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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Radiogenic risks to patients and staff from fluoro-assisted therapeutic cardiac catheterizations
Abdelmoneim Sulieman,A. Abdelrazig,Hamdan I Al-Mohammed,Mohammed Alkhorayef,Mohammed Alkhorayef,Batil Alonazi,Ibrahim I. Suliman,Nouf Abuhadi,D.A. Bradley,D.A. Bradley +9 more
TL;DR: Optisation of radiation dose is required as is follow-up of patients receiving high doses to detect the possibility of tissue reactions and also the radiogenic and tissue reaction risks and staff effective dose during cardiac interventions.
Journal ArticleDOI
Radiation Exposure to Staff and Patient During Videofluoroscopic Swallowing Studies and Recommended Protection Strategies
TL;DR: The evidence shows that patient radiation dose is low; nonetheless, care must be taken for patients that require multiple examinations, and evidence-based recommendations on dose optimisation strategies are made.
Journal ArticleDOI
Radiation Exposure in Pediatric Interventional Procedures
Agapi Ploussi,Elias Brountzos,Spyridon Rammos,Sotiria C. Apostolopoulou,Efstathios P. Efstathopoulos +4 more
TL;DR: In this paper, the authors provide an overview of the radiation exposure in pediatric patients during interventional procedures focusing on the importance of radiation protection in the pediatric population, the reported radiation doses and the techniques of minimizing radiation dose.
Journal ArticleDOI
Connaissances des travailleurs en radioprotection – Enquête au CHU Mongi Slim à La Marsa (Tunisie)
I. Marzouk Moussa,H. Kamoun +1 more
TL;DR: In this article, the connaissances en radioprotection du personnel hospitalier directement affecte aux travaux sous rayonnements ionisants (DATR) were evaluated.
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