 1,842 solid cancer deaths (excluding bone cancer) and 61 deaths from leukemia. The excess relative risk per gray for solid cancer is 0.92 (95% CI 0.2; 1.7), while those for leukemia, including and excluding chronic lymphocytic leukemia, are 4.2 (CI 95% 1.2; 13) and 6.5 (CI 95% 1.8; 24), respectively. It is estimated that about 2.5% of the solid cancer deaths and 63% of the leukemia deaths are associated with the radiation exposure.