The role of dose-rate on risk from internally-deposited radionuclides and the potential need to separate dose-rate effectiveness factor (DREF) from the dose and dose-rate effectiveness factor (DDREF)

In 1980, National Council on Radiation Protection and Measurements suggested the term dose-rate effectiveness factor (DREF) to describe the reduction of effectiveness of protracted radiation in producing biological damage and risk. A nonlinear decrease in damage was also noted following low total doses. The International Commission on Radiological Protection therefore combined the influence of low dose and low dose-rate and assigned a single value of 2.0 for a dose and dose-rate effectiveness factor (DDREF) to be applied for estimating risk for both low total dose and low dose-rate exposures. This paper re-evaluates one extensive data set on inhaled radionuclides in dogs which suggests that there may be a need to separate these factors (DREF and DDREF) for larger protracted doses from internally-deposited radioactive materials. Extensive recent research on the mechanisms of action of both low dose and low dose-rate radiation exposure at the molecular, cellular, and animal level of biological organization suggest that the influence of protraction of radiation may be large and variable, due to adaptive and protective responses, following very low doses and dose-rate exposures. Important observations in this paper in dogs exposed by inhalation to beta-gamma emitting radionuclides include (1) discontinuities in the data sets as a function of both dose and dose-rate suggesting shifts in mechanisms of action following high doses from protracted exposure away from those postulated for cancer from low total doses; (2) no increase in non-neoplastic disease, cancer frequency, or life-shortening following low dose-rate exposures to high total lung doses (up to 25 Gy); (3) all dogs that received doses below 25 Gy were combined and a decrease in the frequency of lung cancer in these exposed animals relative to the controls was noted, while very large doses from all radionuclides studied resulted in very marked increases in lung cancer; (4) a significant increase in hemangiosarcoma in the heart and tracheobronchial lymph nodes was observed after very high doses; (5) in this paper the DREF for lung cancer in dogs relative to single acute radiation exposure was as high as 35; and (6) the amount of life-shortening increased per unit dose as a function of the half-life with (90)Y being eight times as effective per unit of dose as (90)Sr. Such information suggests that there may be a need to assign different values for DDREF and DREF, especially in situations where there are large nonuniform total doses delivered by internally-deposited radionuclides. This is extremely important since the risk from radiation exposure from internally-deposited radionuclides in the lungs following nuclear fallout, accidents and terrorist activities may be much less than currently projected.

Does low dose internal radiation increase lifespan?

No significant differences in lifespan could be established between control dogs and dogs given 241Am, 228Th, 90Sr, 228Ra, 226Ra or monomeric 239Pu at low dosage levels that induced less than 10% skeletal malignancies (low dose animals) in the Utah beagle colony when all dogs surviving at least 1 y were included in the analysis and dogs given individual radionuclides were considered separately or together. Censoring or exclusion of dogs from these groups that were diagnosed with skeletal malignancies or that died in a gran mal epileptic seizure made no important difference to these results. Therefore, an enhanced lifespan of low dose dogs as compared with controls could not be established. It is concluded that low doses from internal (mainly skeletal) deposits of these radionuclides probably do not benefit the survival of individuals so exposed.

Survival and bone tumor hazard from internal deposition of 226Ra in beagles

The survival of 132 young adult control beagles and 117 beagles receiving graded injections of 226Ra ranging from 0.27 kBq kg-1 to 384.2 kBq kg-1 body mass was analyzed. The hazards of natural deaths, all deaths in injection groups, and deaths by bone tumors were assumed to follow a Weibull distribution with a common shape factor of 6.3. Only the scale factors of the Weibull distributions depend on the injection level. There were no significant sex differences. The relative risk with respect to controls for all causes of death increases up to 6,925 for 384.2 kBq kg-1. The dependence of the scale factors for all deaths and death by bone tumors on injected activity was fitted to an empirical regression model, which also contains a term representing radiation-caused deaths other than bone tumors. The risk of bone tumors increases nearly as the square of the injected activity, whereas the risk of the other radiation caused deaths increases approximately in proportion to the injected activity. By means of the regression model, it is possible to predict median survival times for all deaths, bone tumor and non-bone tumor deaths for an arbitrary intake level. Also, simple expressions for the fraction of animals with bone tumors and other radiation-caused deaths can be derived. The empirical model of bone tumor induction, which was based on results from a single injection design, can be generalized to an arbitrary systemic intake schema. This is achieved by using the average dose and dose rate to the skeleton as indices of detriment. Applying the generalized model, it was confirmed that no significant differences in survival can be expected for two groups of beagles receiving multiple injections, if compared to the corresponding single injection groups of about the same total activity. The general model also predicts that even extensive protraction of the intake would increase the survival times only to a very limited extent.

Review of 239Pu and 226Ra effects in beagles

A long term biological study has been completed that was designed to assess the predicted effects in humans of internally deposited 239Pu by comparison with 226Ra in beagles. Herein we summarize for the first time results of several previous reports about the effects of these two radionuclides in our beagles in an attempt to elucidate what has been learned since the beginning of the study in the early 1950's. Perhaps the most important finding was that bone surface-seeking plutonium is more toxic at equal mean skeletal radiation doses (<3 Gy for 239Pu, <20 Gy for 226Ra) than bone volume-seeking radium for the induction of skeletal malignancy by about a factor of 16 for a single intravenous injection of monomeric 239Pu. In addition, ancillary studies have shown that when plutonium transfers continuously onto bone surfaces from a depot of particulate 239Pu in phagocytic cells, its relative toxicity per Gy average skeletal dose is enhanced by about a factor of 2. Juvenile animals or dogs injected as mature adults were only about half as sensitive for equal mean skeletal doses as dogs injected as young adults. Male and female dogs were about equally sensitive to radiation of the skeleton by either radionuclide. Findings about radiation-induced fractures are summarized as well as data on the induction of soft-tissue malignancies by 239Pu or 226Ra. Natural survival was not affected at the lower dosage levels of either 226Ra or 239Pu as compared with control dogs given no radioactivity, but the survival of animals at higher levels was reduced. No additional life-shortening effects beyond those attributable to occurrence of radiation-induced malignancies or other radiation-induced effects were suggested by analysis of data for low dosage levels.

Does longevity in beagles injected with bone-seeking radionuclides depend upon radiation dose in the absence of known radiation effects?

Regression analyses of longevity as a function of skeletal radiation dose among groups of beagles injected with 226Ra, 228Ra, 228Th, 241Am, 90Sr or monomeric 239Pu suggested that at low doses and dose-rates (those at which induced effects are low), age at death seems to be independent of dose when animals dying with specific radiation effects were excluded, although longevity does appear to be a function of dose when animals dying with established radiation effects and at all doses were included. We conclude tentatively that, for mammals receiving skeletal dose from bone-seeking radionuclides at low doses and low dose-rates, longevity may not be dependent upon skeletal radiation dose in the absence of radiation-induced malignancies or other radiation effects.

Effectiveness of DTPA treatments following the injection of particulate plutonium

A limited long-term experiment has been completed in which the chronic toxicity resulting from a single intravenous injection of 31.4 kBq of a poly-disperse 239Pu colloid sol per kg of body weight was tested in Beagle dogs. The Pu deposited mostly in the phagocytic cells of liver, spleen and to a lesser degree in lung and bone marrow. Slow solubilization of the Pu particles by endogenous ligands caused translocation of the nuclide and redeposition mostly as monomeric Pu in the skeleton and in liver hepatocytes. Thus, the deposit behaved as expected from a pulmonary or wound contamination in humans with a moderately soluble depot of Pu such as Class W hot particles. Therefore, this type of deposit provided the basis for a practical model to study the ensuing radiation effects under various experimental conditions. The dogs were divided into three groups of four animals each, and the following conditions were applied: (a) no further treatment was given, allowing free translocation of the Pu to its secondary deposition sites; (b) interception of the Pu translocation by weekly injections of 30 mumol of Ca-DTPA/kg of body weight (Ca-chelate of diethylene-triaminepentaacetic acid); and (c) interception of translocation by daily injections of 30 mumol/kg body weight of Zn-DTPA. For each of the groups (b) and (c), three dogs were used in a lifetime study, and one was sacrificed for nuclide distribution studies. Free translocation and subsequent deposition in the skeleton resulted in the death of each of the non-chelated dogs from osteosarcoma between 1267 and 1594 days after injection. Weekly treatment with Ca-DTPA reduced the total Pu burden significantly, but these dogs also died with osteosarcoma between 1462 and 1783 days. Daily injections with Zn-DTPA reduced the total Pu burden more efficiently than Ca-DTPA and prevented continuous deposition of solubilized Pu on bone surfaces. The mean post-injection survival of these dogs was 3520 days or about 2.1 times that of the animals receiving Ca-DTPA, while the latent period for bone tumour induction was about 2.6 times longer. This treatment reduced the severity of liver lesions and eliminated the occurrence of persistent leukopenia, but it did not prevent the formation of bone cancer.