Estimation and mapping of uranium content of geological units in France

Assessing radiation dosimetry for microorganisms in naturally radioactive mineral springs using GATE and Geant4-DNA Monte Carlo simulations

Mineral springs in Massif Central, France can be characterized by higher levels of natural radioactivity in comparison to the background. The biota in these waters is constantly under radiation exposure mainly from the α-emitters of the natural decay chains, with 226Ra in sediments ranging from 21 Bq/g to 43 Bq/g and 222Rn activity concentrations in water up to 4600 Bq/L. This study couples for the first time micro- and nanodosimetric approaches to radioecology by combining GATE and Geant4-DNA to assess the dose rates and DNA damages to microorganisms living in these naturally radioactive ecosystems. It focuses on unicellular eukaryotic microalgae (diatoms) which display an exceptional abundance of teratological forms in the most radioactive mineral springs in Auvergne. Using spherical geometries for the microorganisms and based on γ-spectrometric analyses, we evaluate the impact of the external exposure to 1000 Bq/L 222Rn dissolved in the water and 30 Bq/g 226Ra in the sediments. Our results show that the external dose rates for diatoms are significant (9.7 μGy/h) and comparable to the threshold (10 μGy/h) for the protection of the ecosystems suggested by the literature. In a first attempt of simulating the radiation induced DNA damage on this species, the rate of DNA Double Strand Breaks per day is estimated to 1.11E-04. Our study confirms the significant mutational pressure from natural radioactivity to which microbial biodiversity has been exposed since Earth origin in hydrothermal springs.

Diatom DNA metabarcoding to assess the effect of natural radioactivity in mineral springs on ASV of benthic diatom communities

Little is still known about the low dose effects of radiation on the microbial communities in the environment. Mineral springs are ecosystems than can be affected by natural radioactivity. These extreme environments are, therefore, observatories for studying the influence of chronic radioactivity on the natural biota. In these ecosystems we find diatoms, unicellular microalgae, playing an essential role in the food chain. The present study aimed to investigate, using DNA metabarcoding, the effect of natural radioactivity in two environmental compartments (i.e. spring sediments and water) on the genetic richness, diversity and structure of diatom communities in 16 mineral springs in the Massif Central, France. Diatom biofilms were collected during October 2019, and a 312 bp region of the chloroplast gene rbcL (coding for the Ribulose Bisphosphate Carboxylase) used as a barcode for taxonomic assignation. A total of 565 amplicon sequence variants (ASV) were found. The dominant ASV were associated with Navicula sanctamargaritae, Gedaniella sp., Planothidium frequentissimum, Navicula veneta, Diploneis vacillans, Amphora copulata, Pinnularia brebissonii, Halamphora coffeaeformis, Gomphonema saprophilum, and Nitzschia vitrea, but some of the ASVs could not be assigned at the species level. Pearson correlation failed to show a correlation between ASV' richness and radioactivity parameters. Non-parametric MANOVA analysis based on ASVs occurrence or abundances revealed that geographical location was the main factor influencing ASVs distribution. Interestingly, ²³⁸U was the second factor that explained diatom ASV structure. Among the ASVs in the mineral springs monitored, ASV associated with one of the genetic variants of Planothidium frequentissimum was well represented in the springs and with higher levels of ²³⁸U, suggesting its high tolerance to this particular radionuclide. This diatom species may therefore represent a bio-indicator of high natural levels of uranium.

Estimating geothermal and background radiation hotspots from primordial radionuclide concentrations in geology of South Africa

Naturally occurring radionuclides are the main generator of geothermal energy in the Earth's crust and mantle. The generated energy is consequently directly proportional to the concentrations of the three main naturally occurring radionuclides (uranium, thorium and potassium), which are primordial in origin. Concentrations of these naturally occurring radionuclides were extracted for all the different geological rock units in South Africa. The radionuclide concentrations were then mapped and integrated by using QGIS. The results were used to estimate and map the geothermal energy production rates for the rock units. The radionuclide concentrations in the rock units were also used to identify regions with high radiation background. These radiation hotspots were plotted and investigated. The estimated geothermal energy and background radiation hotspots were compared to measurements and projections of other studies and good corelations were found.

Deciphering sources of U contamination using isotope ratio signatures in the Loire River sediments: Exploring the relevance of 233U/236U and stable Pb isotope ratios

A broad range of contaminants has been recorded in sediments of the Loire River over the last century. Among a variety of anthropogenic activities of this nuclearized watershed, extraction of uranium and associated activities during more than 50 years as well as operation of several nuclear power plants led to industrial discharges, which could persist for decades in sedimentary archives of the Loire River. Highlighting and identifying the origin of radionuclides that transited during the last decades and were recorded in the sediments is challenging due to i) the low concentrations which are often close or below the detection limits of routine environmental surveys and ii) the mixing of different sources. The determination of the sources of anthropogenic radioactivity was performed using multi-isotopic fingerprints (²³⁶U/²³⁸U, ²⁰⁶Pb/²⁰⁷Pb and ²⁰⁸Pb/²⁰⁷Pb) and the newly developed ²³³U/²³⁶U tracer. For the first time ²³³U/²³⁶U data in a well-dated river sediment core in the French river Loire are reported here. Results highlight potential sources of contamination among which a clear signature of anthropogenic inputs related to two accidents of a former NUGG NPP that occurred in 1969 and 1980. The ²³³U and ²³⁶U isotopes were measured by recent high performance analytical methods due to their ultra-trace levels in the samples and show a negligible radiological impact on health and on the environment. The determination of mining activities by the use of stable Pb isotopes is still challenging probably owing to the limited dissemination of the Pb-bearing material marked by the U-ore signature downstream to the former U mines.

Gamma-radiation levels outdoors in Great Britain based on K, Th and U geochemical data

Gamma-rays from naturally occurring radionuclides are a major component of background radiation. They are an important tool for geology and are also important for radiation protection. In this paper we use over a quarter of a million geochemical measurements of concentrations of potassium, thorium and uranium in soils and in stream sediments to estimate outdoor gamma-ray dose rates across Great Britain. The soil concentrations are generally at a depth of 5-20 cm with some at 35-50 cm. Soil measurements will give spatially relatively precise estimates, but as soil data are not available for much of Scotland, stream sediment data are used there. Kriging methods are used to estimate surface concentrations of K, Th and U and dose rates are imputed from these concentrations. Our results are compared with measurement surveys of both outdoor and indoor gamma-ray dose rates. Recently there has been interest in exploring the carcinogenic risks of low dose radiation by investigating associations between childhood cancer rates and doses from natural background gamma radiation. To achieve adequate statistical power, such studies must be so large that it is impractical to assess exposures by direct measurements in the homes of study subjects. Instead the exposures must be modelled. The results presented here will be an important input to such work.

Radiation exposure of microorganisms living in radioactive mineral springs

The TIRAMISU collaboration gathers expertise from biologists, physicists, radiochemists and geologists within the Zone-Atelier Territoires Uranifères (ZATU) in France to analyze the radiation exposure of microorganisms living in naturally radioactive mineral springs. These springs are small waterbodies that are extremely stable over geological time scales and display different physicochemical and radiological parameters compared to their surroundings. Water and sediment samples collected in 27 mineral springs of the volcanic Auvergne region (Massif Central, France) have been studied for their microbial biodiversity and their radionuclide content. Among the microorganisms present, microalgae (diatoms), widely used as environmental indicators of water quality, have shown to display an exceptional abundance of teratogenic forms in the most radioactive springs studied (radon activity up to 3700 Bq/L). The current work presents a first assessment of the dose received by the diatoms inhabiting these ecosystems. According to ERICA tool, microorganisms living in most of the sampled mineral springs were exposed to dose rates above 10 μGy/h due to the large concentration of radium in the sediments (up to 50 Bq/g). Radiological analyses of water and sediments were used as inputs to Monte Carlo simulations at micro-(GATE) and nano- (Geant4-DNA) scale in order to assess the direct and indirect damages on the diatom DNA.

Factorial kriging for estimating and mapping the geochemical background from in situ gamma dose rate measurements downstream of a former uranium mine

A geostatistical approach is applied for extracting the geochemical background from gamma dose rate data acquired downstream of a former French uranium mining area. The exploratory data analysis shows that the spatial structure of the gamma dose rate consists of two components: a short isotropic component (10 m-range) that corresponds to the geochemical background; and a long anisotropic component (30-60 m-range) that corresponds to the drainage network features previously fed by the mine discharge water. The gamma dose rate on the whole area of interest was estimated and simulated (to deal with uncertainties) through a kriging of the measured values. The spatial component related to the geochemical background was then extracted through factorial kriging. The proportion of the gamma dose rate explained by the geochemical background according to factorial kriging is consistent within uncertainties with geochemical analyses performed on soil and sediment samples. This study thus highlights the potential of such geostatistical approaches for better exploiting radiometric data.

Estimating indoor radon concentrations based on the uranium content of geological units in South Africa

Very few studies have been done on radon in South Africa, even though South Africa holds nearly a tenth of the global uranium deposits. This study aimed to map and estimate the radon risk for South Africa, and to identify potential hotspots. In this study, the uranium content of the different types of rock was determined and uranium concentrations in geological units were then projected. A uranium distribution map of South Africa was then constructed, and indoor radon concentrations were estimated and mapped based on the uranium levels of areas. Towns in areas where indoor radon measurements were conducted compared well with the estimated radon values. The maps predicted high estimated indoor radon concentrations in areas at several geological structures. Towns in these areas that have not been measured were identified. The south-western and north-eastern regions of South Africa pose the highest radon risk according to this study, and extensive radon measurements in the towns of these regions is proposed.

Occurrence and hazard assessment of natural radioactivity in drinking water in South Lebanon

This study is intended to assess the natural radioactivity in the drinking water in the southern region of Lebanon and to determine its suitability for human consumption. In this context, activity concentrations for gross alpha, gross beta, ²³⁸U, ²³⁴U, and radon from selected drinking water sources, wells, and springs and the corresponding tap water, in the area under investigation, were determined during both the wet and the dry seasons. The maximum recorded activities of gross alpha, gross beta, and radon measured using liquid scintillation counter were found to be 374.6 ± 11.5 mBq L^-1 for gross alpha, 418 ± 12 mBq L^-1 for gross beta, and 42,900 ± 370 mBq L^-1 for radon. Whereas, alpha spectroscopy analysis for uranium content showed maximum activities of 53.7 ± 2.1 mBq L^-1 for ²³⁸U and 55.9 ± 2.3 mBq L^-1 for ²³⁴U. Significant seasonal activity variation between wet and dry season was noticed only in gross alpha concentrations. In addition, significant variation between sources and tap water was recorded only in radon concentrations. Whereas, no significant variation was noted in radioactivity concentrations in waters from springs and those from wells. In contrast to all sampled locations, the annual effective dose of only one sampled well (Aitaroun) exceeded the WHO individual dose criterion (IDC) level of 100 µSv year^-1 and recorded an annual effective dose of 170 µSv year^-1, 103 µSv year^-1, and 127 µSv year^-1 for infants, children, and adults, respectively.

A New Methodology for Defining Radon Priority Areas in Spain

One of the requirements of EU-BSS (European Basic Safety Standards) is the design and implementation of a National Radon Action Plan in the member states. This should define, as accurately as possible, areas of risk for the presence of radon gas (222Rn) in homes and workplaces. The concept used by the Spanish Nuclear Safety Council (CSN), the body responsible for nuclear safety and radiation protection in Spain, to identify "radon priority areas" is that of radon potential. This paper establishes a different methodology from that used by the CSN, using the same study variables (indoor radon measurements, gamma radiation exposure data, and geological information) to prepare a radon potential map that improves the definition of the areas potentially exposed to radon in Spain. The main advantage of this methodology is that by using simple data processing the definition of these areas is improved. In addition, the application of this methodology can improve the delimitation of radon priority areas and can be applied within the cartographic system used by the European Commission-Joint Research Center (EC-JRC) in the representation of different environmental parameters.

Uranium retention on iron oxyhydroxides in post-mining environmental conditions

Investigating uranium migration mechanisms related to the weathering of waste rocks is essential for developing strategies that can address the potential environmental issues caused by uranium mining. This work is based on environmental samples containing 2 L ferrihydrite, lepidocrocite and goethite collected in the technosols from granitic waste rock piles, mine drainage conduits and mine waters. The results show the important role of iron oxyhydroxide in U immobilization and re-concentration. EXAFS spectroscopy combined with mineralogical and geochemical studies (Scanning electronic microscopy, Wavelength-dispersive X-ray spectroscopy microprobe, inductively coupled plasma - optical emission spectrometry/mass spectrometry and X-ray diffraction) allowed for the identification of uranyl ternary surface complexes at the ferrihydrite surface that were either composed of phosphate groups or organic matter. Moreover, goethite and lepidocrocite were also identified as a secondary trap for U immobilization. U(VI) is known to be mobile in oxidizing conditions. This study highlights the control of the uranyl mobility by various iron oxyhydroxides in supergene conditions.

Bedrock radioactivity influences the rate and spectrum of mutation

All organisms on Earth are exposed to low doses of natural radioactivity but some habitats are more radioactive than others. Yet, documenting the influence of natural radioactivity on the evolution of biodiversity is challenging. Here, we addressed whether organisms living in naturally more radioactive habitats accumulate more mutations across generations using 14 species of waterlice living in subterranean habitats with contrasted levels of radioactivity. We found that the mitochondrial and nuclear mutation rates across a waterlouse species’ genome increased on average by 60% and 30%, respectively, when radioactivity increased by a factor of three. We also found a positive correlation between the level of radioactivity and the probability of G to T (and complementary C to A) mutations, a hallmark of oxidative stress. We conclude that even low doses of natural bedrock radioactivity influence the mutation rate possibly through the accumulation of oxidative damage, in particular in the mitochondrial genome.

Validation of a database of mean uranium, thorium and potassium concentrations in rock samples of Portuguese geological units, generated of literature data

The European Atlas of Natural Radiation, recently published, contains a collection of maps of Europe showing the levels of natural sources of radiation. Among the lacunae of the Atlas are maps of U, Th and K concentrations in rocks due to lack of European-wide geochemical surveys of bedrock units. The objective of this paper is to investigate the usability of scattered geochemical data of rock samples for large-scale mapping of U, Th and K concentrations in geological units. For this purpose, geochemical data were compiled from literature sources to produce a geochemical database (LIT database) that includes 2817 entries of U, Th and K concentrations measured in rock samples of geological units outcropping in Portugal. Given the methodical heterogeneity within LIT database, the influence of the geochemical analysis techniques was assessed through a three-way analysis of variance (ANOVA) using geological units, geochemical analysis techniques and loss on ignition (LOI) as categorical variables. The percentage of variation explained by geological factors was large (>35%), while the percentage of variation explained by the geochemical analysis techniques and LOI was generally lower than 5%. The geological factors were the main source of variability in the data, followed by the error component which can be assumed to represent the true spatial variability of geochemical concentrations. The pairwise comparison of the least square (LS) means computed through the ANOVA for each geochemical analysis technique indicates that LIT database can be considered consistent within itself, thus, reliable. In order to validate the usability of literature data the terrestrial gamma dose rate (TGDR) calculated from LIT database (TGDR_calc) was compared to the TGDR displayed in the Radiometric Map of Portugal (TGDR_obs). The correlation between TGDR_calc and TGDR_obs was highly significant (p < 0.001) and the results of a paired sample t-test and Wilcoxon median tests indicate that the differences between the arithmetic means of TGDR_calc and TGDR_obs were not statistically significant (p = 0.126 and p = 0.14, respectively). Distributions of TGDR_calc and TGDR_obs were seemingly equal according to the Kolmogorov-Smirnov and Anderson-Darling tests. Although, systematic discrepancies between TGDR_calc and TGDR_obs were observed for sedimentary rocks, the compatibility of the RMP and LIT databases can be considered acceptable, which implies that the estimation of the contents of terrestrial radionuclides using literature data for large-scale mapping of U, Th and K contents in geological units is reasonable.

Geolocation of premises subject to radon risk: Methodological proposal and case study in Madrid

Useful information on the potential radon risk in existing buildings can be obtained by combining data from sources such as potential risk maps, the 'Sistema de Información sobre Ocupación del Suelo de España' (SIOSE) [information system on land occupancy in Spain], cadastral data on built property and population surveys. The present study proposes a method for identifying urban land, premises and individuals potentially subject to radon risk. The procedure draws from geographic information systems (GIS) pooled at the municipal scale and data on buildings possibly affected. The method quantifies the magnitude of the problem in the form of indicators on the buildings, number of premises and gross floor area that may be affected in each risk category. The findings are classified by type of use: residential, educational or office. That information may guide health/prevention policies by targeting areas to be measured based on risk category, or protection policies geared to the construction industry by estimating the number of buildings in need of treatment or remediation. Application of the methodology to Greater Madrid showed that 47% of the municipalities have houses located in high radon risk areas. Using cadastral data to zoom in on those at highest risk yielded information on the floor area of the vulnerable (basement, ground and first storey) premises, which could then be compared to the total. In small towns, the area affected differed only scantly from the total, given the substantial proportion of low-rise buildings in such municipalities.

210Po sequential extraction applied to wetland soils at uranium mining sites

Former uranium mining activities have led to the presence of naturally occurring nuclides embedded in soil. Such activities have also modified the secular equilibrium between radionuclides in ²³⁸U decay series. The objective of this paper is to quantify the long-term effect of former uranium mining activities on the behavior of the final radionuclide in the ²³⁸U-series, i.e. polonium-210 (²¹⁰Po), present in soils. Soil samples are extracted from two uranium sites in France, specifically a quarried site and a natural site. The polonium distribution is studied within the various soil fractions, namely: water soluble, exchangeable, bound to carbonates, bound to iron/manganese oxides, bound to organic matter, and residual. ²¹⁰Po is mainly found in the residual fraction of both study sites (87-90%), followed by the carbonates fraction (5-9%). The ²¹⁰Po activity in the other fractions is very small in comparison with total activity.

Digital version of the European Atlas of natural radiation

The European Atlas of Natural Radiation is a collection of maps displaying the levels of natural radioactivity caused by different sources. It has been developed and is being maintained by the Joint Research Centre (JRC) of the European Commission, in line with its mission, based on the Euratom Treaty: to collect, validate and report information on radioactivity levels in the environment of the EU Member States. This work describes the first version of the European Atlas of Natural Radiation, available in digital format through a web portal, as well as the methodology and results for the maps already developed. So far the digital Atlas contains: an annual cosmic-ray dose map; a map of indoor radon concentration; maps of uranium, thorium and potassium concentration in soil and in bedrock; a terrestrial gamma dose rate map; and a map of soil permeability. Through these maps, the public will be able to: familiarize itself with natural environmental radioactivity; be informed about the levels of natural radioactivity caused by different sources; have a more balanced view of the annual dose received by the European population, to which natural radioactivity is the largest contributor; and make direct comparisons between doses from natural sources of ionizing radiation and those from man-made (artificial) ones, hence, to better assess the latter. Work will continue on the European Geogenic Radon Map and on estimating the annual dose that the public may receive from natural radioactivity, by combining all the information from the different maps. More maps could be added to the Atlas, such us radon in outdoor air and in water and concentration of radionuclides in water, even if these sources usually contribute less to the total exposure.

Redox Fluctuations and Organic Complexation Govern Uranium Redistribution from U(IV)-Phosphate Minerals in a Mining-Polluted Wetland Soil, Brittany, France

Wetlands have been proposed to naturally attenuate U transfers in the environment via U complexation by organic matter and potential U reduction. However, U mobility may depend on the identity of particulate/dissolved uranium source materials and their redox sensitivity. Here, we examined the fate of uranium in a highly contaminated wetland (up to 4500 mg·kg^-1 U) impacted by former mine water discharges. Bulk U L_III-EXAFS and (micro-)XANES combined with SEM-EDXS analyses of undisturbed soil cores show a sharp U redox boundary at the water table, together with a major U redistribution from U(IV)-minerals to U(VI)-organic matter complexes. Above the water table, U is fully oxidized into mono- and bidentate U(VI)-carboxyl and monodentate U(VI)-phosphoryl complexes. Minute amounts of U(VI)-phosphate minerals are also observed. Below the water table, U is fully reduced and is partitioned between U(IV)-phosphate minerals (i.e., ningyoite and a lermontovite-like phase), and bidentate U(IV)-phosphoryl and monodentate U(IV)-carboxyl complexes. Such a U redistribution from U-minerals inherited from mine water discharge deposits could result from redox cycling nearby the water table fluctuation zone. Oxidative dissolution of U(IV)-phosphate minerals could have led to U(VI)-organic matter complexation, followed by subsequent reduction into U(IV)-organic complexes. However, uranium(IV) minerals could have been preserved in permanently waterlogged soil.

U-Th signatures of agricultural soil at the European continental scale (GEMAS): Distribution, weathering patterns and processes controlling their concentrations

Agricultural soil (Ap-horizon, 0-20cm) samples were collected in Europe (33 countries, 5.6millionkm²) as part of the GEMAS (GEochemical Mapping of Agricultural and grazing land Soil) soil-mapping project. The GEMAS survey area includes diverse groups of soil parent materials with varying geological history, a wide range of climate zones, and landscapes. The soil data have been used to provide a general view of U and Th mobility at the continental scale, using aqua regia and MMI® extractions. The U-Th distribution pattern is closely related to the compositional variation of the geological bedrock on which the soil is developed and human impact on the environment has not concealed these genuine geochemical features. Results from both extraction methods (aqua regia and MMI®) used in this study support this general picture. Ternary plots of several soil parameters have been used to evaluate chemical weathering trends. In the aqua regia extraction, some relative Th enrichment-U loss is related to the influence of alkaline and schist bedrocks, due to weathering processes. Whereas U enrichment-Th loss characterizes soils developed on alkaline and mafic bedrock end-members on one hand and calcareous rock, with a concomitant Sc depletion (used as proxy for mafic lithologies), on the other hand. This reflects weathering processes sensu latu, and their role in U retention in related soils. Contrary to that, the large U enrichment relative to Th in the MMI® extraction and the absence of end-member parent material influence explaining the enrichment indicates that lithology is not the cause of such enrichment. Comparison of U and Th to the soil geological parent material evidenced i) higher capability of U to be weathered in soils and higher resistance of Th to weathering processes and its enrichment in soils; and, ii) the MMI® extraction results show a greater affinity of U than Th for the bearing phases like clays and organic matter. The comparison of geological units with U anomalies in agricultural soil at the country scale (France) enables better understanding of U sources in the surficial environment and can be a useful tool in risk assessments.

Recent aspects of uranium toxicology in medical geology

Uranium (U) is a chemo-toxic, radiotoxic and even a carcinogenic element. Due to its radioactivity, the effects of U on humans health have been extensively investigated. Prolonged U exposure may cause kidney disease and cancer. The geological distribution of U radionuclides is still a great concern for human health. Uranium in groundwater, frequently used as drinking water, and general environmental pollution with U raise concerns about the potential public health problem in several areas of Asia. The particular paleo-geological hallmark of India and other Southern Asiatic regions enhances the risk of U pollution in rural and urban communities. This paper highlights different health and environmental aspects of U as well as uptake and intake. It discusses levels of U in soil and water and the related health issues. Also described are different issues of U pollution, such as U and fertilizers, occupational exposure in miners, use and hazards of U in weapons (depleted U), U and plutonium as catalysts in the reaction between DNA and H₂O_2, and recycling of U from groundwater to surface soils in irrigation. For use in medical geology and U research, large databases and data warehouses are currently available in Europe and the United States.

Residential Exposure to Natural Background Radiation and Risk of Childhood Acute Leukemia in France, 1990-2009

BACKGROUND

Exposures to high-dose ionizing radiation and high-dose rate ionizing radiation are established risk factors for childhood acute leukemia (AL). The risk of AL following exposure to lower doses due to natural background radiation (NBR) has yet to be conclusively determined.

METHODS

AL cases diagnosed over 1990-2009 (9,056 cases) were identified and their municipality of residence at diagnosis collected by the National Registry of Childhood Cancers. The Geocap study, which included the 2,763 cases in 2002-2007 and 30,000 population controls, was used for complementary analyses. NBR exposures were modeled on a fine scale (36,326 municipalities) based on measurement campaigns and geological data. The power to detect an association between AL and dose to the red bone marrow (RBM) fitting UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation) predictions was 92%, 45% and 99% for exposure to natural gamma radiation, radon and total radiation, respectively.

RESULTS

AL risk, irrespective of subtype and age group, was not associated with the exposure of municipalities to radon or gamma radiation in terms of yearly exposure at age reached, cumulative exposure or RBM dose. There was no confounding effect of census-based socio-demographic indicators, or environmental factors (road traffic, high voltage power lines, vicinity of nuclear plants) related to AL in the Geocap study.

CONCLUSIONS

Our findings do not support the hypothesis that residential exposure to NBR increases the risk of AL, despite the large size of the study, fine scale exposure estimates and wide range of exposures over France. However, our results at the time of diagnosis do not rule out a slight association with gamma radiation at the time of birth, which would be more in line with the recent findings in the UK and Switzerland.