SOURCES AND EFFECTS OF IONIZING RADIATION : United Nations Scientific Committee on the Effects of Atomic Radiation UNSCEAR 2000 Report to the General Assembly, with Scientific Annexes

NOTE The report of the Committee without its annexes appears as Official Records of the General Assembly, Sixty-third Session, Supplement No. 46. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. The country names used in this document are, in most cases, those that were in use at the time the data were collected or the text prepared. In other cases, however, the names have been updated, where this was possible and appropriate, to reflect political changes. Scientific Annexes Annex A. Medical radiation exposures Annex B. Exposures of the public and workers from various sources of radiation INTROdUCTION 1. In the course of the research and development for and the application of atomic energy and nuclear technologies, a number of radiation accidents have occurred. Some of these accidents have resulted in significant health effects and occasionally in fatal outcomes. The application of technologies that make use of radiation is increasingly widespread around the world. Millions of people have occupations related to the use of radiation, and hundreds of millions of individuals benefit from these uses. Facilities using intense radiation sources for energy production and for purposes such as radiotherapy, sterilization of products, preservation of foodstuffs and gamma radiography require special care in the design and operation of equipment to avoid radiation injury to workers or to the public. Experience has shown that such technology is generally used safely, but on occasion controls have been circumvented and serious radiation accidents have ensued. 2. Reviews of radiation exposures from accidents have been presented in previous UNSCEAR reports. The last report containing an exclusive chapter on exposures from accidents was the UNSCEAR 1993 Report [U6]. 3. This annex is aimed at providing a sound basis for conclusions regarding the number of significant radiation accidents that have occurred, the corresponding levels of radiation exposures and numbers of deaths and injuries, and the general trends for various practices. Its conclusions are to be seen in the context of the Committee's overall evaluations of the levels and effects of exposure to ionizing radiation. 4. The Committee's evaluations of public, occupational and medical diagnostic exposures are mostly concerned with chronic exposures of …

sources and effects of ionizing radiation

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines

In most areas of the world, thyroid cancer incidence has been appreciably increasing over the last few decades, whereas mortality has steadily declined. We updated global trends in thyroid cancer mortality and incidence using official mortality data from the World Health Organization (1970-2012) and incidence data from the Cancer Incidence in Five Continents (1960-2007). Male mortality declined in all the major countries considered, with annual percent changes around -2/-3% over the last decades. Only in the United States mortality declined up to the mid 1980s and increased thereafter. Similarly, in women mortality declined in most countries considered, with APCs around -2/-5% over the last decades, with the exception of the UK, the United States and Australia, where mortality has been declining up to the late 1980s/late 1990s to level off (or increase) thereafter. In 2008-2012, most countries had mortality rates (age-standardized, world population) between 0.20 and 0.40/100,000 men and 0.20 and 0.60/100,000 women, the highest rates being in Latvia, Hungary, the Republic of Moldova and Israel (over 0.40/100,000) for men and in Ecuador, Colombia and Israel (over 0.60/100,000) for women. In most countries, a steady increase in the incidence of thyroid cancer (mainly papillary carcinomas) was observed in both sexes. The declines in thyroid cancer mortality reflect both variations in risk factor exposure and changes in the diagnosis and treatment of the disease, while the increases in the incidence are likely due to the increase in the detection of this neoplasm over the last few decades.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/ijc.29251

Thyroid cancer mortality and incidence: A global overview

The carcinogenic risk induced by low doses of ionizing radiation is controversial. It cannot be assessed with epidemiologic methods alone because at low doses the data are imprecise and often conflicting. Since the 1970s, the radiation protection community has estimated the risk of low doses by means of extrapolation from the risk assessed at high doses, generally by using the linear no-threshold (LNT) model.

The LNT relationship implies proportionality between dose and cancer risk. This approach is based on one set of data and two hypotheses: (a) The relationship between dose and DNA damage in vivo seems linear from 1 mGy to 100 Gy with use of H2AX foci as a marker for DNA double-strand breaks (DSBs)—however, this marker is not specific (1); (b) each DSB is hypothesized to have the same probability of inducing cell transformation, irrespective of the quantity of DSBs present simultaneously in the cell; and (c) each transformed cell is hypothesized to have the same probability of developing into an invasive cancer, irrespective of the dose delivered to the tissue. The advances during the past 2 decades in radiation biology, the understanding of carcinogenesis, and the discovery of defenses against carcinogenesis challenge the LNT model, which appears obsolete (2–6).

Life developed in a bath of ionizing radiation and solar ultraviolet radiation and created aerobic organisms requiring (a) defenses against the metabolically induced reactive oxygen species, (b) DNA repair, and (c) elimination of damaged cells. Several sets of data show the efficacy of these defenses to be much higher at low than at high doses and for fractionated or protracted irradiation than for acute irradiation.

The LNT model was introduced as a concept to facilitate radiation protection (7). But the use of this model led to the claim that even the smallest dose (one electron traversing a cell) may initiate carcinogenesis—for instance, from diagnostic x-ray sources (8,9). This claim is highly hypothetical and has resulted in medical, economic, and other societal harm.

The French Academies report (10) concluded that the LNT model and its use for assessing the risks associated with low doses are not based on scientific evidence. In contrast, the Biological Effects of Ionizing Radiation (BEIR) VII report (11) and that of the International Commission on Radiological Protection (ICRP) (12) recommended the use of the LNT model. We wish to update this debate by using recent radiation biologic and epidemiologic data.

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The linear no-threshold relationship is inconsistent with radiation biologic and experimental data.

relationship was observed up to 1.5 – 2 Gy. The risk of radiation-related thyroid cancer was three times higher in iodine-defi cient areas (relative risk [RR]= 3.2, 95% CI = 1.9 to 5.5) than elsewhere. Administration of potassium iodide as a dietary supplement reduced this risk of radiation-related thyroid cancer by a factor of 3 (RR = 0.34, 95% CI = 0.1 to 0.9, for consumption of potassium iodide versus no consumption). Conclusion: Exposure to 131 I in childhood is associated with an increased risk of thyroid cancer. Both iodine defi ciency and iodine supplementation appear to modify this risk. These results have important public health implications: stable iodine supplementation in iodine-defi cient populations may substantially reduce the risk of thyroid cancer related to radioactive iodines in case of exposure to radioactive iodines in childhood that may occur after radiation accidents or during medical diagnostic and therapeutic procedures. [J Natl Cancer Inst 2005;97:724 – 32]

Risk of Thyroid Cancer After Exposure to 131I in Childhood

The main features of thyroid dose reconstruction after the Chemobyl accident are discussed. The method is also presented taking into account extra-thyroid radiation from other radionuclides distributed inside and on the surface of the human body, and recorded by the equipment simultaneously with 131 I in the thyroid. The choice of the 131 I intake function for thyroid dose estimation and influencing factors is discussed. Reconstruction of an average thyroid dose in settlements without direct measurements was based on the regression analysis of the connection between average 'measured' thyroid dose in settlements and 131 I concentration in milk, or 137 Cs soil contamination, or 134 Cs and 137 Cs whole-body content in residents of the same settlement.

Thyroid Dose Reconstruction for the Population of Russia after the Chernobyl Accident

Individual radiation doses to the thyroid were reconstructed for 2239 subjects of a case-control study of thyroid cancer among young people that was carried out in regions of Belarus and Russia contaminated by radioactive fallout from the Chernobyl accident. Although the process of dose reconstruction provides a point estimate of each subject's dose, it is obvious that there is uncertainty associated with these dose calculations. The following main sources of uncertainty in the estimated individual doses were identified: (1) shared and unshared errors associated with parameters of the dosimetry model; and (2) unshared errors that are associated with the variability, reliability and ability of information from the personal interviews. Besides setting up proper distributions for the parameters of the dosimetry model, inter-individual correlations were also defined to take into account shared errors. By the application of Monte Carlo simulations, a set of approximately log-normally distributed thyroid doses was obtained for each subject; the geometric standard deviations of the distributions are found to vary among individuals from 1.7 to 3.7.

Uncertainties in individual doses in a case–control study of thyroid cancer after the Chernobyl accident

General methodology for reconstruction of the internal dose in groups of inhabitants of the Chernobyl accident area is considered, and practical techniques for reconstruction of the 131 I absorbed dose in thyroid and the effective doses of 137 Cs and 134 Cs radiation are examined. The techniques are based on the results of radiation monitoring performed since 1986 in the Bryansk, Tula, Orel and Kaluga regions of Russia. The WBC measurements of the thyroid or whole body provide the data most relevant to internal dose, and are of first priority for dose reconstruction. Radionuclide intake estimation with food products is considered as the second priority and application of radioecological models as the third priority when measurement data are absent. For the calculation of internal dose intake functions are suggested that describe both consequences of vegetation surface contamination with 131 I and 134,137 Cs in the early period and long-term radionuclide transfer via root systems. The first experimental data on the dependence of 131 I concentration in milk on time, and on density of soil contamination with 137 Cs in four regions of Russia are given. A strong connection between 131 I concentration in milk and thyroid dose in inhabitants based on 131 I in thyroid measurements is proved. Regularities revealed are used for thyroid dose reconstruction in Russian inhabitants. The results explain the phenomenon of the increased thyroid cancer morbidity in areas with low radioactive contamination.

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I. A. Zvonova

Papers

Risk of Thyroid Cancer After Exposure to 131I in Childhood

Thyroid Dose Reconstruction for the Population of Russia after the Chernobyl Accident

Uncertainties in individual doses in a case–control study of thyroid cancer after the Chernobyl accident

Methodology of Internal Dose Reconstruction for A Russian Population after the Chernobyl Accident

Methodology of internal dose reconstruction for the russian population after the chernobyl accident