Southern Urals Biophysics Institute, Russian Federation
The article presents a literature review on the problem of assessing the long-term effects of exposure to diagnostic ionizing radiation. An assessment of the current state of the problem, a characteristic of the sources of diagnostic exposure by the dose levels is given. The main approaches to assessing radiogenic risk of low doses and the possibility of their use in assessing the long-term effects of diagnostic exposure of patients are described. Comparative results of radiogenic risk assessment for external exposure from various industrial sources in wide dose ranges are presented. Particular attention is paid to publications containing the results of studies evaluating the risk of diagnostic exposure during computed tomography, which makes a significant contribution to patient?s dose burden. The main factors affecting the uncertainty of the estimates of radiation risk in the low-dose area typical for diagnostic exposure are described. The expediency of further studying the radiation risk in the field of low doses, in particular, epidemiological studies in the Mayak worker cohort, the first nuclear enterprise in former USSR, is shown.
medical exposure, diagnostic exposure, radiation risk, X-ray, CT, computed tomography, Mayak PA
. Agard E.T. Healthful radiation. Health Physics. 1997; 72(1): 97-99.
2. Brenner D.J., Hall E.J. Computed tomography-an increasing source of radiation exposure // N Engl J Med 2007; 357: 2277-2284.
3. World Health Organization, Future Use of New Imaging Technologies in Developing Countries: Report of WHO Scientific Group, Technical Report Series 723,WHO, Geneva (1983).
4. United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and effects of ionizing radiation: United Nations Scientific Committee on the Effects of Atomic Radiation: UNSCEAR 2000 report to the General Assembly. New York. United Nations; 2000.
5. Pierce D.A., Preston D.L. Radiation-related cancer risks at low doses among atomic bomb survivors // Radiat Res. 2000; 154: 178-86.
6. Preston D.L., Ron E., Tokuoka S., Funamoto S., Nishi N., Soda M., et al. Solid cancer incidence in atomic bomb survivors: 1958-1998 // Radiat Res. 2007; 168: 1-64.
7. IARC monographs on the evaluation of carcinogenic risks to humans. World Health Organization. Ionizing radiation, part 1: X- and gamma (γ)-radiation, and neutrons. International Agency for Research on Cancer. 2000; 75: 508 p.
8. Medical Radiation Exposures. United Nations Scientific Committee on the Effects of Atomic Radiation Report to the General Assembly. 2008. 293 p.
9. Kalra M.K., Maher M.M., D?Souza R., Saini S. Multidetector Computed Tomography Technology: Current Status and Emerging Developments // J Comput Assist Tomogr 2004; 28: S2-S6.
22. Preston D., Ron E., Tokuoka S., Funamoto S., Nishi N., Soda M., Mabuchi K., Kodama K. Solid Cancer Incidence in Atomic Bomb Survivors: 1958-1998. Radiation Research,2007; 168: 1-64.
23. Cardis E., Vrijheid M., Blettner M., Gilbert E., Hakama M., Hill C., et al. The 15-Country Collaborative Study of Cancer Risk among Radiation Workers in the Nuclear Industry: estimates of radiation-related cancer risks. Radiation Research. 2007; 167(4): 396-416.
24. Wiggs L.D., Johnson E.R., Cox-DeVore C.A., Voelz GL. Mortality through 1990 among white male workers at the Los Alamos National Laboratory: Considering exposures to plutonium and external ionizing radiation. Health Phys. 1994; 67(6): 577-88.
25. Koshurnikova N. A., Shilnikova N. S., Okatenko P. V. Characteristics of the Cohort of Workers at the Mayak Nuclear Complex. Radiation Research. 1999; 152: 352 - 362.
26. Shilnikova N. S. et al. Cancer Mortality Risk among Workers at the Mayak Nuclear Complex. Radiation Research. 2003; 159: 787-798.
27. Hunter N., Kuznetsova I.S., Labutina E.V., Harrison J.D. Solid Cancer Incidence other than Lung, Liver and Bone in Mayak Worker Cohort: 1948-2004. 2013; 109: 1989-1996.
28. Sokolnikov ME, Gilbert ES, Preston DL, Ron E, Shilnikova NS, Khokhryakov VV, et al. Lung, liver and bone cancer mortality in Mayak workers. Int J Cancer. 2008; 123(4): 905-11.
29. Gilbert E., Sokolnikov M. E., Preston D.L., Schonfeld S. J., Schadilov A. E., Vasilenko E. K., Koshurnikova N. A. Lung Cancer Risks from Plutonium: An Updated Analysis of Data from the Mayak Worker Cohort. Radiat Res. 2013; 179(3): 332-342. DOI:10.1667/RR3054.1.
31. International Commission on Radiological Protection ICRP (1958). Recommendations of the ICRP, ICRP Publication 1. Pergamon Press, Oxford.
32. United Nations. Medical Radiation Exposures. Report of the United Nations Scientific Committee on the Effects of Atomic Radiation 2010, Fifty-seventh session. New York 2011.
33. Feinendegen L.E. Evidence for beneficial low level radiation effects and radiation hormesis. Br J Radiol 2005; 78: 3-7.
34. Howe G. R. Lung Cancer Mortality between 1950 and 1987 after Exposure to Fractionated Moderate-Dose-Rate Ionizing Radiation in the Canadian Fluoroscopy Cohort Study and the Comparison with Lung Cancer Mortality in the Atomic Bomb Survivors Study. Radiation Research. 1995; 142: 295-304.
35. Tubiana M. Dose-effect relationship and estimation of the carcinogenic effects of low doses of ionizing radiation: The joint report of the Academie des Sciences (Paris) and of the Academie Nationale de Medecine. Int J Radiat Oncol Biol Phys 2005; 63: 317-9.
36. Lee T., Sigurdson A.J., Preston D.L., Cahoon E.K. et al. Occupational ionising radiation and risk of basal cell carcinoma in US radiologic technologists (1983-2005) Occup Environ Med. 2015; 72(12): 862-9. DOI: 10.1136/oemed-2015-102880.
37. Wei K., Lin H., Hung S., at al. Leukemia Risk After Cardiac Fluoroscopic Interventions Stratified by Procedure Number, Exposure Latent Time, and Sex. A Nationwide Population-Based Case-Control Study. Medicine. 2016; 95 (10):e2953. DOI: 10.1097/MD.0000000000002953.
38. Pearce M.S., Salotti J.A., Little M.P., McHugh K., Lee C., Kim K.P., Howe N.L., Ronckers C.M., Rajaraman P., Craft W., Parker L., Berrington de Gonzalez A. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. The Lancet. 2012; 380.
39. Fomin E.P., Osipov M.V. Pooled database of Ozyorsk population exposed to computed tomography. REJR 2019; 9(2): 234-239. DOI:10.21569/2222-7415-2019-9-2-234-239.
41. Ivanov V.K., Kasheev V.V., Menyailo S.U., Pryahin A.N., Cib A.F., Metler F.A. Ocenka radiacionnogo riska medicinskogo oblycheniya v terminah effektivnoi i organnih doz. Radiaciya i risk. 2012; 21(4):7-23.
42. Kasheev V.V., Pryahin E.A., Menyailo S.U., Chekin S.U., Ivanov V.K. Raschet ekvivalentnih doz v otdelnih organah i tkanyah i velichini pojiznennogo radiacionnogo riska razvitiya raka pri provedenii tipovih obsledovanii s ispolzovaniem komputernoi tomografii. Radiaciya i risk. 2013; 22(3):8-20.
43. World Health Organization, Rational Use of Diagnostic Imaging in Paediatrics: Report of a WHO Study Group, Technical Report Series 757, WHO, Geneva, (1987).
44. Brenner D.J., Elliston C.D., Hall E.J. Berdon W.E. Estimated Risks of Radiation-Induced Fatal Cancer from Pediatric CT. AJR 2001;176:289-296.
45. Mathews J.D., Forsythe A.V., Brady Z., Butler M.W. et all. Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians. BMJ 2013; 346:360. DOI: 10.1136/bmj.f2360.
46. Osipov M.V., Sokolnikov M.E. Problemi ocenki kancerogennogo riska medicinskogo oblycheniya v kogorte personala predpriyatiya yaderno-promishlennogo kompleksa. Medicinskaya radiologiya i radiacionnaya bezopasnost. 2015; 60 (6): 60-66.
47. Wakeford R., Little M.P., Kendall G.M. Risk of childhood leukemia after low-level exposure to ionizing radiation. Expert. Rev. Hematol. 2010; 3 (3): 251-254.
48. Ron E., Lubin J.H., Shore R.E., Mabuchi K., Modan B., Pottern L.M., et al., Thyroid cancer after exposure to external radiation: a pooled analysis of seven studies. Radiat. Res. 1995; 141 (3): 259-277.
49. Monty C., 2001. UNSCEAR report 2000: sources and effects of ionizing radiation. J. Radiol. Prot.2000; 21 (1): 83.
50. National Research Council (U.S.), 2006. Committee to assess health risks from exposure to low level of ionizing radiation. In: Health Risks From Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase. Vol. 2 National Academies Press, Washington, D.C.
51. Neglia J.P., Robison L.L., Stovall M., Liu Y., Packer R.J., Hammond S., et al., New primary neoplasms of the central nervous system in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J. Natl. Cancer Inst. 2006; 98(21): 1528-1537.
52. UNSCEAR, 2013. Sources, effects and risks of ionizing radiation. In: Volume II, Scientific Annex B. Effects of Radiation Exposure of Children, New York. Available from. http://www.unscear.org/docs/publications/2013/UNSCEAR_2013_Annex-B.pdf. Accessed 2019.
53. Wall B.F., Haylock R., Jansen J., Hillier M.C., Hart D., Shrimpton P.C. Radiation Risks from Medical X-ray Examinations as a Function of Age and Sex of the Patient. Health Protection Agency. Centre for Radiation. Chemical and Environmental Hazards. Chilton, Didcot. Oxfordshire, 2011.
54. Schultz C.H., Fairley R., Murphy L., Doss M. The Risk of Cancer from CT Scans and Other Sources of Low-Dose Radiation: A Critical Appraisal of Methodologic Quality. 2020; 35(1): 3-16.