Biological estimates of dose to inhabitants of Belarus and Ukraine following the Chernobyl accident

The purpose of this paper is to investigate how well various assays on blood can detect radiation dose to people exposed many years previously and, if possible, to estimate that dose. The assays were applied to persons resident close to Chernobyl in 1986. Blood samples were taken 13-15 years after the reactor accident. The assays used were the frequencies of lymphocyte chromosomal translocations, micronuclei, HPRT mutations and apoptotic cells. Translocation yields in the exposed groups were marginally higher than in their respective controls, leading to dose estimates of about 0.2 Gy but with large uncertainties. All other assays showed inconsistency from person to person or other variations apparently not related to dose. The measurement of translocations, it is concluded, is the biological method of choice for retrospective dosimetry.     

Retrospective dosimetry for Latvian workers at Chernobyl

Between 1986 and 1991 approximately 6500 Latvian inhabitants were recruited for clean-up work at the Chernobyl nuclear power plant. Their absorbed doses are usually unknown, because less than half of them had their external exposure officially documented. Clinical investigations show a high morbidity rate for these clean-up workers when compared with that of the general population. In order to understand the causes of their diseases and the impact of ionising radiation, electron spin resonance (ESR) has been used to measure the absorbed doses in human tooth enamel. The doses estimated by ESR were between two and three times higher than previously documented and are in accord with the results of immunological and biological tests. The results may be explained by considering the effects of irradiation caused by long-lived incorporated radionuclides.     

Retrospective biological dosimetry of absorbed radiation

Frequencies of chromosomal translocations in human peripheral blood lymphocytes irradiated in vitro by 200 kV X rays have been estimated by the fluorescence in situ hybridisation (FISH) technique. Probes specific for whole chromosomes 1, 3 and 4 were labelled with, biotin 16 dUTP + digoxigenin 11 dUTP; biotin 16 dUTP and digoxigenin 11 dUTP respectively, to achieve three colour FISH to distinguish exchanges involving individual chromosomes. The translocation frequencies for individual chromosomes suggested a relationship between the response and the genomic content of the chromosomes studied. Dose-response curves derived from translocations involving all the three painted chromosomes (22.3% of the genome) showed a linear-quadratic response with alpha and beta coefficients of 0.027 +/- 0.009 Gy-1 and 0.033 +/- 0.004 Gy-2, corresponding coefficients for the response curves extrapolated to the entire genome are 0.072 +/- 0.026 Gy-1 and 0.075 +/- 0.011 Gy-2 respectively. Dose-response curves for the induction of dicentrics involving painted chromosomes also showed a similar response, but the dicentric frequencies were consistently lower than the translocation frequencies for all the doses studied. Dose fractionation resulted in a small but significant reduction in the yield of exchanges, thus suggesting repair of some radiation damage during the period between the two fractions. Retrospective biological dosimetry was attempted with FISH assay of five radiation workers with chronically accumulated doses of approximately 500 mSv received over a period of 2-3 decades. Among the 2421 metaphases scored in these subjects 28 translocations involving the painted chromosomes were detected. The dose estimates based on FISH assay ranged from 0.215 +/- 0.116 Gy to 0.635 +/- 0.292 mGy, thus suggesting the usefulness of this assay in retrospective biological dosimetry.     

A cytogenetic follow-up of some highly irradiated victims of the Chernobyl accident

A follow-up of 10 highly irradiated men, mostly reactor crew, from the Chernobyl accident is described. Their pre-accident medical conditions and relevant medical status approximately 10-13 y later are listed. A comparison is made between estimates of their average whole-body penetrating radiation doses derived from several biological parameters. First estimates were based on their presenting severity of prodromal sickness, early changes in blood cell counts and dicentric chromosome aberrations in lymphocytes. In three cases ESR measurements on tooth enamel were also made. Retrospective dosimetry using FISH translocations was attempted 10-13 y later. This showed good agreement for those patients with the lower earlier dose estimates, up to about 3 Gy. For the others, extending up to about 12 Gy, the translocations indicated lower values, suggesting that in these cases translocations had somewhat declined. Repeated chromosomal examinations during the follow-up period showed an expected decline in dicentric frequencies. The pattern of decline was bi-phasic with a more rapid first phase, with a half-life of approximately 4 months followed by a slower decline with half-lives around 2-4 y. The rapid phase persisted for a longer time in those patients who had received the highest doses. 10-13 y later dicentric levels were still above normal background, but well below the translocation frequencies.     

Cytogenetic biodosimetry of an accidental exposure of a radiological worker using multiple assays

A technician involved in the maintenance of X-ray equipment visited the occupational medicine service with complaints of skin lesions, apparently caused by an accidental exposure three months earlier. To estimate the dose received by the technician in the accident, biodosimetry was performed 6 and 18 months post-exposure with the dicentric and micronucleus assays. Part of the latest blood sample was also used for retrospective dosimetry by fluorescence in situ hybridisation (FISH) analysis for translocations. The data obtained 6 and 18 months post-exposure indicate that both dicentrics and micronuclei disappear with a half-time of 1 y. After correction for delayed blood sampling, dose values of 0.75 Gy (95% confidence limits 0.56-1.05 Gy) from dicentrics and 0.96 Gy (95% confidence limits 0.79-1.18 Gy) from micronuclei were obtained. FISH analysis of translocations resulted in a dose estimate of 0.79 Gy (95% confidence limits 0.61-0.99 Gy). The satisfactory agreement between the three cytogenetic endpoints supports the use of the micronucleus assay for triage purposes in the case of large scale radiological accidents and provides further evidence for the valid use of FISH for translocations as a reliable retrospective biological dosimeter.     

Usefulness and limits of biological dosimetry based on cytogenetic methods

Damage from occupational or accidental exposure to ionising radiation is often assessed by monitoring chromosome aberrations in peripheral blood lymphocytes, and these procedures have, in several cases, assisted physicians in the management of irradiated persons. Thereby, circulating lymphocytes, which are in the G0 stage of the cell cycle are stimulated with a mitogenic agent, usually phytohaemagglutinin, to replicate in vitro their DNA and enter cell division, and are then observed for abnormalities. Comparison with dose-response relationships obtained in vitro allows an estimate of exposure based on scoring: Unstable aberrations by the conventional, well-established analysis of metaphases for chromosome abnormalities or for micronuclei; So-called stable aberrations by the classical G-banding (Giemsa-Stain-banding) technique or by the more recently developed fluorescent in situ hybridisation (FISH) method using fluorescent-labelled probes for centromeres and chromosomes. Three factors need to be considered in applying such biological dosimetry: (1) Radiation doses in the body are often inhomogeneous. A comparison of the distribution of the observed aberrations among cells with that expected from a normal poisson distribution can allow conclusions to be made with regard to the inhomogeneity of exposure by means of the so-called contaminated poisson distribution method; however, its application requires a sufficiently large number of aberrations, i.e. an exposure to a rather large dose at a high dose rate. (2) Exposure can occur at a low dose rate (e.g. from spread or lost radioactive sources) rendering a comparison with in vitro exposure hazardous. Dose-effect relationships of most aberrations that were scored, such as translocations, follow a square law. Repair intervening during exposure reduces the quadratic component with decreasing dose rate as exposure is spread over a longer period of time. No valid solution for this problem has yet been developed, although, in theory, both deterministic damage and aberrations might be repaired to a similar degree; a comparison of aberrations following a linear dose relationship might also help when the doses have been sufficiently large. (3) Investigations might have been possible only a certain time after the exposure. The relatively rapid disappearance of lymphocytes carrying unstable aberrations limits their use in retrospective dosimetry, years after exposure. Scoring stable aberrations, thought to persist in the circulating lymphocytes, might appear more appropriate in such situations. However, the examination of a representative number of cells by G-banding is extremely laborious, and the FISH method is not only expensive but has not yet been fully validated in different laboratories. In conclusion, biological dosimetry has serious limitations exactly for situations where the need for information is most urgent. It renders its most useful results when an individual has been exposed to a rather homogeneous high-level radiation over a short time interval, i.e. accidents at high-intensity radiation devices. On the other hand, it yielded less satisfactory information even when the most recent techniques were used for situations, where a low level, low dose rate exposure has occurred at some time in the past, for example for persons living in areas contaminated from the Chernobyl accident. Such negative experiences should be kept in mind in order to avoid futile and expensive investigations in the case of populations exposed from radioactivity and, notably, also from potentially clastogenic chemical agents.     

Stable and unstable chromosomal aberrations among Finnish nuclear power plant workers

Twenty nuclear power plant workers with relatively high recorded cumulative doses were studied using FISH chromosome painting and dicentric analysis after solid Giemsa staining. The results indicated that chronic exposure to ionising radiation can be detected on the group level using translocation analysis after chromosome painting, although the mean cumulative dose was approximately 100 mSv. A significant association between translocation frequency and cumulative dose was observed. Variability in the translocation yields among workers with similar recorded doses was large, resulting in a poor correlation between translocation frequencies and documented doses on the individual level. The yields of dicentric and acentric chromosomes were not correlated with the cumulative dose, indicating the inability of unstable aberrations to monitor long-term exposures. It was also shown that the unstable aberrations were not correlated with the most recent annual dose.     

Radiation-epidemiological studies of thyroid cancer incidence in Russia after the Chernobyl accident (estimation of radiation risks, 1991-2008 follow-up period)

This study presents an analysis of the thyroid cancer incidence in the population of the most contaminated territories of Bryansk, Kaluga, Oryol and Tula oblasts affected by the Chernobyl accident. The follow-up period is 1991-2008, and the cohort size is 309 130 people. For that period 978 thyroid cancer cases were detected. The excess relative risk per 1 Gy (ERR/Gy) is found to be statistically significant for children and adolescents (0-17 y of age) at the time of the Chernobyl accident (ERR/Gy=3.22; 95 % confidence interval (1.56; 5.81). In boys, the ERR/Gy was higher than in girls -6.54 and 2.24, respectively. A statistically significant decrease in ERR/Gy with time since exposure, by a factor of 0.37 per 10 y, was observed for the whole cohort and for boys separately, but not for girls. No radiation risks of a thyroid cancer among people of 18 y of age at exposure and older were found.     

Occupational exposure to external ionising radiation in Poland, 1999

In 1999 about 6208 radiation workers from 389 departments were monitored by CLOR in Poland. The distribution of annual personal doses shows that 85% of controlled workers received doses below the MDL (0.4 mSv) and about 97% controlled workers received doses below 5 mSv. Doses higher than 50 mSv were received by three operators of industrial radiography units. The radiation workers under control are divided into four main work sectors: nuclear industry, research and education, medicine, and general industry. The average annual dose for all workers in each particular sector was 0.22 mSv, 0.22 mSv, 0.30 mSv and 0.80 mSv, respectively. The average annual dose for the entire monitored population was 0.47 mSv. The average annual dose in each particular sector for number of workers receiving E > 0, i.e. Hp(10) > or = 0.4 mSv, amounted to 1.78 mSv, 2.03 mSv, 1.88 mSv and 4.85 mSv, respectively. The average annual dose for the full number of workers receiving E > 0 was 3.21 mSv. This paper contains the detailed analysis of occupational exposure. The distributions of annual occupational exposure in different work sectors are also given.     

Review of retrospective dosimetry techniques for external ionising radiation exposures

The current focus on networking and mutual assistance in the management of radiation accidents or incidents has demonstrated the importance of a joined-up approach in physical and biological dosimetry. To this end, the European Radiation Dosimetry Working Group 10 on 'Retrospective Dosimetry' has been set up by individuals from a wide range of disciplines across Europe. Here, established and emerging dosimetry methods are reviewed, which can be used immediately and retrospectively following external ionising radiation exposure. Endpoints and assays include dicentrics, translocations, premature chromosome condensation, micronuclei, somatic mutations, gene expression, electron paramagnetic resonance, thermoluminescence, optically stimulated luminescence, neutron activation, haematology, protein biomarkers and analytical dose reconstruction. Individual characteristics of these techniques, their limitations and potential for further development are reviewed, and their usefulness in specific exposure scenarios is discussed. Whilst no single technique fulfils the criteria of an ideal dosemeter, an integrated approach using multiple techniques tailored to the exposure scenario can cover most requirements.     

Radiation exposure to the population of Europe following the Chernobyl accident

On the occasion of the 20th anniversary of the Chernobyl accident an attempt has been made to evaluate the impact of the Chernobyl accident on the global burden of human cancer in Europe. This required the estimation of radiation doses in each of the 40 European countries. Dose estimation was based on the analysis and compilation of data either published in the scientific literature or provided by local experts. Considerable variability has been observed in exposure levels among the European populations. The average individual doses to the thyroid from the intake of (131)I for children aged 1 y were found to vary from approximately 0.01 mGy in Portugal up to 750 mGy in Gomel Oblast (Belarus). Thyroid doses to adults were consistently lower than the doses received by young children. The average individual effective doses from external exposure and ingestion of long-lived radiocaesium accrued in the period 1986-2005 varied from approximately 0 in Portugal to approximately 10 mSv in Gomel Oblast (Belarus) and Bryansk Oblast (Russia). The uncertainties in the dose estimates were subjectively estimated on the basis of the availability and reliability of the radiation data that were used for dose reconstruction in each country.     

Occupational exposure to ionising radiation in the region of Anatolia, Turkey for the period 1995-1999

For this study, the individual annual dose information on classified workers who are occupationally exposed to extended radiation sources in Turkey, was assessed and analysed by the Ankara Nuclear Research and Training Centre dosimetry service at the Turkish Atomic Energy Authority for the years 1995-1999. The radiation workers monitored are divided into three main work sectors: conventional industry (8.24%), medicine (90.20%) and research-education (1.56%). The average annual dose for all workers in each particular sector was 0.14, 0.38 and 0.08 mSv, respectively, in 1995-1999. This paper contains the detailed analysis of occupational exposure. The statistical analysis provided includes the mean annual dose, the collective dose, the distributions of the dose over the different sectors and the number of workers who have exceeded any of the established dose levels.     

医学数字摄影中，单纯追求影像质量不可取

在使用医用X-线胶片进行放射摄影时,胶片上的影像密度在冲洗后就不变了,X-线曝光量基本上是规范化的;但是,在数字摄影时,由于曝光产生的信息要经过后期处理,才能获得最终的影像,曝光和后期处理有很大的调整范围;影像的质量决定于信嘈比,而增加曝光量确实可以提高信嘈比,因此往往为了获得最佳的影像质量而追求最大的信嘈比,以便获得最佳影像质量,直接后果是病人得接受较高的射线剂量。但有时适当的影像质量就足可以满足诊断要求,就不应该让病人接受不必要的射线照射,因为过高的射线照射是极其有害的。     

An assessment of annual whole-body occupational radiation exposure in Ireland (1996-2005)

Whole-body occupational exposure to artificial radiation sources in Ireland for the years 1996-2005 has been reviewed. Dose data have been extracted from the database of the Radiological Protection Institute of Ireland, which contains data on >95% of monitored workers. The data have been divided into three sectors: medical, industrial and education/research. Data on exposure to radon in underground mines and show caves for the years 2001-05 are also presented. There has been a continuous increase in the number of exposed workers from 5980 in 1996 to 9892 in 2005. Over the same time period, the number of exposed workers receiving measurable doses has decreased from 676 in 1996 to 189 in 2005 and the collective dose has also decreased from 227.1 to 110.3 man millisievert (man mSv). The collective dose to workers in the medical sector has consistently declined over the 10-y period of the study while that attributable to the industrial sector has remained reasonably static. In the education/research sector, the collective dose typically represents 5% or less of the total collective dose from all practices. Over the 10 y of the study, a total of 77 914 annual dose records have been accumulated, but only 4040 (<6%) of these represent measurable radiation doses in any given year. Over the same time period, there were 283 instances in which exposed workers received individual annual doses >1 mSv and 21 of these exceeded 5 mSv. Most of the doses >1 mSv were received by individuals working in diagnostic radiology (which also includes interventional radiology) in hospitals and site industrial radiography. There has been only one instance of a dose above the annual dose limit of 20 mSv. Evaluating the data for the period 2001-05 separately, the average annual collective dose from the medical, industrial and educational/research sectors are approximately 60, 70 and 2 man mSv with the average dose per exposed worker who received a measurable dose being 0.32, 0.79 and 0.24 mSv, respectively. Diagnostic radiology and site industrial radiography each represents >60% of the collective dose in their respective sectors. Available data on radon exposure in one underground mine and in three show caves indicate an annual collective dose of 75 man mSv from these work activities. By comparison, previous estimates of exposure of Irish air crew to cosmic radiation have given rise to an estimated collective dose of 12 000 man mSv. It can be concluded therefore that the natural radioactivity sources account for well >90% of all occupational exposure in Ireland. This evaluation does not include an estimate of exposure to radon in above-ground workplaces-these data are currently being evaluated and their inclusion will increase both the total occupational collective dose as well as the percentage of that dose due to natural radiation.     

Assessment of plutonium exposures for an epidemiological study of US nuclear workers

An ongoing case-control study evaluating the association between workplace external radiation exposures and leukaemia mortality required an assessment of internal plutonium exposures as a potential confounder. Of the study participants, 1,092 were employed at four Department of Energy sites where plutonium-bearing materials were processed or stored. Exposures were assessed by first categorising exposure potentials based on available bioassay data, then estimating doses for workers in the highest categories using recent recommendations of the International Commission on Radiological Protection. Given the aetiology of leukaemia, equivalent dose to active bone marrow was chosen as the exposure variable. There were 556 workers each with at least one plutonium bioassay result, assigned to one of three evaluation categories. Dose estimates were made for 115 workers resulting in a collective equivalent dose of 2.1 person-Sv for 2,822 exposure-years, compared with 29.8 person-Sv estimated from photon exposures. Modelling uncertainties were examined by comparison of results from independent analyses and by Monte Carlo simulation.     

Evidence of children's vulnerability to radiation in the context of radiological/nuclear events and considerations for emergency response

International organisations, such as International Atomic Energy Agency, United Nations Scientific Committee on the Effects of Atomic Radiation and World Health Organisation, together with committees of experts such as Biological Effects of Ionising Radiation and Committee on Medical Aspects of Radiation in the Environment, have assessed the effects of radiation on large exposed populations (Chernobyl accident, and Hiroshima/Nagasaki atomic bombings) and on nuclear energy workers and people living near nuclear facilities. Childhood and in utero exposure to moderate and high levels of ionizing radiation, such as those experienced during the atomic bombings of Japan, or from radiotherapy, is an established cause of leukaemia and solid cancer. There is no evidence of increase in solid cancers (excluding thyroid cancer) or leukaemia in the children from Chernobyl, and no evident link between worker's exposure to radiation and leukaemia in their offspring or with the presence of leukaemia clusters around nuclear power plants. It has also not been possible to demonstrate the evidence of radiation hereditary effects in human populations. In accordance with international guidance, Canadian Nuclear Safety Commission recommends optimisation of protection strategies to reduce doses to children. The development of credible radiological/nuclear event scenarios would assist in identifying probable sources of radioactivity and pathways of exposure for children. Such scenarios should then be used to identify protection strategies appropriate for children.     

Comparative performance testing of Harshaw 8800 and KDT-02M TLD systems

The Soviet-produced KDT-02M system, which is still widely used for dosimetric monitoring in countries of the former Soviet Union, was compared with the Harshaw 8800 system. The comparison consisted of two stages. In the first stage workplace radiation fields were simulated in the framework of the IAEA intercomparison. In the second stage the two systems were compared when used in parallel by the personnel of Chernobyl Object 'Shelter'. Although in the first stage the Harshaw 8800 demonstrated better performance for various irradiation conditions, an obsolete KDT-02M also proved compliance with the basic requirements to the accuracy of individual dosimetric monitoring. In the second stage, more than 1200 paired measurements were performed, revealing good (r = 0.95) correlation between readouts of both systems. Deviation of the slope of the regression line may be adjusted by proper calibration. Although the KDT-02M system demonstrated adequate results for measurement of deep dose equivalent, its inability to determine shallow dose equivalent calls for its replacement with modem thermoluminesence dosemeters possessing this feature.     

Radiation protection concepts and quantities for the occupational exposure to cosmic radiation.

For the purposes of dose limitation and dose control, the harm, or detriment, of exposure to radiation is assessed by the quantity effective dose. Effective dose is evaluated by the application of factors to the averaged absorbed dose in the organs and tissues of the body. Radiation monitoring instruments are generally calibrated in terms of the quantity ambient dose equivalent which is defined in a simple spherical phantom. The relationship of these quantities is described. Requirements for the radiation protection of aircraft crew are given in the European Union Council Directive 96/29/EURATOM. There are requirements to assess the exposure of aircraft crew, to inform them of health risks, to reduce higher doses, and to control the dose to the fetus. There are no explicit dose limits, other than a dose objective to be applied to the exposure of the fetus, and no requirements for designation of areas or classification of workers. There are significant differences between the exposure condition of aircraft crew and workers in most other industries where there is occupational exposure to radiation. There are greater ranges of radiation types and energy, and there are different dose distributions and characteristics of the working populations. However, the field intensity is predictable and, with the exception of rare solar events, there is no risk of significant unexpected exposures. Dose assessment is anticipated to be by folding staff roster information with estimates of route doses, since there is little variability of dose rate within an aircraft. Route doses, which may be either an agreed average value for a given airport pairing and aircraft type, or be flight specific, will be closely linked to measured values. Requirements as to the accuracy of dose assessment should be applied which are broadly similar to those used in individual monitoring generally.     

Review of translocations detected by FISH for retrospective biological dosimetry applications

Several European laboratories have combined their research efforts to arrive at a consensus view on using fluorescence in situ hybridisation (FISH) for retrospective dosimetry. The aim of this review is to report these views and to highlight some areas where further work is needed. Translocations in the stable cells should be measured only in the cells that contain the full complement of the painted material. Two-way and one-way translocations should be combined with equal weight. The control level of translocations has a strong dependence on age, which has now been measured and the system has been calibrated. In conclusion, the technique works and a lifetime dose to the bone marrow from low-linear energy transfer radiation of 0.5 Gy above normal background levels can be measured for any individual. The main application is considered to provide an independent verification of lifetime doses to individuals who might form a part of an epidemiological study.     

Biomarkers of exposure and dose: state of the art.

Biomarkers provide methods to measure changes in biological systems and to relate them to environmental insults and disease processes. Biomarkers can be classified as markers of exposure and dose, markers of sensitivity, and markers of disease. It is important that the differences and applications of the various types of biomarkers be clearly understood. The military is primarily interested in early biomarkers of exposure and dose that do not require high levels of sensitivity but can be used to rapidly triage war fighters under combat or terrorist conditions and determine which, if any, require medical attention. Biomarkers of long-term radiation risk represent the second area of interest for the military. Biomarkers of risk require high sensitivity and specificity for the disease and insult but do not require rapid data turnaround. Biomarkers will help provide information for quick command decisions in the field, characterise long-term troop risks and identify early stages of radiation-induced diseases. This information provides major positive reassurances about individual exposures and risk that will minimise the physical and psychological impact of wartime radiation exposures.