Journal ArticleDOI
ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs – Threshold Doses for Tissue Reactions in a Radiation Protection Context
F A Stewart,A V Akleyev,Martin Hauer-Jensen,Jolyon H Hendry,N J Kleiman,Thomas J. MacVittie,B M Aleman,Angela B. Edgar,K Mabuchi,C R Muirhead,Roy E. Shore,William Wallace +11 more
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Estimates of ‘practical’ threshold doses for tissue injury defined at the level of 1% incidence are provided and it appears that the rate of dose delivery does not modify the low incidence for reactions manifesting very late after low total doses, particularly for cataracts and circulatory disease.Abstract:
This report provides a review of early and late effects of radiation in normal tissues and organs with respect to radiation protection. It was instigated following a recommendation in Publication 103 (ICRP, 2007), and it provides updated estimates of 'practical' threshold doses for tissue injury defined at the level of 1% incidence. Estimates are given for morbidity and mortality endpoints in all organ systems following acute, fractionated, or chronic exposure. The organ systems comprise the haematopoietic, immune, reproductive, circulatory, respiratory, musculoskeletal, endocrine, and nervous systems; the digestive and urinary tracts; the skin; and the eye. Particular attention is paid to circulatory disease and cataracts because of recent evidence of higher incidences of injury than expected after lower doses; hence, threshold doses appear to be lower than previously considered. This is largely because of the increasing incidences with increasing times after exposure. In the context of protection, it is the threshold doses for very long follow-up times that are the most relevant for workers and the public; for example, the atomic bomb survivors with 40-50years of follow-up. Radiotherapy data generally apply for shorter follow-up times because of competing causes of death in cancer patients, and hence the risks of radiation-induced circulatory disease at those earlier times are lower. A variety of biological response modifiers have been used to help reduce late reactions in many tissues. These include antioxidants, radical scavengers, inhibitors of apoptosis, anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, growth factors, and cytokines. In many cases, these give dose modification factors of 1.1-1.2, and in a few cases 1.5-2, indicating the potential for increasing threshold doses in known exposure cases. In contrast, there are agents that enhance radiation responses, notably other cytotoxic agents such as antimetabolites, alkylating agents, anti-angiogenic drugs, and antibiotics, as well as genetic and comorbidity factors. Most tissues show a sparing effect of dose fractionation, so that total doses for a given endpoint are higher if the dose is fractionated rather than when given as a single dose. However, for reactions manifesting very late after low total doses, particularly for cataracts and circulatory disease, it appears that the rate of dose delivery does not modify the low incidence. This implies that the injury in these cases and at these low dose levels is caused by single-hit irreparable-type events. For these two tissues, a threshold dose of 0.5Gy is proposed herein for practical purposes, irrespective of the rate of dose delivery, and future studies may elucidate this judgement further.read more
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A systems approach to evaluating ionizing radiation: six focus areas to improve quality, efficiency, and patient safety.
TL;DR: A multidisciplinary team was assembled to conduct a comprehensive analysis of practices surrounding the delivery of ionizing radiation to identify potential failure modes and develop solutions to preserve patient safety within a large, national healthcare system.
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Temporal Changes in Sparing and Enhancing Dose Protraction Effects of Ionizing Irradiation for Aortic Damage in Wild-Type Mice
Nobuyuki Hamada,Ki-ichiro Kawano,Takaharu Nomura,Kyoji Furukawa,Farina Mohamad Yusoff,Tatsuya Maruhashi,M. Maeda,Ayumu Nakashima,Yukihito Higashi +8 more
TL;DR: It is reported that irradiation produces qualitatively similar albeit quantitatively less aortic changes at 12 months than at 6 months after stating irradiation, suggesting that dose protraction changes aorti damage, in a fashion that depends on post-irradiation time and is not a simple function of dose rate.
Journal ArticleDOI
Radiation exposure to the lens of the eye for Japanese nuclear power plant workers
Sumi Yokoyama,Hideo Tatsuzaki,Yoshihiko Tanimura,Hiroshi Yoshitomi,Shigekazu Hirao,K. Aoki,Shuichi Tachiki,Iwao Ezaki,K. Hoshi,Norio Tsujimura +9 more
TL;DR: The dose equivalents of high-dose-rate workplaces and the personal doses of 88 workers were estimated at four Japanese commercial nuclear power plant sites and the dose to the lens of the eye and the exposure situations of the workers were analyzed.
Journal ArticleDOI
New Radioprotective Device that can be Used for Fluoroscopic Exam: Possibility to Contribute to Staff Exposure Protection During VFSS
TL;DR: The OLSD effectively provided protection from scattered radiation at the physician’s position during fluoroscopy and may contribute to the reduction of staff exposure for VFSS.
Journal ArticleDOI
Potential risks associated with the use of ionizing radiation for imaging and treatment of colorectal cancer in Lynch syndrome patients
Mingzhu Sun,Jayne Moquet,Michele Ellender,Simon Bouffler,Christophe Badie,Rachel Baldwin-Cleland,K. Monahan,Andrew Latchford,David Lloyd,Susan J. Clark,N. Anyamene,Elizabeth A. Ainsbury,David Burling +12 more
TL;DR: In this article , a review of the literature pertaining to the potential risks of low-dose ionizing radiation to Lynch syndrome patients by use of computed tomography (CT), either diagnostic CT colonography, standard staging CT or CT surveillance is presented.
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