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Hamada N. Noncancer Effects of Ionizing Radiation Exposure on the Eye, the Circulatory System and beyond: Developments made since the 2011 ICRP Statement on Tissue Reactions. Radiat Res 2023; 200:188-216. [PMID: 37410098 DOI: 10.1667/rade-23-00030.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
For radiation protection purposes, noncancer effects with a threshold-type dose-response relationship have been classified as tissue reactions (formerly called nonstochastic or deterministic effects), and equivalent dose limits aim to prevent occurrence of such tissue reactions. Accumulating evidence demonstrates increased risks for several late occurring noncancer effects at doses and dose rates much lower than previously considered. In 2011, the International Commission on Radiological Protection (ICRP) issued a statement on tissue reactions to recommend a threshold of 0.5 Gy to the lens of the eye for cataracts and to the heart and brain for diseases of the circulatory system (DCS), independent of dose rate. Literature published thereafter continues to provide updated knowledge. Increased risks for cataracts below 0.5 Gy have been reported in several cohorts (e.g., including in those receiving protracted or chronic exposures). A dose threshold for cataracts is less evident with longer follow-up, with limited evidence available for risk of cataract removal surgery. There is emerging evidence for risk of normal-tension glaucoma and diabetic retinopathy, but the long-held tenet that the lens represents among the most radiosensitive tissues in the eye and in the body seems to remain unchanged. For DCS, increased risks have been reported in various cohorts, but the existence or otherwise of a dose threshold is unclear. The level of risk is less uncertain at lower dose and lower dose rate, with the possibility that risk per unit dose is greater at lower doses and dose rates. Target organs and tissues for DCS are also unknown, but may include heart, large blood vessels and kidneys. Identification of potential factors (e.g., sex, age, lifestyle factors, coexposures, comorbidities, genetics and epigenetics) that may modify radiation risk of cataracts and DCS would be important. Other noncancer effects on the radar include neurological effects (e.g., Parkinson's disease, Alzheimer's disease and dementia) of which elevated risk has increasingly been reported. These late occurring noncancer effects tend to deviate from the definition of tissue reactions, necessitating more scientific developments to reconsider the radiation effect classification system and risk management. This paper gives an overview of historical developments made in ICRP prior to the 2011 statement and an update on relevant developments made since the 2011 ICRP statement.
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Affiliation(s)
- Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Chiba, Japan
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2
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Rushing CJ, Rathnayake V, Amin T, Pham A, Spinner SM, Ramaswamy II. Intraoperative Radiation Exposure to U.S. Podiatric and Medicine Surgery Residents Annually: How Much Are We Really Getting? J Am Podiatr Med Assoc 2022; 112:19-177. [PMID: 36115034 DOI: 10.7547/19-177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
As the number and complexity of operative techniques taught at U.S. podiatric medicine and surgical residencies (PMSR) with the added credential in reconstructive rearfoot and ankle (RRA) surgery has continued to increase, so to has the use of intraoperative fluoroscopy. The purpose of the present prospective observational pilot study was to quantify and compare the shallow dose equivalent (SDE), deep dose equivalent (DDE), and lens of the eye dose equivalent (LDE) exposures for podiatric medicine and surgery residents at a single PMSR-RRA over 12 consecutive months. Shallow-dose equivalent, DDE, and LDE exposures (in millirems) were measured using Landauer Luxel dosimeters from July of 2018 to July of 2019. Dosimeters were exchanged monthly, and mean monthly/annual SDE, DDE, and LDE exposures were calculated and compared. Overall, residents averaged 19 operative cases per month and 222 per year. More than half (53%) required intraoperative fluoroscopy, for which a mini C-arm was used in most cases. Monthly SDE, DDE, and LDE exposures averaged 7.3, 9.3, and 7.0 mrem, respectively; whereas annual SDE, DDE, and LDE exposures averaged 87.3, 112, and 84 mrem, respectively. No significant monthly (P = 1.0, P = .70, and P = .74) or annual (P = .67, P = .67, and P = .33) differences were identified between residents. The annual SDE, DDE, and LDE for residents at a single PMSR-RRA were well below the recommended dose limits of 50,000 mrem/year (SDE), 5,000 mrem/year (DDE), and 15,000 mrem/year (LDE) set by the National Council on Radiation Protection. However, given that the stochastic effects from low levels of ionizing radiation are cumulative, not well studied long-term, and relate both to the degree and duration of exposure, mini-C arm fluoroscopy, radiation tracking, and use of personal protective equipment provide simple means for residents to reduce any long-term potential for risk.
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Affiliation(s)
| | | | - Tarak Amin
- †Westside Regional Medical Center, Plantation, FL
| | - Alyssa Pham
- †Westside Regional Medical Center, Plantation, FL
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Azizova TV, Bragin EV, Bannikova MV, Hamada N, Grigoryeva ES. The Incidence Risk for Primary Glaucoma and Its Subtypes following Chronic Exposure to Ionizing Radiation in the Russian Cohort of Mayak Nuclear Workers. Cancers (Basel) 2022; 14:cancers14030602. [PMID: 35158870 PMCID: PMC8833586 DOI: 10.3390/cancers14030602] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Glaucoma is a leading cause of irreversible blindness worldwide and also represents one of the normal tissue complications following radiation therapy involving ocular radiation exposure. It has widely been considered that such secondary glaucoma occurs at fractionated high dose (several tens of Gy). In contrast, this study is the first to report that normal-tension glaucoma (a subtype of primary open-angle glaucoma) occurs in radiation workers at a chronic dose of >1 Gy. Such elevated risk of radiogenic normal-tension glaucoma, if confirmed in other cohorts, has significant implications for normal tissue complications in radiotherapy patients receiving ocular radiation exposure, and for ocular radiation protection in radiation workers. Abstract Secondary glaucoma is a typical normal tissue complication following radiation therapy involving ocular radiation exposure at high fractionated dose (several tens of Gy). In contrast, recent studies in acutely exposed Japanese atomic bomb survivors showed a significantly increased risk for normal-tension glaucoma (NTG, a subtype of primary open-angle glaucoma) at much lower dose, but such information is not available in any other cohorts. We therefore set out to evaluate the incidence of risk for primary glaucoma and its subtypes in a Russian cohort of Mayak Production Association nuclear workers who received chronic radiation exposure over many years. Of these, we found a significantly increased relative risk (RR) of NTG incidence (RR = 1.88 95% confidence intervals (CI): 1.01, 3.51; p = 0.047) in workers exposed to gamma rays at cumulative brain absorbed dose above >1 Gy. We observed the linear relationship between NTG incidence and brain absorbed gamma dose with an excess relative risk per unit brain absorbed dose of 0.53 (95% CI: 0.01, 1.68; p < 0.05), but not for any other subtypes nor for total primary glaucoma. Such elevated risk of radiogenic NTG incidence, if confirmed in other cohorts, has significant implications for normal tissue complications in radiotherapy patients receiving ocular radiation exposure, and for ocular radiation protection in radiation workers.
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Affiliation(s)
- Tamara V. Azizova
- Clinical Department, Southern Urals Biophysics Institute (SUBI), 456780 Ozyorsk, Russia; (E.V.B.); (M.V.B.); (E.S.G.)
- Correspondence:
| | - Evgeny V. Bragin
- Clinical Department, Southern Urals Biophysics Institute (SUBI), 456780 Ozyorsk, Russia; (E.V.B.); (M.V.B.); (E.S.G.)
| | - Maria V. Bannikova
- Clinical Department, Southern Urals Biophysics Institute (SUBI), 456780 Ozyorsk, Russia; (E.V.B.); (M.V.B.); (E.S.G.)
| | - Nobuyuki Hamada
- Radiation Safety Unit, Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo 201-8511, Japan;
| | - Evgeniya S. Grigoryeva
- Clinical Department, Southern Urals Biophysics Institute (SUBI), 456780 Ozyorsk, Russia; (E.V.B.); (M.V.B.); (E.S.G.)
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Park S, Lee DN, Jin YW, Cha ES, Jang WI, Park S, Seo S. Non-cancer disease prevalence and association with occupational radiation exposure among Korean radiation workers. Sci Rep 2021; 11:22415. [PMID: 34789809 PMCID: PMC8599676 DOI: 10.1038/s41598-021-01875-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/03/2021] [Indexed: 11/09/2022] Open
Abstract
Radiation-induced cancer risks have known stochastic effects; however, regarding non-cancer diseases, evidence of risk at low radiation doses remains unclear. We aimed to identify underlying characteristics concerning non-cancer disease prevalence and determine associations with radiation dose among Korean radiation workers. Using a nationwide baseline survey, 20,608 workers were enrolled. Data concerning participant demographics, occupational characteristics, lifestyle, and lifetime prevalence of non-cancer diseases were linked to a national dose registry. We compared non-cancer disease prevalences in the Korean general population with those in this cohort and undertook a dose-response analysis concerning the cumulative dose. Hyperlipidemia (10.6%), circulatory (9.6%), and respiratory (4.1%) system diseases, followed by thyroid diseases (3.5%), had the highest prevalences, with hyperlipidemia, thyroid diseases, and hepatitis prevalence being higher in the cohort than in the general population. Radiation doses were associated with elevated prevalences of most diseases; however, associations were attenuated and not significant after adjusting for confounders, except for musculoskeletal system diseases (prevalence odds ratio [POR]/10 mSv, 1.03; 95% confidence interval [CI] 1.00-1.07) and cataracts (POR/10 mSv, 1.04; 95% CI 1.00-1.07). Further studies are warranted to investigate the causality of those non-cancer diseases involving more varied confounders such as physical and psychosocial stresses and ultraviolet light.
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Affiliation(s)
- Soojin Park
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea
| | - Dal Nim Lee
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea
| | - Young Woo Jin
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea
| | - Eun Shil Cha
- grid.222754.40000 0001 0840 2678Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Won-Il Jang
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea ,grid.415464.60000 0000 9489 1588Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Sunhoo Park
- grid.415464.60000 0000 9489 1588National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812 South Korea ,grid.415464.60000 0000 9489 1588Department of Pathology, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Songwon Seo
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 75 Nowon-ro, Nowon-gu, Seoul, 01812, South Korea.
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McCarron RA, Barnard SGR, Babini G, Dalke C, Graw J, Leonardi S, Mancuso M, Moquet JE, Pawliczek D, Pazzaglia S, De Stefano I, Ainsbury EA. Radiation-Induced Lens Opacity and Cataractogenesis: A Lifetime Study Using Mice of Varying Genetic Backgrounds. Radiat Res 2021; 197:57-66. [PMID: 33984859 DOI: 10.1667/rade-20-00266.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/20/2021] [Indexed: 11/03/2022]
Abstract
Recent epidemiological findings and reanalysis of historical data suggest lens opacities resulting from ionizing radiation exposures are likely induced at lower doses than previously thought. These observations have led to ICRP recommendations for a reduction in the occupational dose limits for the eye lens, as well as subsequent implementation in EU member states. The EU CONCERT LDLensRad project was initiated to further understand the effects of ionizing radiation on the lens and identify the mechanism(s) involved in radiation-induced cataract, as well as the impact of dose and dose-rate. Here, we present the results of a long-term study of changes to lens opacity in male and female adult mice from a variety of different genetic (radiosensitive or radioresistant) backgrounds, including mutant strains Ercc2 and Ptch1, which were assumed to be susceptible to radiation-induced lens opacities. Mice received 0.5, 1 and 2 Gy 60Co gamma-ray irradiation at dose rates of 0.063 and 0.3 Gy min-1. Scheimpflug imaging was used to quantify lens opacification as an early indicator of cataract, with monthly observations taken postirradiation for an 18-month period in all strains apart from 129S2, which were observed for 12 months. Opacification of the lens was found to increase with time postirradiation (with age) for most mouse models, with ionizing radiation exposure increasing opacities further. Sex, dose, dose rate and genetic background were all found to be significant contributors to opacification; however, significant interactions were identified, which meant that the impact of these factors was strain dependent. Mean lens density increased with higher dose and dose rate in the presence of Ercc2 and Ptch1 mutations. This project was the first to focus on low (<1 Gy) dose, multiple dose rate, sex and strain effects in lens opacification, and clearly demonstrates the importance of these experimental factors in radiobiological investigations on the lens. The results provide insight into the effects of ionizing radiation on the lens as well as the need for further work in this area to underpin appropriate radiation protection legislation and guidance.
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Affiliation(s)
- R A McCarron
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
| | - S G R Barnard
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom.,Durham University, School of Biosciences, Durham, United Kingdom
| | - G Babini
- Department of Physics, University of Pavia, Pavia, Italy.,Department of Woman and Child Health, Fondazione Policlinico A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - C Dalke
- Helmholtz Zentrum München GmbH, German Research Centre for Environmental Health, Neuherberg, Germany
| | - J Graw
- Helmholtz Zentrum München GmbH, German Research Centre for Environmental Health, Neuherberg, Germany
| | - S Leonardi
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), Rome, Italy
| | - M Mancuso
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), Rome, Italy
| | - J E Moquet
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
| | - D Pawliczek
- Helmholtz Zentrum München GmbH, German Research Centre for Environmental Health, Neuherberg, Germany
| | - S Pazzaglia
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), Rome, Italy
| | - I De Stefano
- Laboratory of Biomedical Technologies, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), Rome, Italy
| | - E A Ainsbury
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
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Ainsbury EA, Dalke C, Hamada N, Benadjaoud MA, Chumak V, Ginjaume M, Kok JL, Mancuso M, Sabatier L, Struelens L, Thariat J, Jourdain JR. Radiation-induced lens opacities: Epidemiological, clinical and experimental evidence, methodological issues, research gaps and strategy. ENVIRONMENT INTERNATIONAL 2021; 146:106213. [PMID: 33276315 DOI: 10.1016/j.envint.2020.106213] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/11/2020] [Accepted: 08/25/2020] [Indexed: 06/12/2023]
Abstract
In 2011, the International Commission on Radiological Protection (ICRP) recommended reducing the occupational equivalent dose limit for the lens of the eye from 150 mSv/year to 20 mSv/year, averaged over five years, with no single year exceeding 50 mSv. With this recommendation, several important assumptions were made, such as lack of dose rate effect, classification of cataracts as a tissue reaction with a dose threshold at 0.5 Gy, and progression of minor opacities into vision-impairing cataracts. However, although new dose thresholds and occupational dose limits have been set for radiation-induced cataract, ICRP clearly states that the recommendations are chiefly based on epidemiological evidence because there are a very small number of studies that provide explicit biological and mechanistic evidence at doses under 2 Gy. Since the release of the 2011 ICRP statement, the Multidisciplinary European Low Dose Initiative (MELODI) supported in April 2019 a scientific workshop that aimed to review epidemiological, clinical and biological evidence for radiation-induced cataracts. The purpose of this article is to present and discuss recent related epidemiological and clinical studies, ophthalmic examination techniques, biological and mechanistic knowledge, and to identify research gaps, towards the implementation of a research strategy for future studies on radiation-induced lens opacities. The authors recommend particularly to study the effect of ionizing radiation on the lens in the context of the wider, systemic effects, including in the retina, brain and other organs, and as such cataract is recommended to be studied as part of larger scale programs focused on multiple radiation health effects.
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Affiliation(s)
- Elizabeth A Ainsbury
- Public Health England (PHE) Centre for Radiation, Chemical and Environmental Hazards, Oxon, United Kingdom.
| | - Claudia Dalke
- Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Germany.
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan.
| | - Mohamed Amine Benadjaoud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP 17, 31 avenue de la division Leclerc, Fontenay-aux-Roses, France.
| | - Vadim Chumak
- National Research Centre for Radiation Medicine, Ukraine.
| | | | - Judith L Kok
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Mariateresa Mancuso
- Laboratory of Biomedical Technologies, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, (ENEA), Rome, Italy.
| | - Laure Sabatier
- Commissariat à l'Energie Atomique et aux Energies Alternatives, Saclay, France.
| | | | - Juliette Thariat
- Laboratoire de physique corpusculaire IN2P3/ENSICAEN -UMR6534 - Unicaen - Normandie University, France
| | - Jean-René Jourdain
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP 17, 31 avenue de la division Leclerc, Fontenay-aux-Roses, France.
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Hamada N, Azizova TV, Little MP. An update on effects of ionizing radiation exposure on the eye. Br J Radiol 2020; 93:20190829. [PMID: 31670577 PMCID: PMC8519632 DOI: 10.1259/bjr.20190829] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/20/2019] [Accepted: 10/26/2019] [Indexed: 12/18/2022] Open
Abstract
The International Commission on Radiological Protection (ICRP) has considered for over 60 years that the lens of the eye is among the most radiosensitive tissues, and has recommended dose limits for the lens to prevent occurrence of vision impairing cataracts (VICs). Epidemiological evidence that doses much lower than previously thought produce cataracts led ICRP to recommend reducing dose threshold for VICs and reducing an occupational equivalent dose limit for the lens in 2011, when only a single threshold of 0.5 Gy was recommended. On the basis of epidemiological evidence, ICRP assumed progression of minor opacities into VICs and no dose rate effect. This contrasts with previously recommended separate thresholds for minor opacities and VICs, and for different exposure scenarios. Progression was assumed based on similar risks of cataracts and cataract surgery in Japanese atomic bomb survivors. The absence of dose rate effect derived from the observed similar thresholds for protracted exposures in Chernobyl cleanup workers and in atomic bomb survivors. Since 2011, there has been an increasing body of epidemiological evidence relating to cataracts and other ocular diseases (i.e. glaucoma and macular degeneration), particularly at low doses and low dose rates. This review paper gives an overview of the scientific basis of the 2011 ICRP recommendation, discusses the plausibility of these two assumptions in the light of emerging scientific evidence, and considers the radiosensitivity of the lens among ocular structures.
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Affiliation(s)
- Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo 201-8511, Japan
| | - Tamara V. Azizova
- Clinical Department, Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk Chelyabinsk Region, 456780, Ozersk, Russia
| | - Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute (NCI), National Institutes of Health (NIH), 9609 Medical Center Drive, MSC 9778, Bethesda, MD 20892-9778, USA
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Pederson SL, Li Puma MC, Hayes JM, Okuda K, Reilly CM, Beasley JC, Li Puma LC, Hinton TG, Johnson TE, Freeman KS. Effects of chronic low-dose radiation on cataract prevalence and characterization in wild boar (Sus scrofa) from Fukushima, Japan. Sci Rep 2020; 10:4055. [PMID: 32132563 PMCID: PMC7055243 DOI: 10.1038/s41598-020-59734-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 01/21/2020] [Indexed: 12/03/2022] Open
Abstract
This study evaluated cataracts in wild boar exposed to chronic low-dose radiation. We examined wild boar from within and outside the Fukushima Exclusion Zone for nuclear, cortical, and posterior subcapsular (PSC) cataracts in vivo and photographically. Plausible upper-bound, lifetime radiation dose for each boar was estimated from radioactivity levels in each animal's home range combined with tissue concentrations of 134+137Cesium. Fifteen exposed and twenty control boar were evaluated. There were no significant differences in overall prevalence or score for cortical or PSC cataracts between exposed and control animals. Nuclear (centrally located) cataracts were significantly more prevalent in exposed boar (p < 0.05) and had statistically higher median scores. Plausible upper-bound, lifetime radiation dose ranged from 1 to 1,600 mGy in exposed animals, with no correlation between dose and cortical or PSC score. While radiation dose and nuclear score were positively associated, the impact of age could not be completely separated from the relationship. Additionally, the clinical significance of even the highest scoring nuclear cataract was negligible. Based on the population sampled, wild boar in the Fukushima Exclusion Zone do not have a significantly higher prevalence or risk of cortical or PSC cataracts compared to control animals.
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Affiliation(s)
- Samantha L Pederson
- Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Margaret C Li Puma
- Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Joshua M Hayes
- Environmental Radiological and Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Kei Okuda
- Institute of Environmental Radioactivity, Fukushima University, Fukushima, Japan
| | | | - James C Beasley
- Savannah River Ecology Laboratory and Warnell School of Forestry and Natural Resources, University of Georgia, Aiken, South Carolina, United States
| | - Lance C Li Puma
- Biomedical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Thomas G Hinton
- Institute of Environmental Radioactivity, Fukushima University, Fukushima, Japan
| | - Thomas E Johnson
- Environmental Radiological and Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - Kate S Freeman
- Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States.
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Gaudreau K, Thome C, Weaver B, Boreham DR. Cataract Formation and Low-Dose Radiation Exposure from Head Computed Tomography (CT) Scans in Ontario, Canada, 1994–2015. Radiat Res 2020; 193:322-330. [DOI: 10.1667/rr15504.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Katherine Gaudreau
- Northern Ontario School of Medicine, Sudbury, Canada, P3E 2C6 and Thunder Bay, Canada, P7B 5E1
| | - Christopher Thome
- Northern Ontario School of Medicine, Sudbury, Canada, P3E 2C6 and Thunder Bay, Canada, P7B 5E1
| | - Bruce Weaver
- Northern Ontario School of Medicine, Sudbury, Canada, P3E 2C6 and Thunder Bay, Canada, P7B 5E1
| | - Douglas R. Boreham
- Northern Ontario School of Medicine, Sudbury, Canada, P3E 2C6 and Thunder Bay, Canada, P7B 5E1
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10
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Azizova T, Moseeva M, Grigoryeva E, Zhuntova G, Bannikova M, Sychugov G, Kazachkov E. Registry of Plutonium-induced Lung Fibrosis in a Russian Nuclear Worker Cohort. HEALTH PHYSICS 2020; 118:185-192. [PMID: 31833971 DOI: 10.1097/hp.0000000000001131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A registry of plutonium-induced lung fibrosis diagnosed in members of a cohort of the first Russian nuclear industry facility Mayak Production Association was established. The registry includes 188 plutonium-induced lung fibrosis diagnoses: 117 (62.23%) in males and 71 (37.77%) in females. This paper describes the structure and detailed characteristics of the registry. Plutonium-induced lung fibrosis was shown to have no association with cumulative lung absorbed dose from external gamma rays as of the date of diagnosis. On the contrary, the plutonium-induced lung fibrosis rate was shown to be associated with cumulative lung absorbed dose from incorporated alpha particles and to increase significantly with increasing dose from internal radiation exposure. This paper discusses potential applications of the registry to scientific investigations in the future.
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Affiliation(s)
- Tamara Azizova
- Federal State Unitary Enterprise, Southern Urals Biophysics Institute at the Federal Medical Biological Agency of the Russian Federation
| | - Maria Moseeva
- Federal State Unitary Enterprise, Southern Urals Biophysics Institute at the Federal Medical Biological Agency of the Russian Federation
| | - Evgeniya Grigoryeva
- Federal State Unitary Enterprise, Southern Urals Biophysics Institute at the Federal Medical Biological Agency of the Russian Federation
| | - Galina Zhuntova
- Federal State Unitary Enterprise, Southern Urals Biophysics Institute at the Federal Medical Biological Agency of the Russian Federation
| | - Maria Bannikova
- Federal State Unitary Enterprise, Southern Urals Biophysics Institute at the Federal Medical Biological Agency of the Russian Federation
| | - Gleb Sychugov
- State Educational Institution of Higher Professional Education, South Ural State Medical University at the Ministry of Health of the Russian Federation
| | - Evgeny Kazachkov
- State Educational Institution of Higher Professional Education, South Ural State Medical University at the Ministry of Health of the Russian Federation
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11
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Glaucoma incidence risk in a cohort of Mayak PA workers occupationally exposed to ionizing radiation. Sci Rep 2019; 9:12469. [PMID: 31462740 PMCID: PMC6713741 DOI: 10.1038/s41598-019-48915-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 08/15/2019] [Indexed: 11/20/2022] Open
Abstract
Glaucoma is a major cause of visual impairment, and secondary glaucoma manifested as neovascular glaucoma has long been known to occur following high-dose fractionated radiation therapy. In contrast, little is known as to whether ionizing radiation exposure causes primary glaucoma, except that a single study in Japanese atomic bomb survivors has reported a significantly increase risk. Therefore, the effect of lower dose and lower dose rate remains unclear. Here we report that in Russian Mayak Production Association workers occupationally exposed to chronic radiation for prolonged periods, incidence of total primary glaucoma and primary open-angle glaucoma is significantly associated with various non-radiation factors (sex, attained age, and cataract diagnosed prior to glaucoma), but neither with cumulative dose from external γ-rays nor with cumulative neutron dose nor with the unweighted sum of cumulative γ and neutron doses. The present results suggest for the first time that chronic radiation exposure does not cause primary glaucoma, although the analyses need to be made in other cohorts exposed at various dose and dose rate.
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12
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Sakashita T, Sato T, Hamada N. A biologically based mathematical model for spontaneous and ionizing radiation cataractogenesis. PLoS One 2019; 14:e0221579. [PMID: 31442279 PMCID: PMC6707595 DOI: 10.1371/journal.pone.0221579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 08/04/2019] [Indexed: 12/20/2022] Open
Abstract
Cataracts have long been known, but a biomathematical model is still unavailable for cataratogenesis. There has been a renewed interest in ionizing radiation cataracts because the recent international recommendation of the reduced lens dose limit stimulated the discussion toward its regulatory implementation in various countries. Nevertheless, a relationship between radiation (dose and dose rate) and response (e.g., incidence, onset and progression) remains incompletely understood, raising the need for a risk-predictive mathematical model. We here report for the first time an in silico model for cataractogenesis. First, a simplified cell proliferation model was developed for human lens growth based on stem and progenitor cell proliferation as well as epithelial-fiber cell differentiation. Then, a model for spontaneous cataractogenesis was developed to reproduce the human data on a relationship between age and cataract incidence. Finally, a model for radiation cataractogenesis was developed that can reproduce the human data on a relationship between dose and cataract onset at various ages, which was further applied to estimate cataract incidence following chronic lifetime exposure. The model can serve as the foundation for further development of the risk-predictive model for cataractogenesis along with additional considerations of various biological mechanisms and epidemiological datasets.
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Affiliation(s)
- Tetsuya Sakashita
- Department of Radiation-Applied Biology Research, Quantum Beam Science Research Directorate, National Institutes for Quantum and Radiological Science and Technology (QST), Watanuki, Takasaki, Gunma, Japan
| | - Tatsuhiko Sato
- Research Group for Radiation Transport Analysis, Nuclear Science and Engineering Center, Japan Atomic Energy Agency (JAEA), Shirakata, Tokai, Ibaraki, Japan
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Iwado-kita, Komae, Tokyo, Japan
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13
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Barnard SGR, McCarron R, Moquet J, Quinlan R, Ainsbury E. Inverse dose-rate effect of ionising radiation on residual 53BP1 foci in the eye lens. Sci Rep 2019; 9:10418. [PMID: 31320710 PMCID: PMC6639373 DOI: 10.1038/s41598-019-46893-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 07/02/2019] [Indexed: 12/25/2022] Open
Abstract
The influence of dose rate on radiation cataractogenesis has yet to be extensively studied. One recent epidemiological investigation suggested that protracted radiation exposure increases radiation-induced cataract risk: cumulative doses of radiation mostly <100 mGy received by US radiologic technologists over 5 years were associated with an increased excess hazard ratio for cataract development. However, there are few mechanistic studies to support and explain such observations. Low-dose radiation-induced DNA damage in the epithelial cells of the eye lens (LECs) has been proposed as a possible contributor to cataract formation and thus visual impairment. Here, 53BP1 foci was used as a marker of DNA damage. Unexpectedly, the number of 53BP1 foci that persisted in the mouse lens samples after γ-radiation exposure increased with decreasing dose-rate at 4 and 24 h. The C57BL/6 mice were exposed to 0.5, 1 and 2 Gy ƴ-radiation at 0.063 and 0.3 Gy/min and also 0.5 Gy at 0.014 Gy/min. This contrasts the data we obtained for peripheral blood lymphocytes collected from the same animal groups, which showed the expected reduction of residual 53BP1 foci with reducing dose-rate. These findings highlight the likely importance of dose-rate in low-dose cataract formation and, furthermore, represent the first evidence that LECs process radiation damage differently to blood lymphocytes.
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Affiliation(s)
- Stephen G R Barnard
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, UK.
- Durham University, Department of Biosciences, Durham, UK.
| | - Roisin McCarron
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, UK
| | - Jayne Moquet
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, UK
| | - Roy Quinlan
- Durham University, Department of Biosciences, Durham, UK.
| | - Elizabeth Ainsbury
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon, UK
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Godard B. [Innovation in healthcare in space to improve life on Earth]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2019; 64:18-23. [PMID: 31208576 DOI: 10.1016/j.soin.2019.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Today, sending people into space has become almost routine. However, it is a potentially dangerous environment for humans. Astronauts' health is closely monitored to ensure they are fit to continue their mission. The conquest of space has also resulted in the development of numerous tools and medicines beneficial for all living beings on Earth.
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Affiliation(s)
- Brigitte Godard
- Institut de médecine physiologie spatiale (IMPS)-Medes, BP 74404, 31405 Toulouse cedex 4, France.
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15
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Azizova TV, Hamada N, Bragin EV, Bannikova MV, Grigoryeva ES. Risk of cataract removal surgery in Mayak PA workers occupationally exposed to ionizing radiation over prolonged periods. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2019; 58:139-149. [PMID: 30879144 DOI: 10.1007/s00411-019-00787-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 03/07/2019] [Indexed: 06/09/2023]
Abstract
In this study, the risk of cataract removal surgery was assessed in a cohort of workers occupationally exposed to ionizing radiation over a prolonged period. The study cohort includes 22,377 workers of the Mayak Production Association (about 25% of whom are females) first employed at one of the main facilities in 1948-1982, who were followed up to the end of 2008. Dose estimates used in the study are provided by the Mayak Worker Dosimetry System 2008. The mean cumulative dose from external γ-rays [personal dose equivalent Hp(10)] is 0.54 ± 0.76 Sv for males and 0.44 ± 0.65 Sv for females. The mean cumulative doses from neutrons (personal dose equivalent Hp(10)n) were 0.034 ± 0.080 Sv for males and 0.033 ± 0.092 Sv for females. Relative risks and excess relative risks per unit dose were calculated based on maximum likelihood. Among 4,177 workers diagnosed with a verified diagnosis of senile cataract, 701 lens removal surgeries (16.7%) were performed by the end of the follow-up period. The risk of cataract removal surgery was shown to be significantly associated with non-radiation factors such as sex, attained age, smoking, an ocular comorbidity (e.g., glaucoma), and a somatic comorbidity (e.g., diabetes mellitus). There was no significant association of cataract removal surgery with external γ-dose regardless of inclusion of the neutron dose adjustment with either linear or non-linear models. It is concluded that cataract removal surgery rate may not be a highly sensitive and specific indicator that could serve as a surrogate for radiation-related cataracts.
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Affiliation(s)
- Tamara V Azizova
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk, Chelyabinsk Region, 456780, Russia.
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo, 201-8511, Japan
| | - Evgeny V Bragin
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk, Chelyabinsk Region, 456780, Russia
| | - Maria V Bannikova
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk, Chelyabinsk Region, 456780, Russia
| | - Evgeniya S Grigoryeva
- Southern Urals Biophysics Institute (SUBI), Ozyorskoe Shosse 19, Ozyorsk, Chelyabinsk Region, 456780, Russia
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16
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Yokoyama S, Hamada N, Tsujimura N. Recent discussions toward regulatory implementation of the new occupational equivalent dose limit for the lens of the eye and related studies in Japan. Int J Radiat Biol 2019; 95:1103-1112. [PMID: 30964367 DOI: 10.1080/09553002.2019.1605464] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Purpose: In 2011, the International Commission on Radiological Protection (ICRP) recommended an equivalent dose limit for the lens of the eye of 20 mSv/year, averaged over defined periods of 5 years, with no single year exceeding 50 mSv for occupational exposure in planned exposure situations. Since then, there have been extensive discussions toward regulatory implementation of such a new occupational lens dose limit. This paper provides an overview of the recent discussions toward regulatory implementation and the current status of the studies related to radiation exposure of the lens and its effect in Japan. Conclusions: In Japan, the Radiation Council established a Subcommittee in July 2017 to discuss the feasibility of implementing the new occupational lens dose limit. In March 2018, the Radiation Council requested all relevant government ministries and agencies to take necessary actions toward implementation of the new occupational lens dose limit, considering a series of discussions made by the Subcommittee. According to the currently available information, the new occupational lens dose limit (20 mSv/year, averaged over defined periods of 5 years, with no single year exceeding 50 mSv) will be implemented into regulations in Japan, most likely in April 2021, albeit subject to change. In particular, there were extensive discussions about reduction of a dose limit and radiation control for workers who may exceed 20 mSv per year, such as the Fukushima Daiichi Nuclear Power Plant decommissioning workers and medical staff, and measurement of 3 mm dose equivalent. In order to underpin regulatory practice, epidemiological and biological studies on radiation effects on the lens and studies on lens dose measurements have been conducted in Japan, some of which have been funded by the Japanese Nuclear Regulation Authority.
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Affiliation(s)
- Sumi Yokoyama
- a Faculty of Radiological Technology, School of Medical Sciences, Fujita Health University , Aichi , Japan
| | - Nobuyuki Hamada
- b Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI) , Tokyo , Japan
| | - Norio Tsujimura
- c Radiation Protection Department, Nuclear Fuel Cycle Engineering Laboratories, Japan Atomic Energy Agency , Ibaraki , Japan
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Cataractogenic load – A concept to study the contribution of ionizing radiation to accelerated aging in the eye lens. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2019; 779:68-81. [DOI: 10.1016/j.mrrev.2019.02.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 12/11/2022]
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18
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Risk of various types of cataracts in a cohort of Mayak workers following chronic occupational exposure to ionizing radiation. Eur J Epidemiol 2018; 33:1193-1204. [DOI: 10.1007/s10654-018-0450-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 10/03/2018] [Indexed: 11/27/2022]
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19
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Vaiserman A, Koliada A, Zabuga O, Socol Y. Health Impacts of Low-Dose Ionizing Radiation: Current Scientific Debates and Regulatory Issues. Dose Response 2018; 16:1559325818796331. [PMID: 30263019 PMCID: PMC6149023 DOI: 10.1177/1559325818796331] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 12/31/2022] Open
Abstract
Health impacts of low-dose ionizing radiation are significant in important fields such as X-ray imaging, radiation therapy, nuclear power, and others. However, all existing and potential applications are currently challenged by public concerns and regulatory restrictions. We aimed to assess the validity of the linear no-threshold (LNT) model of radiation damage, which is the basis of current regulation, and to assess the justification for this regulation. We have conducted an extensive search in PubMed. Special attention has been given to papers cited in comprehensive reviews of the United States (2006) and French (2005) Academies of Sciences and in the United Nations Scientific Committee on Atomic Radiation 2016 report. Epidemiological data provide essentially no evidence for detrimental health effects below 100 mSv, and several studies suggest beneficial (hormetic) effects. Equally significant, many studies with in vitro and in animal models demonstrate that several mechanisms initiated by low-dose radiation have beneficial effects. Overall, although probably not yet proven to be untrue, LNT has certainly not been proven to be true. At this point, taking into account the high price tag (in both economic and human terms) borne by the LNT-inspired regulation, there is little doubt that the present regulatory burden should be reduced.
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Dalke C, Neff F, Bains SK, Bright S, Lord D, Reitmeir P, Rößler U, Samaga D, Unger K, Braselmann H, Wagner F, Greiter M, Gomolka M, Hornhardt S, Kunze S, Kempf SJ, Garrett L, Hölter SM, Wurst W, Rosemann M, Azimzadeh O, Tapio S, Aubele M, Theis F, Hoeschen C, Slijepcevic P, Kadhim M, Atkinson M, Zitzelsberger H, Kulka U, Graw J. Lifetime study in mice after acute low-dose ionizing radiation: a multifactorial study with special focus on cataract risk. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2018; 57:99-113. [PMID: 29327260 PMCID: PMC5902533 DOI: 10.1007/s00411-017-0728-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 12/21/2017] [Indexed: 05/28/2023]
Abstract
Because of the increasing application of ionizing radiation in medicine, quantitative data on effects of low-dose radiation are needed to optimize radiation protection, particularly with respect to cataract development. Using mice as mammalian animal model, we applied a single dose of 0, 0.063, 0.125 and 0.5 Gy at 10 weeks of age, determined lens opacities for up to 2 years and compared it with overall survival, cytogenetic alterations and cancer development. The highest dose was significantly associated with increased body weight and reduced survival rate. Chromosomal aberrations in bone marrow cells showed a dose-dependent increase 12 months after irradiation. Pathological screening indicated a dose-dependent risk for several types of tumors. Scheimpflug imaging of the lens revealed a significant dose-dependent effect of 1% of lens opacity. Comparison of different biological end points demonstrated long-term effects of low-dose irradiation for several biological end points.
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Affiliation(s)
- Claudia Dalke
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Developmental Genetics, 85764 Neuherberg, Germany
| | - Frauke Neff
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Pathology, Neuherberg, Germany
- Present Address: Municipal Clinical Center Munich, Munich, Germany
| | - Savneet Kaur Bains
- Department of Life Sciences, Brunel University London, Uxbridge, UK
- Present Address: Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, UK
| | - Scott Bright
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, UK
- Present Address: University of Texas, MD Anderson, Houston, TX USA
| | - Deborah Lord
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, UK
| | - Peter Reitmeir
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - Ute Rößler
- Department Radiation Protection and Health, Federal Office for Radiation Protection, Oberschleissheim, Germany
| | - Daniel Samaga
- Department Radiation Protection and Health, Federal Office for Radiation Protection, Oberschleissheim, Germany
- Present Address: Helmholtz Center Munich, German Research Center for Environmental Health, Research Unit of Radiation Cytogenetics, Neuherberg, Germany
| | - Kristian Unger
- Helmholtz Center Munich, German Research Center for Environmental Health, Research Unit of Radiation Cytogenetics, Neuherberg, Germany
| | - Herbert Braselmann
- Helmholtz Center Munich, German Research Center for Environmental Health, Research Unit of Radiation Cytogenetics, Neuherberg, Germany
| | - Florian Wagner
- Helmholtz Center Munich, German Research Center for Environmental Health, Research Unit Medical Radiation Physics and Diagnostics, Neuherberg, Germany
- Present Address: Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Radiation Protection, Neuherberg, Germany
| | - Matthias Greiter
- Helmholtz Center Munich, German Research Center for Environmental Health, Research Unit Medical Radiation Physics and Diagnostics, Neuherberg, Germany
- Present Address: Helmholtz Center Munich, German Research Center for Environmental Health, Individual Monitoring Service, Neuherberg, Germany
| | - Maria Gomolka
- Department Radiation Protection and Health, Federal Office for Radiation Protection, Oberschleissheim, Germany
| | - Sabine Hornhardt
- Department Radiation Protection and Health, Federal Office for Radiation Protection, Oberschleissheim, Germany
| | - Sarah Kunze
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Developmental Genetics, 85764 Neuherberg, Germany
| | - Stefan J. Kempf
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Radiation Biology, Neuherberg, Germany
- Present Address: Department of Bioanalytical Sciences, CSL Behring GmbH, Marburg, Germany
| | - Lillian Garrett
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Developmental Genetics, 85764 Neuherberg, Germany
| | - Sabine M. Hölter
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Developmental Genetics, 85764 Neuherberg, Germany
| | - Wolfgang Wurst
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Developmental Genetics, 85764 Neuherberg, Germany
| | - Michael Rosemann
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Radiation Biology, Neuherberg, Germany
| | - Omid Azimzadeh
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Radiation Biology, Neuherberg, Germany
| | - Soile Tapio
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Radiation Biology, Neuherberg, Germany
| | - Michaela Aubele
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Pathology, Neuherberg, Germany
| | - Fabian Theis
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Computational Biology, Neuherberg, Germany
| | - Christoph Hoeschen
- Helmholtz Center Munich, German Research Center for Environmental Health, Research Unit Medical Radiation Physics and Diagnostics, Neuherberg, Germany
- Present Address: Chair of Medical Systems Technology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | | | - Munira Kadhim
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford, UK
| | - Michael Atkinson
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Radiation Biology, Neuherberg, Germany
| | - Horst Zitzelsberger
- Helmholtz Center Munich, German Research Center for Environmental Health, Research Unit of Radiation Cytogenetics, Neuherberg, Germany
| | - Ulrike Kulka
- Department Radiation Protection and Health, Federal Office for Radiation Protection, Oberschleissheim, Germany
| | - Jochen Graw
- Helmholtz Center Munich, German Research Center for Environmental Health, Institute of Developmental Genetics, 85764 Neuherberg, Germany
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Thome C, Chambers DB, Hooker AM, Thompson JW, Boreham DR. Deterministic Effects to the Lens of the Eye Following Ionizing Radiation Exposure: is There Evidence to Support a Reduction in Threshold Dose? HEALTH PHYSICS 2018; 114:328-343. [PMID: 29360710 DOI: 10.1097/hp.0000000000000810] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Ionizing radiation exposure to the lens of the eye is a known cause of cataractogenesis. Historically, it was believed that the acute threshold dose for cataract formation was 5 Sv, and annual dose limits to the lens were set at 150 mSv. Recently, however, the International Commission on Radiological Protection has reduced their threshold dose estimate for deterministic effects to 0.5 Gy and is now recommending an occupational limit of 20 mSv per year on average. A number of organizations have questioned whether this new threshold and dose limit are justified based on the limited reliable data concerning radiation-induced cataracts. This review summarizes all of the published human epidemiological data on ionizing radiation exposure to the lens of the eye in order to evaluate the proposed threshold. Data from a variety of exposure cohorts are reviewed, including atomic bomb survivors, Chernobyl liquidators, medical workers, and radiotherapy patients. Overall, there is not conclusive evidence that the threshold dose for cataract formation should be reduced to 0.5 Gy. Many of the studies reviewed here are challenging to incorporate into an overall risk model due to inconsistencies with dosimetry, sample size, and scoring metrics. Additionally, risk levels in the studied cohorts may not relate to occupational scenarios due to differences in dose rate, radiation quality, age at exposure and latency period. New studies should be designed specifically focused on occupational exposures, with reliable dosimetry and grading methods for lens opacities, to determine an appropriate level for dose threshold and exposure limit.
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Bowman JR, Razi A, Watson SL, Pearson JM, Hudson PW, Patt JC, Ames SE, Leddy LR, Khoury JG, Tubb CC, McGwin G, Ponce BA. What Leads to Lead: Results of a Nationwide Survey Exploring Attitudes and Practices of Orthopaedic Surgery Residents Regarding Radiation Safety. J Bone Joint Surg Am 2018; 100:e16. [PMID: 29406352 DOI: 10.2106/jbjs.17.00604] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Excessive radiation to health-care providers has been linked to risks of cancer and cataracts, but its negative effects can be substantially reduced by lead aprons, thyroid shields, and leaded glasses. Hospitals are required to provide education and proper personal protective equipment, yet discrepancies exist between recommendations and compliance. This article presents the results of a survey of U.S. orthopaedic surgery residents concerning attitudes toward radiation exposure and personal protective equipment behavior. METHODS An invitation to participate in a web-based, anonymous survey was distributed to 46 U.S. allopathic orthopaedic surgery residency programs (1,207 potential resident respondents). The survey was conceptually divided into the following areas: demographic characteristics, training and attitudes concerning occupational hazards, personal protective equipment provision and use, and general safety knowledge. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated for the association between these characteristics and compliance with thyroid shield or lead gown wear. RESULTS In this study, 518 surveys were received, with 1 survey excluded because of insufficient response, leaving 517 surveys for analysis (42.8% response rate). Ninety-eight percent of residents believed that personal protective equipment should be provided by the hospital or residency program. However, provision of personal protective equipment was not universal, with 33.8% reporting none and 54.2% reporting provision of a gown and thyroid shield. The prevalence of leaded glasses usage was 21%. Poor lead gown compliance and thyroid shield wear were associated with difficulty finding the corresponding equipment: PR, 2.51 (95% CI, 1.75 to 3.62; p < 0.001) for poor lead gown compliance and PR, 2.14 (95% CI, 1.46 to 3.16; p < 0.0001) for poor thyroid shield wear. Not being provided with personal protective equipment was also significantly associated with low compliance with both lead gowns (PR, 1.47 [95% CI, 1.04 to 2.08]; p = 0.03) and thyroid shields (PR, 1.69 [95% CI, 1.18 to 2.41]; p = 0.004). Respondents from the Southeast, West, or Midwest had lower compliance with lead gown usage. Forgetting was the number 1 reason to not wear a lead apron (42%). CONCLUSIONS Radiation exposure is associated with increased risk of serious health problems. Our findings identified that the availability of lead personal protective equipment leads to increased compliance among residents surveyed. In addition to yearly occupational hazard training specific to orthopaedic surgery, greater efforts by residency programs and hospitals are needed to improve access to lead personal protective equipment and compliance for orthopaedic residents.
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Affiliation(s)
- James R Bowman
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Afshin Razi
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, New York
| | | | | | - Parke W Hudson
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | | | - Lee R Leddy
- Medical University of South Carolina, Charleston, South Carolina
| | | | - Creighton C Tubb
- New Braunfels Orthopedic Surgery & Sports Medicine, New Braunfels, Texas
| | - Gerald McGwin
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Brent A Ponce
- University of Alabama at Birmingham, Birmingham, Alabama
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23
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Hamada N. Ionizing radiation sensitivity of the ocular lens and its dose rate dependence. Int J Radiat Biol 2016; 93:1024-1034. [DOI: 10.1080/09553002.2016.1266407] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan
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