Reconstruction of long-lived radionuclide intakes for Techa riverside residents: strontium-90

Using portable X-ray fluorescence elemental analysis to explore porous skeletal lesions: Interplay of sex, age at death, and cause of death

OBJECTIVES

Search for possible associations between bone elemental concentration and the presence of porous skeletal lesions (PSLs), considering the sex, age, and cause of death (COD) of the individuals.

MATERIALS AND METHODS

The sample comprised 107 non-adult individuals (56 females, 51 males) aged 0-20 (x̄ = 13.2, SD = 5.8) from the Coimbra and Lisbon Identified Skeletal Collections. Cribra cranii, orbitalia, humeralis, and femoralis were recorded as present/absent, and elemental concentrations were assessed by portable x-ray fluorescence (pXRF). A multivariate statistical approach was applied.

RESULTS

Well-preserved skeletons with minimal diagenesis showed no sex-related elemental variations or PSL associations. In contrast, age-at-death correlated with elevated Ca, P, Sr, and Pb levels. Cribra cranii increased with age while other cribra declined post-adolescence. Higher concentrations of Fe and lower of S were linked to cribra cranii. Respiratory infections as COD increased the odds of expressing cribra femoralis (OR = 5.25, CI = 1.25-15.14), cribra cranii (OR = 2.91, CI = 0.97-8.69), and cribra orbitalia (OR = 2.76, CI = 1.06-7.24).

DISCUSSION

Feasible pXRF results and low cribra intraobserver error assure replicability. Elevated Ca, P, and Sr in older individuals may relate to skeletal growth, while increased Pb suggests bioaccumulation. Cribra's increase with age reflects different rates of marrow conversion and bone remodeling. Higher Fe and lower S in individuals with cribra cranii possibly reflects poor nutrition, early alcohol use, and sideroblastic anemia, aligning with 19th-20th-century Portugal's living conditions. Respiratory infections increased cribra expression, revealing intricate interplays among inflammation, anemia(s), marrow expansion, and diet. This research highlights a complex scenario and blazes a new path for cribra interpretation.

Model of age-dependent dynamics and biokinetics of T-cells as natural biodosimeters

Circulating T-lymphocytes are used as "natural biodosimeters" for estimating radiation doses, since the frequency of chromosomal aberrations induced in them is proportional to the accumulated dose. Moreover, stable chromosomal aberrations (translocations) are detected years and decades after exposure. Internal incorporation of radionuclides often leads to non-uniform exposure, which resulted in difficulties in the application of retrospective biodosimetry using T-lymphocytes. Some properties of T-lymphocytes complicate retrospective biodosimetry in this case: (1) the thymic production of T-cells depends significantly on age, the maximum is observed in early childhood; (2) the "lymphocyte-dosimeter" accumulates changes (translocations) while circulating through the body. The objective of this paper is to describe the technical characteristics of the model of age dynamics and T-cell biokinetics and approaches to assessing the dose to circulating lymphocytes under various exposure scenarios. The model allows to quantify the fractions of T-lymphocytes that were formed before and after exposure. The model takes into account the time fractions that circulating lymphocytes spend in various lymphoid organs. Age-related thymic involution was also considered. The model predicts that after internal exposure to 90Sr, the doses to T-lymphocytes can differ significantly from the doses to the bone marrow and other tissues. For uniform external γ-exposure, and for internal exposure due to non-bone -seeking radionuclides (for example, 144Ce), predicted doses to T-lymphocytes are very close to bone marrow doses. The model allows to quantify the correction factors for FISH-based doses to obtain doses to organs and tissues.

Enhanced Strontium Removal through Microbially Induced Carbonate Precipitation by Indigenous Ureolytic Bacteria

Microbial ureolysis offers the potential to remove metals including Sr2+ as carbonate minerals via the generation of alkalinity coupled to NH4+ and HCO3- production. Here, we investigated the potential for bacteria, indigenous to sediments representative of the U.K. Sellafield nuclear site where 90Sr is present as a groundwater contaminant, to utilize urea in order to target Sr2+-associated (Ca)CO3 formation in sediment microcosm studies. Strontium removal was enhanced in most sediments in the presence of urea only, coinciding with a significant pH increase. Adding the biostimulation agents acetate/lactate, Fe(III), and yeast extract to further enhance microbial metabolism, including ureolysis, enhanced ureolysis and increased Sr and Ca removal. Environmental scanning electron microscopy analyses suggested that coprecipitation of Ca and Sr occurred, with evidence of Sr associated with calcium carbonate polymorphs. Sr K-edge X-ray absorption spectroscopy analysis was conducted on authentic Sellafield sediments stimulated with Fe(III) and quarry outcrop sediments amended with yeast extract. Spectra from the treated Sellafield and quarry sediments showed Sr2+ local coordination environments indicative of incorporation into calcite and vaterite crystal structures, respectively. 16S rRNA gene analysis identified ureolytic bacteria of the genus Sporosarcina in these incubations, suggesting they have a key role in enhancing strontium removal. The onset of ureolysis also appeared to enhance the microbial reduction of Fe(III), potentially via a tight coupling between Fe(III) and NH4+ as an electron donor for metal reduction. This suggests ureolysis may support the immobilization of 90Sr via coprecipitation with insoluble calcium carbonate and cofacilitate reductive precipitation of certain redox active radionuclides, e.g., uranium.

Uncertainty of stochastic parametric approach to bone marrow dosimetry of 89,90Sr

The objective of this study is to evaluate the uncertainties of the dosimetric modeling of active marrow (AM) exposure from bone-seeking 89,90Sr. The stochastic parametric skeletal dosimetry (SPSD) model was specifically developed to study the long-term effects resulting from chronic 89,90Sr exposure in populations of the radioactively contaminated territories of the Southern Urals region of the Russian Federation. The method permits the evaluation of the dose factors (DF(AM ← TBV) and DF(AM ← CBV)), which convert the radionuclide activity concentration in trabecular (TBV) and cortical (CBV) bone volumes into dose rate in the AM, and their uncertainties. The sources of uncertainty can be subdivided into inherent uncertainties related to the individual variability of the simulated objects and introduced uncertainties related to model simplifications. Inherent uncertainty components are the individual variability of bone chemical composition, bone density, bone micro- and macro-architecture as well as AM distribution within the skeleton. The introduced uncertainties may result from the stylization of bone segment geometry, assumption of uniform cortical thickness, restriction of bone geometry and the selection of the applied voxel resolution. The inherent uncertainty depends on a number of factors of influence. Foremost, it is the result of variability of AM distribution within the skeleton. Another important factor is the variability of bone micro- and macro-architecture. The inherent uncertainty of skeletal-average dose factors was found to be about 40-50%. The introduced uncertainty associated with the SPSD model approach does not exceed 16% and mainly depends on the error of bone-shape stylization. The overall inherent and introduced uncertainties of DF(AM ← TBV) and DF(AM ← CBV) are below 55% and 63%, respectively. The results obtained will be incorporated into the stochastic version of the Techa River Dosimetry System (TRDS-2016MC) that provides multiple realizations of the annual doses for each cohort member to obtain both a central estimate of the individual dose and information on the dose uncertainty.

Dose estimates and their uncertainties for use in epidemiological studies of radiation-exposed populations in the Russian Southern Urals

Many residents of the Russian Southern Urals were exposed to radioactive environmental pollution created by the operations of the Mayak Production Association in the mid- 20th century. There were two major releases: the discharge of about 1x1017 Bq of liquid waste into the Techa River between 1949 and 1959; and the atmospheric release of 7.4 * 1016 Bq as a result an explosion in the radioactive waste-storage facility in 1957. The releases into the Techa River resulted in the exposure of more than 30,000 people who lived in riverside villages between 1950 and 1961. The 1957 accident contaminated a larger area with the highest exposure levels in an area that is called the East Urals Radioactive Trace (EURT). Current epidemiologic studies of the exposed populations are based on dose estimates obtained using a Monte-Carlo dosimetry system (TRDS-2016MC) that provides multiple realizations of the annual doses for each cohort member. These dose realizations provide a central estimate of the individual dose and information on the uncertainty of these dose estimates. In addition, the correlation of individual annual doses over realizations provides important information on shared uncertainties that can be used to assess the impact of shared dose uncertainties on risk estimate uncertainty.This paper considers dose uncertainties in the TRDS-2016MC. Individual doses from external and internal radiation sources were reconstructed for 48,036 people based on environmental contamination patterns, residential histories, individual 90Sr body-burden measurements and dietary intakes. Dietary intake of 90Sr resulted in doses accumulated in active bone marrow (or simply, marrow) that were an order of magnitude greater than those in soft tissues. About 84% of the marrow dose and 50% of the stomach dose was associated with internal exposures. The lognormal distribution is well-fitted to the individual dose realizations, which, therefore, could be expressed and easily operated in terms of geometric mean (GM) and geometric standard deviation (GSD). Cohort average GM for marrow and stomach cumulative doses are 0.21 and 0.03 Gy, respectively. Cohort average dose uncertainties in terms of GSD are as follows: for marrow it is 2.93 (90%CI: 2.02-4.34); for stomach and the other non-calcified tissues it is 2.32 (90% CI: 1.78-2.9).

Radiobiology of Select Radionuclides in Hanford Site Tank Waste

There are several important radionuclides involved in the "clean-up" or environmental isolation of nuclear waste contained in US Department of Energy Hanford Site underground waste tanks that drive many of the decisions associated with this activity. To make proper human health risk analyses and ensure that the most appropriate decisions are made, it is important to understand the radiation biology and the human health risk associated with these radionuclides. This manuscript provides some basic radiological science, in particular radiation biology, for some of these radionuclides, i.e., 3 H, 90 Sr, 137 Cs, 99 Tc, 129 I, and the alpha emitters 239, 240 Pu, 233,234,235,238 U, and 241 Am. These radionuclides were selected based on their designation as "constituents of potential concern," historical significance, or potential impact on human health risk. In addition to the radiobiology of these select radionuclides, this manuscript provides brief discussions of the estimated cost of planned management of Hanford tank waste and a comparison with releases into the Techa River from activities associated with the Mayak Production Association. A set of summary conclusions of the potential human health risks associated with these radionuclides is given.

Public health response and medical management of internal contamination in past radiological or nuclear incidents: A narrative review

Following a radiological or nuclear emergency, workers, responders and the public may be internally contaminated with radionuclides. Screening, monitoring and assessing any internal contamination and providing necessary medical treatment, especially when a large number of individuals are involved, is challenging. Experience gained and lessons learned from the management of previous incidents would help to identify gaps in knowledge and capabilities on preparedness for and response to radiation emergencies. In this paper, eight large-scale and five workplace radiological and nuclear incidents are reviewed cross 14 technical areas, under the broader topics of emergency preparedness, emergency response and recovery processes. The review findings suggest that 1) new strategies, algorithms and technologies are explored for rapid screening of large populations; 2) exposure assessment and dose estimation in emergency response and dose reconstruction in recovery process are supported by complementary sources of information, including 'citizen science'; 3) surge capacity for monitoring and dose assessment is coordinated through national and international laboratory networks; 4) evidence-based guidelines for medical management and follow-up of internal contamination are urgently needed; 5) mechanisms for international and regional access to medical countermeasures are investigated and implemented; 6) long-term health and medical follow up programs are designed and justified; and 7) capabilities and capacity developed for emergency response are sustained through adequate resource allocation, routine non-emergency use of technical skills in regular exercises, training, and continuous improvement.

Stochastic parametric skeletal dosimetry model for humans: General approach and application to active marrow exposure from bone-seeking beta-particle emitters

The objective of this study is to develop a skeleton model for assessing active marrow dose from bone-seeking beta-emitting radionuclides. This article explains the modeling methodology which accounts for individual variability of the macro- and microstructure of bone tissue. Bone sites with active hematopoiesis are assessed by dividing them into small segments described by simple geometric shapes. Spongiosa, which fills the segments, is modeled as an isotropic three-dimensional grid (framework) of rod-like trabeculae that “run through” the bone marrow. Randomized multiple framework deformations are simulated by changing the positions of the grid nodes and the thickness of the rods. Model grid parameters are selected in accordance with the parameters of spongiosa microstructures taken from the published papers. Stochastic modeling of radiation transport in heterogeneous media simulating the distribution of bone tissue and marrow in each of the segments is performed by Monte Carlo methods. Model output for the human femur at different ages is provided as an example. The uncertainty of dosimetric characteristics associated with individual variability of bone structure was evaluated. An advantage of this methodology for the calculation of doses absorbed in the marrow from bone-seeking radionuclides is that it does not require additional studies of autopsy material. The biokinetic model results will be used in the future to calculate individual doses to members of a cohort exposed to ^89,90Sr from liquid radioactive waste discharged to the Techa River by the Mayak Production Association in 1949–1956. Further study of these unique cohorts provides an opportunity to gain more in-depth knowledge about the effects of chronic radiation on the hematopoietic system. In addition, the proposed model can be used to assess the doses to active marrow under any other scenarios of ⁹⁰Sr and ⁸⁹Sr intake to humans.

Long-Term Accumulation of Metals in the Skeleton as Related to Osteoporotic Derangements

The concentrations of metals in the environment are still not within the recommended limits as set by the regulatory authorities in various countries because of human activities. They can enter the food chain and bioaccumulate in soft and hard tissues/organs, often with a long half-life of the metal in the body. Metal exposure has a negative impact on bone health and may result in osteoporosis and increased fracture risk depending on concentration and duration of metal exposure and metal species. Bones are a long-term repository for lead and some other metals, and may approximately contain 90% of the total body burden in birds and mammals. The present review focuses on the most common metals found in contaminated areas (mercury, cadmium, lead, nickel, chromium, iron, and aluminum) and their effects on bone tissue, considering the possibility of the long-term bone accumulation, and also some differences that might exist between different age groups in the whole population.

Enhancements in the Techa River Dosimetry System: TRDS-2016D Code for Reconstruction of Deterministic Estimates of Dose From Environmental Exposures

Waterborne releases to the Techa River from the Mayak plutonium facility in Russia during 1949-1956 resulted in significant doses to persons living downstream. The dosimetry system Techa River Dosimetry System-2016D has been developed, which provides individual doses of external and internal exposure for the members of the Techa River cohort and other persons who were exposed to releases of radioactive material to the Southern Urals. The results of computation of individual doses absorbed in red bone marrow and extraskeletal tissues for the Techa River cohort members (29,647 persons) are presented, which are based on residence histories on the contaminated Techa River and the East Urals Radioactive Trace, which was formed in 1957 as a result of the Kyshtym Accident. Available Sr body-burden measurements and available information on individual household locations have been used for refinement of individual dose estimates. Techa River Dosimetry System-2016D-based dose estimates will be used for verification of risk of low-dose-rate effects of ionizing radiation in the Techa River cohort.

COMPARISON OF MEASURES ON PROTECTION AGAINST ACCIDENTAL RADIATION AND INDOOR RADON EXPOSURE IN MUSLYUMOVO, TECHA RIVER

The objective of the study was comparison of the doses received due to contamination of the Techa River with those received from the indoor radon exposure. The study was performed on the example of Muslyumovo, the village closest to Mayak nuclear complex. The accidental doses were estimated using data on radionuclide intakes and ICRP-72 dose coefficients, and Techa River Dosimetry System. Radon exposure was estimated applying results of the radon surveys in 1992 and 2015. The doses prevented by means of different protection measures were considered. The maximum reduction of population exposure could be achieved in the case of timely evacuation to uncontaminated territory together with the indoor radon prevention measures.

Calculations of individual doses for Techa River Cohort members exposed to atmospheric radioiodine from Mayak releases

Time-dependent thyroid doses were reconstructed for over 29,000 Techa River Cohort members living near the Mayak production facilities from ¹³¹I released to the atmosphere for all relevant exposure pathways. The calculational approach uses four general steps: 1) construct estimates of releases of ¹³¹I to the air from production facilities; 2) model the transport of ¹³¹I in the air and subsequent deposition on the ground and vegetation; 3) model the accumulation of ¹³¹I in environmental media; and 4) calculate individualized doses. The dose calculations are implemented in a Monte Carlo framework that produces best estimates and confidence intervals of dose time-histories. Other radionuclide contributors to thyroid dose were evaluated. The ¹³¹I contribution was 75-99% of the thyroid dose. The mean total thyroid dose for cohort members was 193 mGy and the median was 53 mGy. Thyroid doses for about 3% of cohort members were larger than 1 Gy. About 7% of children born in 1940-1950 had doses larger than 1 Gy. The uncertainty in the ¹³¹I dose estimates is low enough for this approach to be used in regional epidemiological studies.

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.

Cancer Incidence after In Utero Exposure to Ionizing Radiation in Techa River Residents

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.

DNA damage induced by Strontium-90 exposure at low concentrations in mesenchymal stromal cells: the functional consequences

⁹⁰Sr is one of the radionuclides released after nuclear accidents that can significantly impact human health in the long term. ⁹⁰Sr accumulates mostly in the bones of exposed populations. Previous research has shown that exposure induces changes in bone physiology both in humans and in mice. We hypothesize that, due to its close location with bone marrow stromal cells (BMSCs), ⁹⁰Sr could induce functional damage to stromal cells that may explain these biological effects due to chronic exposure to ⁹⁰Sr. The aim of this work was to verify this hypothesis through the use of an in vitro model of MS5 stromal cell lines exposed to 1 and 10 kBq.mL^-1 of ⁹⁰Sr. Results indicated that a 30-minute exposure to ⁹⁰Sr induced double strand breaks in DNA, followed by DNA repair, senescence and differentiation. After 7 days of exposure, MS5 cells showed a decreased ability to proliferate, changes in cytokine expression, and changes in their ability to support hematopoietic progenitor proliferation and differentiation. These results demonstrate that chronic exposure to a low concentration of ⁹⁰Sr can induce functional changes in BMSCs that in turn may explain the health effects observed in following chronic ⁹⁰Sr exposure.

In utero exposure to radiation and haematological malignancies: pooled analysis of Southern Urals cohorts

BACKGROUND

It is scientifically uncertain whether in utero exposure to low-dose ionising radiation increases the lifetime risk of haematological malignancies.

METHODS

We pooled two cohorts from the Southern Urals comprising offspring of female workers of a large nuclear facility (the Mayak Production Association) and of women living in areas along the Techa River contaminated by nuclear accidents/waste from the same facility, with detailed dosimetry.

RESULTS

The combined cohort totalled 19 536 subjects with 700 504 person-years at risk over the period of incidence follow-up, and slightly more over the period of mortality follow-up, yielding 58 incident cases and 36 deaths up to age 61 years. Risk was increased in subjects who received in utero doses of ⩾80 mGy (excess relative risk (ERR): 1.27; 95% confidence interval (CI): -0.20 to 4.71), and the risk increased consistently per 100 mGy of continuous exposure in utero (ERR: 0.77; CI: 0.02 to 2.56). No association was apparent in mortality-based analyses. Results for leukaemia and lymphoma were similar. A very weak positive association was observed between incidence and postnatal exposure.

CONCLUSIONS

In summary, the results suggest a positive association between in utero exposure to ionising radiation and risk of haematological malignancies, but the small number of outcomes and inconsistent incidence and mortality findings preclude firm conclusions.

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.

Incidence and Mortality of Solid Cancers in People Exposed In Utero to Ionizing Radiation: Pooled Analyses of Two Cohorts from the Southern Urals, Russia

BACKGROUND

Previous studies have shown that acute external in utero exposure to ionizing radiation can increase cancer risk. It is not known whether chronic exposure at low dose rates, including due to radionuclide intake, influences the lifetime risk of solid cancers in the offspring. The objective of this study was to investigate solid cancer risk after in utero irradiation.

METHODS

Cancer incidence and mortality over a 60-year period (from January 1950 to December 2009) were analyzed in the Urals Prenatally Exposed Cohort (UPEC). The cohort comprised in utero exposed offspring of Mayak Production Association female workers and of female residents of Techa River villages. Some of the offspring also received postnatal exposure, either due to becoming radiation workers themselves or due to continuing to live in the contaminated areas of the Techa River. The mortality analyses comprised 16,821 subjects (601,372 person-years), and the incidence analyses comprised 15,813 subjects (554,411 person-years). Poisson regression was used to quantify the relative risk as a function of the in utero soft tissue dose (with cumulative doses up to 944.9 mGy, mean dose of 14.1 mGy in the pooled cohort) and the postnatal stomach dose for solid cancer incidence and mortality.

RESULTS

When a log-linear model was used, relative risk of cancer per 10 mGy of in utero dose was 0.99 (95% confidence interval (CI) = 0.96 to 1.01) based on incidence data and 0.98 (CI = 0.94 to 1.01) based on mortality data. Postnatal exposure to ionizing radiation was positively associated with the solid cancer risk in members of the UPEC, with a relative risk of 1.02 per 10mGy CI = 1.00 to 1.04).

CONCLUSIONS

No strong evidence was found that chronic low-dose-rate exposure of the embryo and fetus increased the risk of solid cancers in childhood or in adulthood. For both incidence and mortality, a tendency towards a decreased relative risk was noted with increasing doses to soft tissues of the fetus. Further follow-up will provide more precise radiation risk estimates of solid cancer as cohort members are approaching their 60s and cancer becomes more common.

Dose and dose-rate effects of ionizing radiation: a discussion in the light of radiological protection

The biological effects on humans of low-dose and low-dose-rate exposures to ionizing radiation have always been of major interest. The most recent concept as suggested by the International Commission on Radiological Protection (ICRP) is to extrapolate existing epidemiological data at high doses and dose rates down to low doses and low dose rates relevant to radiological protection, using the so-called dose and dose-rate effectiveness factor (DDREF). The present paper summarizes what was presented and discussed by experts from ICRP and Japan at a dedicated workshop on this topic held in May 2015 in Kyoto, Japan. This paper describes the historical development of the DDREF concept in light of emerging scientific evidence on dose and dose-rate effects, summarizes the conclusions recently drawn by a number of international organizations (e.g., BEIR VII, ICRP, SSK, UNSCEAR, and WHO), mentions current scientific efforts to obtain more data on low-dose and low-dose-rate effects at molecular, cellular, animal and human levels, and discusses future options that could be useful to improve and optimize the DDREF concept for the purpose of radiological protection.

Strontium biokinetic model for the lactating woman and transfer to breast milk: application to Techa River studies

This paper presents a biokinetic model for strontium metabolism in the lactating woman and transfer to breast milk for members of Techa River communities exposed as a result of discharges of liquid radioactive wastes from the Mayak plutonium production facility (Russia) in the early 1950s. This model was based on that developed for the International Commission for Radiological Protection with modifications to account for population specific features of breastfeeding and maternal bone mineral metabolism. The model is based on a biokinetic model for the adult female with allowances made for changes in mineral metabolism during periods of exclusive and partial breast-feeding. The model for females of all ages was developed earlier from extensive data on (90)Sr-body measurements for Techa Riverside residents. Measurements of (90)Sr concentrations in the maternal skeleton and breast milk obtained in the1960s during monitoring of global fallout in the Southern Urals region were used for evaluation of strontium transfer to breast and breast milk. The model was validated with independent data from studies of global fallout in Canada and measurements of (90)Sr body-burden in women living in the Techa River villages who were breastfeeding during maximum (90)Sr-dietary intakes. The model will be used in evaluations of the intake of strontium radioisotopes in breast milk by children born in Techa River villages during the radioactive releases and quantification of (90)Sr retention in the maternal skeleton.

Strontium biokinetic model for the pregnant woman and fetus: application to Techa River studies

A biokinetic model for strontium (Sr) for the pregnant woman and fetus (Sr-PWF model) has been developed for use in the quantification of doses from internal radiation exposures following maternal ingestion of Sr radioisotopes before or during pregnancy. The model relates in particular to the population of the Techa River villages exposed to significant amounts of ingested Sr radioisotopes as a result of releases of liquid radioactive wastes from the Mayak plutonium production facility (Russia) in the early 1950s. The biokinetic model for Sr metabolism in the pregnant woman was based on a biokinetic model for the adult female modified to account for changes in mineral metabolism during pregnancy. The model for non-pregnant females of all ages was developed earlier with the use of extensive data on (90)Sr-body measurements in the Techa Riverside residents. To determine changes in model parameter values to take account of changing mineral metabolism during pregnancy, data from longitudinal studies of calcium homeostasis during human pregnancy were analysed and applied. Exchanges between maternal and fetal circulations and retention in fetal skeleton and soft tissues were modelled as adaptations of previously published models, taking account of data on Sr and calcium (Ca) metabolism obtained in Russia (Southern Urals and Moscow) relating to dietary calcium intakes, calcium contents in maternal and fetal skeletons and strontium transfer to the fetus. The model was validated using independent data on (90)Sr in the fetal skeleton from global fallout as well as unique data on (90)Sr-body burden in mothers and their still-born children for Techa River residents. While the Sr-PWF model has been developed specifically for ingestion of Sr isotopes by Techa River residents, it is also more widely applicable to maternal ingestion of Sr radioisotopes at different times before and during pregnancy and different ages of pregnant women in a general population.

Age and gender specific biokinetic model for strontium in humans

A biokinetic model for strontium in humans is necessary for quantification of internal doses due to strontium radioisotopes. The ICRP-recommended biokinetic model for strontium has limitations for use in a population study, because it is not gender specific and does not cover all age ranges. The extensive Techa River data set on (90)Sr in humans (tens of thousands of measurements) is a unique source of data on long-term strontium retention for men and women of all ages at intake. These, as well as published data, were used for evaluation of age- and gender-specific parameters for a new compartment biokinetic model for strontium (Sr-AGe model). The Sr-AGe model has a similar structure to the ICRP model for the alkaline earth elements. The following parameters were mainly re-evaluated: gastrointestinal absorption and parameters related to the processes of bone formation and resorption defining calcium and strontium transfers in skeletal compartments. The Sr-AGe model satisfactorily describes available data sets on strontium retention for different kinds of intake (dietary and intravenous) at different ages (0-80 years old) and demonstrates good agreement with data sets for different ethnic groups. The Sr-AGe model can be used for dose assessment in epidemiological studies of general populations exposed to ingested strontium radioisotopes.

Increase in accumulation of strontium-90 in the maternal skeleton during pregnancy and lactation: analysis of the Techa River data

The unique contamination of the Techa River (Southern Urals, Russia) in the 1950s by long-lived (90)Sr allows investigation of the accumulation of bone-seeking elements in humans. This study is based on information compiled at the Urals Research Center for Radiation Medicine (Chelyabinsk, Russia) over a long period of time. It includes the results of in vivo measurements of (90)Sr-body burden with a whole body counter (WBC), data on personal medical examinations and residence and family histories. Data on 185 women from two Techa riverside villages Muslyumovo and Brodokalmak were selected. The settlements differ in terms of (90)Sr diet intake (higher in Muslyumovo than in Brodokalmak) and ethnicity (residents were mainly Slavs in Brodokalmak and Turkic in Muslyumovo). Results of a total of 555 WBC measurements performed in 1974-1997 were available for the women studied; maximum measured values reached 40 kBq/body. The women from each settlement were subdivided into three groups according to their childbearing history: pregnancy and lactation occurred (1) during the period of maximal (90)Sr intake (1950-1951); (2) after the period of maximal intake and (3) before this period or women who were childless. An increase was found in accumulation of (90)Sr in maternal skeleton during pregnancy and lactation (group 1) by a factor of 1.5-2 in comparison with non-pregnant, non-lactating women. This result was found in both Muslyumovo and Brodokalmak samples. An increase in accumulation of toxic elements in pregnant/lactating women is associated with increased radiation/toxic doses and risk for the women's health.

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.

Leukaemia incidence in the Techa River Cohort: 1953-2007

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.

Reconstruction of long-lived radionuclide intakes for Techa riverside residents: 137Cs

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.

Chronic low-dose exposure in the Techa River Cohort: risk of mortality from circulatory diseases

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.

Solid cancer mortality in the techa river cohort (1950-2007)

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.

Reconstruction of the contamination of the Techa River in 1949-1951 as a result of releases from the "Mayak" Production Association

More accurate reconstruction of the radioactive contamination of the Techa River system in 1949-1951 has been made on the basis of refined data on the amounts and the rate of discharge of radionuclides into the Techa River from the Mayak Production Association; this has led to the development of a modified Techa River model that describes the transport of radionuclides through the up-river ponds and along the Techa River and deposition of radionuclides in the river-bottom sediments and flooded areas. The refined Techa River source-term data define more precisely the time-dependent rates of release and radionuclide composition of the releases that occurred during 1949-1951. The Techa River model takes into account the time-dependent characteristics of the releases and considers (a) the transport of radionuclides adsorbed on solid particles originally contained in the discharges or originating in the up-river ponds as a result of stirring up of contaminated bottom sediments and (b) the transport of radionuclides in soluble form. The output of the Techa River model provides concentrations of all source-term radionuclides in the river water, bottom sediments, and floodplain soils at different distances from the site of radioactive releases for the period of major contamination in 1950-1951. The outputs of the model show good agreement with historical measurements of water and sediment contamination. In addition, the river-model output for (90)Sr concentration in the river water is harmonized with retrospective estimates derived from the measurements of (90)Sr in the residents of the Techa Riverside villages. Modeled contamination of the floodplain soils by (137)Cs is shown to be in agreement with the values reconstructed from late measurements of this radionuclide. Reconstructed estimates of the Techa River contamination are being used for the quantification of internal and external doses received by residents of the Techa Riverside communities.

Apoptosis of peripheral blood lymphocytes and mutations in the gene of the T-cell receptor in survivors of chronic radiation exposure

This research has been conducted to study the activity of apoptosis of peripheral blood lymphocytes (PBLs) and the frequency of CD3-/CD4+ PBLs in people who have suffered chronic low-intensity radiation exposure. An increase in the frequency of apoptotic cells (TUNEL) is demonstrated in the group of exposed individuals relative to the control group. The frequency of mutations in the gene of the T-cell receptor in the exposed individuals is also elevated. Analyses of the mean values of apoptosis and CD3-CD4+ PBLs in different dose subgroups have found an increase in the proportion of cells with mutant T-cell receptors against the background of a decrease in the frequency of apoptotic cells in the range of low and medium radiation doses.

Reevaluation of waterborne releases of radioactive materials from the Mayak Production Association into the Techa River in 1949-1951

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.

Does the cortical bone resorption rate change due to 90Sr-radiation exposure? Analysis of data from Techa Riverside residents

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.