Trends in radiation protection.
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BACKGROUND: Interleukin-1, tumornecrosisfactor-alpha and interferon-gamma endogenously provide protection of the hematopoietic system against radiation. Thiols have already been used successfully as radioprotective agents. In this study the effect von N-acetylcysteine (NAC) on the release of interleukin-1 alpha and beta (IL-1), interleukin-2 (IL-2), interferon-gamma (IFN-gamma) and tumornecrosisfactor-alpha (TNF-alpha) was assessed in an in vitro assay. PATIENTS AND METHODS: Whole blood samples from 8 healthy volunteers were stimulated with 7.5 micrograms/ml PHA. NAC was added at concentrations of 0.6, 6, 12 and 24 mmol/l. Subsequently the samples were irradiated with a dose of 18 Gy according to preceding validation experiments. RESULTS: IL-1 alpha, IL-1 beta b and IL-2: In comparison to stimulation and radiation alone the addition of 0.6 and 6 mmol/l, with IL-2 also 12 mmol/l, NAC resulted in a significant increase of the cytokine-concentrations. The highest concentration of 24 mmol/l NAC, however, resulted in a decrease beyond control levels. IFN-gamma and TNF-alpha: Until 12 mmol/l NAC no changes were observed. 24 mmol/l NAC resulted in a significant decrease, too. CONCLUSION: N-acetylcysteine is capable to co-stimulate radioprotective cytokines like IL-1 alpha and IL-1 beta and to enhance IL-2 in vitro, whereas higher doses result in a suppression.
The aim of this study was to estimate the radioactive risk for surgical staff performing radioguided sentinel lymph node (SN) biopsy and to calculate the contamination level in the operating room for assessment of the possible need for specific radiation protection procedures. We studied 20 patients who were selected for quadrantectomy and SN biopsy. The day before surgery a volume of 0.15 mL of 99mTc-nanocoll was injected: the activity was 3.11 +/- 0.85 MBq in group A (15 pts) and 11.6 +/- 0.6 MBq in group B (5 pts). External radiation to staff was evaluated by measuring the exposure rate in air one hour after radiopharmaceutical administration. The air KERMA rate during surgery was estimated considering the physical decay of 99mTc. Contamination of disposable materials and surgical instruments in the operating room was measured using a contamination monitor, whereas the residual activity in the SN and the injection site was measured with a gamma probe. The exposure rate at 20 cm from the injection site was 0.75 microSv/h when the most radioactive patients (group B) were treated. Contamination in the operating room proved to be negligible. Considering the number of radioguided treatments carried out by a surgeon in one year, an equivalent effective dose of 0.075 mSv was estimated; the recommended dose limit according to the relevant Italian law, DL 230/95, is 1 mSv/yr. Surgical staff therefore do not require a classification of "exposed workers" and there is no need to supply the operating room with special containers for radioactive waste.
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An attempt has been made to clarify the two most important issues relevant to personal eye dosimetry. This involves the identification of the cells which are most at risk from radiation and the specification of their position in the eye. A survey of the radiobiological literature concerning animals and humans shows that the epithelial cells in the equatorial region of the lens are those which are involved in radiation cataract induction. The depth of these cells has been evaluated in the human eye by means of geometrical construction. The relevant dimensions have been determined from a survey of published anatomical data and supplemented by new data obtained by slit-image photography. In a normal adult population (20-65 years) the minimum depth of the incriminated cells is 2.3 plus or minus 0.4 mm; the upper and lower values are associated with young and old subjects respectively. Approximate calculations for isotropic 90Sr/90Y and 106Rh beta-radiation fields indicate that a planar dosemeter, which integrates the tissue dose between depths of 2.5-3.5 mm, should give a reasonable measure of the mean equatorial dose for the variety of eye and irradiation geometries likely to be met during a life-time exposure. The long established, but tentative, value of 3 mm for the effective depth of the lens is thus confirmed.
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Our present understanding of the role of ionizing radiation in the induction of malignant disease and genetic disorders has taken many years to develop. Over this period there has been a considerable degree of international collaboration in producing recommendations for good practice, and today many countries have legislation which aims to protect both the user of a dental x-ray set and the patient from receiving unnecessary doses of radiation. It is, however, not possible to eliminate completely the stochastic risks and considerable effort is being expended to see that these risks are minimized. In the case of the dentist using the set, it is important to ensure that these risks are small compared to other risks of everyday life. In the case of the patient it is vital to ensure that the benefits of a radiographic examination outweight the risks. A number of fatal malignancies are likely to be induced each year as a result of the use of dental radiology, and it is very necessary that there is proper clinical justification for every radiograph. The dental profession must ensure that the collective dose to the population is kept as low as reasonably achievable.