“Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2 (2006)

The National Academy Press - Open Book

Excerpts:

Cap. 8. “Occupational Radiation Studies”

“Since then (1940) numerous studies have considered the mortality and cancer incidence of
various ocupationally exposed groups, in medicine (radiologists and radiological technicians),
nuclear medicine, specialists (dentists and hygienists), industry (nuclear and radiochemical
industries, as well as other industries where industrial radiography is used to assess the
soundness of material and structures), defense, research, and even transportation (airline crews as
well as workers involved in the maintenance or operation of nuclear - powered vessels).

The type of ionizing radiation exposure varies among occupations, with differing contributions
from photons, neutrons, and alpha - and beta - particles.”

“Studies of populations with occupational radiation exposure are of relevance for radiation
protection in that most workers have received protracted (lasting for a long time) low - level
exposures ( a type of exposure of considerable importance for radiation protection of the public
and of workers).

Further, studies of some occupationally exposed groups, particularly in the nuclear industry, are
well suited for direct estimation of the effects of low doses and low - dose rates of ionizing
radiation (2000, Cardis and others), for the following reason:

• large numbers of workers have been employed in this industry since its beginning in
the early to mid 1940s (more than 1 million workers worlwide),
• These populations are relatively stable
• And by law, individual real - time monitoring of potentially exposed personnel has been
carried out in most countries with the use of personal dosimeters (at least for external higher -
energy exposures) and the measurements have been kept.

Many studies of mortality - and, in some instances, cancer incidence - among nuclear industry
workers have been carried out over the past 20 years. Published studies have covered workers in
Canada, Finland, France, India, Japan, Russia, Spain, the United Kingdom, and the United
States. Most have been cohort (group of people with a characteristic) studies.

In Canada, the study of the National Dose Registry (NDR) covered 206 620 workers, in the
industrial, medical, and dental fields, as well as nuclear power, followed for mortality through
1987 (Ashmore and others 1998) and cancer incidence through 1988 (Sont and others 2001).
About 25% of these were nuclear industry workers, but detalied results were not presented for
this group.
The average dose for the entire cohort is low (6.6 mSv). The avereage length of the follow up
was slightley less than 10 years in the incidence study, which covered a total of 191 333 person
years of follow up. A study of mortality in the subgroup of nuclear power industry have been
recently published, in 2004, included 45468 workers monitored for more than 1 year between
1957 - 1994. The average cummulative dose was 1.5 mSv. The average length of follow up was
13.4 years.

In high - dose studies, the majority of excess deaths from cancer have been demonstrated in
subject exposed at doses of at least 1 Sv. There were approximately 3000 such subjects among
atomic bomb survivors. Doses received by exmployees of nuclear industry facilities are
considerably lower.

In the Sellafield cohort, (Douglas and Others, 1994), in which the highest doses among the
nuclear industry worker studies have been reported, only 60 out of more that 10 000 individuals
monitored for external radiation exposure had received doses of 1 Sv or more. And these doses
were accumulated over the course of a working life. The mean cummulative radiation dose in the
three - country combined analyses was 40.2 mSv per worker and the collective dose was 3843 Sv
(IARC 1995).

Women comprises fewer than 15% of the workers, and their mean cummulative dose was low
(6.2 mSv) compared to that of men (46.0 mSv).
Overall, the distribution of doses was very skewed, almost, 60% of subjects had cummulative
doses less than 10mSv.

80% were less than 50 mSv, and less than 2% had greater than 400 mSv.

Results: In most of the nuclear industry workers studies, death rates among worker populations
were compared with national or regional rates. In most cases, rates for all causes, and all cancer
mortality in the workers were substantially lower than in the reference populations. Possible
explanations include: the healthy worker effect, and unknown differences between nuclear
industry workers, and the general population.

IN MOST STUDIES, ANALYSES OF MORTALITY IN RELATION TO CUMMULATIVE

EXTERNAL RADIATION DOSE, were conducted for many specific types of cancer. THESE
STUDIES HAVE GENERALLY NOT SHOWN SIGNIFICANT INCREASES IN RISK
AMONG EXPOSED WORKERS FOR MOST CANCER TYPE EXAMINED,

Although a few positive associations have been found.

Page 245.
“the above human data well illustrate the problems of limited statistical power, that surround
epidemiologically based conclusions on the shape of the low dose - response for radiation cancer
risk, and how it might vary between tumor types.

Many studies are broadly consistent with a linear no - threshold dose response,

But there are a number of examples of highly curvilinear , threshold like relationships.

It is abundantly clear, that direct epidemiologic and animal approaches to low dose cancer risk
are intrinsically limited in their capacity to define possible curvilinearity or dose thresholds for
risk in the range 0 -100 mSv.

RADIONUCLIES IN THE WORKING ENVIRONMENT

At uranium fuel production facilities, inhalation of airborne uranium dust, may represent an
important potential source of radiation exposure.

Workers at these facilities have 2 main possible sources of radiological exposure, to tissues, of
the whole body: external gamma - ray exposure, and internal depositions that deliver radiation
doses (mainly from alpha particles), primarily to the lung and lymphatic system.

If the uranium dust is soluble, exposure of other tissues may also occur, such as liver, kidney,
and bone, although organ doses would be expected to be small.

Low LET (linear energy transfer) radiation risk estimates for tumors in these organss are
possibly confounded by high LET radiation exposure for workers, at uranium production
facilities, since workers with a significant dose from internal contamination are often persons
with substantial external exposure.

Comparison of findings among uranium - processing facilities is complicated by the fact that
processes and historical periods of operation have differed among facilties, leading to differences
in exposure conditions, and follow up among cohorts.

further, assessment of past internal uranium exposure of nuclear workers, is complicated by the
methodological difficulties of internal dosimetry, as well by inadequate historical information,
with to which to quantify internal radiation doses accurately.

These exposure measurement problems pose significant difficulties for epidemiology.

It is an inability to classify workers accurately by level of internal radiation exposure which

may lead to confounding the analyses of association between external low LET radiation dose
and cancer risk.
asadar, ipotezele care stau la baza elaborarii ordinului CNCAN nr. 40 / 1990 nu sunt adevarate,
sunt contrazise de toate studiile mai sus mentionatel deci acest ordin este fondat pe niste ipoteze
stiintifice nereale.