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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DissertationDOI
Evaluation of occupational exposures in Endoscopic Retrograde Cholangiopancreatography using Monte Carlo simulation
TL;DR: The objective of this work was to apply Monte Carlo (MC) simulation to evaluate patient and staff radiation exposure during ERCP procedures and the first results of a greater project focused on the radiation protection at an university hospital are presented.
Journal ArticleDOI
Radiation distribution in a hybrid operating room, utilizing different X-ray imaging systems: investigations to minimize occupational exposure.
TL;DR: In this article, the effects of staff positioning, different X-ray imaging systems, and freestanding radiation protection shields (RPSs) were considered to reduce occupational radiation exposure in a hybrid operating room (OR).
Journal ArticleDOI
Ionizing radiation reduces glutathione levels in the eye: A pilot study
TL;DR: In this paper , the authors analyzed dose rate and time-dependent changes in whole-eye reduced glutathione (GSH) and oxidized GSSG (GSSG) levels after γ-irradiation.
Book ChapterDOI
Dose Assessment in the Management of Patient Protection in Diagnostic and Interventional Radiology
Paul Shrimpton,Kwan Hoong Ng +1 more
TL;DR: DRLs represent a pragmatic mechanism for promoting continuing improvement in performance by facilitating comparison with national values and practice elsewhere and can form the basis not only for estimates of typical organ and effective doses utilizing appropriate coefficients, but also local diagnostic reference levels (DRLs).
Journal ArticleDOI
Atomic bomb survivor cataract surgery prevalence data are consistent with non-zero threshold dose--Comment on article by Nakashima et al. 2013.
TL;DR: The analysis using a meta-analytic approach to combine data from all years indicates the atomic bomb survivor data do indeed indicate the presence of a significant non-zero dose threshold for cataract surgery, contrary to the conclusion of the authors.
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