Showing papers in "Journal of Radiological Protection in 2015"

NCICT: a computational solution to estimate organ doses for pediatric and adult patients undergoing CT scans

Abstract: We developed computational methods and tools to assess organ doses for pediatric and adult patients undergoing computed tomography (CT) examinations. We used the International Commission on Radiological Protection (ICRP) reference pediatric and adult phantoms combined with the Monte Carlo simulation of a reference CT scanner to establish comprehensive organ dose coefficients (DC), organ absorbed dose per unit volumetric CT Dose Index (CTDIvol) (mGy/mGy). We also developed methods to estimate organ doses with tube current modulation techniques and size specific dose estimates. A graphical user interface was designed to obtain user input of patient- and scan-specific parameters, and to calculate and display organ doses. A batch calculation routine was also integrated into the program to automatically calculate organ doses for a large number of patients. We entitled the computer program, National Cancer Institute dosimetry system for CT(NCICT). We compared our dose coefficients with those from CT-Expo, and evaluated the performance of our program using CT patient data. Our pediatric DCs show good agreements of organ dose estimation with those from CT-Expo except for thyroid. Our results support that the adult phantom in CT-Expo seems to represent a pediatric individual between 10 and 15 years rather than an adult. The comparison of CTDIvol values between NCICT and dose pages from 10 selected CT scans shows good agreements less than 12% except for two cases (up to 20%). The organ dose comparison between mean and modulated mAs shows that mean mAs-based calculation significantly overestimates dose (up to 2.4-fold) to the organs in close proximity to lungs in chest and chest-abdomen-pelvis scans. Our program provides more realistic anatomy based on the ICRP reference phantoms, higher age resolution, the most up-to-date bone marrow dosimetry, and several convenient features compared to previous tools. The NCICT will be available for research purpose in the near future.

Eye lens monitoring for interventional radiology personnel: dosemeters, calibration and practical aspects of H-p(3) monitoring. A 2015 review

Abstract: A thorough literature review about the current situation on the implementation of eye lens monitoring has been performed in order to provide recommendations regarding dosemeter types, calibration procedures and practical aspects of eye lens monitoring for interventional radiology personnel. Most relevant data and recommendations from about 100 papers have been analysed and classified in the following topics: challenges of today in eye lens monitoring; conversion coefficients, phantoms and calibration procedures for eye lens dose evaluation; correction factors and dosemeters for eye lens dose measurements; dosemeter position and influence of protective devices. The major findings of the review can be summarised as follows: the recommended operational quantity for the eye lens monitoring is H p (3). At present, several dosemeters are available for eye lens monitoring and calibration procedures are being developed. However, in practice, very often, alternative methods are used to assess the dose to the eye lens. A summary of correction factors found in the literature for the assessment of the eye lens dose is provided. These factors can give an estimation of the eye lens dose when alternative methods, such as the use of a whole body dosemeter, are used. A wide range of values is found, thus indicating the large uncertainty associated with these simplified methods. Reduction factors from most common protective devices obtained experimentally and using Monte Carlo calculations are presented. The paper concludes that the use of a dosemeter placed at collar level outside the lead apron can provide a useful first estimate of the eye lens exposure. However, for workplaces with estimated annual equivalent dose to the eye lens close to the dose limit, specific eye lens monitoring should be performed. Finally, training of the involved medical staff on the risks of ionising radiation for the eye lens and on the correct use of protective systems is strongly recommended.

EPI-CT: design, challenges and epidemiological methods of an international study on cancer risk after paediatric and young adult CT

Abstract: Computed tomography (CT) has great clinical utility and its usage has increased dramatically over the years. Concerns have been raised, however, about health impacts of ionising radiation exposure from CTs, particularly in children, who have a higher risk for some radiation induced diseases. Direct estimation of the health impact of these exposures is needed, but the conduct of epidemiological studies of paediatric CT populations poses a number of challenges which, if not addressed, could invalidate the results. The aim of the present paper is to review the main challenges of a study on the health impact of paediatric CTs and how the protocol of the European collaborative study EPI-CT, coordinated by the International Agency for Research on Cancer (IARC), is designed to address them. The study, based on a common protocol, is being conducted in Belgium, Denmark, France, Germany, the Netherlands, Norway, Spain, Sweden and the United Kingdom and it has recruited over one million patients suitable for long-term prospective follow-up. Cohort accrual relies on records of participating hospital radiology departments. Basic demographic information and technical data on the CT procedure needed to estimate organ doses are being abstracted and passive follow-up is being conducted by linkage to population-based cancer and mortality registries. The main issues which may affect the validity of study results include missing doses from other radiological procedures, missing CTs, confounding by CT indication and socioeconomic status and dose reconstruction. Sub-studies are underway to evaluate their potential impact. By focusing on the issues which challenge the validity of risk estimates from CT exposures, EPI-CT will be able to address limitations of previous CT studies, thus providing reliable estimates of risk of solid tumours and leukaemia from paediatric CT exposures and scientific bases for the optimisation of paediatric CT protocols and patient protection.

Risk of mortality from circulatory diseases in Mayak workers cohort following occupational radiation exposure.

Abstract: Mortality from circulatory diseases (CD) (ICD-9 codes 390–459) was studied in an extended Mayak worker cohort, which included 22 377 workers first employed at the Mayak Production Association in 1948–1982 and followed up to the end of 2008. The enlarged cohort and extended follow-up as compared to the previous analyses provided an increased number of deaths from CD and improved statistical power of this mortality study. The analyses were based on dose estimates provided by a new Mayak Worker Dosimetry System 2008 (MWDS-2008). For the first time in the study of non-cancer effects in this cohort quantitative smoking data (smoking index) were taken into account. A significant increasing trend for CD mortality with increasing dose from external gamma-rays was found after having adjusted for non-radiation factors; the excess relative risk per unit dose (ERR/Gy) was 0.05 (95% confidence interval (CI): >0, 0.11). Inclusion of an additional adjustment for dose from internal alpha-radiation to the liver resulted in a two-fold increase of ERR/Gy = 0.10 (95% CI: 0.02, 0.21). A significant increasing trend in CD mortality with increasing dose from internal alpha-radiation to the liver was observed (ERR/Gy = 0.27, 95% CI: 0.12, 0.48). However the ERR/Gy decreased and lost its significance after adjusting for dose from external gamma-rays. Results of the current study are in good agreement with risk estimates obtained for the Japanese LSS cohort as well as other studies of cohorts of nuclear workers.

Calculation of lifetime lung cancer risks associated with radon exposure, based on various models and exposure scenarios.

Abstract: The risk of lung cancer mortality up to 75 years of age due to radon exposure has been estimated for both male and female continuing, ex- and never-smokers, based on various radon risk models and exposure scenarios. We used risk models derived from (i) the BEIR VI analysis of cohorts of radon-exposed miners, (ii) cohort and nested case-control analyses of a European cohort of uranium miners and (iii) the joint analysis of European residential radon case-control studies. Estimates of the lifetime lung cancer risk due to radon varied between these models by just over a factor of 2 and risk estimates based on models from analyses of European uranium miners exposed at comparatively low rates and of people exposed to radon in homes were broadly compatible. For a given smoking category, there was not much difference in lifetime lung cancer risk between males and females. The estimated lifetime risk of radon-induced lung cancer for exposure to a concentration of 200 Bq m−3 was in the range 2.98–6.55% for male continuing smokers and 0.19–0.42% for male never-smokers, depending on the model used and assuming a multiplicative relationship for the joint effect of radon and smoking. Stopping smoking at age 50 years decreases the lifetime risk due to radon by around a half relative to continuing smoking, but the risk for ex-smokers remains about a factor of 5–7 higher than that for never-smokers. Under a sub-multiplicative model for the joint effect of radon and smoking, the lifetime risk of radon-induced lung cancer was still estimated to be substantially higher for continuing smokers than for never smokers. Radon mitigation—used to reduce radon concentrations at homes—can also have a substantial impact on lung cancer risk, even for persons in their 50 s; for each of continuing smokers, ex-smokers and never-smokers, radon mitigation at age 50 would lower the lifetime risk of radon-induced lung cancer by about one-third. To maximise risk reductions, smokers in high-radon homes should both stop smoking and remediate their homes.

Luminescence-based retrospective dosimetry using Al2O3 from mobile phones: a simulation approach to determine the effects of position

Abstract: Monte Carlo modelling has been performed in support of efforts to establish emergency dosimetry services based on optically or thermally stimulated luminescence (OSL/TL) of the Al2O3 substrate present on the resistors found in mobile phones, which can act as fortuitous retrospective dosemeters for photon exposures. Specifically, a range of exposure conditions has been modelled to assess the dependence of the dosimetry on factors such as the position of resistors within a phone, the orientation of the phone relative to the source, and the location of the phone relative to its owner. Variations due to the resistors? positions and the phone?s orientation were generally found to contribute just a few percent to the uncertainty on the dose assessments, though the electrical contacts surrounding the resistors could potentially enhance these by several 10s of percent. But, the location of the phone was found to impact dosimetry greatly. The largest discrepancies in the results were found for low-energy exposures: for 192Ir, differences of up to an order-of-magnitude were found between resistor and whole body doses. The outcome of the work was to derive correction / calibration factors that can be applied to estimate whole body doses from OSL/TL readings, the accurate application of which would depend on the knowledge of the exposure geometry and the degree of conservatism acceptable for the dose assessment.

Age and gender specific biokinetic model for strontium in humans

Abstract: 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 90Sr 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.

Investigation of radiation protection of medical staff performing medical diagnostic examinations by using PET/CT technique.

Abstract: Positron emission tomography (PET) is now one of the most important methods in the diagnosis of cancer diseases. Due to the rapid growth of PET/CT centres in Poland in less than a decade, radiation protection and, consequently, the assessment of worker exposure to ionising radiation, emitted mainly by the isotope (18)F, have become essential issues. The main aim of the study was to analyse the doses received by workers employed in the Medical Diagnostic Centre. The analysis comprises a physicist, three nurses, three physicians, three technicians, as well as two administrative staff employees. High-sensitivity thermoluminescent detectors (TLDs) were used to measure the doses for medical staff. The personnel was classified into categories, among them employees having direct contact with the 'source of radiation'-(18)FDG. The TLDs were placed on the fingertips of both hands and they were also attached at the level of eye lenses, thyroid and gonads depending on the assigned category. The highest dose of radiation was observed during the administration of the (18)FDG to the patients. In the case of the physicist, the highest dose was recorded during preparation of the radiopharmaceutical-(18)FDG. The body parts most exposed to ionizing radiation are the fingertips of the thumb, index and middle finger.

What have we learned from a questionnaire survey of citizens and doctors both inside and outside Fukushima?: survey comparison between 2011 and 2013.

Abstract: The disaster at the Fukushima Daiichi Nuclear Power Plant (FDNPP) remains unresolved because the estimated time to decommission a nuclear reactor appears to be approximately 40 years. The number of workers exposed to radiation doses ranging from 1 to 100 mSv continues to increase. To understand the accident progression at Fukushima and to anticipate what we should do in the future for occupational and environmental health, we performed a survey of citizens and doctors who lived inside and outside Fukushima in 2011 and 2013. In a comparison of these 2 years, the citizens inside Fukushima continue to suffer anxiety, although those living outside Fukushima tended to feel less anxious. Medical students who had recently studied radiation biology showed much less ongoing anxiety compared with other groups, suggesting that learning about the effects of radiation is essential to understanding one's own circumstances objectively and correctly. The lack of trust in the government and in the Tokyo Electric Power Company (TEPCO) in 2013 remains high in all groups. Therefore, long-term forthright explanations from the government, TEPCO, and radiation experts are indispensable not only to establish trust with people but also to alleviate psychological stress.

Radiological and Chemical Toxicity Due to Ingestion of Uranium through Drinking Water in the Environment of Bangalore, India

Abstract: Groundwater samples collected from 96 bore wells in the study area (city of Bangalore) were analysed for concentration of natural uranium using laser-induced fluorimetry. The risk to the population of the region associated with radiological and chemical toxicity of uranium due to its ingestion through drinking water over a lifetime was estimated. The concentration of uranium was found to be in the range 0.136 to 2027.5 μg L−1 with an average value of 92.42 μg L−1. In the present study, about 61% of the samples show concentrations of uranium within the safe limit of 30 μg L−1 as set by the world health organisation. The radiological risk estimated as lifetime cancer risk is in the range 4.3 × 10−7 to 6.4 × 10−3 with an average of 2.9 × 10−4. The chemical toxicity risk measured as lifetime average daily dose is found to range from 0.005 to 75.42 μg kg−1 d−1. The reference dose estimated as 1.12 μg kg−1 d−1 was used to assess the chemical toxicity. The results indicate that the chemical toxicity due to ingestion of uranium through drinking water is of more concern than the radiological toxicity. The present study, being the first of its kind in this region, will augment the database of uranium in groundwater.

Patient doses in paediatric interventional cardiology: impact of 3D rotational angiography

Abstract: The aim of this study was to calculate the contribution of 3D rotational angiography to radiation doses received by paediatric patients in a cardiac catheterisation laboratory. The percentage increase in the median value of air kerma-area product due to cone beam CT was 33 and 16% for diagnostic and therapeutic procedures, respectively. Results are presented separately for five age groups and ten weight groups. Several methods for reducing radiation from 3D rotational angiography are suggested and patient doses are compared with previously published values.

Germline minisatellite mutations in workers occupationally exposed to radiation at the Sellafield nuclear facility

Abstract: Germline minisatellite mutation rates were investigated in male workers occupationally exposed to radiation at the Sellafield nuclear facility. DNA samples from 160 families with 255 offspring were analysed for mutations at eight hypervariable minisatellite loci (B6.7, CEB1, CEB15, CEB25, CEB36, MS1, MS31, MS32) by Southern hybridisation. No significant difference was observed between the paternal mutation rate of 5.0% (37 mutations in 736 alleles) for control fathers with a mean preconceptional testicular dose of 9 mSv and that of 5.8% (66 in 1137 alleles) for exposed fathers with a mean preconceptional testicular dose of 194 mSv. Subgrouping the exposed fathers into two dose groups with means of 111 mSv and 274 mSv revealed paternal mutation rates of 6.0% (32 mutations in 536 alleles) and 5.7% (34 mutations in 601 alleles), respectively, neither of which was significantly different in comparisons with the rate for the control fathers. Maternal mutation rates of 1.6% (12 mutations in 742 alleles) for the partners of control fathers and 1.7% (19 mutations in 1133 alleles) for partners of exposed fathers were not significantly different. This study provides evidence that paternal preconceptional occupational radiation exposure does not increase the germline minisatellite mutation rate and therefore refutes suggestions that such exposure could result in a destabilisation of the germline that can be passed on to future generations.

On the feasibility of utilizing active personal dosimeters worn on the chest to estimate occupational eye lens dose in x-ray angiography.

Abstract: The International Commission on Radiological Protection (ICRP) has recommended that the occupational dose limit to the eye lens be substantially reduced. To ensure compliance with these recommendations, monitoring of the occupational eye lens dose is essential in certain hospital work environments. For assessment of the eye lens dose it is recommended to use a supplementary dosimeter placed at a position adjacent to the eye(s). Wearing a dosimeter at eye level can, however, be impractical and distributing and managing additional dosimeters over long periods of time is cumbersome and costly for large clinical sites. An attractive alternative is to utilize active personal dosimeters (APDs), which are routinely used by clinical staff for real-time monitoring of the personal dose equivalent rate (H(p)(10)). In this work, a formalism for the determination of eye lens dose from the response of such APD's worn on the chest is proposed and evaluated. The evaluation is based on both phantom and clinical measurements performed in an x-ray angiography suite for interventional cardiology. The main results show that the eye lens dose to the primary operator and to the assisting clinical staff can be conservatively estimated from the APD response as D(eye)(conductor) = 2.0 APD chest and D(eye)(assisting) = 1.0 APD chest, respectively. However, care should be exercised for particularly short assisting staff and if radiation protection shields are misused. These concerns can be greatly mitigated if the clinical staff are provided with adequate radiation protection training.

US Transuranium and Uranium Registries case study on accidental exposure to uranium hexafluoride.

Abstract: The United States Transuranium and Uranium Registries? (USTUR) whole-body donor (Case 1031) was exposed to an acute inhalation of uranium hexafluoride (UF6) produced from an explosion at a uranium processing plant 65?years prior to his death. The USTUR measurements of tissue samples collected at the autopsy indicated long-term retention of inhaled slightly enriched uranium material (0.85% 235U) in the deep lungs and thoracic lymph nodes. In the present study, the authors combined the tissue measurement results with historical bioassay data, and analysed them with International Commission on Radiological Protection (ICRP) respiratory tract models and the ICRP Publication 69 systemic model for uranium using maximum likelihood and Bayesian statistical methods. The purpose of the analysis was to estimate intakes and model parameter values that best describe the data, and evaluate their effect on dose assessment. The maximum likelihood analysis, which used the ICRP Publication 66 human respiratory tract model, resulted in a point estimate of 79?mg of uranium for the occupational intake composed of 86% soluble, type F material and 14% insoluble, type S material. For the Bayesian approach, the authors applied the Markov Chain Monte Carlo method, but this time used the revised human respiratory tract model, which is currently being used by ICRP to calculate new dose coefficients for workers. The Bayesian analysis estimated that the mean uranium intake was 160?mg, and calculated the case-specific lung dissolution parameters with their associated uncertainties. The parameters were consistent with the inhaled uranium material being predominantly soluble with a small but significant insoluble component. The 95% posterior range of the rapid dissolution fraction (the fraction of deposited material that is absorbed to blood rapidly) was 0.12 to 0.91 with a median of 0.37. The remaining fraction was absorbed slowly, with a 95% range of 0.000?22?d?1 to 0.000?36?d?1 and a median of 0.000?31?d?1. The effective dose per unit intake calculated using the dissolution parameters derived from the maximum likelihood and the Bayesian analyses was higher than the current ICRP dose coefficient for type F uranium by a factor of 2 or 7, respectively; the higher value of the latter was due to use of the revised respiratory tract model. The dissolution parameter values obtained here may be more appropriate to use for radiation protection purposes when individuals are exposed to a UF6 mixture that contains an insoluble uranium component.

Calculating disability-adjusted life years (DALY) as a measure of excess cancer risk following radiation exposure.

Abstract: This paper has proposed that disability-adjusted life year (DALY) can be used as a measure of radiation health risk. DALY is calculated as the sum of years of life lost (YLL) and years lived with disability (YLD). This multidimensional concept can be expressed as a risk index without a probability measure to avoid the misuse of the current radiation detriment at low doses. In this study, we calculated YLL and YLD using Japanese population data by gender. DALY for all cancers in Japan per 1 Gy per person was 0.84 year in men and 1.34 year in women. The DALY for all cancers in the Japanese baseline was 4.8 in men and 3.5 in women. When we calculated the ICRP detriment from the same data, DALYs for the cancer sites were similar to the radiation detriment in the cancer sites, excluding leukemia, breast and thyroid cancer. These results suggested that the ICRP detriment overestimate the weighting fraction of leukemia risk and underestimate the weighting fraction of breast and thyroid cancer. A big advantage over the ICRP detriment is that DALY can calculate the risk components for non-fatal diseases without the data of lethality. This study showed that DALY is a practical tool that can compare many types of diseases encountered in public health.

Occupational exposures to radiofrequency fields: results of an Israeli national survey.

Abstract: Relatively high exposures to radiofrequency (RF) fields can occur in the broadcast, medical, and communications industries, as well in occupations that use RF emitting equipment (e.g. law enforcement). Information on exposure to workers employed in these industries and occupations is limited. We present results of an Israeli National Survey of occupational RF field levels at frequencies between ~100 kHz and 40 GHz, representing Industrial Heating, Communications, Radar, Research, and Medicine. Almost 4300 measurements from 900 sources across 25 occupations were recorded and categorised as 'routine', 'incidental', or 'unintended'. The occupation-specific geometric means (GMs) of the percentage of the American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit values (TLVs) for each of the three exposure scenarios are presented together with the geometric standard deviation (GSD). Additionally, we present estimates of occupation-specific annual personal exposures and collective exposures. The vast majority of the GM of routine exposures ranged from a fraction to less than 1% of ACGIH TLVs, except for Walkie-Talkie (GM 94% of ACGIH), Induction Heating (17%), Plastic Welding (11%), Industrial Heating (6%) and Diathermy (6%). The GM of incidental and unintended exposures exceeded the TLV for one and 14 occupations, respectively. In many cases, the within-occupation GSD was very large, and though the medians remained below TLV, variable fractions of these occupations were projected to exceed the TLV. In rank order, Walkie-Talkie, Plastic Welding, and Induction Heating workers had the highest annual cumulative personal exposure. For cumulative collective exposures within an occupation, Walkie-Talkie dominated with 96.3% of the total, reflecting both large population and high personal exposure. A brief exceedance of the TLV does not automatically translate to hazard as RF exposure limits (issued by various bodies, including ACGIH) include a 10-fold safety factor relative to thermal thresholds and are based on a 6 min averaging period.

Validation of a technique for estimating organ doses for kilovoltage cone-beam CT of the prostate using the PCXMC 2.0 patient dose calculator

Abstract: The use of cone beam CT in common radiotherapy treatments is increasing with the growth of image guided radiotherapy. Whilst the benefits that this technology offers are clear, such as improved patient positioning prior to treatment, it is always important to consider the implications of such intensive imaging regimes on the patient, especially when considering the fundamental radiation protection requirements for justification and optimisation.The purpose of this study was to develop a technique that uses readily available dose calculation software (PCXMC 2.0) to estimate the organ and effective doses that result from these types of examination in prostate treatments on the Varian OBI system. It has been shown that by separating these types of examinations into 28 different projections, with a range of x-ray beam qualities, it is possible to reproduce the complex geometry that is used on these imaging systems in PCXMC i.e. asymmetric radiation field with a half bowtie filter rotating 360° around the patient.This new technique has been validated with thermo-luminescent dosimeter measurements in the Rando anthropomorphic phantom, and has been shown to give excellent agreement with this established method (R(2) = 0.995). This technique will prove to be valuable to radiotherapy departments that are looking to optimise their CBCT imaging protocols as it allows a rapid evaluation of the impact of any changes on patient dose. It also serves to further highlight the levels of dose that these types of patient are subject to when having daily CBCT scans as part of the treatment, which further reinforces the need for optimisation of both patient dose and image quality on these systems.

Magnetic fields and childhood cancer: an epidemiological investigation of the effects of high-voltage underground cables

Abstract: Epidemiological evidence of increased risks for childhood leukaemia from magnetic fields has implicated, as one source of such fields, high-voltage overhead lines. Magnetic fields are not the only factor that varies in their vicinity, complicating interpretation of any associations. Underground cables (UGCs), however, produce magnetic fields but have no other discernible effects in their vicinity. We report here the largest ever epidemiological study of high voltage UGCs, based on 52,525 cases occurring from 1962-2008, with matched birth controls. We calculated the distance of the mother's address at child's birth to the closest 275 or 400 kV ac or high-voltage dc UGC in England and Wales and the resulting magnetic fields. Few people are exposed to magnetic fields from UGCs limiting the statistical power. We found no indications of an association of risk with distance or of trend in risk with increasing magnetic field for leukaemia, and no convincing pattern of risks for any other cancer. Trend estimates for leukaemia as shown by the odds ratio (and 95% confidence interval) per unit increase in exposure were: reciprocal of distance 0.99 (0.95-1.03), magnetic field 1.01 (0.76-1.33). The absence of risk detected in relation to UGCs tends to add to the argument that any risks from overhead lines may not be caused by magnetic fields.

Residential mobility and associated factors in relation to the assessment of exposure to naturally occurring radiation in studies of childhood cancer.

Abstract: Migration, that is the study of subjects moving from one residential address to another, is a complication for epidemiological studies where exposures to the agent of interest depend on place of residence. In this paper we explore migration in cases from a large British case-control study of childhood cancer and natural background radiation. We find that 44% of cases had not moved house between birth and diagnosis, and about two-thirds were living within 2 km of their residence at birth. The estimated dose at the diagnosis address was strongly correlated with that at the birth address, suggesting that use of just the birth address in this case-control study does not lead to serious bias in risk estimates. We also review other individual-based studies of naturally occurring radiation, with particular emphasis on those from Great Britain. Interview-based case-control and cohort studies can potentially establish full residential histories for study subjects and make direct measurements of radiation levels in the dwellings in question. However, in practice, because of study size and difficulties in obtaining adequate response rates, interview-based studies generally do not use full residential histories, and a substantial proportion of dose estimates often derive from models rather than direct measurements. More seriously, problems of incomplete response may lead to bias, not just to loss of power. Record-based case-control studies, which do not require direct contact with study subjects, avoid such problems, but at the expense of having only model-based exposure estimates that use databases of measurements.

The advantages of creating a positive radiation safety culture in the higher education and research sectors

Abstract: The safety culture of any organisation plays a critical role in setting the tone for both effective delivery of service and high standards of performance. By embedding safety at a cultural level, organisations are able to influence the attitudes and behaviours of stakeholders. To achieve this requires the ongoing commitment of heads of organisations and also individuals to prioritise safety no less than other competing goals (e.g. in universities, recruitment and retention are key) to ensure the protection of both people and the environment. The concept of culture is the same whatever the sector, e.g. medical, nuclear, industry, education, and research, but the higher education and research sectors within the UK are a unique challenge in developing a strong safety culture. This report provides an overview of the challenges presented by the sector, the current status of radiation protection culture, case studies to demonstrate good and bad practice in the sector and the practical methods to influence change.

Radiation dose to the heart in paediatric interventional cardiology.

Abstract: Recent ICRP publications have reviewed evidence for induction of heart disease. Studies suggest the threshold dose to the heart may be as low as 500 mGy. Doses to the heart from paediatric interventional procedures performed in Glasgow between April 2012 and July 2013 to correct congenital heart defects were investigated to assess the level of potential risk of cardiovascular disease. For common procedures, doses were found to be typically less than 50 mGy, with the highest dose in the period for which data are available estimated to be 330 mGy. These results suggest that any increased risk due to paediatric interventional cardiology is likely to be small, but cumulative doses over a number of years could reach the threshold for effects.

radir package: an R implementation for cytogenetic biodosimetry dose estimation.

Abstract: The Bayesian framework has been shown to be very useful in cytogenetic dose estimation. This approach allows description of the probability of an event in terms of previous knowledge, e.g. its expectation and/or its uncertainty. A new R package entitled radir (radiation inverse regression) has been implemented with the aim of reproducing a recent Bayesian-type dose estimation methodology. radir adopts the method of dose estimation under the Poisson assumption of the responses (the chromosomal aberrations counts) for the required dose-response curve (typically linear or quadratic). The individual commands are described in detail and relevant examples of the use of the methods and the corresponding radir software tools are given. The suitability of this methodology is highlighted and its application encouraged by providing a user-friendly command-type software interface within the R statistical software (version 3.1.1 or higher), which includes a complete manual.

Gamma radiation shielding and health physics characteristics of diaspore-flyash concretes.

Abstract: Different gamma radiation interaction parameters has been measured experimentally for the prepared diaspore-flyash concretes at 59.54, 662, 1173 and 1332 keV using narrow-beam transmission geometry and results are found to be in good agreement with theoretical values computed with a computer programme, WinXCom. The radiation exposure rate and absorbed dose rate for the gamma radiation with and without shielding of diasporeflyash concretes have been determined using linear attenuation results. The results show that on average, there is reduction of 95%, 53% and 40% in dose rate for gamma sources 241 Am, 137 Cs and 60 Co, respectively with diasporeflyash concretes as shielding material. Other health physics parameters namely equivalent dose, effective dose, gamma flux and energy fluence rate have also been determined.

Chernobyl cleanup workers from Estonia: cohort description and related epidemiological research.

Abstract: The Estonian study of Chernobyl cleanup workers was one of the first investigations to evaluate the possible health consequences of working in the Chernobyl area (the 30 km exclusion zone and/or adjacent territories) after the 1986 reactor accident. The cohort consists of 4831 men who were dispatched in 1986-1991 for tasks involving decontamination, construction of buildings, transport, radiation measurement, guard duty or other activities. By 31 December 2012, the follow-up of the cohort yielded 102 158 person-years of observation. Exposure and health data were collected by postal questionnaires, biodosimetry evaluations, thyroid screenings, and record-linkages with cancer, causes of death and health insurance reimbursement registers and databases. These data cover socio-demographic factors, employment history, aspects of health behaviour, medical history, work and living conditions in the Chernobyl area, biomarkers of exposure, cancer and non-cancer disease occurrence and causes of death. Cancer incidence data were obtained for 1986-2008, mortality data for 1986-2011 and non-cancer morbidity data for 2004-2012. Although the cohort is relatively small, it has been extensively examined and benefited from comprehensive nationwide population and health registers. The major finding was an increased risk of suicide. Thyroid examinations did not reveal an association with thyroid nodular disease and radiation dose, but did indicate the importance of accounting for screening when making comparisons with unscreened populations. No risk of leukaemia was observed and risks higher than 2.5-fold could be excluded with 95% confidence. Biodosimetry included GPA analyses and chromosomal translocation analyses and indicated that the Estonian cleanup workers experienced a relatively low mean exposure of the order of 0.1 Gy. One value of the Estonian study is in the methodologic processes brought to bear in addressing possible health effects from the Chernobyl accident. Twenty-five years of research are summarised and opportunities for the future listed.

Radionuclides in drinking water: the recent legislative requirements of the European Union.

Abstract: In November 2013, a new EURATOM Directive was issued on the protection of public health from the radionuclide content in drinking water. After introducing the contents of the Directive, the paper analyses the hypotheses about drinking water ingestion adopted in documents of international and national organizations and the data obtained from national/regional surveys. Starting from the Directive's parametric value for the Indicative Dose, some examples of derived activity concentrations of radionuclides in drinking water are reported for some age classes and three exposure situations, namely, (i) artificial radionuclides due to routine water release from nuclear power facilities, (ii) artificial radionuclides from nuclear medicine procedures, and (iii) naturally occurring radionuclides in drinking water or resulting from existing or past NORM industrial activities.

A Monte Carlo-based radiation safety assessment for astronauts in an environment with confined magnetic field shielding.

Abstract: The active shielding technique has great potential for radiation protection in space exploration because it has the advantage of a significant mass saving compared with the passive shielding technique. This paper demonstrates a Monte Carlo-based approach to evaluating the shielding effectiveness of the active shielding technique using confined magnetic fields (CMFs). The International Commission on Radiological Protection reference anthropomorphic phantom, as well as the toroidal CMF, was modeled using the Monte Carlo toolkit Geant4. The penetrating primary particle fluence, organ-specific dose equivalent, and male effective dose were calculated for particles in galactic cosmic radiation (GCR) and solar particle events (SPEs). Results show that the SPE protons can be easily shielded against, even almost completely deflected, by the toroidal magnetic field. GCR particles can also be more effectively shielded against by increasing the magnetic field strength. Our results also show that the introduction of a structural Al wall in the CMF did not provide additional shielding for GCR; in fact it can weaken the total shielding effect of the CMF. This study demonstrated the feasibility of accurately determining the radiation field inside the environment and evaluating the organ dose equivalents for astronauts under active shielding using the CMF.

Review of methods to measure internal contamination in an emergency.

Abstract: In the event of a radiation emergency, people close to the site of the incident may be exposed to radiation by external exposure, or as a result of intakes of radioactive material. For these incidents it may be necessary to monitor members of the public both for external and internal contamination. This work reviews currently available equipment for the assessment of internal exposure following an emergency. It concentrates on incidents involving the spread of radioactive material and on contamination by radionuclides which emit penetrating radiation. It is essential that this monitoring is carried out as soon as possible so that people who have been exposed at a level which could have an effect on health can be identified and receive prompt medical assessment. Proposed action levels to identify people who need medical attention are reviewed to determine the required sensitivity of monitoring equipment. For releases containing gamma-ray emitting radionuclides the best means of measuring internal contamination is to use detectors placed close to the body (whole body or partial body monitoring). Laboratory based whole body monitors could be used but these may well be inconveniently located and so equipment which can be deployed to the site of an incident has been developed and these are described. The need for rapid selection and prioritisation of people for monitoring, methods to deal with potentially high numbers of contaminated people and the requirement for a means of rapidly interpreting monitoring information are also discussed.It has been found that for many types of incidents and scenarios, systems based on unshielded high-resolution detectors and hand-held instruments do have the required sensitivity to identify people who require medical assessment.

A biokinetic model for systemic technetium in adult humans.

Abstract: This paper reviews biokinetic data for technetium and proposes a biokinetic model for systemic technetium in adult humans. The development of parameter values focuses on data for pertechnetate TcO(-)(4) the most commonly encountered form of technetium and the form expected to be present in body fluids. The model is intended as a default model for occupational or environmental intake of technetium, i.e. applicable in the absence of form- or site-specific information. Tissues depicted explicitly in the model include thyroid, salivary glands, stomach wall, right colon wall, liver, kidneys, and bone. Compared with the ICRP's current biokinetic model for occupational or environmental intake of technetium (ICRP 1993, 1994), the proposed model provides a more detailed and biologically realistic description of the systemic behaviour of technetium and is based on a broader set of experimental and medical data. For acute input of (99m)Tc (T(1/2) = 6.02 h) to blood, the ratios of cumulative (time-integrated) activity predicted by the current ICRP model to that predicted by the proposed model range from 0.4-7 for systemic regions addressed explicitly in both models. For acute input of (99)Tc (T(1/2) = 2.1 × 10(5) year) to blood, the corresponding ratios range from 0.2-30.

Effective dose conversion coefficients for health care provider exposed to pediatric and adult victims in radiological dispersal device incident

Abstract: After an incident of radiological dispersal devices (RDD), health care providers will be exposed to the contaminated patients in the extended medical treatments. Assessment of potential radiation dose to the health care providers will be crucial to minimize their health risk. In this study, we compiled a set of conversion coefficients (mSv MBq(-1) s(-1)) to readily estimate the effective dose from the time-integrated activity for the health care providers while they deal with internally contaminated patients at different ages. We selected Co-60, Ir-192, Am-241, Cs-137, and I-131 as the major radionuclides that may be used for RDD. We obtained the age-specific organ burdens after the inhalation of those radionuclides from the Dose and Risk Calculation Software (DCAL) program. A series of hybrid computational phantoms (1-, 5-, 10-, and 15 year-old, and adult males) were implemented in a general purpose Monte Carlo (MC) transport code, MCNPX v 2.7, to simulate an adult male health care provider exposed to contaminated patients at different ages. Two exposure scenarios were taken into account: a health care provider (a) standing at the side of patients lying in bed and (b) sitting face to face with patients. The conversion coefficients overall depended on radionuclides, the age of the patients, and the orientation of the patients. The conversion coefficient was greatest for Co-60 and smallest for Am-241. The dose from the 1 year-old patient phantom was up to three times greater than that from the adult patient phantom. The conversion coefficients were less dependent on the age of the patients in the scenario of a health care provider sitting face to face with patients. The dose conversion coefficients established in this study will be useful to readily estimate the effective dose to the health care providers in RDD events.