Health Risks of Ionizing Radiation: - Clark University

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Preconceptional exposures are discussed in detail in section 10 and appendix C. 3.7 Radiologists’ occupational exposures In contrast to estimates of the controlled exposure received by patients, exposure estimates for radiologists are uncertain and often based on the number of years a radiologist is certified. Exposures have decreased dramatically over time, so that a although radiologist in the 1920s or 30s might have been exposed to 1 Gy per year, exposures today are about a thousand times less (0.5 mGy per year; Berrington et al. 2001). Doody et al. (1998) and Mohan et al. (2003) conducted a cohort study of radiologists in the US. Mortality was lower, overall, than in the general population, indicating a healthy worker effect. Comparisons between radiologists first employed in the 1940s or 50s and radiologists entering the field more recently are useful because, as noted above, exposure has declined over time. Radiologists in the 1950s were likely exposed to 50-100 mGy per year (Berrington et al. 2001). Mohan et al. found increased risks of breast cancer (RR 2.92, 1.22- 7.00) and leukemia (RR 1.64, 0.42-6.31) making such comparisons 39 . This study also found that the risk of breast cancer or leukemia was related to the number of years working in the field before 1950. Sigurdson et al. (2003) found that radiologists who were employed in the US between 1926 and 1982 were at elevated risk of all solid tumors, breast cancer, melanoma, and thyroid cancer. Although the eligibility requirements for the study were that radiologists must have been certified in the US between 1926 and 1982, thus allowing for earlier employees who may have had higher exposures, 78% of the cohort was first certified in 1960 or later. This implies that the doses that radiologists received were low, although there are no direct dose estimates available. Berrington et al. (2001) looked at occupational exposure in the UK and found again that there was a significant risk only for those radiologists who had been registered for over 40 years. In conclusion, although risks associated Medical Exposures 31 with historical exposures can be quantified, the risks associated with the low doses that radiologists currently receive would be too small to be detected by epidemiological methods (Brenner and Hall 2003). 3.8 Conclusions There are several areas of medical radiation epidemiology that have a particularly strong body of evidence associating low doses and risk. Several important characteristics of these risks have been described in the studies discussed above: • There is a wide body of research that shows that radiation therapy for non-cancer disease can cause cancer in patients, although these are typically high-dose exposures. Radiation therapy varies according to the disease being treated, the parts of the body that are exposed, and the cancer sites that might respond. Leukemia and cancers of the pancreas, stomach, small intestine, liver, gall bladder, kidney, brain, central nervous system, connective tissue, breast, and thyroid have all been associated with therapeutic exposure. Davis et al. (1989), Boice et al. (1991) and Little and Boice (1999) show some of the most compelling evidence for the risks of low dose and fractionated exposure where fluoroscopy patients who were exposed to small doses over time show risks similar to those observed in the atomic bomb survivors. • Comparisons of medical exposure and atomic bomb studies seem to show that some cell-killing and risk attenuation effects may occur with fractionated doses (Little et al. 1999), but there is also evidence suggesting that radiosensitive tissues such as the breast may be more sensitive to fractionated doses (Boice et al. 1991, Doody et al. 2000, Davis et al. 1999). • Gibson et al. (1972), Preston Martin et al. (1988), Preston-Martin et al. (1988), and Doody et al. (2000) have found risks of leukemia, parotid gland tumors and breast cancer associated 39 The breast cancer risk estimate compares first employment before 1940 to after 1960; the leukemia risk estimate compares first employment before or after 1950.
32 Medical Exposures with diagnostic exposure. Preston-Martin et al. (1989) found a significant trend associated with cumulative bone marrow doses. • Thyroid cancer is an important topic in medical radiation research because the thyroid is one of the most radiosensitive tissues in the body. Children have demonstrated particularly high risks with linear dose response relationships appearing down to doses as low as 0.1 Gy (De Vathaire et al. 1999, Modan et al. 1977). The most convincing evidence for childhood thyroid cancer risk associated with medical irradiation is the pooled analysis of Ron et al. (1995), where the ERR was found to be 7.7/Gy. • In-utero diagnostic x-ray exposure has been convincingly related to cancer risk, and although the magnitude of the risk per unit dose is uncertain, there does appear to be evidence of a significant risk at doses as low as 10 mGy (Wakeford and Little 2003).
Page 1 and 2: Health Risks of Ionizing Radiation:
Page 3 and 4: Contents List of Tables ...........
Page 5 and 6: Contents iii Rocky Flats ..........
Page 7 and 8: Contents v APPENDIX A .............
Page 9 and 10: List of Figures Figure 1-1 Average
Page 11 and 12: We are indeed grateful to those who
Page 13 and 14: 2 Introduction 1.2 A brief history
Page 15 and 16: 4 Introduction Figure 1-2. The evol
Page 17 and 18: 6 Introduction Figure 1-5(a). Alpha
Page 19 and 20: 8 Introduction In epidemiological s
Page 21 and 22: 10 Introduction precision to detect
Page 23 and 24: 12 Introduction available informati
Page 25 and 26: 14 Background Radiation Figure 2-1.
Page 27 and 28: 16 Background Radiation Figure 2-3.
Page 29 and 30: 18 Background Radiation
Page 31 and 32: 20 Medical Exposures Fi
Page 33 and 34: 22 Medical Exposures
Page 35 and 36: 24 Medical Exposures with national
Page 37 and 38: 26 Medical Exposures localized expo
Page 39 and 40: 28 Medical Exposures (2.1-28.7). Th
Page 41: 30 Medical Exposures posed 2.69 tim
Page 45 and 46: 34 Medical Exposures Table 3-1. Stu
Page 55 and 56: 44 Atomic Bomb Survivors Figure 4-2
Page 57 and 58: 46 Atomic Bomb Survivors
Page 59 and 60: 48 Atomic Bomb Survivors approximat
Page 61 and 62: 50 Atomic Bomb Survivors (ALL), acu
Page 63 and 64: 52 Atomic Bomb Survivors of the 8 t
Page 69 and 70: 5 Nuclear Weapons Testing Over 500
Page 71 and 72: 60 Nuclear Weapons Testing by disti
Page 73 and 74: 62 Nuclear Weapons Testing Figure 5
Page 75 and 76: 64 Nuclear Weapons Testing near the
Page 77 and 78: 66 Nuclear Weapons Testing
Page 79 and 80: 68 Nuclear Weapons Testing
Page 81 and 82: 6 RADIATION WORKERS Introduction Th
Page 83 and 84: 72 Radiation Workers • 50 rem (0.
Page 85 and 86: 74 Radiation Workers work, reports
Page 87 and 88: 76 Radiation Workers Figure 6-5. A
Page 89 and 90: 78 Radiation Workers Figure 6-8. To
Page 91 and 92: 80 Radiation Workers Figure 6-10. A
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82 Radiation Workers Feed Material
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84 Radiation Workers by Beral et al
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86 Radiation Workers Figure 6-14. A
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88 Radiation Workers Table 6-1. Leu
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90 Radiation Workers No
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92 Radiation Workers N
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94 Radiation Workers S
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96 Radiation Workers ERR estim
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98 Mayak Workers Table 1. Dose (Gy)
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100 Mayak Workers workers at the ra
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102 Mayak Workers
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104 Uranium Miners enrichment facil
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106 Uranium Miners Samet et al. (19
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108 Uranium Miners were selected 12
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Uranium Miners 111
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9 RADIATION EXPOSURE IN FLIGHT The
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DNA damage (a chemical change in DN
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10 PRECONCEPTION EXPOSURES Several
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of risk in the lowest dose groups,
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found elevated solid cancer risk wi
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preconception doses between 2.5 and
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Table 10-1. Preconception irradiati
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Preconception Exposures 127
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Tracheoesophageal fistula and conge
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cancer were both associated with th
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0.10-4.71) while respiratory system
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elationship was not significant for
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times higher than in less-contamina
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Nuclear Power Accidents 139
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12 COMMUNITIES NEAR NUCLEAR FACILIT
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levels (this could not in itself be
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Figure 12-3. Native Americans from
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of leukemia was measured over a lar
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(RR 1.06; 1.00-1.11) and risks of s
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more that we can say about this app
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Communities Near Nuclear Facilities
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54 observed vs. 46.1 expected death
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13 DISCUSSION Our intention in crea
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myeloid leukemia) was significantly
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0.1-3.5 WLM; this is roughly equiva
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adon (Lubin et al. 1997). These res
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Leukemia Leukemia, a general term t
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vical cancer. The doses to these pa
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England have found it convenient to
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Thyroid disease Thyroid cancer is a
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1986 through 1995. These workers sh
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dence of this disease includes elev
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Analysis of preconception exposure
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Paternal age, education, drinking O
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Gardner et al. 1990 Employed at Sel
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we consider this group of a few hun
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Leukemia risk (excluding CLL) among
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Glossary of Terms for Epidemiology
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Glossary 199 Beta radiation: Stream
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Dosimetry: Measurement or estimatio
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Glossary 203 Hypothyroidism: The cl
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Glossary 205 Metastasis: 1. Movemen
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Glossary 207 waves, ultra violet (U
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Glossary 209 Thyroid Disease: disea
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Bibliography ATSDR. Public Health A
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Bhatia S, Sklar C. Second cancers i
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Bibliography 215 Cavallo D, Tomao P
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Bibliography 217 Department of Ener
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Bibliography 219 Gardner MJ, Hall A
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Haldorsen T, Reitan JB, Tveten U. C
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Bibliography 223 Howe GR, Nair R, N
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of Mayak, A comparison of numerical
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Bibliography 227 Laird NM. Thyroid
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control population. International J
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Bibliography 231 Neel JV, Schull WJ
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2003.160:381-407. Bibliography 233
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Bibliography 235 Saccomanno G, Auer
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Bibliography 237 analysis of cancer
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Bibliography 239 Tokarskaya ZB, Sco
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Journal of Epidemiology 1987.125(2)
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Actinium, 84 Acute lymphocytic leuk
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and Nevada Test Site, 60-61, 62 nuc
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Hashimoto’s thyroiditis, 185 Heal
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studies, 101-2 Medical exposure, 19
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(RERF), 43 Radiation Exposure Compe
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Viruses, 118, 154, 193 West Germany
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