Retrospective dose estimates in Estonian Chernobyl clean-up workers by means of FISH

Lessons from the accident with 137Cesium in Goiania, Brazil: Contributions to biological dosimetry in case of human exposure to ionizing radiation

Human exposure to ionizing radiation has increased over time, mainly due to medical applications, occupational and environmental exposure, as well as accidents involving radioactive materials. In September 1987, an accident with ¹³⁷Cesium occurred in Goiânia city, Brazil; the accident started with the removal of a 50.9-TBq ¹³⁷Cesium source from an abandoned radiotherapy unit. Among the radiation-exposed victims, at least 50 individuals showed symptoms of whole-body and local acute irradiation, and also external or internal contamination. In this report, the purpose was to review and summarize the main results of cytogenetic studies carried out with victims of ¹³⁷Cesium, for blood collection performed shortly after the accident, and following several years post-exposure. The importance of dose estimates by biological dosimetry is highlighted, and also several lessons that were learned from the initial to follow-up (7-10 years after the accident) studies, mainly by applying the fluorescence in situ hybridization (FISH) method. A relevant aspect discussed on the basis of the results obtained in those studies refers to the incidence of chromosomal translocations, which were directly compared to the initial frequencies of dicentrics that were previously used to estimate the absorbed doses. In general, translocation frequencies were two to three times lower than the dicentric frequencies, and the differences were dose-dependent. Furthermore, regarding attempts to perform retrospective dosimetry (10 years post-accident), the dose estimates using translocation frequencies for victims of ¹³⁷Cesium indicate the feasibility of this approach only for low level exposure (below 0.5 Gy), while for higher doses there are some limitations, and the requirement to apply appropriate correction factors, which were discussed on the basis of literature data. Apart of this, in general terms, important aspects to be mentioned refer to the need for better care and control of radioactive devices, as well as adequate education programs for professionals and also the population.

Influence of anticoagulants and storage temperatures on blood counts and mitotic index of blood samples collected for cytogenetic biodosimetry

PURPOSE

In order to establish suitable protocols of blood culture to obtain sufficient numbers of metaphases for dicentric chromosome assay (DCA), we have examined the effect of storage temperature, storage time, and anticoagulant type.

MATERIALS AND METHODS

Peripheral blood was collected from five healthy donors with lithium heparin and ethylenediaminetetraacetic acid dipotassium salt (EDTA-2K). These samples were irradiated with X-rays at 3 Gy or sham; the samples were further divided into groups that were either stored at room temperature (RT) or 5.2 ± 1.0 °C. After 6, 24, 48, 72, and 168 h of storage, both blood counts and the mitotic index (MI) were analyzed.

RESULTS

Heparinized blood samples stored under cold conditions exhibited low white blood cell, lymphocyte, and platelet counts. EDTA-treated blood samples did not show such obvious changes in cell counts. After 6 h of storage, heparinized blood samples stored at RT had MI of 21.5-29.3%. Similar MI was obtained in the EDTA-washed group stored for 6, 24, 48, and 72 h.

CONCLUSIONS

Our study confirms that heparinized blood samples should be stored at RT to get sufficient metaphases for DCA, and that EDTA blood samples also can be used for blood culture after washing and storage under 5.2 ± 1.0 °C.

Chernobyl cleanup workers from Estonia: cohort description and related epidemiological research

The Estonian study of Chernobyl cleanup workers was one of the first investigations to evaluate the possible health consequences of working in the Chernobyl area (the 30 km exclusion zone and/or adjacent territories) after the 1986 reactor accident. The cohort consists of 4831 men who were dispatched in 1986-1991 for tasks involving decontamination, construction of buildings, transport, radiation measurement, guard duty or other activities. By 31 December 2012, the follow-up of the cohort yielded 102 158 person-years of observation. Exposure and health data were collected by postal questionnaires, biodosimetry evaluations, thyroid screenings, and record-linkages with cancer, causes of death and health insurance reimbursement registers and databases. These data cover socio-demographic factors, employment history, aspects of health behaviour, medical history, work and living conditions in the Chernobyl area, biomarkers of exposure, cancer and non-cancer disease occurrence and causes of death. Cancer incidence data were obtained for 1986-2008, mortality data for 1986-2011 and non-cancer morbidity data for 2004-2012. Although the cohort is relatively small, it has been extensively examined and benefited from comprehensive nationwide population and health registers. The major finding was an increased risk of suicide. Thyroid examinations did not reveal an association with thyroid nodular disease and radiation dose, but did indicate the importance of accounting for screening when making comparisons with unscreened populations. No risk of leukaemia was observed and risks higher than 2.5-fold could be excluded with 95% confidence. Biodosimetry included GPA analyses and chromosomal translocation analyses and indicated that the Estonian cleanup workers experienced a relatively low mean exposure of the order of 0.1 Gy. One value of the Estonian study is in the methodologic processes brought to bear in addressing possible health effects from the Chernobyl accident. Twenty-five years of research are summarised and opportunities for the future listed.

FISH chromosome aberration analysis on retired radiation workers from the Sellafield nuclear facility

Chromosome analysis using fluorescence in situ hybridization was undertaken on 294 retired workers from the British Nuclear Fuels plc facility at Sellafield, 95 with external occupational exposure <50 mSv, 108 with 50-499 mSv, and 91 with >500 mSv. In univariate analyses, external dose (P <10-s) and age (P = 0.0075) were significantly associated with translocation frequency, but no effect was found for smoking status. In a multivariate analysis with age and external dose as continuous variables, the slopes were 0.017 +/- 0.0075 x 10(-2) translocations per cell per year for age (P = 0.024) and 1.11+/- 0.190 x 10(-2) translocations per cell per sievert for external dose (P < 10(-5)). The dose response for translocation induction for occupational workers is similar to the linear component of in vitro dose-response curves, thus supporting the use of translocation frequency for retrospective biological dosimetry in situations of chronic low-dose exposure occurring over many years. The dose response obtained in this study is lower than the linear component of the dose response for stable chromosome aberrations obtained for the Japanese atomic bomb survivors. Thus, if chromosome aberration levels are indicative of cancer risk, this would suggest that low-dose risks derived from the Japanese atomic bomb survivor data will overestimate the risks associated with the occupational exposure encountered by the men in this study.

Stable chromosome aberration frequencies in men occupationally exposed to radiation

The introduction of fluorescence in situ hybridisation techniques to cytogenetic biodosimetry has enabled the detection of stable aberrations, e.g. translocations, which can provide an integrated measure of radiation exposure. The opportunity to study stable aberration frequencies in lymphocyte cultures from occupationally exposed workers with well-documented dosimetry records enables the establishment of dose-response relationships which can be compared with those obtained from studies of populations with high acute exposures. Since there is good mechanistic evidence for the role of translocations in oncogenesis, this provides an insight into the risks associated with low-dose exposure for which no direct epidemiological evidence is available. This paper provides preliminary data on a group of 98 individuals with cumulative occupational doses > 500 mSv and 96 controls with doses < 50 mSv. An increased frequency of translocations was found for the high-dose group (20.50 +/- 0.78 x 10(-3) per genome equivalent) in comparison with the control group (11.71 +/- 0.59 x 10(-3) per genome equivalent). Further analysis of the control group revealed increasing frequencies of translocations with increasing age. An increase associated with ever-smoking status was found for the control group which appeared to be driven by the lower age groups but no overall effect of smoking was seen in the > 500 mSv group.

Hereditary minisatellite mutations among the offspring of Estonian Chernobyl cleanup workers

A single accidental event such as the fallout released from the Chernobyl reactor in 1986 can expose millions of people to non-natural environmental radiation. Ionizing radiation increases the frequency of germline mutations in experimental studies, but the genetic effects of radiation in humans remain largely undefined. To evaluate the hereditary effects of low radiation doses, we compared the minisatellite mutation rates of 155 children born to Estonian Chernobyl cleanup workers after the accident with those of their siblings born prior to it. All together, 94 de novo paternal minisatellite mutations were found at eight tested loci (52 and 42 mutants among children born after and before the accident, respectively). The minisatellite mutation rate was nonsignificantly increased among children born after the accident (0.042 compared to 0.036, OR 1.33, 95% CI 0.80-2.20). Furthermore, there was some indication of an increased mutation rate among offspring born after the accident to workers who had received doses of 20 cSv or above compared with their siblings born before the accident (OR 3.0, 95% CI 0.97-9.30). The mutation rate was not associated with the father's age (OR 1.04, 95% CI 0.94-1.15) or the sex of the child (OR 0.95, 95% CI 0.50-1.79). Our results are consistent with both no effect of radiation on minisatellite mutations and a slight increase at dose levels exceeding 20 cSv.

Evaluation of a high dose to a finger from a 60Co accident

Electron spin resonance and fluorescence in situ hybridization were used to evaluate the dose to the finger of a worker who accidentally touched a radiotherapy 60Co therapy source in November 1995. In September 1999, the middle finger was amputated. We estimated the dose to the bone of the finger to be 6.4 +/- 0.5 Gy using the electron spin resonance additive dose method and a corrected dose of about 20 +/- 3 Gy could be inferred by translocation analysis in peripheral lymphocytes using the fluorescence in situ hybridization method. This retrospective dosimetry was performed for the victim 4 y after the accident, but the compatibility of the results obtained by physical and biological methods reinforce their validity, although in the case of partial-body exposure the biological method has limitations and demonstrates the need to find appropriate correction factors.

Environmental biodosimetry: a biologically relevant tool for ecological risk assessment and biomonitoring

Biodosimetry, the estimation of received doses by determining the frequency of radiation-induced chromosome aberrations, is widely applied in humans acutely exposed as a result of accidents or for clinical purposes, but biodosimetric techniques have not been utilized in organisms chronically exposed to radionuclides in contaminated environments. The application of biodosimetry to environmental exposure scenarios could greatly improve the accuracy, and reduce the uncertainties, of ecological risk assessments and biomonitoring studies, because no assumptions are required regarding external exposure rates and the movement of organisms into and out of contaminated areas. Furthermore, unlike residue analyses of environmental media, environmental biodosimetry provides a genetically relevant biomarker of cumulative lifetime exposure. Symmetrical chromosome translocations can impact reproductive success, and could therefore prove to be ecologically relevant as well. We describe our experience in studying aberrations in the yellow-bellied slider turtle as an example of environmental biodosimetry.

Induction and decline of HPRT mutants and deletions following a low dose radiation exposure at Chernobyl

This study was conducted to evaluate the ability of mutation in the hypoxanthine-phosphoribosyltransferase gene (HPRT) to detect radiation-induced mutation in lymphocytes of Russian Chernobyl Clean-up workers, particularly as a function of time after exposure. It is part of a multi-endpoint study comparing HPRT mutation with chromosome translocation and glycophorin A mutation [Radiat. Res. 148 (1997) 463], and extends an earlier report on HPRT [Mutat. Res. 431 (1999) 233] by including data from all 9 years of our study (versus the first 6 years) and analysis of deletion size. Blood samples were collected from 1991 to 1999. HPRT mutant frequency (MF) as determined by the cloning assay was elevated 16% in Clean-up workers (N=300, the entire group minus one outlier) compared to Russian Controls (N=124) when adjusted for age and smoking status (P=0.028). Since exposures occurred over a short relative to the long sampling period, the year of sampling corresponded roughly to the length of time since exposure (correlation coefficient=0.94). When date of blood sample was considered, Control MF was not time dependent. Clean-up worker MF was estimated to be 47% higher than Control MF in 1991 (P=0.004) and to decline 4.4% per year thereafter (P=0.03). A total of 1123 Control mutants and 2799 Clean-up worker mutants were analyzed for deletion type and size by PCR assay for retention of HPRT exons and flanking markers on the X chromosome. There was little difference between the overall deletion spectra of Clean-up workers and Controls. However, there was a decline in the average size of deletions of Clean-up workers as time after exposure at Chernobyl increased from 6 to 13 years (P< or =0.05). The results illustrate the sensitivity of HPRT somatic mutation as a biomarker for populations with low dose radiation exposure, and the dependence of this sensitivity on time elapsed since radiation exposure.

137Cesium-induced chromosome aberrations analyzed by fluorescence in situ hybridization: eight years follow up of the Goiânia radiation accident victims

The radiation accident in focus here occurred in a section of Goiânia (Brazil) where more than a hundred individuals were contaminated with 137Cesium on September 1987. In order to estimate the absorbed radiation doses, initial frequencies of dicentrics and rings were determined in 129 victims [A.T. Ramalho, PhD Thesis, Subsidios a tecnica de dosimetria citogenetica gerados a partir da analise de resultados obtidos com o acidente radiologico de Goiânia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil, 1992]. We have followed some of these victims cytogenetically over the years seeking for parameters that could be used as basis for retrospective radiation dosimetry. Our data on translocation frequencies obtained by fluorescence in situ hybridization (FISH) could be directly compared to the baseline frequencies of dicentrics available for those same victims. Our results provided valuable information on how precise these estimates are. The frequencies of translocations observed years after the radiation exposure were two to three times lower than the initial dicentrics frequencies, the differences being larger at higher doses (>1 Gy). The accuracy of such dose estimates might be increased by scoring sufficient amount of cells. However, factors such as the persistence of translocation carrying lymphocytes, translocation levels not proportional to chromosome size, and inter-individual variation reduce the precision of these estimates.

Cytogenetic effects in lymphocytes from children exposed to radiation fall-out after the Chernobyl accident

In a previous paper we reported that a group of children exposed to ionizing radiation following the Chernobyl accident exhibited an appreciable number of chromosome breaks and rearrangements reflecting the persistence of a radiation-induced damage. The results suggested that the children were still exposed to radioactive contamination through consumer foodstuff and life styles. In the present paper, 31 exposed children have been considered together with a control group of 11 children with the aim to confirm previous results. All children underwent whole-body counter (WBC) measures and conventional cytogenetic analysis. The frequency of chromosome aberrations detected by conventional cytogenetics in the group of children chronically exposed to low doses of ionizing radiation resulted in significant differences with respect to the control group. The present work suggests that, for these groups of children, even if the frequency of aberrations is very low and the observation of statistically significant differences is consequently a problem, a persistently abnormal cytogenetic picture is still present several years after the accident.

DNA content proportionality and persistence of radiation-induced chromosomal aberrations studied by FISH

Chromosome aberrations induced by radiation have been used for the purpose of dosimetry for a long time. Translocations are especially useful for retrospective dosimetry, since they are assumed to be stable. The method of chromosome painting (FISH) has facilitated objective scoring of aberrations considerably. Translocation frequencies, obtained by FISH, for retrospective dosimetry rely on the main assumptions of neutral selection value and that the distribution of aberrations over the chromosomes is a known function of the DNA content of the chromosomes. Data scrutinising the two above-mentioned assumptions indicate deviations from both. Other factors potentially causing problems for retrospective dosimetry, such as inter-individual variations in background and induction patterns, are discussed. Finally, a brief analysis of the statistical power of dosimetry studies shows that establishing low doses (approximately 0.25 Gy) with good precision requires a great effort, which is probably unrealistic for individual dose estimates in epidemiological studies.