Study design A retrospective cohort study was conducted in 5573 female patients with scoliosis who were referred for treatment at 14 orthopedic medical centers in the United States. Patients were less than 20 years of age at diagnosis which occurred between 1912 and 1965. Objectives To evaluate patterns in breast cancer mortality among women with scoliosis, with special emphasis on risk associated with diagnostic radiograph exposures. Summary of background data A pilot study of 1030 women with scoliosis revealed a nearly twofold statistically significant increased risk for incident breast cancer. Although based on only 11 cases, findings were consistent with radiation as a causative factor. Methods Medical records were reviewed for information on personal characteristics and scoliosis history. Diagnostic radiograph exposures were tabulated based on review of radiographs, radiology reports in the medical records, radiograph jackets, and radiology log books. Radiation doses were estimated for individual examinations. The mortality rate of the cohort through January 1, 1997, was determined by using state and national vital statistics records and was compared with that of women in the general U. S. population. Results Nearly 138,000 radiographic examinations were recorded. The average number of examinations per patient was 24.7 (range, 0-618); mean estimated cumulative radiation dose to the breast was 10.8 cGy (range, 0-170). After excluding patients with missing information, 5466 patients were included in breast cancer mortality analyses. Their mean age at diagnosis was 10.6 years and average length of follow-up was 40.1 years. There were 77 breast cancer deaths observed compared with the 45.6 deaths expected on the basis of U.S. mortality rates (standardized mortality ratio [SMR] = 1.69; 95% confidence interval [CI] = 1.3-2.1). Risk increased significantly with increasing number of radiograph exposures and with cumulative radiation dose. The unadjusted excess relative risk per Gy was 5.4 (95% CI = 1.2-14.1); when analyses were restricted to patients who had undergone at least one radiographic examination, the risk estimate was 2.7 (95% CI = -0. 2-9.3). Conclusions These data suggest that exposure to multiple diagnostic radiographic examinations during childhood and adolescence may increase the risk of breast cancer among women with scoliosis; however, potential confounding between radiation dose and severity of disease and thus with reproductive history may explain some of the increased risk observed.

Breast cancer mortality after diagnostic radiography: findings from the U.S. Scoliosis Cohort Study.

Radon generated within the upper few meters of the Earth's crust by the radioactive decay of radium can migrate during its brief lifetime from soil into the atmosphere. This phenomenon leads to a human health concern as inhalation of the short-lived decay products of radon causes irradiation of cells lining the respiratory tract. This paper reviews the factors that control the rate at which two radon isotopes, 222Rn and 220Rn, enter outdoor and indoor air from soil. The radium content of surface soils in the United States is usually in the range 10–100 Bq kg−1. The emanation coefficient, which refers to the fraction of radon generated in a material that enters the pore fluids, varies over a wide range with a typical value being 0.2. Radon in soil pores may be partitioned among three states: in the pore air, dissolved in the pore water, and sorbed to the soil grains. Except in the immediate vicinity of buildings, radon migrates through soil pores principally by molecular diffusion. Average reported flux densities from undisturbed soil into the atmosphere are 0.015–0.048 Bq m−2 s−1 for 222Rn and 1.6–1.7 Bq m−2 s−1 for 220Rn. Soil is the dominant source of radon in most buildings. Advective flow of soil gas across substructure penetrations is a key element in the transport process. The advective flow is driven by the weather (wind and indoor-outdoor temperature differences) and by the operation of building systems, such as heating and air conditioning equipment. A typical radon entry rate into a single-family dwelling of 10–15 kBq h−1 can be accounted for by weather-induced pressure-driven flow through moderately to highly permeable soils. The extent to which diffusion through soil pores contributes to radon entry into buildings is not known, but in buildings with elevated concentrations, diffusion is believed to be less important than advection.

Radon transport from soil to air

http://projects.itn.pt/Methasource_2015/Etiope_Martinelli_2002.pdf

Migration of carrier and trace gases in the geosphere: an overview

Estimation of radon emanation factor in Indian building materials

Background Several ecologic analyses have shown significant positive associations between mean indoor radon concentrations and risk of leukemia at all ages (acute myeloid leukemia and chronic lymphocytic leukemia) and for children (all leukemia, acute myeloid leukemia, and acute lymphoblastic leukemia [ALL]). As part of an age-matched, case-control study of childhood ALL in the United States, we investigated the association between the incidence of ALL in children under age 15 years and indoor radon exposure. Methods Radon detectors were placed in current and previous homes of subjects where they resided for 6 months or longer. Children were included in analyses if radon measurements covered 70% or more of the 5-year period prior to diagnosis for case subjects (or from birth for case subjects under age 5 years) and the corresponding reference dates for control subjects. Radon levels could be estimated for 97% of the exposure period for the eligible 505 case subjects and 443 control subjects. Results Mean radon concentration was lower for case subjects (65.4 becquerels per cubic meter [Bqm(-3)]) than for control subjects (79.1 Bqm(-3)). For categories less than 37, 37-73, 74-147, and 148 or more Bqm(-3) of radon exposure, relative risks based on matched case-control pairs were 1.00, 1.22, 0.82, and 1.02, respectively, and were similar to results from an unmatched analysis. There was no association between ALL and radon exposure within subgroups defined by categories of age, income, birth order, birth weight, sex, type of residence, magnetic field exposure, parental age at the subject's birth, parental occupation, or parental smoking habits. Conclusions In contrast to prior ecologic studies, the results from this analytic study provide no evidence for an association between indoor radon exposure and childhood ALL.

Case-Control Study of Childhood Acute Lymphoblastic Leukemia and Residential Radon Exposure

Radon and Its Decay Products in Indoor Air and Indoor Radon and Its Hazards and Environmental Radon

The question of the risks associated with low-level exposure to ionizing radiation and the associated statutory limitations on exposure remains a topic of vigorous debate amongst medical and health physicists, clinical radiologists and members of the public. DEGREESIHealth Effects of Exposure to Low-Level Ionizing Radiation presents a comprehensive, consideration of these issues within a solid historical and scientific framework. It provides a thorough and understandable discussion of radiation sources, health effects, radiation protection, and worker and public perception and education about radiat

Health Effects of Exposure to Low-Level Ionizing Radiation

New methods being developed for future extraction of plutonium and uranium from nuclear waste incorporate safeguards against weapons proliferation.

Reprocessing spent nuclear fuel

This book presents information on energy futures; energy demand, energy supplies; exclusive paths and difficult choices--hard, soft, and moderate energy paths; an energy-deficient society; energy shortages; economics of light-water reactors; fast breeder reactor economics; international cooperation in the nuclear field; nuclear recycling; alternative fuels, fuel cycles, and reactors; the nuclear weapons proliferation issue; paths to a world with more reliable nuclear safeguards; the homemade bomb issue; LWR risk assessment; accident analysis and risk assessment; the waste disposal risk; radon problems; risks in our society; health effects of low-level radiation; routine releases of radioactivity from the nuclear industry; low-level radioactivity and infant mortality; the myth of plutonium toxicity; myths about high-level radioactive waste; the aging reactor myth; the police state myth; insurance and nuclear power--the Price-Anderson Act; and solar and nuclear power as partners.

David Bodansky

Papers

Radon and Its Decay Products in Indoor Air and Indoor Radon and Its Hazards and Environmental Radon

Health Effects of Exposure to Low-Level Ionizing Radiation

Reprocessing spent nuclear fuel

Nuclear Energy: A Sensible Alternative