Preliminary uncertainty analysis for the doses estimated using the Techa River dosimetry system--2000

Enhancements in the Techa River Dosimetry System: TRDS-2016D Code for Reconstruction of Deterministic Estimates of Dose From Environmental Exposures

Waterborne releases to the Techa River from the Mayak plutonium facility in Russia during 1949-1956 resulted in significant doses to persons living downstream. The dosimetry system Techa River Dosimetry System-2016D has been developed, which provides individual doses of external and internal exposure for the members of the Techa River cohort and other persons who were exposed to releases of radioactive material to the Southern Urals. The results of computation of individual doses absorbed in red bone marrow and extraskeletal tissues for the Techa River cohort members (29,647 persons) are presented, which are based on residence histories on the contaminated Techa River and the East Urals Radioactive Trace, which was formed in 1957 as a result of the Kyshtym Accident. Available Sr body-burden measurements and available information on individual household locations have been used for refinement of individual dose estimates. Techa River Dosimetry System-2016D-based dose estimates will be used for verification of risk of low-dose-rate effects of ionizing radiation in the Techa River cohort.

Does the cortical bone resorption rate change due to 90Sr-radiation exposure? Analysis of data from Techa Riverside residents

The Mayak Production Association released large amounts of (90)Sr into the Techa River (Southern Urals, Russia) with peak amounts in 1950-1951. Techa Riverside residents ingested an average of about 3,000 kBq of (90)Sr. The (90)Sr-body burden of approximately 15,000 individuals has been measured in the Urals Research Center for Radiation Medicine in 1974-1997 with use of a special whole-body counter (WBC). Strontium-90 had mainly deposited in the cortical part of the skeleton by 25 years following intake, and (90)Sr elimination occurs as a result of cortical bone resorption. The effect of (90)Sr-radiation exposure on the rate of cortical bone resorption was studied. Data on 2,022 WBC measurements were selected for 207 adult persons, who were measured three or more times before they were 50-55 years old. The individual-resorption rates were calculated with the rate of strontium recirculation evaluated as 0.0018 year(-1). Individual absorbed doses in red bone marrow (RBM) and bone surface (BS) were also calculated. Statistically significant negative relationships of cortical bone resorption rate were discovered related to (90)Sr-body burden and dose absorbed in the RBM or the BS. The response appears to have a threshold of about 1.5-Gy RBM dose. The radiation-induced decrease in bone resorption rate may not be significant in terms of health. However, a decrease in bone remodeling rate can be among several causes of an increased level of degenerative dystrophic bone pathology in exposed persons.

Early hematopoietic effects of chronic radiation exposure in humans

The major goal of this study is to investigate and quantitatively describe the nature of the relationship between the characteristics of chronic exposure to ionizing radiation and specific patterns of hematopoiesis reduction. The study is based on about 3,200 hemograms taken for inhabitants of the Techa riverside villages over the years 1951-1956, i.e., the period characterized by a gradual decrease in dose rates. The mean cumulative red bone marrow dose was 333.6 + or - 4.6 mGy. The approach to statistical analyses involved both empirical methods and modeling (generalized linear models and logistic regressions). The results of the analyses highlighted a gradual increase in the frequency of cytopenias with dose rate. The impact of exposure on hematopoiesis reduction patterns was found to be more substantial than that of age and health status. Dose rates resulting in a two-fold increase in the frequency of cytopenias have been estimated.

Comparison of mortality and incidence solid cancer risk after radiation exposure in the Techa River Cohort

In the present paper, analysis of solid cancer mortality and incidence risk after radiation exposure in the Techa River Cohort in the Southern Urals region of Russia is described. Residents along the Techa River received protracted exposure to ionizing radiation in the 1950s due to the releases of radioactive materials from the Mayak Production Association. The current follow-up through December 2003 includes individuals exposed on the Techa riverside within the Chelyabinsk and Kurgan oblasts using mortality data, and within the Chelyabinsk oblast using incidence data. The analysis was performed by means of the biologically based two-stage clonal expansion (TSCE) model and conventional excess relative risk models. For the mortality and incidence cohorts, central estimates of the excess relative risk per dose of 0.85 Gy(-1) (95% CI 0.36; 1.38) and 0.91 Gy(-1) (95% CI 0.35; 1.52) were found, respectively. For both the mortality and incidence cohorts, the best description of the radiation risk was achieved with the same TSCE model including a lifelong radiation effect on the promotion rate of initiated cells. An increase in the excess risk with attained age was observed, whereas no significant change of risk with age at exposure was seen. Direct comparison of the mortality and incidence cohorts showed that the excess relative risk estimates agreed very well in both cohorts, as did the excess absolute risk and the hazard after correction for the different background rates.

Early hematopoiesis inhibition under chronic radiation exposure in humans

The major goal of this study was to identify and quantitatively describe the association between the characteristics of chronic (low-dose rate) exposure to (low LET) ionizing radiation and cellularity of peripheral blood cell lines. About 3,200 hemograms (i.e., spectra of blood counts) obtained over the years of maximal exposure to ionizing radiation (1950-1956) for inhabitants of the Techa River were used in analyses. The mean cumulative red bone marrow dose (with standard errors), calculated using Techa River Dosimetry System-2000, was 333.6 +/- 4.6 mGy (SD = 259.9 mGy, max = 1151 mGy) to the year 1956. The statistical approach included both empirical methods for estimating frequencies of cytopenic states of the investigated blood cell lines (e.g. neutrophile, platelets, erythrocyte, etc.), and regression methods, including generalized linear models and logistic regressions which allowed taking into account confounding factors (e.g., attained age, age at maximal exposure, presence of concomitant diseases, and demographic characteristics). The results of the analyses demonstrated hematopoiesis inhibition manifested by a decrease in peripheral blood cellularity and an increase in the frequency of cytopenia in all blood cell lines (leukocytes, including lymphocytes, monocytes, neutrophiles, as well as platelets and erythrocytes). The intensity of hematopoiesis inhibition in the period of maximal exposures is determined by the combined influence of the dose rate and cumulative dose. The contribution of specific confounding factors was quantified and shown to be much less important than dose characteristics. The best predictor among dose characteristics was identified for each blood cell line. A 2-fold increase in dose rate is assumed to be a characteristic of radiosensitivity and a quantitative characteristic of the effect.

Lung, liver and bone cancer mortality after plutonium exposure in beagle dogs and nuclear workers

The Mayak Production Association (MPA) worker registry has shown evidence of plutonium-induced health effects. Workers were potentially exposed to plutonium nitrate [(239)Pu(NO(3))(4)] and plutonium dioxide ((239)PuO(2)). Studies of plutonium-induced health effects in animal models can complement human studies by providing more specific data than is possible in human observational studies. Lung, liver, and bone cancer mortality rate ratios in the MPA worker cohort were compared to those seen in beagle dogs, and models of the excess relative risk of lung, liver, and bone cancer mortality from the MPA worker cohort were applied to data from life-span studies of beagle dogs. The lung cancer mortality rate ratios in beagle dogs are similar to those seen in the MPA worker cohort. At cumulative doses less than 3 Gy, the liver cancer mortality rate ratios in the MPA worker cohort are statistically similar to those in beagle dogs. Bone cancer mortality only occurred in MPA workers with doses over 10 Gy. In dogs given (239)Pu, the adjusted excess relative risk of lung cancer mortality per Gy was 1.32 (95% CI 0.56-3.22). The liver cancer mortality adjusted excess relative risk per Gy was 55.3 (95% CI 23.0-133.1). The adjusted excess relative risk of bone cancer mortality per Gy(2) was 1,482 (95% CI 566.0-5686). Models of lung cancer mortality based on MPA worker data with additional covariates adequately described the beagle dog data, while the liver and bone cancer models were less successful.

Evaluation of anthropogenic dose distribution amongst building walls at the Metlino area of the upper Techa River region

This paper presents the results of an effort to evaluate anthropogenic doses in bricks from old buildings located on the banks of the Techa River. The river area was contaminated in 1949-1956 as a result of radioactive waste releases by the Mayak plutonium facility (Southern Urals, Russia). Absorbed doses were determined by luminescence measurements of quartz extracted from the near-surface layers of bricks sampled in 1991-1997 from three remained buildings (a mill, a granary and a church). These buildings are located in the former residence area of Metlino, which was the settlement located closest to the release site (residents of Metlino were relocated from the contaminated river in 1956). The measured anthropogenic dose in the three buildings was found to be comparable: minimum values were equal to 0.5-0.9 Gy and maximum values amounted to about 3-4 Gy. Unfortunately, the geometry of gamma-exposure of the brick samples changed significantly in 1956 as a result of creation of an artificial reservoir downstream of the Metlinsky pond. Since luminescence data provide absorbed dose in the investigated samples accumulated over the whole period of irradiation, for interpretation of the data obtained it is important to know the exposure geometry for the period of maximal exposure, which was in the early 1950s. In 2005, archival data describing configuration of contaminated water streams and shorelines (which were the main sources of gamma-irradiation) were published. Comparison of these data with the results of the luminescence study presented here showed that the bricks with the highest thermoluminescence (TL)-based doses faced contaminated shores and were located close to them. In contrast, the bricks with lower values of measured dose were opposite to contaminated shores and/or being shielded. This demonstrates that the luminescence method allowed reconstruction of the anthropogenic dose distribution in the former settlement center. The obtained results suggest new options for further luminescence studies in Metlino aimed at the reconstruction of the external exposures of the affected population.

Analysis of solid cancer mortality in the techa river cohort using the two-step clonal expansion model

In this study the solid cancer mortality data in the Techa River Cohort in the Southern Urals region of Russia was analyzed. The cohort received protracted exposure in the 1950s due to the releases of radioactive materials from the Mayak plutonium complex. The Extended Techa River Cohort includes 29,849 people who resided along the Techa River between 1950 and 1960 and were followed from January 1, 1950 through December 31, 1999. The analysis was done within the framework of the biologically based two-stage clonal expansion (TSCE) model. It was found that about 2.6% of the 1854 solid cancer deaths (excluding 18 bone cancer cases) could be related to radiation exposure. At age 63, which is the mean age for solid cancer deaths, the excess relative risk (ERR) and excess absolute risk (EAR) were found to be 0.76 Gy(-1) (95% CI 0.23; 1.29) and 33.0 (10(4) PY Gy)(-1) (95% CI 9.8; 52.6), respectively. These risk estimates are consistent with earlier excess relative risk analyses for the same cohort. The change in the ERR with age was investigated in detail, and an increase in risk with attained age was observed. Furthermore, the data were tested for possible signs of genomic instability, and it was found that the data could be described equally well by a model incorporating effects of genomic instability. Results from the TSCE models indicated that radiation received at older ages might have stronger biological effects than exposure at younger ages.

Solid cancer incidence and low-dose-rate radiation exposures in the Techa River cohort: 1956 2002

BACKGROUND

This is the first analysis of solid cancer incidence in the Techa River cohort, a general population of men and women of all ages who received chronic low-dose rate exposures from environmental radiation releases associated with the Soviet nuclear weapons programme. This cohort provides one of the few opportunities to evaluate long-term human health risks from low-dose radiation exposures.

METHODS

Cancer incidence rates in this cohort were analysed using excess relative risk (ERR) models. The analyses make use of individualized dose estimates that take into account residence history, age and other factors. Cases are identified on the basis of continuing, active follow-up of mortality and cancer incidence.

RESULTS

Based on 1836 solid cancer cases with 446 588 person years accrued over 47 years of follow-up, solid cancer incidence rates were found to increase with dose and about 3% of the cases were attributable to radiation exposure. The ERR was 1.0/Gy (P = 0.004 95% CI (0.3; 1.9) in a linear dose-response model. There was no significant non-linearity in the dose response and no indication of effect modification by gender, ethnicity, attained age or age at first exposure.

CONCLUSIONS

The Techa River cohort provides strong evidence that low-dose, low-dose rate exposures lead to significant increases in solid cancer risks that appear to be linear in dose. The results do not suggest that risks associated with low-dose rate exposures are less than those seen following acute exposures such as were received by atomic bomb survivors.

Development of an Improved Dose Reconstruction System for the Techa River Population Affected by the Operation of the Mayak Production Association

The Techa River Dosimetry System (TRDS) has been developed to provide estimates of dose received by approximately 30,000 members of the Extended Techa River Cohort (ETRC). Members of the ETRC were exposed beginning in 1949 to significant levels of external and internal (mainly from (90)Sr) dose but at low to moderate dose rates. Members of this cohort are being studied in an effort to test the hypothesis that exposure at low to moderate dose rates has the same ability to produce stochastic health effects as exposure at high dose rates. The current version of the TRDS is known as TRDS-2000 and is the subject of this paper. The estimated doses from (90)Sr are supported strongly by approximately 30,000 measurements made with a tooth beta-particle counter, measurements of bones collected at autopsy, and approximately 38,000 measurements made with a special whole-body counter that detects the bremsstrahlung from (90)Y. The median doses to the red bone marrow and the bone surface are 0.21 and 0.37 Gy, respectively. The maximum doses to the red bone marrow and bone surface are 2.0 and 5.2 Gy, respectively. Distributions of dose to other organs are provided and are lower than the values given above. Directions for future work are discussed.

Risk analysis of leukaemia incidence among people living along the Techa River: a nested case-control study

Large quantities of radioactive materials released over time from the Mayak nuclear weapons facility caused significant internal and external exposure for people living along the banks of the Techa River (Southern Urals, Russia). We conducted a nested case-control study in the Extended Techa River Cohort to determine whether the risk of leukaemia incidence increased with protracted exposure to ionising radiation or with other non-radiation risk factors. The study included 83 cases identified over 47 years of follow-up and 415 controls matched for sex, age at diagnosis, age (within a 5 year age group), and date of initial residence in the riverside area. External and internal doses have been calculated using the Techa River Dosimetry System 1996 (TRDS96). Conditional logistic regression was used to calculate odds ratios per Gray (OR/Gy) and 95% confidence intervals (95% CI). After excluding cases of chronic lymphoid leukaemia, the OR/Gy of total, external, and internal doses were 4.6 (95% CI: 1.7-12.3), 7.2 (95%CI: 1.7-30.0) and 5.4 (95%CI: 1.1-27.2), respectively. A history of solid tumour, either malignant or benign, before the leukaemia diagnosis was associated with a 2.5-fold increase in the leukaemia risk (95% CI: 1.1-5.9). Even though the analysis of confounders was less useful than expected because of missing data, multivariate analyses that took the exposure dose into account confirmed the association between leukaemia incidence and tumour history.

Protracted radiation exposure and cancer mortality in the Techa River Cohort

In the 1950s many thousands of people living in rural villages on the Techa River received protracted internal and external exposures to ionizing radiation from the release of radioactive material from the Mayak plutonium production complex. The Extended Techa River Cohort includes 29,873 people born before 1950 who lived near the river sometime between 1950 and 1960. Vital status and cause of death are known for most cohort members. Individualized dose estimates have been computed using the Techa River Dosimetry System 2000. The analyses provide strong evidence of long-term carcinogenic effects of protracted low-dose-rate exposures; however, the risk estimates must be interpreted with caution because of uncertainties in the dose estimates. We provide preliminary radiation risk estimates for cancer mortality based on 1,842 solid cancer deaths (excluding bone cancer) and 61 deaths from leukemia. The excess relative risk per gray for solid cancer is 0.92 (95% CI 0.2; 1.7), while those for leukemia, including and excluding chronic lymphocytic leukemia, are 4.2 (CI 95% 1.2; 13) and 6.5 (CI 95% 1.8; 24), respectively. It is estimated that about 2.5% of the solid cancer deaths and 63% of the leukemia deaths are associated with the radiation exposure.

The Techa River Cohort: Study Design and Follow-up Methods

Residents living on the banks of the Techa River in the Southern Urals region of Russia were exposed to radioactive contamination from the Mayak plutonium production and separation facility that discharged liquid radioactive waste into this river. This paper describes the methods used to establish and follow the Extended Techa River Cohort (ETRC), which includes almost 30,000 people living along the Techa River who were exposed to a complex mixture of radionuclides, largely 90Sr and 137Cs. The system of regular follow-up allows ascertainment of vital status, cause of death and cancer incidence. With over 50 years of follow-up and over 50% deceased, the ETRC now provides a valuable opportunity to study a wide range of health effects, both early and late, associated with protracted internal and external radiation exposures. The wide range of doses allows analysis of the nature of the dose-response relationship based on internal comparisons. Other features of the cohort are the high proportion (40%) exposed under age 20, and the inclusion of both sexes. The limitations of the study include loss to follow-up due to difficulties in tracing some cohort members and migration and incomplete ascertainment of cause of death.

Electron paramagnetic resonance and fluorescence in situ hybridization-based investigations of individual doses for persons living at Metlino in the upper reaches of the Techa River

Waterborne releases to the Techa River from the Mayak Production Association in Russia during 1949-1956 resulted in significant doses to persons living downstream; the most contaminated village was Metlino, about 7 km from the site of release. Internal and external doses have been estimated for these residents using the Techa River Dosimetry System-2000 (TRDS-2000); the primary purpose is to support epidemiological studies of the members of the Extended Techa River Cohort. Efforts to validate the calculations of external and internal dose are considered essential. One validation study of the TRDS-2000 system has been performed by the comparison of calculated doses to quartz from bricks in old buildings at Metlino with those measured by luminescence dosimetry. Two additional methods of validation considered here are electron paramagnetic resonance (EPR) measurements of teeth and fluorescence in situ hybridization (FISH) measurements of chromosome translocations in circulating lymphocytes. For electron paramagnetic resonance, 36 measurements on 26 teeth from 16 donors from Metlino were made at the GSF-National Research Center for Environment and Health (16 measurements) and the Institute of Metal Physics (20 measurements); the correlation among measurements made at the two laboratories has been found to be 0.99. Background measurements were also made on 218 teeth (63 molars, 128 premolars, and 27 incisors). Fluorescence in situ hybridization measurements were made for 31 residents of Metlino. These measurements were handicapped by the analysis of a limited number of cells; for several individuals no stable translocations were observed. Fluorescence in situ hybridization measurements were also made for 39 individuals believed to be unexposed. The EPR- and FISH-based estimates agreed well for permanent residents of Metlino: 0.67 +/- 0.21 Gy and 0.48 +/- 0.18 Gy (mean +/- standard error of the mean), respectively. Results of the two experimental methods also agreed well with the estimates derived from the use of the TRDS-2000. For all persons investigated according to each technique, the EPR-measured dose to enamel was 0.55 +/- 0.17 Gy, and the TRDS-2000 prediction for the dose to enamel for these individuals is 0.55 +/- 0.07 Gy. The fluorescence in situ hybridization-based dose, 0.38 +/- 0.10 Gy, compared well to the TRDS-2000 prediction of external dose, 0.31 +/- 0.03 Gy, to red bone marrow for these persons. Validation of external doses at the remaining villages is an active area of investigation.

Age dependencies of 90Sr incorporation in dental tissues: comparative analysis and interpretation of different kinds of measurements obtained for residents on the Techa River

Human teeth have been considered as dosimeters for decades. Methods include the in vivo measurement of 90Sr/90Y in teeth with a tooth-beta counter, the radiochemical determination of 90Sr in whole teeth, and the measurement of dose in teeth by use of electron paramagnetic resonance. Presented in this paper are results of 2,514 tooth-beta counter measurements, 334 radiochemical measurements, and 218 electron paramagnetic resonance measurements for residents living in settlements along the Techa River. All three kinds of measurements indicate a sharp peak that corresponds to the uptake of 90Sr by tooth tissue. The results can be interpreted in terms of an intake function for 90Sr only if the period of calcification of each individual tooth is considered--such detail on a tooth-by-tooth basis is presented in this paper. The conclusion is reached that the tooth-beta counter data are the most reliable in terms of reconstruction of 90Sr intake; this is due in part to the fact that the tooth-beta counter measures four teeth (all at position 1) with essentially the same time periods of mineralization and because there are a large number of tooth-beta counter measurements. The main utility of electron paramagnetic resonance measurements is considered to be the validation of estimates of external dose; but for this purpose teeth with 90Sr taken up into enamel must be avoided.

Verification of external exposure assessment for the upper Techa riverside by luminescence measurements and Monte Carlo photon transport modeling

An area located in the Southern Urals was contaminated in 1949-1956 as a result of radioactive waste releases into the Techa river by the Mayak Production Association. The external dose reconstruction of the Techa river dosimetry system (TRDS-2000) for the exposed population is based on an assessment of dose rates in air (DRA) obtained by modeling transport and deposition of radionuclides along the river for the time before 1952 and by gamma dose rate measurements since 1952. The aim of this paper is to contribute to a verification of the TRDS-2000 external dose assessment. Absorbed doses in bricks from a 130-year-old building in the heavily exposed Metlino settlement were measured by a luminescence technique. By the autumn of 1956 the population of Metlino had been evacuated, and then a water reservoir was created at the village location, which led to a change in the radioactive source geometry. Radiation transport calculations for assumed environmental sources before and since 1957 were performed with the MCNP Monte Carlo code. In combination with TRDS-2000 estimates for annual dose rates in air at the shore of the Techa river for the period 1949-1956 and contemporary dose rate in air measurements, absorbed doses in bricks were calculated. These calculations were performed deterministically with best estimates of the modeling parameters and stochastically by propagating uncertainty distributions through the calculation scheme. Assessed doses in bricks were found to be consistent with measured values within the uncertainty bounds, while their best estimates were approximately 15% lower than the luminescence measurements.

Evaluation of uncertainties in 90Sr-body-burdens obtained by whole-body count: application of Bayes' rule to derive detection limits by analysis of a posteriori data

A whole body counter (WBC) designed to measure bremsstrahlung from 90Y, the short-lived daughter of 90Sr, has been used since 1974 to measure 90Sr-body burdens in residents along the Techa River, which was contaminated by releases from the Mayak Production Association. Bayes' rule has been applied to the a posteriori WBC data in order to derive the uncertainties associated with the data: The lower limit of reliable detection is 2.0 kBq and the uncertainty of routine measurements is 1.6 kBq.