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Lee D, Cha ES, Park S, Sung H, Noh E, Jeong H, Jang WI, Seo S. Cohort Profile: The Korean Radiation Workers Study (KRWS). Int J Epidemiol 2024; 53:dyae060. [PMID: 38628072 DOI: 10.1093/ije/dyae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 04/05/2024] [Indexed: 04/19/2024] Open
Affiliation(s)
- Dalnim Lee
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Eun Shil Cha
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Soojin Park
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Hyoju Sung
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Eunbi Noh
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Haesu Jeong
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Won-Il Jang
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
- Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Songwon Seo
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
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Menakuru S, Dhillon V, Ali M, Salih A, Hanna N. EPR24-112: Lung Cancer in Never Smokers: The Role of Radon Exposure and Public Knowledge. J Natl Compr Canc Netw 2024; 22:EPR24-112. [PMID: 38580258 DOI: 10.6004/jnccn.2023.7148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Affiliation(s)
| | | | - Marriam Ali
- 1Indiana University School of Medicine, Muncie, IN
| | - Ahmed Salih
- 1Indiana University School of Medicine, Muncie, IN
| | - Nasser Hanna
- 2Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN
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Zhang W, Haylock RG, Gillies M, Hunter N. Shape of radiation dose response relationship for ischaemic heart disease mortality and its interpretation: analysis of the national registry for radiation workers (NRRW) cohort. J Radiol Prot 2024; 44:021502. [PMID: 38530293 DOI: 10.1088/1361-6498/ad37c7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 03/26/2024] [Indexed: 03/27/2024]
Abstract
Statistically significant increases in ischemic heart disease (IHD) mortality with cumulative occupational external radiation dose were observed in the National Registry for Radiation Workers (NRRW) cohort. There were 174 541 subjects in the NRRW cohort. The start of follow up was 1955, and the end of the follow-up for each worker was chosen as the earliest date of death or emigration, their 85th birthday or 31 December 2011. The dose-response relationship showed a downward curvature at a higher dose level >0.4 Sv with the overall shape of the dose-response relationship best described by a linear-quadratic model. The smaller risk at dose >0.4 Sv appears to be primarily associated with workers who started employment at a younger age (<30 years old) and those who were employed for more than 30 years. We modelled the dose response by age-at-first exposure. For the age-at-first exposure of 30+ years old, a linear dose-response was the best fit. For age-at-first exposure <30 years old, there was no evidence of excess risk of IHD mortality for radiation doses below 0.1 Sv or above 0.4 Sv, excess risk was only observed for doses between 0.1-0.4 Sv. For this age-at-first exposure group, it was also found that the doses they received when they were less than 35 years old or greater than 50 years old did not contribute to any increased IHD risk.
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Affiliation(s)
- Wei Zhang
- Radiation, Chemical and Environment Hazards Directorate, UK Health Security Agency, Chilton, Didcot OX11 0RQ, United Kingdom
| | - Richard Ge Haylock
- Radiation, Chemical and Environment Hazards Directorate, UK Health Security Agency, Chilton, Didcot OX11 0RQ, United Kingdom
| | - Michael Gillies
- Radiation, Chemical and Environment Hazards Directorate, UK Health Security Agency, Chilton, Didcot OX11 0RQ, United Kingdom
| | - Nezahat Hunter
- Radiation, Chemical and Environment Hazards Directorate, UK Health Security Agency, Chilton, Didcot OX11 0RQ, United Kingdom
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Ulanowski A, Ban N, Ozasa K, Rühm W, Semones E, Shavers M, Vaillant L. Time-integrated radiation risk metrics and interpopulation variability of survival. Z Med Phys 2024; 34:64-82. [PMID: 37669888 PMCID: PMC10919971 DOI: 10.1016/j.zemedi.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 09/07/2023]
Abstract
Task Group 115 of the International Commission on Radiological Protection is focusing on mission-related exposures to space radiation and concomitant health risks for space crew members including, among others, risk of cancer development. Uncertainties in cumulative radiation risk estimates come from the stochastic nature of the considered health outcome (i.e., cancer), uncertainties of statistical inference and model parameters, unknown secular trends used for projections of population statistics and unknown variability of survival properties between individuals or population groups. The variability of survival is usually ignored when dealing with large groups, which can be assumed well represented by the statistical data for the contemporary general population, either in a specific country or world averaged. Space crew members differ in many aspects from individuals represented by the general population, including, for example, their lifestyle and health status, nutrition, medical care, training and education. The individuality of response to radiation and lifespan is explored in this modelling study. Task Group 115 is currently evaluating applicability and robustness of various risk metrics for quantification of radiation-attributed risks of cancer for space crew members. This paper demonstrates the impact of interpopulation variability of survival curves on values and uncertainty of the estimates of the time-integrated radiation risk of cancer.
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Affiliation(s)
- Alexander Ulanowski
- International Atomic Energy Agency, IAEA Laboratories, Friedensstrasse 1, A-2444 Seibersdorf, Austria.
| | - Nobuhiko Ban
- Nuclear Regulation Authority, 1-9-9 Roppongi, Minato-ku, Tokyo 106-8450, Japan
| | - Kotaro Ozasa
- Health Management Center, Kyoto Prefectural University of Medicine, Kyoto 602-8566 Japan
| | - Werner Rühm
- Federal Office for Radiation Protection, Ingolstädter Landstraße 1, 85764 Oberschleißheim, Germany
| | - Edward Semones
- NASA Space Radiation Analysis Group, Johnson Space Center, Houston, TX, USA
| | - Mark Shavers
- KBR Human Health and Performance, NASA Johnson Space Center, Houston, TX, USA
| | - Ludovic Vaillant
- Centre d'étude sur l'Evaluation de la Protection dans le domaine Nucléaire, 28 rue de la Redoute, 92260 Fontenay aux Roses, France
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6
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Radivoyevitch T, Gale RP, Kalaycio ME. What do atomic bomb survivors teach us about therapy-free remission in people with chronic myeloid leukaemia? Leukemia 2024; 38:207-209. [PMID: 37949937 PMCID: PMC10776394 DOI: 10.1038/s41375-023-02081-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Tomas Radivoyevitch
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
| | - Robert Peter Gale
- Centre for Haematology, Department of Immunology and Inflammation, Imperial College of Science, Technology and Medicine, London, UK
| | - Matt E Kalaycio
- Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH, USA
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Kelly-Reif K, Bertke S, Daniels RD, Richardson DB, Schubauer-Berigan MK. Authors' response: Solid cancer mortality among US radiation workers. Int J Epidemiol 2023; 52:1994-1995. [PMID: 37741933 DOI: 10.1093/ije/dyad132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/14/2023] [Indexed: 09/25/2023] Open
Affiliation(s)
- Kaitlin Kelly-Reif
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Steven Bertke
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Robert D Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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Wakeford R. Solid cancer mortality among US radiation workers. Int J Epidemiol 2023; 52:1992-1994. [PMID: 37789594 DOI: 10.1093/ije/dyad131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/23/2023] [Indexed: 10/05/2023] Open
Affiliation(s)
- Richard Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
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Calabrese EJ, Selby PB. Hermann Muller and his LNT scientific and policy leadership: Private communication reveals uncertainties. Sci Total Environ 2023; 904:166757. [PMID: 37660820 DOI: 10.1016/j.scitotenv.2023.166757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 09/05/2023]
Abstract
The present paper highlights numerous publications of Hermann J. Muller with a focus on his opinions concerning the validity of the linear no-threshold dose response model for hereditary and cancer risk assessment. These comments reflect a very consistent and powerfully supporting position for the LNT model. However, newly discovered correspondence between Muller and Robley D. Evans reveals that Muller was highly uncertain about the supportive science, and therefore hid his real opinions, deliberately misleading the scientific community and governmental agencies. Of further historical value is that in the correspondence with Evans, Muller proposed what might be the first articulation of an environmentally based Precautionary Principle. These perspectives have remained unknown since Muller requested Evans to keep this letter private.
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Affiliation(s)
- Edward J Calabrese
- School of Public Health and Health Sciences, Department of Environmental Health Sciences, Morrill I, N344, University of Massachusetts, Amherst, MA 01003, United States of America.
| | - Paul B Selby
- Retired from Oak Ridge National Laboratory, Oak Ridge, TN, United States of America
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Affiliation(s)
- Barry R Bloom
- From the Harvard T.H. Chan School of Public Health, Boston
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11
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Kreuzer M, Deffner V, Sommer M, Fenske N. Updated risk models for lung cancer due to radon exposure in the German Wismut cohort of uranium miners, 1946-2018. Radiat Environ Biophys 2023; 62:415-425. [PMID: 37695330 PMCID: PMC10628028 DOI: 10.1007/s00411-023-01043-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/12/2023]
Abstract
UNSCEAR recently recommended that future research on the lung cancer risk at low radon exposures or exposure rates should focus on more contemporary uranium miners. For this purpose, risk models in the German Wismut cohort of uranium miners were updated extending the follow-up period by 5 years to 1946-2018. The full cohort (n = 58,972) and specifically the 1960 + sub-cohort of miners first hired in 1960 or later (n = 26,764) were analyzed. The 1960 + sub-cohort is characterized by low protracted radon exposure of high quality of measurements. Internal Poisson regression was used to estimate the excess relative risk (ERR) for lung cancer per cumulative radon exposure in Working Level Months (WLM). Applying the BEIR VI exposure-age-concentration model, the ERR/100 WLM was 2.50 (95% confidence interval (CI) 0.81; 4.18) and 6.92 (95% CI < 0; 16.59) among miners with attained age < 55 years, time since exposure 5-14 years, and annual exposure rates < 0.5 WL in the full (n = 4329 lung cancer deaths) and in the 1960 + sub-cohort (n = 663 lung cancer deaths), respectively. Both ERR/WLM decreased with older attained ages, increasing time since exposure, and higher exposure rates. Findings of the 1960 + sub-cohort are in line with those from large pooled studies, and ERR/WLM are about two times higher than in the full Wismut cohort. Notably, 20-30 years after closure of the Wismut mines in 1990, the estimated fraction of lung cancer deaths attributable to occupational radon exposure is still 26% in the full Wismut cohort and 19% in the 1960 + sub-cohort, respectively. This demonstrates the need for radiation protection against radon.
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Affiliation(s)
- M Kreuzer
- Federal Office for Radiation Protection, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany.
| | - V Deffner
- Federal Office for Radiation Protection, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
| | - M Sommer
- Federal Office for Radiation Protection, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
| | - N Fenske
- Federal Office for Radiation Protection, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
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Shimura H, Yokoya S, Suzuki S, Iwadate M, Suzuki S, Matsuzuka T, Suzuki S, Hayashi F, Nagao M, Ohira T, Yasumura S, Ohto H, Kamiya K. Confounding factors and biases involved in regional differences in the detection rate of thyroid cancer in the second-round Thyroid Ultrasound Examination: the Fukushima Health Management Survey. J Radiat Res 2023; 64:761-768. [PMID: 37429608 PMCID: PMC10516727 DOI: 10.1093/jrr/rrad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/01/2023] [Indexed: 07/12/2023]
Abstract
In response to concerns about health due to radiation exposure, the Fukushima Prefecture launched the Thyroid Ultrasound Examination program for residents aged 0-18 years at the time of the earthquake. Herein, we considered the confounding factors involved in the regional differences in the development of thyroid cancer. In this study, the 242 065 individuals who participated in both first- and second-round surveys were classified into four groups by address according to their air radiation dose. The number of participants diagnosed as malignant or suspicious for malignancy by cytological examination were 17, 38, 10 and 4 with detection rates of 53.8, 27.8, 21.7 and 14.5 per 100 000 participants in Regions 1, 2, 3 and 4, respectively. Sex (P = 0.0400), age at the time of the primary examination (P < 0.0001) and interval between the first- and second-round surveys (P < 0.0001) were significantly different among the four regions, and these were suspected to be confounding factors affecting regional differences in malignant nodule detection rates. In addition, significant regional differences were observed in the participation rate in the confirmatory examination (P = 0.0037) and the fine needle aspiration cytology implementation rate (P = 0.0037), which could be potential biases. No significant regional differences in the detection of malignant nodules were found in the multivariate logistic regression analysis after adjusting for the survey interval alone or for sex, age and survey interval. The confounding factors and biases identified in this study that may have important impacts on thyroid cancer detection rate should be fully considered in future studies.
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Affiliation(s)
- Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
- Department of Laboratory Medicine, Fukushima Medical University Fukushima School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Susumu Yokoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
- Thyroid and Endocrine Center, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Satoru Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Manabu Iwadate
- Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
- Department of Surgery, Minamisoma Municipal General Hospital, 2-54-6 Takamicho, Haramachi-ku, Minamisoma City, Fukushima 975-0033, Japan
| | - Satoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
- Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Takashi Matsuzuka
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
- Department of Otolaryngology, School of Medicine, Asahi University Hospital, 3-23, Hashimoto-cho, Gifu City, Gifu 500-8523, Japan
| | - Shinichi Suzuki
- Department of Thyroid Therapeutic Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Fumikazu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Masanori Nagao
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
- Research Institute for Radiation Biology and Medicine, Hiroshima, University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima 734-8553, Japan
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Pihl C, Bendtsen KMS, Jensen HE, Andersen F, Bjerring P, Haedersdal M, Lerche CM. Oral phytochemicals as photoprotectants in UVR exposed hairless mice: A study of hesperidin methyl chalcone, phloroglucinol, and syringic acid. J Photochem Photobiol B 2023; 246:112760. [PMID: 37535996 DOI: 10.1016/j.jphotobiol.2023.112760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
Ultraviolet radiation is the primary risk factor for keratinocyte carcinoma. Because of increasing incidence rates, new methods of photoprotection must be explored. Oral supplementation with photoprotective compounds presents a promising alternative. Phytochemical compounds like hesperidin methyl chalcone, phloroglucinol, and syringic acid are particularly of interest because of their antioxidant properties. Our primary outcome was to evaluate the effects of oral phytochemicals on photocarcinogenesis with time until tumour onset as the primary endpoint. A total of 125 hairless C3.Cg-Hrhr/TifBom Tac mice were randomised to receive tap water supplemented with either 100 mg/kg hesperidin methyl chalcone, phloroglucinol, or syringic acid, 600 mg/kg nicotinamide as a positive control, or no supplementation. The mice were irradiated with 3.5 standard erythema doses thrice weekly to induce photocarcinogenesis. Supplementation with the phytochemicals phloroglucinol and syringic acid and nicotinamide delayed tumour onset from a median of 140 days to 151 (p = 0.036), 157 days (p = 0.02), and 178 (p = 2.7·10-5), respectively. Phloroglucinol and nicotinamide supplementation reduced tumour number. Nicotinamide increased UV-induced pigmentation and reduced oedema formation, while phloroglucinol supplementation reduced epidermal thickness. These results indicate that oral supplementation with phloroglucinol and syringic acid protects against photocarcinogenesis in hairless mice, but not to the same extent as nicotinamide.
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Affiliation(s)
- Celina Pihl
- Dept of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Dept of Pharmacy, University of Copenhagen, 2400 Copenhagen, Denmark.
| | - Katja M S Bendtsen
- Dept of Veterinary and Animal Sciences, Copenhagen University, 1870 Frederiksberg, Denmark.
| | - Henrik E Jensen
- Dept of Veterinary and Animal Sciences, Copenhagen University, 1870 Frederiksberg, Denmark.
| | - Flemming Andersen
- Dept of Dermatology, Private Hospital Molholm, 7100 Vejle, Denmark; Dept of Dermatology, Aalborg University Hospital, 9100 Aalborg, Denmark.
| | - Peter Bjerring
- Dept of Dermatology, Aalborg University Hospital, 9100 Aalborg, Denmark.
| | - Merete Haedersdal
- Dept of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Dept of Clinical Medicine, University of Copenhagen, 2400 Copenhagen, Denmark.
| | - Catharina M Lerche
- Dept of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Dept of Pharmacy, University of Copenhagen, 2400 Copenhagen, Denmark.
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Cilla S, Deodato F, Romano C, Macchia G, Buwenge M, Boccardi M, Pezzulla D, Pierro A, Zamagni A, Morganti AG. Risk evaluation of secondary malignancies after radiotherapy of breast cancer in light of the continuous development of planning techniques. Med Dosim 2023; 48:279-285. [PMID: 37659968 DOI: 10.1016/j.meddos.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/12/2023] [Accepted: 07/26/2023] [Indexed: 09/04/2023]
Abstract
Secondary cancer risk is a significant concern for women treated with breast radiation therapy due to improved long-term survival rates. We evaluated the potential of new advanced automated planning algorithms together with hybrid techniques to minimize the excess absolute risk (EAR) for secondary cancer in various organs after radiation treatment for early staged breast cancer. Using CT data set of 25 patients, we generated 4 different radiation treatment plans of different complexity, including 3-dimensional conformal radiotherapy (3D-CRT), field-in-field (FinF), hybrid-IMRT (HMRT) and automated hybrid-VMAT (HVMAT) techniques. The organ-equivalent dose (OED) was calculated from differential dose-volume histograms on the basis of the "linear-exponential," "plateau," and "full mechanistic" dose-response models and was used to evaluate the EAR for secondary cancer in the contralateral breast (CB), contralateral lung (CL), and ipsilateral lung (IL). Statistical comparisons of data were performed by a Kruskal-Wallis analysis of variance. The planning objectives were fulfilled with all the planning techniques for both target coverage and organs-at-risk sparing. The differences in EAR for CB, CL and IL secondary tumor induction were not significant among the 4 techniques. For the CB and CL, the mean absolute difference did not reach 1 case of 10000 patient-years. For the IL, the mean absolute difference was up to 5 cases of 10,000 patient-years. In conclusion, the automated HVMAT technique allows an EAR reduction at the level of well-consolidated tangential 3D-CRT or FinF techniques, keeping all the HVMAT dosimetric improvements unchanged. On the basis of this analysis, the adoption of the HVMAT technique poses no increase in EAR and could be considered safe also for younger patients.
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Affiliation(s)
- Savino Cilla
- Medical Physics Unit, Gemelli Molise Hospital, Campobasso, Italy.
| | - Francesco Deodato
- Radiation Oncology Unit, Gemelli Molise Hospital, Campobasso, Italy; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Carmela Romano
- Medical Physics Unit, Gemelli Molise Hospital, Campobasso, Italy
| | | | - Milly Buwenge
- Radiation Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Donato Pezzulla
- Radiation Oncology Unit, Gemelli Molise Hospital, Campobasso, Italy
| | - Antonio Pierro
- Radiology Unit, Gemelli Molise Hospital, Campobasso, Italy
| | - Alice Zamagni
- Radiation Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alessio Giuseppe Morganti
- Radiation Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Experimental, Diagnostic, and Specialty Medicine-DIMES, Alma Mater Studiorum, Università di Bologna, Italy
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Richardson DB, Leuraud K, Laurier D, Gillies M, Haylock R, Kelly-Reif K, Bertke S, Daniels RD, Thierry-Chef I, Moissonnier M, Kesminiene A, Schubauer-Berigan MK. Cancer mortality after low dose exposure to ionising radiation in workers in France, the United Kingdom, and the United States (INWORKS): cohort study. BMJ 2023; 382:e074520. [PMID: 37586731 PMCID: PMC10427997 DOI: 10.1136/bmj-2022-074520] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE To evaluate the effect of protracted low dose, low dose rate exposure to ionising radiation on the risk of cancer. DESIGN Multinational cohort study. SETTING Cohorts of workers in the nuclear industry in France, the UK, and the US included in a major update to the International Nuclear Workers Study (INWORKS). PARTICIPANTS 309 932 workers with individual monitoring data for external exposure to ionising radiation and a total follow-up of 10.7 million person years. MAIN OUTCOME MEASURES Estimates of excess relative rate per gray (Gy) of radiation dose for mortality from cancer. RESULTS The study included 103 553 deaths, of which 28 089 were due to solid cancers. The estimated rate of mortality due to solid cancer increased with cumulative dose by 52% (90% confidence interval 27% to 77%) per Gy, lagged by 10 years. Restricting the analysis to the low cumulative dose range (0-100 mGy) approximately doubled the estimate of association (and increased the width of its confidence interval), as did restricting the analysis to workers hired in the more recent years of operations when estimates of occupational external penetrating radiation dose were recorded more accurately. Exclusion of deaths from lung cancer and pleural cancer had a modest effect on the estimated magnitude of association, providing indirect evidence that the association was not substantially confounded by smoking or occupational exposure to asbestos. CONCLUSIONS This major update to INWORKS provides a direct estimate of the association between protracted low dose exposure to ionising radiation and solid cancer mortality based on some of the world's most informative cohorts of radiation workers. The summary estimate of excess relative rate solid cancer mortality per Gy is larger than estimates currently informing radiation protection, and some evidence suggests a steeper slope for the dose-response association in the low dose range than over the full dose range. These results can help to strengthen radiation protection, especially for low dose exposures that are of primary interest in contemporary medical, occupational, and environmental settings.
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Affiliation(s)
- David B Richardson
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
| | - Klervi Leuraud
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - Dominique Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | | | | | - Kaitlin Kelly-Reif
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Stephen Bertke
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Robert D Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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Kelly-Reif K, Bertke S, Daniels RD, Richardson DB, Schubauer-Berigan MK. Ionizing radiation and solid cancer mortality among US nuclear facility workers. Int J Epidemiol 2023; 52:1015-1024. [PMID: 37253388 PMCID: PMC10527884 DOI: 10.1093/ije/dyad075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/10/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND The risk of solid cancers from low-level protracted ionizing radiation is not well characterized. Nuclear workers provide valuable information on the effects of ionizing radiation in contemporary exposure scenarios relevant to workers and the public. METHODS We evaluated the association between penetrating ionizing radiation exposure and solid cancer mortality among a pooled cohort of nuclear workers in the USA, with extended follow-up to examine cancers with long latencies. This analysis includes 101 363 workers from five nuclear facilities, with 12 069 solid cancer deaths between 1944 and 2016. The association between cumulative equivalent dose measured in sieverts (Sv) and solid cancer subtypes were modelled as the excess relative rate per Sv (ERR Sv-1) using Cox regression. RESULTS For the association between ionizing radiation exposure and all solid cancer mortality we observed an elevated rate (ERR Sv-1=0.19; 95% CI: -0.10, 0.52), which was higher among a contemporary sub-cohort of workers first hired in 1960 or later (ERR Sv-1= 2.23; 95% CI: 1.13, 3.49). Similarly, we observed an elevated rate for lung cancer mortality (ERR Sv-1= 0.65; 95% CI: 0.09, 1.30) that was higher among contemporary hires (ERR Sv-1= 2.90; 95% CI: 1.00, 5.26). CONCLUSIONS Although concerns remain about confounding, measurement error and precision, this analysis strengthens the evidence base indicating there are radiogenic risks for several solid cancer types.
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Affiliation(s)
- Kaitlin Kelly-Reif
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Steven Bertke
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Robert D Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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Racka I, Majewska K, Winiecki J, Kiluk K. Hybrid planning techniques for early-stage left-sided breast cancer: dose distribution analysis and estimation of projected secondary cancer-relative risk. Acta Oncol 2023; 62:932-941. [PMID: 37516978 DOI: 10.1080/0284186x.2023.2238553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE The purpose of this study was to evaluate three techniques of irradiation of left-sided breast cancer patients, three-dimensional conformal radiotherapy (3D-CRT), hybrid Intensity-Modulated Radiotherapy (h-IMRT), and hybrid Volumetric-Modulated Arc Therapy (h-VMAT, h-ARC), in terms of dose distribution in the planning target volume (PTV) and organs at risk (OARs). The second aim was to estimate the projected relative risk of radiation-induced secondary cancers for hybrid techniques. MATERIALS AND METHODS Three treatment plans were prepared in 3D-CRT, h-IMRT, and h-VMAT techniques for each of the 40 patients, who underwent CT simulation in deep inspiration breath-hold (DIBH). For hybrid techniques, plans were created by combining 3D-CRT and dynamic fields with an 80%/20% dose ratio for 3D-CRT and IMRT or VMAT. Cumulative dose-volume histograms were used to compare dose distributions within the PTV and OARs (heart, left anterior descending coronary artery [LAD], left and right lung [LL, RL], right breast [RB]). Projected risk ratios for secondary cancers were estimated relative to 3D-CRT using the organ equivalent dose (OED) concept for the Schneider's linear exponential, plateau, and full mechanistic dose-response model. RESULTS All plans fulfilled the PTV criterium: V95%≥95%. Compared to 3D-CRT, both hybrid techniques showed significantly better target coverage (PTV: V95%>98%, p < 0.001), and the best conformality was achieved by h-ARC plans (CI: 1.18 ± 0.09, p < 0.001). Compared to 3D-CRT and h-ARC, h-IMRT increased the average sum of monitor units (MU) over 129.9% (p < 0.001). H-ARC increased the mean dose of contralateral organs and the LL V5Gy parameter (p < 0.001). Both hybrid techniques significantly reduced the Dmax of the heart by 5 Gy. Compared to h-IMRT, h-ARC increased secondary cancer projected relative risk ratios for LL, RL, and RB by 18, 152, and 81%, respectively. CONCLUSIONS The results confirmed that both hybrid techniques provide better target quality and OARs sparing than 3D-CRT. Hybrid VMAT delivers less MU compared to hybrid IMRT but may increase the risk of radiation-induced secondary malignancies.
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Affiliation(s)
- Iga Racka
- Medical Physics Department, Prof. Franciszek Łukaszczyk Memorial Oncology Center, Bydgoszcz, Poland
| | - Karolina Majewska
- Medical Physics Department, Prof. Franciszek Łukaszczyk Memorial Oncology Center, Bydgoszcz, Poland
| | - Janusz Winiecki
- Medical Physics Department, Prof. Franciszek Łukaszczyk Memorial Oncology Center, Bydgoszcz, Poland
- Clinic of Oncology and Brachytherapy, Collegium Medicum in Bydgoszcz, Nicholas Copernicus University, Torun, Poland
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18
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Suzuki K, Imaoka T, Tomita M, Sasatani M, Doi K, Tanaka S, Kai M, Yamada Y, Kakinuma S. Molecular and cellular basis of the dose-rate-dependent adverse effects of radiation exposure in animal models. Part II: Hematopoietic system, lung and liver. J Radiat Res 2023; 64:228-249. [PMID: 36773331 PMCID: PMC10036110 DOI: 10.1093/jrr/rrad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 10/04/2022] [Indexed: 06/18/2023]
Abstract
While epidemiological data have greatly contributed to the estimation of the dose and dose-rate effectiveness factor (DDREF) for human populations, studies using animal models have made significant contributions to provide quantitative data with mechanistic insights. The current article aims at compiling the animal studies, specific to rodents, with reference to the dose-rate effects of cancer development. This review focuses specifically on the results that explain the biological mechanisms underlying dose-rate effects and their potential involvement in radiation-induced carcinogenic processes. Since the adverse outcome pathway (AOP) concept together with the key events holds promise for improving the estimation of radiation risk at low doses and low dose-rates, the review intends to scrutinize dose-rate dependency of the key events in animal models and to consider novel key events involved in the dose-rate effects, which enables identification of important underlying mechanisms for linking animal experimental and human epidemiological studies in a unified manner.
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Affiliation(s)
- Keiji Suzuki
- Corresponding author, Department of Radiation Medical Sciences, Nagasaki University Atomic Bomb Disease Institute. 1-12-4 Sakamoto, Nagasaki 852-8523, Japan. Tel:+81-95-819-7116; Fax:+81-95-819-7117; E-mail:
| | | | | | | | - Kazutaka Doi
- Department of Radiation Regulatory Science Research, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Satoshi Tanaka
- Department of Radiobiology, Institute for Environmental Sciences, 1-7 Ienomae, Obuchi, Rokkasho-mura, Kamikita-gun, Aomori 039-3212, Japan
| | - Michiaki Kai
- Nippon Bunri University, 1727-162 Ichiki, Oita, Oita 870-0397, Japan
| | - Yutaka Yamada
- Department of Radiation Effects Research, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Shizuko Kakinuma
- Department of Radiation Effects Research, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
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19
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McNabb E, Sharma D, Sannachi L, Giles A, Yang W, Czarnota GJ. MR-guided ultrasound-stimulated microbubble therapy enhances radiation-induced tumor response. Sci Rep 2023; 13:4487. [PMID: 36934140 PMCID: PMC10024768 DOI: 10.1038/s41598-023-30286-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/20/2023] [Indexed: 03/20/2023] Open
Abstract
High intensity focused ultrasound (HIFU) systems have been approved for therapeutic ultrasound delivery to cause tissue ablation or induced hyperthermia. Microbubble agents have also been used in combination with sonication exposures. These require temperature feedback and monitoring to prevent unstable cavitation and prevent excess tissue heating. Previous work has utilized lower power and pressure to oscillate microbubbles and transfer energy to endothelial cells in the absence of thermally induced damage that can radiosensitize tumors. This work investigated whether reduced acoustic power and pressure on a commercial available MR-integrated HIFU system could result in enhanced radiation-induced tumor response after exposure to ultrasound-stimulated microbubbles (USMB) therapy. A commercially available MR-integrated HIFU system was used with a hyperthermia system calibration provided by the manufacturer. The ultrasound transducer was calibrated to reach a peak negative pressure of - 750 kPa. Thirty male New Zealand white rabbits bearing human derived PC3 tumors were grouped to receive no treatment, 14 min of USMB, 8 Gy of radiation in a separate irradiation cabinet, or combined treatments. In vivo temperature changes were collected using MR thermometry at the tumor center and far-field muscle region. Tissues specimens were collected 24 h post radiation therapy. Tumor cell death was measured and compared to untreated controls through hematoxylin and eosin staining and immunohistochemical analysis. The desired peak negative pressure of - 750 kPa used for previous USMB occurred at approximately an input power of 5 W. Temperature changes were limited to under 4 °C in ten of twelve rabbits monitored. The median temperature in the far-field muscle region of the leg was 2.50 °C for groups receiving USMB alone or in combination with radiation. Finally, statistically significant tumor cell death was demonstrated using immunohistochemical analysis in the combined therapy group compared to untreated controls. A commercial MR-guided therapy HIFU system was able to effectively treat PC3 tumors in a rabbit model using USMB therapy in combination with radiation exposures. Future work could find the use of reduced power and pressure levels in a commercial MR-guided therapy system to mechanically stimulate microbubbles and damage endothelial cells without requiring high thermal doses to elicit an antitumor response.
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Affiliation(s)
- Evan McNabb
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Deepa Sharma
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | | | - Anoja Giles
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Wenyi Yang
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Gregory J Czarnota
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
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20
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Zhang W, Haylock RGE, Gillies M, Hunter N, Zhang E. Effects of radiation on respiratory disease mortality: analysis of the national registry for radiation workers in United Kingdom. Int J Radiat Biol 2023; 99:1531-1541. [PMID: 36880846 DOI: 10.1080/09553002.2023.2187474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023]
Abstract
PURPOSE While some evidence of an effect of radiation exposure on respiratory disease at low dose levels has now emerged, there is heterogeneity in the risks between different studies and countries. In this paper, we aim to show the effect of radiation on three different sub-types of respiratory disease mortality through the analysis of the NRRW cohort in UK. MATERIALS AND METHODS The NRRW cohort consisted of 174,541 radiation workers. Doses to the surface of the body were monitored using individual film badges. Most of the doses are associated with X-rays and gamma rays and to a less extent of beta and neutron particles. The overall mean 10-year lagged lifetime external dose was 23.2 mSv. Some workers were potentially exposed to alpha particles. However, doses from internal emitters were not available for the NRRW cohort. 25% of male workers and 17% of female workers were identified as being monitored for internal exposure. The Poisson regression methods for grouped survival data with a stratified baseline hazard function were used to describe the dependence of the risk on cumulative external radiation dose. The disease was analyzed by the following subgroups: Pneumonia (1066 cases including 17 cases of influenza), COPD and allied disease (1517 cases) and other remaining respiratory diseases (479 cases). RESULTS There was very little radiation effect on pneumonia mortality, but evidence of a reduction in mortality risk for COPD and allied disease (ERR/Sv= -0.56, 95%CI: -0.94, -0.06; p = .02) and an increase in risk for other respiratory disease mortality (ERR/Sv = 2.30, 95%CI: 0.67, 4.62; p = .01) with increasing cumulative external dose were observed. The effects of radiation were more prominent amongst workers monitored for internal exposure. The reduction in mortality risk of COPD and allied disease per cumulative external dose was statistically significant for the radiation workers monitored for internal exposure (ERR/Sv= -0.59, 95%CI: -0.99, -0.05; p = .017) but not significant among the workers who were not monitored (ERR/Sv= -0.43, 95%CI: -1.20, 0.74; p = .42). A statistically significant increased risk was observed for other respiratory diseases among monitored radiation workers (ERR/Sv = 2.46, 95%CI: 0.69, 5.08; p = .019), but not among unmonitored workers (ERR/Sv = 1.70, 95%CI: -0.82, 5.65; p = .25). CONCLUSION The effects of radiation exposure can be different depending on the type of respiratory disease. No effect was seen in pneumonia; a reduction in mortality risk of COPD, and increased mortality risk of other respiratory diseases were observed with cumulative external radiation dose. More studies are needed to verify these findings.
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Affiliation(s)
| | - Richard G E Haylock
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Directorate, Didcot, Oxon
| | - Michael Gillies
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Directorate, Didcot, Oxon
| | - Nezahat Hunter
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Directorate, Didcot, Oxon
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21
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Paulo MS, Symanzik C, Ádam B, Gobba F, Kezic S, van der Molen HF, Peters CE, Rocholl M, Tenkate T, John SM, Loney T, Modenese A, Wittlich M. Risk of cutaneous squamous cell carcinoma due to occupational exposure to solar ultraviolet radiation: Protocol for a systematic review and meta-analysis. PLoS One 2023; 18:e0282664. [PMID: 36867594 PMCID: PMC9983864 DOI: 10.1371/journal.pone.0282664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/20/2023] [Indexed: 03/04/2023] Open
Abstract
Solar ultraviolet radiation (UVR) is the most significant occupational carcinogenic exposure in terms of the number of workers exposed (i.e., outdoor workers). Consequently, solar UVR-induced skin cancers are among the most common forms of occupational malignancies that are potentially expected globally. This systematic review is registered in PROSPERO (CRD42021295221) and aims to assess the risk of cutaneous squamous cell carcinoma (cSCC) associated to occupational solar UVR exposure. Systematic searches will be performed in three electronic literature databases (PubMed/Medline, EMBASE, and Scopus). Further references will be retrieved by a manual search (e.g., in grey literature databases, internet search engines, and organizational websites). We will include cohort studies and case-control studies. Risk of Bias assessment will be conducted separately for case-control and cohort studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) will be used for the certainty of assessment. In case quantitative pooling is not feasible, a narrative synthesis of results will be performed.
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Affiliation(s)
- Marília Silva Paulo
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Cara Symanzik
- Department of Dermatology, Environmental Medicine, and Health Theory, Osnabrück University, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabrück University, Osnabrück, Germany
| | - Balázs Ádam
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Sanja Kezic
- Amsterdam UMC, Department of Occupational and Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Henk F. van der Molen
- Amsterdam UMC, Department of Occupational and Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Cheryl E. Peters
- BC Centre for Disease Control, Vancouver, Canada
- BC Cancer, Vancouver, Canada
- University of British Columbia, Vancouver, Canada
| | - Marc Rocholl
- Department of Dermatology, Environmental Medicine, and Health Theory, Osnabrück University, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabrück University, Osnabrück, Germany
| | - Thomas Tenkate
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine, and Health Theory, Osnabrück University, Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at Osnabrück University, Osnabrück, Germany
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, Modena, Italy
| | - Marc Wittlich
- Institute for Occupational Safety and Health of the German Social Accidents Insurance (IFA), Sankt Augustin, Germany
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Calabrese EJ, Agathokleous E, Giordano J, Selby PB. Manhattan Project genetic studies: Flawed research discredits LNT recommendations. Environ Pollut 2023; 319:120902. [PMID: 36566922 DOI: 10.1016/j.envpol.2022.120902] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/28/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
This paper reexamines the technical report (∼ one page) of Uphoff and Stern (1949) in Science that was highly relied upon by the US National Academy of Sciences (NAS) Biological Effects of Atomic Radiation (BEAR) I Genetics Panel to support a linearity dose response for radiation risk assessment. The present paper demonstrates that research of Uphoff and Stern (1949) to evaluate whether total dose or dose rate best estimated radiation risks included two variables, thereby precluding the ability to accurately derive a reliable conclusion about this topic. Furthermore, the acute dose selected by Uphoff and Stern was given at a strikingly low dose rate that may have precluded the capacity to adequately test the total dose/dose rate hypothesis, even with a proper study design which also this research did not possess. The issue of total dose and dose rate was much later successfully addressed by Russell et al. (1958) using a murine model, yielding a dose-rate rather than a total dose conclusion. The failure to subject the experimental details of the Uphoff and Stern (1949) study to peer-review and publication in the open literature precluded a rigorous and necessary evaluation, profoundly and improperly impacting the adoption of the linear dose response model.
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Affiliation(s)
- Edward J Calabrese
- Department of Environmental Health Sciences; Morrill I, N344; University of Massachusetts, Amherst, MA, 01003, USA.
| | - Evgenios Agathokleous
- School of Applied Meteorology; Nanjing University of Information Science & Technology, Nanjing, 210044, China.
| | - James Giordano
- Departments of Neurology and Biochemistry, and Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, Washington, DC, 20007, USA.
| | - Paul B Selby
- Retired from Oak Ridge National Laboratory at Oak Ridge, TN, USA; 4088 Nottinghill Gate Road; Upper Arlington, OH, 43220, USA.
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23
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Azizova TV, Grigoryeva ES, Hamada N. Dose rate effect on mortality from ischemic heart disease in the cohort of Russian Mayak Production Association workers. Sci Rep 2023; 13:1926. [PMID: 36732598 PMCID: PMC9895442 DOI: 10.1038/s41598-023-28954-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
For improvement of the radiation protection system it is crucial to know the factors that modify the radiation dose-response relationship. One of such key factors is the ionizing radiation dose rate. There are, however, very few studies that examine the impact of the dose rate on radiogenic risks observed in human cohorts exposed to radiation at various dose rates. Here we investigated the impact of the dose rate (in terms of the recorded annual dose) on ischemic heart disease (IHD) mortality among Russian nuclear workers chronically exposed to radiation. We observed significantly increased excess relative risks (ERR) of IHD mortality per unit of external gamma-ray absorbed dose accumulated at higher dose rates (0.005-0.050 Gy/year). The present findings provide evidence for the association between radiation dose rate and ERRs of IHD mortality in occupationally chronically exposed workers per unit total dose. IHD mortality risk estimates considerably increased with increasing duration of uninterrupted radiation exposure at high rates. The present findings are consistent with other studies and can contribute to the scientific basis for recommendations on the radiation protection system.
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Affiliation(s)
- Tamara V Azizova
- Clinical Department, Southern Urals Biophysics Institute, Ozyorsk, Chelyabinsk Region, Russia.
| | - Evgeniya S Grigoryeva
- Clinical Department, Southern Urals Biophysics Institute, Ozyorsk, Chelyabinsk Region, Russia
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan
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Calabrese EJ, Giordano J. Ethical Issues in the US 1956 National Academy of Sciences BEAR I Genetics Panel Report to the Public. Health Phys 2022; 123:387-391. [PMID: 35848926 DOI: 10.1097/hp.0000000000001608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
ABSTRACT This paper presents newly discovered evidence from the personal correspondence of four US National Academy of Sciences (NAS) Biological Effects of Atomic Radiation (BEAR) Genetics Panelists that their 1956 report to the public was written by a third party and was neither reviewed nor approved by the Panel prior to its publication and release to the public. The letters revealed that the 1956 Report contained serious errors and did not represent the views of the Panel. The failure of the US NAS to notify the public that the Report had not been reviewed and approved by the Panel represents a serious breach of ethics. Further ethical issues relate to the failure of the NAS to (1) correct the errors in the Report within an appropriately timely manner and (2) reveal the lack of approval by the Panel even after the Report's release. In light of these discoveries and the profound historical-and continuing-significance of the 1956 Report to all conventional cancer-related risk assessment processes, we opine that this ethical improbity must be acknowledged and that this document must be retracted by the NAS.
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Affiliation(s)
- Edward J Calabrese
- Department of Environmental Health Sciences, Morrill I, N344, University of Massachusetts, Amherst, MA 01003
| | - James Giordano
- Departments of Neurology and Biochemistry and Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, Washington, DC 2007, or email at
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25
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Kelly-Reif K, Bertke S, Daniels RD, Richardson DB, Schubauer-Berigan MK. Nonmalignant respiratory disease mortality in male Colorado Plateau uranium miners, 1960-2016. Am J Ind Med 2022; 65:773-782. [PMID: 35941829 PMCID: PMC10031748 DOI: 10.1002/ajim.23419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/17/2022] [Accepted: 07/20/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND To evaluate trends of nonmalignant respiratory disease (NMRD) mortality among US underground uranium miners on the Colorado Plateau, and to estimate the exposure-response association between cumulative radon progeny exposure and NMRD subtype mortality. METHODS Standardized mortality ratios (SMRs) and excess relative rates per 100 working level months (excess relative rate [ERR]/100 WLM) were estimated in a cohort of 4021 male underground uranium miners who were followed from 1960 through 2016. RESULTS We observed elevated SMRs for all NMRD subtypes. Silicosis had the largest SMR (n = 52, SMR = 41.4; 95% confidence interval [CI]: 30.9, 54.3), followed by other pneumoconiosis (n = 49, SMR = 39.6; 95% CI: 29.6, 52.3) and idiopathic pulmonary fibrosis (IPF) (n = 64, SMR = 4.77; 95% CI 3.67, 6.09). SMRs for silicosis increased with duration of employment; SMRs for IPF increased with duration of employment and calendar period. There was a positive association between cumulative radon exposure and silicosis with evidence of modification by smoking (ERR/100 WLM≥10 pack-years = 0.78; 95% CI: 0.05, 24.6 and ERR/100 WLM<10 pack-years = 0.01; 95% CI: -0.03, 0.52), as well as a small positive association between radon and IPF (ERR/100 WLM = 0.06, 95% CI: 0.00, 0.24); these associations were driven by workers with prior employment in hard rock mining. CONCLUSIONS Uranium mining workers had excess NMRD mortality compared with the general population; this excess persisted throughout follow-up. Exposure-response analyses indicated a positive association between radon exposure and IPF and silicosis, but these analyses have limitations due to outcome misclassification and missing information on occupational co-exposures such as silica dust.
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Affiliation(s)
- Kaitlin Kelly-Reif
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Stephen Bertke
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Robert D Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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Zouain N, Saade C, Dib Nehme R. Weight-Based Protocols Offer Significant Reduction in Radiation Dose Without Affecting PET-CT Image Quality. Radiol Technol 2022; 94:24-33. [PMID: 36347619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/26/2021] [Indexed: 05/18/2023]
Abstract
PURPOSE To investigate the use of weight-based protocols during full- and half-body fluorodeoxyglucose F 18 (FDG) positron emission tomography-computed tomography (PET-CT) and their effect on image quality, radiation dose, and lifetime attributable risks. METHODS A total of 1817 patients were referred for FDG PET-CT studies. Each scanning group (4 total: full-body groups A and C and half-body groups B and D) was randomly allotted into conventional or weight-based CT. Groups A and B followed a conventional protocol of 120 kVp, 120 mA, 0.5 second rotation time, and pitch 0.8 mm/rotation for all body weights. Groups C and D were scanned using 1 of 4 weight-based CT protocols. All 4 weight-based protocols used 140 kVp, 0.75 seconds rotation time, and pitch 0.8 mm/rotation. Milliamperage varied by body weight as follows: protocol I (≤ 60kg [132.3 lb]), 35 mA; protocol II (61-80 kg [134.5-176.4 lb]), 50 mA; protocol III (81-100 kg [178.6-220.5 lb]), 65 mA; and protocol IV (> 100kg [222.7 lb]), 100 mA. All protocols (weight based and conventional) employed tube current modulation. CT quantitative image quality measurements were evaluated for each protocol, and lifetime attributable risks were calculated for each age group and sex. RESULTS Patient demographics demonstrated no significant differences between groups. Mean effective dose was significantly lower for group C (full body, weight based) compared with A (full body, conventional) (P < .001), as were lifetime attributable risks (P < .001). Mean effective dose and lifetime attributable risks also were significantly lower (P < .001) for group D (half body, weight based) compared with B (half body, conventional). Contrast-to-noise ratios showed no difference between groups (P = .12), supporting a preference for the weigh-based protocols used for groups C and D. For half-body, weight-based protocols (group D), the lifetime attributable risks decreased for men by 91.9% and for women by 38.9%. For full-body, weight-based protocols (group C), the lifetime attributable risks decreased by 72.5% and 66.3% for men and women, respectively. DISCUSSION Radiologists and radiologic technologists face the challenge of balancing the potential risks of radiation-induced cancer against providing diagnostic-quality images and uncompromised disease detection. Weight-based protocols address this challenge without compromising image quality or pathology detection. CONCLUSION Significant reductions in radiation dose and lifetime attributable risks can be achieved using CT weight-based protocols during half- and whole-body FDG PET-CT without compromising CT image quality.
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Affiliation(s)
- Nicolas Zouain
- Nicolas Zouain, MD, works for Clemenceau Medical Center in Beirut, Lebanon
| | - Charbel Saade
- Charbel Saade, PhD, works for University College Cork, Ireland
| | - Ryan Dib Nehme
- Ryan Dib Nehme, BS, is a medical student at the American University of Beirut, Lebanon
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Onishi S, Yamasaki F, Amatya VJ, Takayasu T, Yonezawa U, Taguchi A, Ohba S, Takeshima Y, Horie N, Sugiyama K. Characteristics and therapeutic strategies of radiation-induced glioma: case series and comprehensive literature review. J Neurooncol 2022; 159:531-538. [PMID: 35922583 DOI: 10.1007/s11060-022-04090-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/05/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The so-called radiation-induced glioma (RIG, a secondary glioma after cranial irradiation), is a serious late effect after cranial radiation therapy. The clinical characteristics of and ideal treatment for these tumors are unclear. We analyzed our case series and conducted a comprehensive literature review to reveal the precise characteristics of RIGs. METHODS We analyzed the cases of six patients with RIGs treated at our institution and 354 patients with RIGs from the literature. The latency period from irradiation to the development of each RIG and the median overall survival of the patients were subjected to Kaplan-Meier analyses. Spearman's correlation test was used to determine the relationship between age at irradiation and the latency period. RESULTS The mean age of the 360 patients at the development of RIG was 27.42 ± 17.87 years. The mean latency period was 11.35 ± 8.58 years. Multiple gliomas were observed in 28.4%. WHO grade 3 and 4 RIGs accounted for 93.3%. The latency periods were significant shorter in the higher WHO grade group (p = 0.0366) and the concomitant systemic chemotherapy group (p < 0.0001). Age at irradiation was negatively associated with the latency period (r =- 0.2287, p = 0.0219). The patients treated with radiotherapy achieved significantly longer survival compared to those treated without radiotherapy (p = 0.0011). CONCLUSIONS Development in younger age, multiplicity, and high incidence of grade 3 and 4 are the clinical characteristics of RIGs. Cranial irradiation at older ages and concomitant chemotherapy were associated with shorter latency for the development of RIG. Radiation therapy may be the feasible treatment option despite radiation-induced gliomas.
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Affiliation(s)
- Shumpei Onishi
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan.
- Department of Neurosurgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama-cho, Kure City, Hiroshima, 737-0023, Japan.
| | - Fumiyuki Yamasaki
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Vishwa Jeet Amatya
- Department of Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Takeshi Takayasu
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Ushio Yonezawa
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Akira Taguchi
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Shinji Ohba
- Department of Neurosurgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama-cho, Kure City, Hiroshima, 737-0023, Japan
| | - Yukio Takeshima
- Department of Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Nobutaka Horie
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Kazuhiko Sugiyama
- Department of Clinical Oncology and Neuro-oncology Program, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
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Calabrese EJ, Selby PB, Giordano J. Ethical challenges of the linear non-threshold (LNT) cancer risk assessment revolution: History, insights, and lessons to be learned. Sci Total Environ 2022; 832:155054. [PMID: 35390380 DOI: 10.1016/j.scitotenv.2022.155054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/01/2022] [Accepted: 04/01/2022] [Indexed: 06/14/2023]
Abstract
This paper provides historical review and evaluation of the development, adoption, and advocacy of the linear non-threshold (LNT) dose response model for cancer risk assessment as applied in practices and policies worldwide. It extends previous historical assessments and provides novel insights regarding: 1) how LNT bias became institutionalized in US governmental agencies, 2) how improper editorial practices at the journal Science promoted the adoption of LNT, 3) how a Nobel Prize winning scientist unjustifiably espoused and influenced support for replacing the threshold dose response model with the LNT model, 4) how the cover-up of striking and substantial experimental cancer data by US government scientists reduced support for the threshold dose response model at a critical period of cancer risk assessment policy adoption, and 5) how these events have negatively influenced cancer risk assessment practices and environmental and public health decisions for decades. These findings are presented to illustrate how profound and recognized mistakes, biases and unethical activities, inclusive of frank scientific misconduct, converged, and should motivate regulatory agencies worldwide to critically evaluate any existing policies that apply the LNT model as well as to serve as object lessons for current and future ethical conduct of research, and the provision of ethico-legal education in and across scientific curricula and institutions.
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Affiliation(s)
- Edward J Calabrese
- School of Public Health and Health Sciences, Department of Environmental Health Sciences, University of Massachusetts, Morrill I, N344, Amherst, MA 01003, USA.
| | - Paul B Selby
- Retired, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - James Giordano
- Departments of Neurology and Biochemistry and Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, Washington, DC 20007, USA
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Sharma D, Czarnota GJ. Involvement of Ceramide Signalling in Radiation-Induced Tumour Vascular Effects and Vascular-Targeted Therapy. Int J Mol Sci 2022; 23:ijms23126671. [PMID: 35743121 PMCID: PMC9223569 DOI: 10.3390/ijms23126671] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 02/04/2023] Open
Abstract
Sphingolipids are well-recognized critical components in several biological processes. Ceramides constitute a class of sphingolipid metabolites that are involved in important signal transduction pathways that play key roles in determining the fate of cells to survive or die. Ceramide accumulated in cells causes apoptosis; however, ceramide metabolized to sphingosine promotes cell survival and angiogenesis. Studies suggest that vascular-targeted therapies increase endothelial cell ceramide resulting in apoptosis that leads to tumour cure. Specifically, ultrasound-stimulated microbubbles (USMB) used as vascular disrupting agents can perturb endothelial cells, eliciting acid sphingomyelinase (ASMase) activation accompanied by ceramide release. This phenomenon results in endothelial cell death and vascular collapse and is synergistic with other antitumour treatments such as radiation. In contrast, blocking the generation of ceramide using multiple approaches, including the conversion of ceramide to sphingosine-1-phosphate (S1P), abrogates this process. The ceramide-based cell survival "rheostat" between these opposing signalling metabolites is essential in the mechanotransductive vascular targeting following USMB treatment. In this review, we aim to summarize the past and latest findings on ceramide-based vascular-targeted strategies, including novel mechanotransductive methodologies.
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Affiliation(s)
- Deepa Sharma
- Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada;
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Departments of Medical Biophysics and Radiation Oncology, University of Toronto, Toronto, ON M4N 3M5, Canada
- Correspondence: ; Tel.: +1-416-480-6100 (ext. 89533)
| | - Gregory J. Czarnota
- Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada;
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
- Departments of Medical Biophysics and Radiation Oncology, University of Toronto, Toronto, ON M4N 3M5, Canada
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30
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Toft DJ, Schneider AB. Protecting the Thyroid in Times of Conflict (Ukraine 2022). Thyroid 2022; 32:607-610. [PMID: 35469429 DOI: 10.1089/thy.2022.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Daniel J Toft
- Department of Endocrinology, Diabetes and Metabolism and University of Illinois at Chicago, Chicago, Illinois, USA
| | - Arthur B Schneider
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
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31
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Wojcik A. Reflections on effects of low doses and risk inference based on the UNSCEAR 2021 report on 'biological mechanisms relevant for the inference of cancer risks from low-dose and low-dose-rate radiation'. J Radiol Prot 2022; 42:023501. [PMID: 35226888 DOI: 10.1088/1361-6498/ac591c] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
The 2021 United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) report summarises the knowledge on biological mechanisms of radiation action at low doses where, due to low statistical power of epidemiological investigations, the level of cancer risk must be inferred. It is the fourth UNSCEAR report since 1994 that looks into biological effects following low dose exposure with the aim of examining whether they support the assumption of the linear non-threshold (LNT) dose response for radiation-induced cancers. The conclusions of all four reports are affirmative. The new aspect of the 2021 report is that it focuses on the process of cancer risk inference. The aim of this article is to discuss the consequences of the conclusions regarding LNT and the possibilities of inferring risks from biological studies.
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Affiliation(s)
- Andrzej Wojcik
- Centre for Radiation Protection Research, MBW Department, Stockholm University, Svante Arrhenius väg 20C, 106 91 Stockholm, Sweden Institute for Biology, Jan Kochanowski University, Kielce, Poland
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32
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Furuta H, Kudo S, Ishizawa N, Saigusa S. Reanalysis of cancer mortality using reconstructed organ-absorbed dose: J-EPISODE 1991‒2010. J Radiol Prot 2022; 42:011509. [PMID: 34801992 DOI: 10.1088/1361-6498/ac3bc5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/21/2021] [Indexed: 06/13/2023]
Abstract
The Japanese Epidemiological Study on Low-Dose Radiation Effects (J-EPISODE) has been conducted since 1990 by the Radiation Effects Association to analyse health effects for nuclear workers. It uses the recorded doses, i.e. dosimeter readings, evaluated inHp(10) for estimation of radiation risk; however, the International Commission on Radiological Protection does not recommend the use of effective doses for epidemiological evaluation and instead recommends the use of organ-absorbed doses for assessing cancer risk. Recently, the J-EPISODE has developed a conversion factor that can convert dosimeter readings to organ-absorbed doses following, in principle, the approach adopted by the International Agency for Research on Cancer 15-Country Collaborative Study. The approach was modified based on recent dosimeter usage practices and the Japanese physique. The aim of this study was to reanalyse the excess relative risk (ERR) of cancer mortality for the J-EPISODE using the previous analysis method but substituting the organ-absorbed dose for the recorded dose to confirm the adaptability and relevance of organ-absorbed doses for the J-EPISODE. The organ-absorbed doses from 1957 to 2010 were reconstructed for the whole cohort. The cancer mortality risk was reanalysed with Poisson regression methods, first by comparing the ERR/Gy for all cancers excluding leukaemia with the risk after excluding lung cancer for the whole cohort of 204 103 participants. In the whole cohort, all cancers excluding leukaemia, lung cancer and non-Hodgkin's lymphoma had statistically significant positive ERR/Gy estimates; leukaemia excluding chronic lymphocytic leukaemia had negative but not statistically significant estimates. Gallbladder cancer and pancreatic cancer showed statistically significant negative. Then, a subcohort of 71 733 respondents was selected based on lifestyle surveys with data on qualitative smoking status as well as quantitative smoking information on pack-years. Pack-years for current smokers and former smokers and years since the cessation of smoking for former smokers were used for the smoking-adjusted model. The most important feature of the J-EPISODE revealed to date was a decreasing tendency of the ERR/Sv by the smoking adjustment. For almost all causes of death such as lung cancer and stomach cancer, the estimated ERR/Gy decreased by the smoking adjustment, although those for the colon, prostate and kidney and other urinary organs were almost the same after the adjustment. This tendency remained unchanged even when using the organ-absorbed dose, indicating the appropriateness of using organ-absorbed doses for further risk analysis. At the same time, it indicated that confounding by smoking seriously biased the radiation risk estimates in the J-EPISODE and thus should be accounted even if organ dose is used.
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Affiliation(s)
- Hiroshige Furuta
- Institute of Radiation Epidemiology, Radiation Effects Association, 1-9-16, Kajicho, Chiyoda-ku, Tokyo 101-0044, Japan
| | - Shin'ichi Kudo
- Institute of Radiation Epidemiology, Radiation Effects Association, 1-9-16, Kajicho, Chiyoda-ku, Tokyo 101-0044, Japan
| | - Noboru Ishizawa
- Institute of Radiation Epidemiology, Radiation Effects Association, 1-9-16, Kajicho, Chiyoda-ku, Tokyo 101-0044, Japan
| | - Shin Saigusa
- Institute of Radiation Epidemiology, Radiation Effects Association, 1-9-16, Kajicho, Chiyoda-ku, Tokyo 101-0044, Japan
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Chirikova E, McConnell RJ, O'Kane P, Yauseyenka V, Little MP, Minenko V, Drozdovitch V, Veyalkin I, Hatch M, Chan JM, Huang CY, Mabuchi K, Cahoon EK, Rozhko A, Zablotska LB. Association between exposure to radioactive iodine after the Chernobyl accident and thyroid volume in Belarus 10-15 years later. Environ Health 2022; 21:5. [PMID: 34996456 PMCID: PMC8742457 DOI: 10.1186/s12940-021-00820-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND While there is a robust literature on environmental exposure to iodine-131 (131I) in childhood and adolescence and the risk of thyroid cancer and benign nodules, little is known about its effects on thyroid volume. METHODS To assess the effect of 131I dose to the thyroid on the volume of the thyroid gland, we examined the data from the baseline screening of the Belarusian-American Cohort Study of residents of Belarus who were exposed to the Chernobyl fallout at ages ≤18 years. Thyroid dose estimates were based on individual thyroid activity measurements made shortly after the accident and dosimetric data from questionnaires obtained 10-15 years later at baseline screening. During baseline screening, thyroid gland volume was assessed from thyroid ultrasound measurements. The association between radiation dose and thyroid volume was modeled using linear regression where radiation dose was expressed with power terms to address non-linearity. The model was adjusted for attained age, sex, and place of residence, and their modifying effects were examined. RESULTS The analysis was based on 10,703 subjects. We found a statistically significant positive association between radiation dose and thyroid volume (P < 0.001). Heterogeneity of association was observed by attained age (P < 0.001) with statistically significant association remaining only in the subgroup of ≥18 years at screening (P < 0.001). For this group, increase in dose from 0.0005 to 0.15 Gy was associated with a 1.27 ml (95% CI: 0.46, 2.07) increase in thyroid volume. The estimated effect did not change with increasing doses above 0.15 Gy. CONCLUSIONS This is the first study to examine the association between 131I dose to the thyroid gland and thyroid volume in a population of individuals exposed during childhood and systematically screened 10-15 years later. It provides evidence for a moderate statistically significant increase in thyroid volume among those who were ≥ 18 years at screening. Given that this effect was observed at very low doses and was restricted to a narrow dose range, further studies are necessary to better understand the effect.
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Affiliation(s)
- Ekaterina Chirikova
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | | | - Patrick O'Kane
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Vasilina Yauseyenka
- Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Belarus
| | - Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Victor Minenko
- Institute for Nuclear Problems, Belarusian State University, Minsk, Belarus
| | - Vladimir Drozdovitch
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Ilya Veyalkin
- Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Belarus
| | - Maureen Hatch
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - June M Chan
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Chiung-Yu Huang
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Alexander Rozhko
- Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Belarus
| | - Lydia B Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
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Simon SL, Bouville A, Beck HL, Anspaugh LR, Thiessen KM, Hoffman FO, Shinkarev S. Dose Estimation for Exposure to Radioactive Fallout from Nuclear Detonations. Health Phys 2022; 122:1-20. [PMID: 34898514 PMCID: PMC8677604 DOI: 10.1097/hp.0000000000001501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
ABSTRACT In recent years, the prospects that a nuclear device might be detonated due to a regional or global political conflict, by violation of present nuclear weapons test ban agreements, or due to an act of terrorism, has increased. Thus, the need exists for a well conceptualized, well described, and internally consistent methodology for dose estimation that takes full advantage of the experience gained over the last 70 y in both measurement technology and dose assessment methodology. Here, the models, rationale, and data needed for a detailed state-of-the-art dose assessment for exposure to radioactive fallout from nuclear detonations discussed in five companion papers are summarized. These five papers present methods and data for estimating radionuclide deposition of fallout radionuclides, internal and external dose from the deposited fallout, and discussion of the uncertainties in the assessed doses. In addition, this paper includes a brief discussion of secondary issues related to assessments of radiation dose from fallout. The intention of this work is to provide a usable and consistent methodology for both prospective and retrospective assessments of exposure from radioactive fallout from a nuclear detonation.
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Affiliation(s)
- Steven L. Simon
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - André Bouville
- National Cancer Institute, National Institutes of Health, Bethesda, MD (retired)
| | | | - Lynn R. Anspaugh
- Department of Radiology, University of Utah (Emeritus), Henderson, NV
| | | | | | - Sergey Shinkarev
- State Research Center-Burnasyan Federal Medical Biophysical Center, Federal Medical Biological Agency, Moscow, Russian Federation
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Calabrese E. Linear Non-Threshold (LNT) historical discovery milestones. Med Lav 2022; 113:e2022033. [PMID: 36006093 PMCID: PMC9484288 DOI: 10.23749/mdl.v113i4.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 11/25/2022]
Abstract
The present paper provides a summarized identification of critical historical milestones in the discovery of the flawed and corrupt foundations of cancer risk assessment, with particular focus on the LNT Dose Response model. The milestone sequence presented herein is based on a large body of published findings by the author. The history of LNT and cancer response represents what may be the most significant case of scientific misconduct reported in the US, with its revelation severely damaging the scientific credibility and moral authority of leading US regulatory agencies and organizations such as the National Academy of Sciences (NAS) and the journal Science. The consequences of this corrupt history are substantial, affecting cancer risk assessment throughout the world, critical aspects of national economies, the development of critical technologies and public health practices.
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Lie RT. Invited Commentary: Ionizing Radiation and Future Reproductive Health-Old Cohorts Still Deserve Attention. Am J Epidemiol 2021; 190:2334-2336. [PMID: 34023897 DOI: 10.1093/aje/kwab156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 01/08/2023] Open
Abstract
Radiation from nuclear weapons or power plants has caused great concern among the public-concern that needs to be addressed with the best available data. Among the concerns associated with ionizing radiation are possible serious and far-reaching effects on reproductive health. Relevant data that can be used to address these concerns are scarce. The Hiroshima and Nagasaki bombings of World War II and the 1986 Chernobyl disaster in Ukraine are probably among the most dramatic and important sources of information on health effects, but much of the information is historical, and the exposed cohorts are getting old. In their accompanying article, Yamada et al. (Am J Epidemiol. 2021;190(11):2323-2333) revisit data on reproductive health outcomes in survivors of the Hiroshima and Nagasaki bombings during the years after the blasts. Exposure levels were very high, but after Yamada et al.'s reanalysis, effect estimates were low, and the evidence for overall effects on birth defects and perinatal mortality is still weak. The authors acknowledge that their data have limitations and that the generalizability of the findings is limited by the devastating conditions that prevailed in the 2 Japanese cities after the blasts.
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Andersson M, Eckerman K, Pawel D, Almén A, Mattsson S. IMPROVED AGE- AND GENDER-SPECIFIC RADIATION RISK MODELS APPLIED ON COHORTS OF SWEDISH PATIENTS. Radiat Prot Dosimetry 2021; 195:334-338. [PMID: 34056661 PMCID: PMC8507445 DOI: 10.1093/rpd/ncab075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/13/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
UNLABELLED The aim of this study is to implement lifetime attributable risk (LAR) predictions for radiation induced cancers for Swedish cohorts of patients of various age and sex, undergoing diagnostic investigations by nuclear medicine methods. METHODS Calculations are performed on Swedish groups of patients with Paget's disease and with bone metastases from prostatic cancer and diagnosed with bone scintigraphy with an administration of 500 MBq 99mTc-phosphonate. RESULTS The inclusion of patient survival rates into the calculations lowers the induced radiation cancer risk, as it takes into account that cohorts of patients have shorter predicted survival times than the general population. CONCLUSION LAR estimations could be valuable for referring physicians, nuclear medicine physicians, nurses, medical physicists, radiologists, and oncologists and as well as ethical committees for risk estimates for specific subgroups of patients. Caution is however advised with respect to application of LAR predictions to individuals (because of individual sensitivities, circumstances, etc.).
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Affiliation(s)
| | - Keith Eckerman
- Center for Radiation Protection Knowledge, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - David Pawel
- United States Environmental Protection Agency, Washington, DC, USA
| | - Anja Almén
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital, SUS, Malmö, Sweden
- Department of Radiation Protection, Swedish Radiation Safety Authority, Stockholm, Sweden
| | - Sören Mattsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital, SUS, Malmö, Sweden
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Walsh L, Shore R, Azizova TV, Rühm W. On the choice of methodology for evaluating dose-rate effects on radiation-related cancer risks. Radiat Environ Biophys 2021; 60:493-500. [PMID: 34170393 PMCID: PMC8310494 DOI: 10.1007/s00411-021-00920-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/17/2021] [Indexed: 05/06/2023]
Abstract
Recently, several compilations of individual radiation epidemiology study results have aimed to obtain direct evidence on the magnitudes of dose-rate effects on radiation-related cancer risks. These compilations have relied on meta-analyses of ratios of risks from low dose-rate studies and matched risks from the solid cancer Excess Relative Risk models fitted to the acutely exposed Japanese A-bomb cohort. The purpose here is to demonstrate how choices of methodology for evaluating dose-rate effects on radiation-related cancer risks may influence the results reported for dose-rate effects. The current analysis is intended to address methodological issues and does not imply that the authors recommend a particular value for the dose and dose-rate effectiveness factor. A set of 22 results from one recent published study has been adopted here as a test set of data for applying the many different methods described here, that nearly all produced highly consistent results. Some recently voiced concerns, involving the recalling of the well-known theoretical point-the ratio of two normal random variables has a theoretically unbounded variance-that could potentially cause issues, are shown to be unfounded when aimed at the published work cited and examined in detail here. In the calculation of dose-rate effects for radiation protection purposes, it is recommended that meta-estimators should retain the full epidemiological and dosimetric matching information between the risks from the individual low dose-rate studies and the acutely exposed A-bomb cohort and that a regression approach can be considered as a useful alternative to current approaches.
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Affiliation(s)
- Linda Walsh
- Department of Physics, Science Faculty, University of Zürich, Winterthurerstrasse 190, 8057 Zürich, Switzerland
| | - Roy Shore
- Department of Population Health, New York University Grossman School of Medicine, New York, USA
| | - Tamara V. Azizova
- Southern Urals Biophysics Institute, Ozyorskoe shosse 19, Ozyorsk, Chelyabinsk region 456780 Russia
| | - Werner Rühm
- Institute of Radiation Medicine, Helmholtz Zentrum München- German Research Center for Environmental Health, 85764 Neuherberg, Germany
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Little MP, Pawel DJ, Abalo K, Hauptmann M. Methodological improvements to meta-analysis of low dose rate studies and derivation of dose and dose-rate effectiveness factors. Radiat Environ Biophys 2021; 60:485-491. [PMID: 34218328 PMCID: PMC10656154 DOI: 10.1007/s00411-021-00921-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/19/2021] [Indexed: 06/13/2023]
Abstract
Epidemiological studies of cancer rates associated with external and internal exposure to ionizing radiation have been subject to extensive reviews by various scientific bodies. It has long been assumed that radiation-induced cancer risks at low doses or low-dose rates are lower (per unit dose) than those at higher doses and dose rates. Based on a mixture of experimental and epidemiologic evidence the International Commission on Radiological Protection recommended the use of a dose and dose-rate effectiveness factor for purposes of radiological protection to reduce solid cancer risks obtained from moderate-to-high acute dose studies (e.g. those derived from the Japanese atomic bomb survivors) when applied to low dose or low-dose rate exposures. In the last few years there have been a number of attempts at assessing the effect of extrapolation of dose rate via direct comparison of observed risks in low-dose rate occupational studies and appropriately age/sex-adjusted analyses of the Japanese atomic bomb survivors. The usual approach is to consider the ratio of the excess relative risks in the two studies, a measure of the inverse of the dose rate effectiveness factor. This can be estimated using standard meta-analysis with inverse weighting of ratios of relative risks using variances derived via the delta method. In this paper certain potential statistical problems in the ratio of estimated excess relative risks for low-dose rate studies to the excess relative risk in the Japanese atomic bomb survivors are discussed, specifically the absence of a well-defined mean and the theoretically unbounded variance of this ratio. A slightly different method of meta-analysis for estimating uncertainties of these ratios is proposed, motivated by Fieller's theorem, which leads to slightly different central estimates and confidence intervals for the dose rate effectiveness factor. However, given the uncertainties in the data, the differences in mean values and uncertainties from the dose rate effectiveness factor estimated using delta-method-based meta-analysis are not substantial, generally less than 70%.
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Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA.
| | - David J Pawel
- Office of Radiation and Indoor Air, Environmental Protection Agency, 1200 Pennsylvania Avenue, Washington, DC 20460, USA
| | - Kossi Abalo
- Laboratoire D'Épidémiologie, Institut de Radioprotection et de Sûreté Nucléaire, BP 17, 92262, Fontenay-aux-Roses Cedex, France
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Fehrbelliner Strasse 38, 16816, Neuruppin, Germany
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Calabrese EJ. LNT and cancer risk assessment: Its flawed foundations part 2: How unsound LNT science became accepted. Environ Res 2021; 197:111041. [PMID: 33794170 DOI: 10.1016/j.envres.2021.111041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
This paper argues that Edward B. Lewis served as a type of independent academic radiation LNT-cancer risk assessment-stalking horse for the BEAR Genetics Panel, a task for which he had no expertise or experience (e.g. radiation, leukemia, epidemiology and statistical modelling). His efforts produced an insufficiently documented, strongly biased, and high-profile paper in Science (May 17, 1957), whose principal conclusions had not been proven, he asserted privately, in writing. This inconclusive perspective was well camouflaged in the published paper by means of sophisticated wordsmithing. At the time his academic department head George Beadle came to chair the BEAR Genetics Panel in the summer of 1956, the Beadle-inspired-Lewis LNT activity acquired an urgency when a study of 70,000 offspring from survivors of the A-bombs failed to show genetic damage after a decade of careful study, undercutting Panel recommendations. With Beadle's guidance, the Lewis effort redirected the Panel's focus from the atomic bomb genetic damage study, which had acrimoniously disrupted Panel relationships and priorities, to more immediate disciplinary/professional opportunities with concerns about fallout, leukemia risks and a new cancer causation role for mutation. The serious limitations of the Lewis paper affected neither its publication in Science nor its receiving an editorial endorsement, possibly due to influence by powerful Panel members, such as Bentley Glass, one of only six senior editors for Science. The Science publication restored, even though improperly, the scientific and moral initiatives of the Panel and led directly to multiple high level LNT recommendations for cancer risk assessment based on the Precautionary Principle, which Lewis asserted, and which remains in place today in essentially all countries. The present paper explores how such a scientific long-shot and quasi-stalking horse, who was unsupported by BEAR Panel members during the withering criticism prompted by his Science article, nevertheless endured in the pursuit of his LNT goal, becoming strikingly successful in achieving a global cancer risk assessment revolution which remains in place.
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Affiliation(s)
- Edward J Calabrese
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, 01003, USA.
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Shonka JL. The Likelihood of Adverse Pregnancy Outcomes and Genetic Disease from the 1945 Trinity Atomic Bomb. Health Phys 2021; 120:683-686. [PMID: 33879648 DOI: 10.1097/hp.0000000000001422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Joseph L Shonka
- Shonka Research Associates, Inc., 119 Ridgemore Circle, Toccoa, GA 30577
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Bunevicius A, Pikis S, Schlesinger D, Sheehan J. Editorial: Radiosurgical induced malignancy associated with stereotactic radiosurgery. Acta Neurochir (Wien) 2021; 163:969-970. [PMID: 33404875 DOI: 10.1007/s00701-020-04667-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Adomas Bunevicius
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA
| | - Styllianos Pikis
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA
| | - David Schlesinger
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA
| | - Jason Sheehan
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA.
- Health Sciences Center, Box 800212, Charlottesville, VA, 22908, USA.
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Calabrese EJ. Ethical failings: The problematic history of cancer risk assessment. Environ Res 2021; 193:110582. [PMID: 33290793 DOI: 10.1016/j.envres.2020.110582] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
This paper demonstrates that unethical conduct by the US National Academy of Sciences (NAS) Biological Effects of Atomic Radiation (BEAR) I Genetics Panel led to their recommendation of the Linear Non-Threshold (LNT) Model for radiation risk assessment and its subsequent adoption by the US and the world community. The analysis, which is based largely on preserved communications of the US NAS Genetics Panel members, reveals that Panel members and their administrative leadership at the NAS displayed an integrated series of unethical actions designed to ensure, (1) the acceptance of the LNT and (2) funding to radiation geneticist panel members and professional colleagues. These findings are significant because major public policies in open democracies, such as cancer risk assessment and other issues impacted by public fears of radiation or chemical exposures, require ethical foundations. Recognition of these ethical failures of the BEAR I Genetics Panel should require a high level administrative, legislative and scientific reassessment of the scientific foundations of cancer risk assessment, with the likely result necessitating revision of current policies and practices. The BEAR I Genetics Panel, 1956 Science journal publication should immediately be retracted because it contains deliberate misrepresentations of the scientific record that were designed to manipulate scientific and public opinion on radiation risk assessment in a dishonest manner.
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Affiliation(s)
- Edward J Calabrese
- Department of Environmental Sciences, University of Massachusetts, Amherst, MA, 01003, USA.
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Chancellor J, Nowadly C, Williams J, Aunon-Chancellor S, Chesal M, Looper J, Newhauser W. Everything you wanted to know about space radiation but were afraid to ask. J Environ Sci Health C Toxicol Carcinog 2021; 39:113-128. [PMID: 33902392 DOI: 10.1080/26896583.2021.1897273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The space radiation environment is a complex combination of fast-moving ions derived from all atomic species found in the periodic table. The energy spectrum of each ion species varies widely but is prominently in the range of 400-600 MeV/n. The large dynamic range in ion energy is difficult to simulate in ground-based radiobiology experiments. Most ground-based irradiations with mono-energetic beams of a single one ion species are delivered at comparatively high dose rates. In some cases, sequences of such beams are delivered with various ion species and energies to crudely approximate the complex space radiation environment. This approximation may cause profound experimental bias in processes such as biologic repair of radiation damage, which are known to have strong temporal dependencies. It is possible that this experimental bias leads to an over-prediction of risks of radiation effects that have not been observed in the astronaut cohort. None of the primary health risks presumably attributed to space radiation exposure, such as radiation carcinogenesis, cardiovascular disease, cognitive deficits, etc., have been observed in astronaut or cosmonaut crews. This fundamentally and profoundly limits our understanding of the effects of GCR on humans and limits the development of effective radiation countermeasures.
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Affiliation(s)
- Jeffery Chancellor
- Department of Physics & Astronomy, Louisiana State University, Baton Rouge, Louisiana, USA
- Department of Preventive Medicine & Population Health, University of Texas Medical Branch, Galveston, Texas, USA
- Outer Space Insititute, Universit of British Columbia, CA
| | - Craig Nowadly
- Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
| | - Jacqueline Williams
- Departments of Environmental Medicine & Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA
| | - Serena Aunon-Chancellor
- Department of Preventive Medicine & Population Health, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Internal Medicine, LSU Health Science Center, Baton Rouge, Louisiana, USA
- Astronaut Office, NASA Johnson Space Center, Houston, Texas, USA
| | - Megan Chesal
- Department of Physics & Astronomy, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Jayme Looper
- Department of Veterinary Clinical Sciences, LSU School of Veterinary Medicine, Baton Rouge, Louisiana, USA
| | - Wayne Newhauser
- Department of Physics & Astronomy, Louisiana State University, Baton Rouge, Louisiana, USA
- Department of Physics, Mary Bird Perkins Cancer Center, Baton Rouge, Louisiana, USA
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45
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Chadwick KH. Low dose radiation risk: comment on the opinion article 'Interpretation of risk for low dose radiation exposures: inconsistences, philosophical problems and fallacies' by Walsh (2020). J Radiol Prot 2020; 40:1534-1538. [PMID: 33226010 DOI: 10.1088/1361-6498/abc17f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/15/2020] [Indexed: 06/11/2023]
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Abstract
The purpose of the ICRP detriment concept is to enable a quantitative comparison of stochastic radiation damage for the various organs. For this purpose, the organ-specific nominal risk coefficients are weighted with a function that is intended to express the amount of damage or, respectively, the severity of a disease. This function incorporates a variety of variables that do not depend on radiation parameters, but on characteristics of the disease itself. The question is raised as to whether the rather subtle way of defining the amount of damage is necessary for radiation protection purposes and whether a much simpler relationship can serve for this purpose as well or even better.
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Affiliation(s)
- Joachim Breckow
- Institute of Medical Physics and Radiation Protection (IMPS), University of Applied Sciences, THM, Giessen, Germany.
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47
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Huang EG, Wang RY, Xie L, Chang P, Yao G, Zhang B, Ham DW, Lin Y, Blakely EA, Sachs RK. Simulating galactic cosmic ray effects: Synergy modeling of murine tumor prevalence after exposure to two one-ion beams in rapid sequence. Life Sci Space Res (Amst) 2020; 25:107-118. [PMID: 32414484 DOI: 10.1016/j.lssr.2020.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/24/2019] [Accepted: 01/02/2020] [Indexed: 06/11/2023]
Abstract
Health risks from galactic cosmic rays (GCR) in space travel above low earth orbit remain a concern. For many years accelerator experiments investigating space radiation induced prevalence of murine Harderian gland (HG) tumorigenesis have been performed to help estimate GCR risks. Most studies used acute, relatively low fluence, exposures. Results on a broad spectrum of individual ions and linear energy transfers (LETs) have become available. However, in space, the crew are exposed simultaneously to many different GCR. Recent upgrades at the Brookhaven NASA Space Radiation Laboratory (NSRL) now allow mixtures in the form of different one-ion beams delivered in rapid sequence. This paper uses the results of three two-ion mixture experiments to illustrate conceptual, mathematical, computational, and statistical aspects of synergy analyses and also acts as an interim report on the mixture experiments' results. The results were interpreted using the following: (a) accumulated data from HG one-ion accelerator experiments; (b) incremental effect additivity synergy theory rather than simple effect additivity synergy theory; (c) parsimonious models for one-ion dose-effect relations; and (d), computer-implemented numerical methods encapsulated in freely available open source customized software. The main conclusions are the following. As yet, the murine HG tumorigenesis experimental studies show synergy in only one case out of three. Moreover, some theoretical arguments suggest GCR-simulating mixed beams are not likely to be synergistic. However, more studies relevant to possible synergy are needed by various groups that are studying various endpoints. Especially important is the possibility of synergy among high-LET radiations, since individual high-LET ions have large relative biological effectiveness for many endpoints. Selected terminology, symbols, and abbreviations. DER - dose-effect relation; E(d) - DER of a one-ion beam, where d is dose; HG prevalence p - in this paper, p is the number of mice with at least one Harderian gland tumor divided by the number of mice that are at risk of developing Harderian gland tumors (so that in this paper prevalence p can never, conceptually speaking, be greater than 1); IEA - incremental effect additivity synergy theory; synergy level - a specification, exemplified in Fig. 5, of how clear-cut an observed synergy is; mixmix principle - a consistency condition on a synergy theory which insures that the synergy theory treats mixtures of agent mixtures in a mathematically self-consistent way; NTE - non-targeted effect(s); NSNA - neither synergy nor antagonism; SEA - simple effect additivity synergy theory; TE - targeted effect(s); β* - ion speed relative to the speed of light, with 0 < β* < 1; SLI - swift light ion(s).
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Affiliation(s)
- Edward Greg Huang
- Department of Mathematics, University of California at Berkeley, United States
| | - Ren-Yi Wang
- Department of Mathematics, University of California at Berkeley, United States
| | - Liyang Xie
- Department of Mathematics, University of California at Berkeley, United States
| | - Polly Chang
- SRI International, Menlo Park, CA 94025, United States
| | - Gracie Yao
- Department of Statistics, University of California at Berkeley, United States
| | - Borong Zhang
- Department of Mathematics, University of California at Berkeley, United States
| | - Dae Woong Ham
- Department of Statistics, University of California at Berkeley, United States
| | - Yimin Lin
- Department of Mathematics, University of California at Berkeley, United States
| | | | - Rainer K Sachs
- Department of Mathematics, University of California at Berkeley, United States.
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Bulhosa VM, Funcke RPN, Brum T, Sanchez JS, Lima ZR, Vital HC, Prah M, Andrade ER. Solid cancer risk dependence on the Pasquill-Gifford atmospheric stability classes in a radiological event. Radiat Environ Biophys 2020; 59:337-342. [PMID: 32221699 DOI: 10.1007/s00411-020-00840-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 03/16/2020] [Indexed: 06/10/2023]
Abstract
In a radiological event, the lack of preliminary information about the site of explosion and the difficulty in predicting the accurate path and distribution of radioactive plumes makes it difficult to predict expected health effects of exposed individuals. So far, in such a health evaluation, radiation-induced stochastic health effects such as cancer are not included. The Pasquill-Gifford atmospheric classes generally allow connecting atmospheric stability with dispersion of radioactive contaminants to the environment. In this work, an environmental release of radioactive Cs-137 was simulated and the resulting relative risk for solid cancer incidence among the affected population calculated. The HotSpot health physics code was used to simulate the radioactive atmospheric dispersion and calculate the Total Effective Dose Equivalent (TEDE), which was then used to estimate the relative risk of cancer incidence. The main results from this work suggest that the relative cancer risk and atmospheric stability classes are linked by differences in the TEDE. Such a finding may support triage, because it adds additional information on the potentially affected population at the early stages of an emergency response.
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Affiliation(s)
| | | | - Tercio Brum
- Defense Engineering Graduate Program, Military Institute of Engineering (IME), Rio de Janeiro, Brazil
| | | | - Zelmo R Lima
- Institute of Nuclear Engineering (CNEN/IEN), Rio de Janeiro, Brazil
| | - Hélio C Vital
- Nuclear Defense Section, IDQBRN/CTEx, Rio de Janeiro, Brazil
| | - Matjaž Prah
- Department for Nuclear Power Plant, Croatian National Electric Utility-HEP D.D., Zagreb, Croatia
| | - Edson R Andrade
- Defense Engineering Graduate Program, Military Institute of Engineering (IME), Rio de Janeiro, Brazil.
- Graduate Program in Development and Environment (PRODEMA), Federal University of Paraiba, João Pessoa, Brazil.
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Park EJ, Lee H, Kim HC, Sheen SS, Koh SB, Park KS, Cho NH, Lee CM, Kang DR. Residential Radon Exposure and Cigarette Smoking in Association with Lung Cancer: A Matched Case-Control Study in Korea. Int J Environ Res Public Health 2020; 17:E2946. [PMID: 32344675 PMCID: PMC7215527 DOI: 10.3390/ijerph17082946] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/19/2022]
Abstract
Residential radon exposure and cigarette smoking are the two most important risk factors for lung cancer. The combined effects thereof were evaluated in a multi-center matched case-control study in South Korea. A total of 1038 participants were included, comprising 519 non-small cell lung cancer cases and 519 age- and sex- matched community-based controls. Residential radon levels were measured for all participants. Multivariate logistic regression was used to calculate odds ratios (OR) for lung cancer according to radon exposure (high ≥ 100 Bq/m3 vs. low < 100 Bq/m3), smoking status, and combinations of the two after adjusting for age, sex, indoor hours, and other housing information. The median age of the participants was 64 years, and 51.3% were women. The adjusted ORs (95% confidence intervals [CIs]) for high radon and cigarette smoking were 1.56 (1.03-2.37) and 2.53 (1.60-3.99), respectively. When stratified according to combinations of radon exposure and smoking status, the adjusted ORs (95% CIs) for lung cancer in high-radon non-smokers, low-radon smokers, and high-radon smokers were 1.40 (0.81-2.43), 2.42 (1.49-3.92), and 4.27 (2.14-8.52), respectively, with reference to low-radon non-smokers. Both residential radon and cigarette smoking were associated with increased odds for lung cancer, and the difference in ORs according to radon exposure was much greater in smokers than in non-smokers.
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Affiliation(s)
- Eung Joo Park
- Department of Precision Medicine & Biostatistics, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.L.); (H.C.K.)
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea; (H.L.); (H.C.K.)
- Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Seung Soo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon 16499, Korea;
| | - Sang Baek Koh
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Ki Soo Park
- Department of Preventive Medicine, School of Medicine, Gyeongsang National University, Jinju 52828, Korea;
| | - Nam Han Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon 16499, Korea;
| | - Cheol-Min Lee
- Department of Chemical and Biological Engineering, Seokyeong University, Seoul 02713, Korea;
| | - Dae Ryong Kang
- Department of Precision Medicine & Biostatistics, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
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Cahoon EK. Commentary: Breast cancer risk among women exposed to fallout after the Chernobyl accident. Int J Epidemiol 2020; 49:456-458. [PMID: 32215648 DOI: 10.1093/ije/dyaa038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 02/27/2020] [Indexed: 12/17/2022] Open
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