Genetic susceptibility to cancer: ICRP Publication 79

A Task Group of the ICRP Committee 1 (Radiation Effects) has reviewed relevant data with the objective of advising the Main Commission of the ICRP on the possible implications for radiological protection of emerging views on genetic susceptibility to cancer (Chapter 1).Chapter 2 considers DNA damage and its processing/repair after ionising radiation and serves principally to demonstrate that a few rare cancer-prone, human recessive genetic disorders show DNA repair deficiency and profound increases in radiosensitivity. Less dramatic changes in radiosensitivity are also apparent in a wider range of such disorders. The cellular mechanisms that underly the association between DNA damage processing and tumorigenesis are discussed.Chapter 3 reviews the mechanisms and genetics of solid tumours illustrating the ways in which mutations in proto-oncogenes, tumour suppressor genes together with those in DNA repair and cell cycle control genes can contribute to tumour development. Specific examples are given of how germ line mutation of such genes can predispose to familial cancer. It is judged that up to 5% of all solid tumours have a recognisable genetic component. Heritable organ-specific effects are most usual and cancers of the breast and colon tend to show the most obvious genetic components. Clearly discernible genetic effects are seen when rare dominant germ line mutations express strongly as familial cancer (high penetrance mutations), but the existence of perhaps less rare low penetrance mutations and gene–gene interactions are recognised but not well understood.Chapter 4 considers the mechanisms and genetics of lympho-haemopoietic tumours. Specific chromosomal translocations and proto-oncogene activation events are much more frequent in human leukaemia/lymphoma than in solid tumours. Genetic predisposition to leukaemia/lymphoma is found in a number of non-familial recessive genetic disorders of DNA processing and/or chromosomal instability. Familial manifestation of susceptibility to these tumours is, however, extremely rare. The genetic component, although poorly defined, is judged to be less than that of solid tumours and expressed largely in childhood.Chapter 5 reviews and discusses limited data that comment upon tumorigenic radiosensitivity in cancer-prone genetic conditions. From knowledge of the fundamental processes involved it is judged that in most, but not all, cases genetic susceptibility to spontaneous tumours will be accompanied by a greater-than-normal risk after radiation. A review of epidemiological, clinical and experimental data relevant to this issue suggests that although a wide range of different sensitivities may be involved, a factor of 10 increase in sensitivity broadly accords with the limited human data available. This interim judgement of a factor of 10 increase in radiation risk in such human genetic disorders is made for the purposes of illustrative modelling and calculation. In addition, specific attention is given to breast cancer risk in heterozygotes for the radiosensitive human disorder, ataxia-telangiectasia; this association, while in no way discounted, is judged to be less strong than that claimed by some.Chapter 6 discusses and develops computational modelling procedures that aim to describe the impact of genetic factors on radiation-tumorigenesis in human populations. Estimates of the prevalence of known cancer-prone genetic disorders are made but breast cancer susceptibility is used to illustrate the application of the model developed. The most important message to emerge from this work is that, even at an assumed high level of radiation sensitivity, the prevalence of familial (high penetrance) genetic disorders in the population is too low (<1%) for there to be a significant impact on risk in typical human populations. In principle, however, there is the potential for such impact in atypical inbred sub-populations where these mutations can be more common. These modelling procedures are also used to illustrate how incomplete penetrance of these mutations will dilute any impact on population risk.In conjunction with the Main Commission of the ICRP, in Chapter 7 the Task Group discusses the potential implications of the main report for radiological protection. Their principal conclusions are: (i) That current estimates of radiation cancer risk already include an unknown contribution from genetically radiosensitive sub-populations. (ii) Using the data cited, the likely contribution to radiation risk from familial cancer disorders is too low to generate an unacceptable distortion of current estimates of cancer risk in the vast majority of human populations. (iii) There is insufficient knowledge to judge the contribution to risk from mutations of low penetrance that do not express as familial cancer. (iv) Because of the high risk of spontaneous cancer in familial disorders, low doses of radiation (say 100 mSv) are most unlikely to impact significantly on life-time cancer risk in an affected individual; at high doses, such as those experienced in radiotherapy, this relative risk may however become important. (v) Because organ-specific cancer risk is predicted in most familial disorders, the absolute increase overall in risk to an affected individual will be diluted, ie. comparing normal and affected individuals. (vi) The utility of genetic testing for cancer predisposition in the context of radiological protection is currently limited by technical factors and concerns on predictive power. In the future genetic testing may find selected use prior to certain medical exposures to radiation, but the value of such procedures, as applied to low-dose occupationally exposed individuals, is open to doubt; it would also be subject to major ethical scrutiny outside the remit of the ICRP.The Task Group and the Main Commission of the ICRP stress that, because of the current lack of knowledge, the above judgements should be regarded as preliminary. The report serves principally to provide a framework on which to develop further views in this rapidly advancing area of human genetics.     

ICRP Publication 105. Radiation protection in medicine

This report was prepared to underpin the Commission's 2007 Recommendations with regard to the medical exposure of patients, including their comforters and carers, and volunteers in biomedical research. It addresses the proper application of the fundamental principles (justification, optimisation of protection, and application of dose limits) of the Commission's 2007 Recommendations to these individuals. With regard to medical exposure of patients, it is not appropriate to apply dose limits or dose constraints, because such limits would often do more harm than good. Often, there are concurrent chronic, severe, or even life-threatening medical conditions that are more critical than the radiation exposure. The emphasis is then on justification of the medical procedures and on the optimisation of radiological protection. In diagnostic and interventional procedures, justification of procedures (for a defined purpose and for an individual patient), and management of the patient dose commensurate with the medical task, are the appropriate mechanisms to avoid unnecessary or unproductive radiation exposure. Equipment features that facilitate patient dose management, and diagnostic reference levels derived at the appropriate national, regional, or local level, are likely to be the most effective approaches. In radiation therapy, the avoidance of accidents is a predominant issue. With regard to comforters and carers, and volunteers in biomedical research, dose constraints are appropriate. Over the last decade, the Commission has published a number of documents that provided detailed advice related to radiological protection and safety in the medical applications of ionising radiation. Each of the publications addressed a specific topic defined by the type of radiation source and the medical discipline in which the source is applied, and was written with the intent of communicating directly with the relevant medical practitioners and supporting medical staff. This report consolidates that advice.     

Retrospective radon progeny measurements through measurements of Po activities on glass objects using stacked LR 115 detectors

A stacked LR 115 detector consisting of two active layers was proposed for determining ²¹⁰Po activity in glass surfaces after deposition of short-lived radon progeny. The sensitivities of both active layers were calculated. Two glass samples were exposed in a chamber to determine the experimental calibration factors for the radon gas and progeny, which were then compared with the theoretical calibration factors from simulations. The experimental and the simulated calibration factors for radon progeny agreed well. The discrepancy between the calibration factors for radon gas was due to a much higher equilibrium factor used in the experimental calibration than the nominal value assumed in the simulation. A mini-survey of contemporary and retrospective radon progeny concentrations was carried out at 10 residential sites. A relationship between contemporary and retrospective radon progeny concentrations was not readily observable.     

Prevention of high-dose-rate brachytherapy accidents. ICRP Publication 97

High-dose-rate brachytherapy is a rapidly growing technique (HDR) that has been replacing low-dose-rate (LDR) procedures over the last few years in both industrialised and developing countries. It is estimated that about 500,000 procedures (administration of treatment) are performed by HDR units annually. LDR equipment has been discontinued by many manufacturers over the last few years, leaving HDR brachytherapy as the major alternative. HDR brachytherapy techniques deliver a very high dose, of the order of 1.6-5.0 Gy/min, so mistakes can lead to under- or overdosage with the potential for clinical adverse effects. More than 500 HDR accidents (including one death) have been reported along the entire chain of procedures from source packing to delivery of dose. Human error has been the prime cause of radiation events. In the present report, the International Commission on Radiological Protection concludes that many accidents could have been prevented if staff had had functional monitoring equipment and paid attention to the results. Since iridium has relatively short half-life, the HDR sources need to be replaced approximately every 4 months. Over 10,000 HDR sources are transported annually, with the resultant potential for accidents; therefore, appropriate procedures and regulations must be observed. A number of specific recommendations on procedures and equipment are given in this report. The need for an emergency plan and for practising emergency procedures is stressed. The possibility of loss or theft of sources must be kept in mind. A collaborating team of specifically trained personnel following quality assurance (QA) procedures is necessary to prevent accidents. Maintenance is indispensable component of QA; external audits of procedures re-enforce good and safe practice, and identify potential causes of accidents. QA should include peer review of cases. Accidents and incidents should be reported and the lessons learned should be shared with other users to prevent similar mistakes.     

基于扣除算法的环境氡和氡子体连续测量仪

环境氡和氡子体连续测量是准确计算氡的辐射剂量、客观评价氡危害的前提。介绍了一种使用闪烁室法和滤膜收集法、基于扣除算法的能够同时连续测量氡和氡子体的智能化测量仪器，详细介绍了仪器的测量原理、结构，并给出了在标准氡室和办公室中的部分测量数据。     

ICRP Publication 114. Environmental protection: transfer parameters for reference animals and plants

In Publication 103 (ICRP, 2007), the Commission included a section on the protection of the environment, and indicated that it would be further developing its approach to this difficult subject by way of a set of Reference Animals and Plants (RAPs) as the basis for relating exposure to dose, and dose to radiation effects, for different types of animals and plants. Subsequently, a set of 12 RAPs has been described in some detail (ICRP, 2008), particularly with regard to estimation of the doses received by them, at a whole-body level, in relation to internal and external radionuclide concentrations; and what is known about the effects of radiation on such types of animals and plants. A set of dose conversion factors for all of the RAPs has been derived, and the resultant dose rates can be compared with evaluations of the effects of dose rates using derived consideration reference levels (DCRLs). Each DCRL constitutes a band of dose rates for each RAP within which there is likely to be some chance of the occurrence of deleterious effects. Site-specific data on Representative Organisms (i.e. organisms of specific interest for an assessment) can then be compared with such values and used as a basis for decision making. It is intended that the Commission's approach to protection of the environment be applied to all exposure situations. In some situations, the relevant radionuclide concentrations can be measured directly, but this is not always possible or feasible. In such cases, modelling techniques are used to estimate the radionuclide concentrations. This report is an initial step in addressing the needs of such modelling techniques. After briefly reviewing the basic factors relating to the accumulation of radionuclides by different types of biota, in different habitats, and at different stages in the life cycle, this report focuses on the approaches used to model the transfer of radionuclides through the environment. It concludes that equilibrium concentration ratios (CRs) are most commonly used to model such transfers, and that they currently offer the most comprehensive data coverage. The report also reviews the methods used to derive CRs, and describes a means of summarising statistical information from empirical data sets. Emphasis has been placed on using data from field studies, although some data from laboratory experiments have been included for some RAPs. There are, inevitably, many data gaps for each RAP, and other data have been used to help fill these gaps. CRs specific to each RAP were extracted from a larger database, structured in terms of generic wildlife groups. In cases where data were lacking, values from taxonomically-related organisms were used to derive suitable surrogate values. The full set of rules which have been applied for filling gaps in RAP-specific CRs is described. Statistical summaries of the data sets are provided, and CR values for 39 elements and 12 RAP combinations are given. The data coverage, reliance on derived values, and applicability of the CR approach for each of the RAPs is discussed. Finally, some consideration is given to approaches where RAPs and their life stages could be measured for the elements of interest under more rigorously controlled conditions to help fill the current data gaps.     

Radiation safety aspects of brachytherapy for prostate cancer using permanently implanted sources. A report of ICRP Publication 98

The use of permanent radioactive implants (125I or 103Pd seeds) to treat selected localised prostate cancer patients has been increasing rapidly all over the world for the last 15 years. It is estimated that more than 50,000 patients are treated this way every year in the world, and this number is anticipated to increase in the near future. Although no accidents or adverse effects involving medical staff and/or members of the patient's family have been reported to date, this brachytherapy technique raises a number of radiation safety issues that need specific recommendations from the ICRP. All data concerning the dose received by people approaching patients after implantation have been reviewed. Those doses have been either been measured directly or calculated. The available data show that, in the vast majority of cases, the dose to comforters and carers remains well below the recommended limit of 1 mSv/year. Only the (rare) case where the patient's partner is pregnant at the time of implantation may need specific precautions. Expulsion of sources through urine, semen, or the gastro-intestinal tract is rare. Specific recommendations should be given to patients to allow them to deal adequately with this event. Of note, due to the low activity of an isolated seed and its low photon energy, no incident/accident linked to seed loss has ever been recorded. When performed in the first few months after implantation, cremation of bodies (frequent in some countries) raises several issues related to: (1) the activity that remains in the patient's ashes; and (2) the airborne dose, potentially inhaled by crematorium staff or members of the public. Review of available data shows that cremation can be allowed if 12 months have elapsed since implantation with 125I (3 months for 103Pd). If the patient dies before this delay has elapsed, specific measures must be undertaken. Specific recommendations have to be given to the patient to warn his surgeon in case of subsequent pelvic or abdominal surgery. A 'wallet card' with all relevant information about the implant is useful. In most cases, brachytherapy does make the patient infertile. However, although the therapy-related modifications of the semen reduce fertility, patients must be aware of the possibility of fathering children after such a permanent implantation, with a limited risk of genetic effects for the child. Patients with permanent implants must be aware of the possibility of triggering certain types of security radiation monitors. The 'wallet card' including the main information about the implant (see above) may prove to be helpful in such a case. Considering the available experience after brachytherapy and external irradiation of prostate cancer, the risk of radio-induced secondary tumours appears to be extremely low. The demonstrated benefit of brachytherapy clearly outweighs, by far, the very limited (mainly theoretical)increase in the radiation-induced cancer risk.     

气溶胶粒径分布对肺模型评价氡子体有效剂量的影响

剂量学近似方法常用于评估氡子体有效剂量。在回顾ICRP66号肺模型的基础上,计算分析了气溶胶粒径对肺部区域沉积份额的影响。在此基础上,计算讨论了气溶胶粒径分布对氡子体有效剂量转换系数的影响,结合粒径分布实验测量值,综述了典型环境下氡子体有效剂量转换系数同未结合态份额及结合态粒径分布的关系。     

A framework for assessing the impact of ionising radiation on non-human species. ICRP Publication 91

In its 1990 Recommendations, the ICRP indicated that it believed that the standards of environmental control needed to protect man to the degree currently thought desirable would ensure that other species are not put at risk. The ICRP considers that its system of radiological protection has provided a fairly good indirect protection of the human habitat. However, no internationally agreed criteria or policies explicitly address protection of the environment from ionising radiation, and it is difficult to determine or demonstrate whether or not the environment is adequately protected from potential impacts of radiation under different circumstances. The present report suggests a framework, based on scientific and ethical-philosophical principles, by which a policy for the protection of non-human species could be achieved. The primary purpose of developing such a framework is to fill a conceptual gap in radiological protection; it does not reflect any particular concern over environmental radiation hazards. The proposed framework is designed to harmonise with the ICRP's approach to the protection of human beings, but does not intend to set regulatory standards. Instead, the proposed framework is intended to be a practical tool to provide high-level advice and guidance for regulators and operators. An agreed set of quantities and units, a set of reference dose models, reference dose-per-unit-intake (or unit exposure), and reference fauna and flora are required to serve as a basis for the more fundamental understanding and interpretation of the relationships between exposure and dose and between dose and certain categories of effect, for a few, clearly defined types of animals and plants. As a first step, a small set of reference fauna and flora with supporting databases will be developed by the ICRP. Others can then develop more area- and situation-specific approaches to assess and manage risks to non-human species.     

氡及其子体对大鼠肺组织和外周血的损伤作用

为研究氡及其子体对大鼠肺组织的病理损伤和外周血损伤的生物学效应,以多功能生态氡室对SD大鼠进行氡及其子体染毒,累积染毒剂量分别达60、90、120工作水平月(Working level month,WLM)后,收集外周血,观察外周血中白细胞计数和分类的变化.同时选取右肺及与其相连的支气管,观察大鼠肺及支气管的损伤程度....     

Human alimentary tract model for radiological protection. ICRP Publication 100. A report of The International Commission on Radiological Protection

In this report, the ICRP provides a new biokinetic and dosimetric model of the human alimentary tract to replace the Publication 30 (ICRP, 1979) model. The new human alimentary tract model (HATM) will be used together with the human respiratory tract model (HRTM; ICRP, 1994a,b) in future ICRP publications on doses from ingested and inhaled radionuclides. The HATM is applicable to all situations of radionuclide intake by children and adults. It provides age-dependent parameter values for the dimensions of the alimentary tract regions, and associated transit times for the movement of materials through these regions. For adults, gender-dependent parameter values are given for dimensions and transit times. The default assumption is that radionuclide absorption takes place in the small intestine, but the model allows for absorption in other regions and for retention in or on tissues within the alimentary tract when information is available. Doses are calculated to target cells for cancer induction in the oral cavity, oesophagus, stomach, small intestine, and colon. This report provides reviews of information on the transit of materials through the alimentary tract and on radionuclide retention and absorption. It considers data on health effects, principally in order to specify the target cells for cancer induction within the mucosal lining of the tract and to justify approaches taken to dose averaging within regions. Comparisons are made between doses calculated using the HATM and the Publication 30 model for examples of radionuclide ingestion for which absorption is assumed to occur in the small intestine alone. Examples are also given of the effects on doses of considering absorption from other regions and the effect of possible retention in the alimentary tract. This report also considers uncertainties in model assumptions and their effect on doses, including alimentary tract dimensions, transit times, radionuclide absorption values, and the location of targets for cancer induction.     

Radiation protection recommendations as applied to the disposal of long-lived solid radioactive waste. ICRP Publication 81

The present publication deals with the radiological protection of members of the public following the disposal of long-lived solid radioactive waste using the 'concentrate and retain' strategy. It covers options including shallow land burial and deep geological disposal. The recommendations made in this report apply to new disposal facilities.The main protection issue concerns exposure that may or may not occur in the far future, i.e. a situation of potential exposure. Constrained optimisation is the central approach to evaluating the radiological acceptability of a waste disposal system. In this context optimisation of protection is a judgmental process with social and economic factors being taken into account and should be conducted in a structured essentially qualitative way.Two broad categories of exposure situations have to be considered: natural processes and human intrusion. Application of the radiological protection criteria to these two categories of exposure situations is different.In the first case, assessed doses or risks arising from natural processes should be compared with a constraint of no more than about 0.3 mSv per year or its risk equivalent of around 10(-5) per year. With regard to human intrusion, understood here as inadvertent human intrusion, the consequences from one or more plausible stylised scenarios should be considered in order to evaluate the resilience of the repository to such events. The Commission considers that in circumstances where human intrusion could lead to doses to those living around the site sufficiently high that intervention on current criteria would almost always be justified, reasonable efforts should be made at the repository development stage to reduce the probability of human intrusion or to limit its consequences. In this respect, the Commission has previously advised that an existing(1) annual dose of around 10 mSv per year may be used as a generic reference level below which intervention is not likely to be justifiable. Conversely, an existing(1) annual dose of around 100 mSv per year may be used as a generic reference level above which intervention should be considered almost always justifiable. Similar considerations apply in situations where the thresholds for deterministic effects in relevant organs are exceeded.The conclusion of the report is that in the Commission's view, provided reasonable measures have been taken both to satisfy the constraint for natural processes and to reduce the probability or the consequences of inadvertent human intrusion, and technical and managerial principles have been followed, then radiological protection requirements can be considered to have been complied with.     

吸入氡子体肺部有效剂量转换系数的影响因素研究

基于ICRP 66号报告中的呼吸道生物动力学模型,采用MATLAB软件中的Simulink仿真工具,建立了人体呼吸道的廓清模型,利用建立的廓清模型计算了不同参数条件下肺部有效剂量转换系数(mSv/WLM)的变化规律。结果显示吸入氡子体粒径对肺部有效剂量转换系数的影响最大,当粒径在0.7～10 000 nm之间变化时,肺部有效剂量转换系数的变化能达到10倍以上;其次是呼吸率,呼吸率直接决定了吸入氡子体粒子的数量,当成年男性重度工作状态时肺部有效剂量转换系数是睡眠状态下的4.2倍;未结合态份额对剂量转换系数的影响会随着吸入氡子体粒径值不同而发生改变,当未结合态份额从0变化到0.08时,肺部有效剂量转换系数最多能增大79%;相比而言吸收入血速率对肺部有效剂量转换系数的影响只有不到4%。     

一种调控氡子体平衡因子的高浓度单分散性气溶胶发生器的研制

为了满足氡室内氡子体辐射场的调控要求,结合蒸发冷凝法的原理,利用电子烟发生器产生的癸二酸二辛酯(DEHS)与雾化器产生的NaCl颗粒结合再冷凝的方法,研制了高浓度单分散的气溶胶发生器。将该发生器应用于中国计量科学研究院20 m³氡室,充胶1分钟后气溶胶浓度最高可达到2.26×10⁵ cm^-3,平均粒径156.8 nm,单分散性1.38,氡室内氡子体平衡因子可调控达到0.65。