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International comparison of cave radon concentrations identifying the potential alpha radiation risks to British cave users.

Elevated concentrations of 222Rn have been recorded in many limestone caves throughout the world. As prolonged exposure to high radon concentrations has been linked to cancer and tumors, particularly of the lung (National Academy of Science 1988; Eatough and Henshaw 1990), a national survey of radon in British caves was undertaken. Passive radon detectors were exposed at 250 sites in 47 caves over four 7-d sampling periods. Mean concentrations ranging from 454-8,868 Bq m-3 were recorded. In one system, in the Peak District, radon concentrations of 155,000 Bq m-3 were recorded. The results indicate that the potential radiation dose from a single 4-h trip could exceed the national average annual background radiation dose (for the UK) from radon of 1.25 mSv.

Air↗

Radiation risk--a Chinese perspective: 1996 G. William Morgan Lecture.

The great honor of being selected by the Presidents Emeritus Committee of the Health Physics Society as the G. William Morgan Lecturer for 1996 provides me this opportunity to present my lecture at the Plenary Session of the 1996 Health Physics Society Annual Meeting. Under the guidance of Mr. Li Deping, in the late fifties and the early sixties when I began my scientific career, I made a comprehensive literature survey on radiation protection to be aware of this field. Based on this study and on the actual situation in China, I presented the paper "Outline to Health Physics" (Pan 1963), one of the papers I completed in the early times. This gave me a preliminary understanding of the important thoughts of ICRP, NCRP, ICRU and the pioneers of health physics with respect to radiation protection. Preliminary assessment of population dose in China has been done. The natural background radiation sources contribute 93.4% to the total dose, of which is due to radon and thoron progeny. Among the medical exposure from man-made activity, the maximum is from medical exposure (4.21%), the next is from occupational exposure (1.25%), the public exposure contributes about 1.1%. Several practices need to pay special attention: (1) medical exposures, 60.4% of the total increase exposure from man-made activity, (2) the exposure of underground mines, (3) the exposure from coal energy chain, with the sum approximately 100%. The collective dose from nuclear industry contribute 5 x 10(-4). In the coming decade, the doses to the population of China will not significantly increase and may even decrease.

Humans↗

[Ionizing radiations and the antimicrobial resistance of the body in warm-blooded animals].

Various aspects of ionizing radiation action on microorganisms and course of endo- and exogenous infections are considered. The immune response is discussed from the standpoint of its significance in development of infectious-inflammatory processes under conditions of radiation of a microorganism and higher radiation background. Quantitative and functional changes in the immune system of the organism subjected to radiation are discussed in detail and peculiarities of these changes under low doses of radiation are shown. The analysis of the data obtained has confirmed a decrease of the natural resistance of organism to various infectious agents of endo- and exogenous origin under the effect of ionizing radiation; the main reason of that is disturbance of the immunity system, particularly at the cellular level.

Animals↗

Health hazards of radiation exposure in the context of brain imaging research: special consideration for children.

UNLABELLED: This review provides information on health and biological effects of low-dose radiation to help institutional review boards and investigators make educated assessments of the risks of low-level radiation exposure involved in research, particularly in children. METHODS: Studies of low-level radiation exposure with large sample sizes and long follow-up were reviewed. To help interpret the studies, we clarified the measures and measurement strategies of radiation exposure and of health risks. The few large studies of risks of low-level radiation in children have failed to detect an increased incidence of cancer. Most studies of low-level radiation involve adults. RESULTS: The risk of increased rates of cancer after low-level radiation exposure is not supported by population studies of health hazards from exposure to background radiation, radon in homes, radiation in the workplace or radiotherapy. Compared to the frequency of daily spontaneous genetic mutations, the biological effect of low-level radiation at the cellular level seems extremely low. Furthermore, the potentiation of cellular repair mechanisms by low-level radiation may result in a protective effect from subsequent high-level radiation. Studies approved by institutional review boards in the U.S. that involve the exposure of healthy normal children to ionizing radiation were reviewed. CONCLUSION: Health risks from low-level radiation could not be detected above the "noise" of adverse events of everyday life. In addition, no data were found that demonstrated higher risks with younger age at low-level radiation exposure.

Brain↗

Radiation-induced bystander effects: are they good, bad or both?

Our current knowledge of the mechanisms underlying the induction of bystander effects by low dose-low linear-energy-transfer ionising radiation is reviewed, and the question of how bystander effects may be related to observed adaptive responses, systemic genomic instability or other effects of low doses exposures is considered. Bystander effects appear to be the result of a generalised stress response in tissues or cells. The signals may be produced by all exposed cells but the response may require a quoram in order to be expressed. The major response involving low LET radiation exposure discussed in the existing literature is a death response, which has many characteristics of apoptosis but may be detected in cell lines without p53 expression. While a death response might appear to be adverse, it can in fact be protective and remove damaged cells from the population. Since many cell populations carry damaged cells without being exposed to radiation ('background damage') low doses exposures might cause removal of cells damaged by agents other than the test dose of radiation, which would lead to the production of 'u- or n-shaped' dose-response curves. The level of harmful or beneficial response would then be related to the background damage carried by the cell population and the genetic programme determining response to damage. This model may be important when attempting to predict the consequences of mixed exposures involving radiation and other environmental stressors.

Adaptation, Physiological↗

Biological and biophysical techniques to assess radiation exposure: a perspective.

Biological dosimeters measure biologically relevant effects of radiation exposure that are in some sense an estimate of effective dose, whereas biophysical indicators serve as surrogates of absorbed dose in a manner analogous to conventional thermoluminescent dosimeters (TLD). The biological and biophysical dosimeters have the potential to play an important role in assessing unanticipated or occupational radiation exposures. For example, where the exposure is large and uncertain (i.e. radiation accidents), accurate dose information can help in deciding the most appropriate therapy and medical treatment. Another useful area is that of lifetime accumulated dose determination, and the ability to distinguish between and integrate the exposures from natural and anthropogenic (medical X-rays, indoor radon, natural background radiation, occupational and non-occupational exposures). Also, the possibility to monitor individual response and differences in inherent or induced radiation sensitivity may have important implications for radiation protection. More commonly, this type of dosimetry could be used for routine monitoring to detect and quantify unsuspected exposure, for regulatory purposes or for epidemiological studies of the long-term effects of radiation exposure (e.g. in Japanese A-bomb survivors or in the population surrounding Chernobyl). This review is a comparative study of the existing techniques and their future prospects. It summarizes the sensitivity, reproducibility, limiting dose, dose-rate, energy, LET response, sources of variability and uncertainty, and other practical aspects of each bio-indicator. The strengths and weaknesses of each approach are evaluated on the basis of common criteria for particular applications, and are summarized for each assay both in the text and in tabular form, for convenience. It is clear that no single indicator qualifies to reliably measure occupational exposures at the current levels of sensitivity conventional dosimetry services provide. Most of the bio-techniques are applicable to the detection of relatively high radiation exposures at relatively short times after exposure. Some of the bio-indicators have been identified that are, or offer future prospects for becoming, appropriate bio-indicators for dosimetry needs. However, all methods are subject to biological and other variables that are presently uncontrolled, and represent a major source of uncertainty. These include variations in background signals not directly associated with radiation exposure, inter- and intra-individual variability of radiation response, and genetic and environmental effects. Although these factors contribute to the lack of confidence in biological dosimetry, promising bio-indicators may be applied to large populations to establish the inherent variability and confounding factors that limit quantitative data collection and analysis, and reduce reliability and reproducibility.

Biological Assay↗

Administration guidelines for radioimmunotherapy of non-Hodgkin's lymphoma with (90)Y-labeled anti-CD20 monoclonal antibody.

90Y-ibritumomab tiuxetan is a novel radioimmunotherapeutic agent recently approved for the treatment of relapsed or refractory low-grade, follicular, or CD20+ transformed non-Hodgkin's lymphoma (NHL). (90)Y-ibritumomab tiuxetan consists of a murine monoclonal antibody covalently attached to a metal chelator, which stably chelates (111)In for imaging and (90)Y for therapy. Both health care workers and patients receiving this therapy need to become familiar with how it differs from conventional chemotherapy and what, if any, safety precautions are necessary. Because (90)Y is a pure beta-emitter, the requisite safety precautions are not overly burdensome for health care workers or for patients and their families. (90)Y-ibritumomab tiuxetan is dosed on the basis of the patient's body weight and baseline platelet count; dosimetry is not required for determining the therapeutic dose in patients meeting eligibility criteria similar to those used in clinical trials, such as <25% lymphomatous involvement of the bone marrow. (111)In- and (90)Y-ibritumomab tiuxetan are labeled at commercial radiopharmacies and delivered for on-site dose preparation and administration. Plastic and acrylic materials are appropriate for shielding during dose preparation and administration; primary lead shielding should be avoided because of the potential exposure risk from bremsstrahlung. Because there are no penetrating gamma-emissions associated with the therapy, (90)Y-ibritumomab tiuxetan is routinely administered on an outpatient basis. Furthermore, the risk of radiation exposure to patients' family members has been shown to be in the range of background radiation, even without restrictions on contact. There is therefore no need to determine activity limits or dose rate limits before patients who have been treated with (90)Y radioimmunotherapy are released, as is necessary with patients who have been treated with radiopharmaceuticals that contain (131)I. Standard universal precautions for handling body fluids are recommended for health care workers and patients and their family members after (90)Y-ibritumomab tiuxetan administration. In summary, (90)Y-ibritumomab tiuxetan introduces (90)Y into clinical practice and expands the role nuclear medicine plays in the care of patients with cancer. Understanding the unique properties of this novel radioimmunoconjugate will facilitate its safe and effective use.

Antibodies, Monoclonal↗

Does the use of new intracoronary interventional devices prolong radiation exposure in the cardiac catheterization laboratory?

OBJECTIVES: The aim of this study was to compare the duration of radiation exposure associated with new percutaneous coronary interventional devices with that associated with conventional balloon angioplasty. BACKGROUND: Radiation exposure levels have been documented to be higher with coronary balloon angioplasty than with routine diagnostic coronary angiography. However, the effect of new interventional devices on radiation exposure has not been studied. METHODS: Fluoroscopic and cineangiographic data from the Mayo Clinic cardiac catheterization laboratory data base of patients having single-segment coronary intervention during a recent 46-month period were retrospectively analyzed. Of 897 patients studied, 646 underwent balloon angioplasty, 138 directional coronary atherectomy (42 with adjunctive balloon angioplasty), 76 excimer laser angioplasty (50 with adjunctive balloon angioplasty) and 37 placement of an intracoronary stent (16 emergencies). RESULTS: Duration of fluoroscopy during balloon angioplasty was 24 +/- 18 min, which was longer than with directional atherectomy (18 +/- 8 min; p = 0.001). Fluoroscopy time was 25 +/- 17 min with laser angioplasty and 29 +/- 15 min with elective stent placement (neither time was significantly different from that with balloon angioplasty). When atherectomy or laser angioplasty was performed with adjunctive balloon angioplasty or if emergency intracoronary stent placement was performed, the duration of fluoroscopy was significantly prolonged compared with balloon angioplasty alone. CONCLUSIONS: Fluoroscopy duration is not prolonged with the use of new interventional coronary devices compared with conventional angioplasty unless adjunctive balloon angioplasty is used or emergency stent placement is required.

Aged↗

Effects of very low doses of ionizing radiation on the clonal life-span in Paramecium tetraurelia.

Effects of very low doses of ionizing radiation were investigated on life-span in Paramecium tetraurelia. After autogamy single cell cultures were place (1) in a control chamber with radiopermeable walls; (2) in a shielded device with 10 cm thick lead walls; (3) in a similar shielding device including a 60Co source giving a dose of 760 mrad per year at the culture level. Life-spans, expressed in days and in mean total number of fissions measured from autogamy to the death of all sublines, were about 200 fissions and 55 days in controls. Life-spans of shielded sublines were increased and lower life-spans were observed in both shielded and irradiated sublines. These findings provide new evidence for a biological effect of very low doses of ionizing radiations and show that fission potential of Paramecium tetraurelia can be affected by variations in the background radiation level.

Animals↗

Radiation exposure and estimate of late effects of chest roentgen examination in children.

The energy imparted and the radiation dose to the lungs, the breasts, the thyroid and to the bone marrow at chest radiography of infants and children were measured or calculated and the risk of inducing future malignant diseases was estimated. The radiation doses to the various organs corresponded to 5 to 30 per cent of the yearly background radiation. In infants of both sexes as well as for boys at a later age, radiation-induced leukemia and thyroid carcinoma constituted the greatest risk of future malignancies. After infancy, girls were more exposed to the risk of future breast carcinoma. On the whole, the risk of developing breast carcinoma constitutes a greater problem than does, for example, the risk of leukemia. Reversing the beam direction from postero-anterior to anteroposterior increases this risk while the risk of leukemia will remain unchanged.

Bone Marrow↗

[Morphological and cytogenetic disorders in rats following chronic exposure to elevated radiation].

Object of the investigation were effects of elevated radiation background on specific body systems in two generations of rats that had been chronically exposed to radiation in the most badly polluted areas of the Kaluga district and eaten local food. Findings included some compensatory deviations in the white blood count, decrease in karyocytes and increase in chromosomal aberration rate in nucleus-containing cells from the femoral bone marrow in younger animals of several groups, morphologic and histochemical shifts in mucous membrane of the esophagus and the stomach, and morphofunctional changes in neurons and glia of the cerebral cortex. These changes are compensatory-adaptive by nature and indicative of destabilization of homeostasis in experimental animals.

Acetylcholinesterase↗

Low dose beta-emitter source induces sexual reproduction instead of fragmentation in an earthworm, Enchytraeus japonensis.

We examined whether background radiation, or radiation at a slightly higher level, plays a role in the reproduction of a terrestrial earthworm. Enchytraeus japonensis a recently described terrestrial oligochaete, reproduces asexually by fragmentation and subsequent regeneration. Following radiation exposure in which the worms were subjected to a 32P beta-emitter source at 15 times the background dose rate (4.5 microGy/h), a statistically significant decrease in the number of fragmentations was observed as compared with the sham controls. At that time, in a stained preparation with haematoxylin and eosin (HE), sexual reproduction occurred instead of asexual fragmentation, and mature oocytes were observed in the body of grown worms. However, increasing the radiation dose rate by 30 microGy/h resulted in the complete disappearance of the radiation-induced effects, i.e., fragmentation again occurred after 14 h. The results of this study indicate that a lower dose of radiation may be essential to achieve sexual reproduction, inducing an inhibition of fragmentation (asexual reproduction), but at higher, more cytotoxic doses of radiation these effects are negated.

Animals↗

RADIATION PROTECTION IN CANADA. III. THE ROLE OF THE RADIATION PROTECTION DIVISION IN SAFEGUARDING THE HEALTH OF THE PUBLIC.

The current status of radiation protection in Canada is discussed in the last of a three-part series. Particular emphasis has been placed on the role of the Radiation Protection Division of the Department of National Health and Welfare. A radioactive fallout study program has been established involving the systematic collection of air and precipitation samples from 24 locations, soil samples from 23 locations, fresh-milk samples from 16 locations, wheat samples from nine areas and human-bone specimens from various hospitals throughout Canada. A whole-body-counting facility and a special study of fallout in Northern areas have also been initiated. For any age group, the highest average strontium-90 concentration in human bone so far reported has been less than four picocuries per gram of calcium compared with the maximum permissible level of 67 derived from the International Committee on Radiation Protection (ICRP) recommendations. By the end of 1963 a general downward trend of levels of radioactivity detected in other parts of the program has been observed. Programs to assess the contribution to the radiation exposure of members of the population from medical x-rays, nuclear reactor operations and natural background-radiation sources have also been described. The annual genetically significant dose from diagnostic x-ray examinations in Canadian public hospitals has been estimated to be 25.8 mrem. Results from the reactor-environment monitoring programs have not suggested the presence of radioactivity beyond that contributed from fallout.

Air Pollution↗

[The possibility of using the method of neutron activation radiography to detect micro-quantities of environmental radioactive pollutants].

A method of neutron-activation radiography was employed to investigate U distribution in leaves of plants (poplars, birches), growing in areas of mining ores with a high level of U which penetrates plants from the soil via the root system and appears on the surface of leaves, repeating their macrostructure. U also falls out on the surface of leaves in radioactive dust. The shapes of U manifestation permit the identification of its routes of penetration of the leaves of plants. Local U concentration even in an insignificant total excess of a radiation background can be considerable, leading to the destruction of tissues of plants as a result of alpha-radiation of U nuclei. A conclusion has been made of the danger of contamination of agricultural plants, growing in areas with ecological problems.

Mining↗

Toward a national consensus: teaching radiobiology to radiation oncology residents.

PURPOSE: The ASTRO Joint Working Group on Radiobiology Teaching, a committee composed of members having affiliations with several national radiation oncology and biology-related societies and organizations, commissioned a survey designed to address issues of manpower, curriculum standardization, and instructor feedback as they relate to resident training in radiation biology. METHODS AND MATERIALS: Radiation biology instructors at U.S. radiation oncology training programs were identified and asked to respond to a comprehensive electronic questionnaire dealing with instructor educational background, radiation biology course content, and sources of feedback with respect to curriculum planning and resident performance on standardized radiation biology examinations. RESULTS: Eighty-five radiation biology instructors were identified, representing 73 radiation oncology residency training programs. A total of 52 analyzable responses to the questionnaire were received, corresponding to a response rate of 61.2%. CONCLUSION: There is a decreasing supply of instructors qualified to teach classic, and to some extent, clinical, radiobiology to radiation oncology residents. Additionally, those instructors with classic training in radiobiology are less likely to be comfortable teaching cancer molecular biology or other topics in cancer biology. Thus, a gap exists in teaching the whole complement of cancer and radiobiology curricula, particularly in those programs in which the sole responsibility for teaching falls to one faculty member (50% of training programs are in this category). On average, the percentage of total teaching time devoted to classic radiobiology (50%), clinical radiobiology (30%), and molecular and cancer biology (20%) is appropriate, relative to the current makeup of the board examination. Nevertheless large variability exists between training programs with respect to the total number of contact hours per complete radiobiology course (ranging from approximately 10 to >50 h). A number of lecture topics, particularly in clinical radiobiology, are covered by fewer than 60% of training programs. A sizeable minority of radiation biology instructors are dissatisfied with the feedback they receive with respect to both course content and the performance of their residents on standardized radiobiology examinations administered by the American College of Radiology and/or the American Board of Radiology.

Curriculum↗

Contamination of the home environment by patients treated with Iodine-131: initial results.

We have employed twin sodium iodide radiation detectors to analyze iodine-131 transfer from thyroid patients to their families. Unlike previous studies of this problem, we measured thyroid radioiodine activity directly and are able to detect as little as 92 pCi of iodine 131 in adult thyroids. As in previous studies, we have also measured direct radiation exposures of family members with wristband thermoluminescent dosimeters. Thus far, we have studied seven families with 17 persons. Eleven of these are children under age 16. Direct radiation exposure of family persons from proximity of these radioactive patients ranged from 0.17 to 126 mR per day (natural background radiation amounts to approximately 0.35 mR per day). The maximum activity of iodine-131 in family thyroids ranged from less than 92 pCi to as high as 110,000 pCi and resulted in thyroid dose equivalents of 4 to 1330 mrem. Based on recent estimates of thyroid cancer, the latter dose equivalent could possibly double the risk of thyroid malignancy in children over what is expected normally. Such a risk implies the addition of 10 induced cases to the 10 naturally occurring cases per million people per year.

Adolescent↗

Is the loss of endothelial thrombomodulin involved in the mechanism of chronicity in late radiation enteropathy?

BACKGROUND AND PURPOSE: Radiation enteropathy is characterized by locally elevated levels of inflammatory and fibrogenic cytokines. Microvascular injury may sustain these alterations through persistent local hypercoagulopathy, platelet aggregation, leukocyte adhesion and release of biologically active mediators. This study assessed the relationship of endothelial thrombomodulin (TM), a key regulator of the protein C anticoagulant pathway and marker of endothelial function, with transforming growth factor beta (TGF-beta) immunoreactivity and morphologic alterations in radiation enteropathy. MATERIALS AND METHODS: Small bowel resection specimens from 9 patients with radiation enteropathy were analyzed by computerized quantitative immunohistochemistry using antibodies against TM, von Willebrand factor (vWF) and TGF-beta. Identical measurements were performed on intestinal resection specimens from otherwise healthy penetrating trauma victims and on archived small intestines. A previously validated image analysis technique was used to assess submucosal vessels for TM and vWF immunoreactivity, and the intestinal wall for total extracellular matrix-associated TGF-beta immunoreactivity. RESULTS: Specimens from irradiated patients showed prominent submucosal and subserosal thickening and fibrosis, and obliterative vasculopathy. Control specimens were histopathologically normal. Vascular density and vWF immunoreactivity were similar in radiation enteropathy patients and controls. The image-analysis techniques were highly reproducible, with correlation coefficients for repeated measurements ranging from 0.86 to 0.93. Radiation enteropathy specimens exhibited a highly significant reduction in the number and proportion of TM-positive submucosal vessels per unit area (P < 0.0001) and increased intestinal wall TGF-beta immunoreactivity (P = 0.002). CONCLUSIONS: These data support the theory that sustained endothelial dysfunction is involved in the molecular pathogenesis of radiation enteropathy, and point to TM as important in the chronic nature of radiation enteropathy and a potential target for prophylactic and therapeutic interventions.

Aged↗

Molecular biology, epidemiology, and the demise of the linear no-threshold (LNT) hypothesis.

The prime concern of radiation protection policy since 1959 has been protecting DNA from damage. The 1995 NCRP Report 121 on collective dose states that since no human data provides direct support for the linear no threshold hypothesis (LNT), and some studies provide quantitative data that, with statistical significance, contradict LNT, ultimately, confidence in LNT is based on the biophysical concept that the passage of a single charged particle could cause damage to DNA that would result in cancer. Current understanding of the basic molecular biologic mechanisms involved and recent data are examined before presenting several statistically significant epidemiologic studies that contradict the LNT hypothesis. Over eons of time a complex biosystem evolved to control the DNA alterations (oxidative adducts) produced by about 10(10) free radicals/cell/d derived from 2-3% of all metabolized oxygen. Antioxidant prevention, enzymatic repair of DNA damage, and removal of persistent DNA alterations by apoptosis, differentiation, necrosis, and the immune system, sequentially reduce DNA damage from about 10(6) DNA alterations/cell/d to about 1 mutation/cell/d. These mutations accumulate in stem cells during a lifetime with progressive DNA damage-control impairment associated with aging and malignant growth. A comparatively negligible number of mutations, an average of about 10(-7) mutations/cell/d, is produced by low LET radiation background of 0.1 cGy/y. The remarkable efficiency of this biosystem is increased by the adaptive responses to low-dose ionizing radiation. Each of the sequential functions that prevent, repair, and remove DNA damage are adaptively stimulated by low-dose ionizing radiation in contrast to their impairment by high-dose radiation. The biologic effect of radiation is not determined by the number of mutations it creates, but by its effect on the biosystem that controls the relentless enormous burden of oxidative DNA damage. At low doses, radiation stimulates this biosystem with consequent significant decrease of metabolic mutations. Low-dose stimulation of the immune system may not only prevent cancer by increasing removal of premalignant or malignant cells with persistent DNA damage, but used in human radioimmunotherapy may also completely remove malignant tumors with metastases. The reduction of gene mutations in response to low-dose radiation provides a biological explanation of the statistically significant observations of mortality and cancer mortality risk decrements, and contradicts the biophysical concept of the basic mechanisms upon which, ultimately, the NCRPs confidence in the LNT hypothesis is based.

Antimutagenic Agents↗