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Ionizing radiation: Radiation protection standards need to be improved

ionizing radiation

Translated by Hervé Courtois

Doctors and scientists are warning about the health risks of ionizing radiation.

Even small doses of about 1 millisievert (mSv) increase the risk of developing radiation-induced diseases.

There is no threshold below which radiation could be considered harmless.

Summary of a meeting of experts in Ulm (Germany) on 19 October 2013

On 19 October 2013, the German and Swiss members of the International Physicians for the Prevention of Nuclear War (IPPNW) invited doctors and scientists in the fields of radiobiology, epidemiology , statistics and physics at a meeting of experts in Ulm, Einstein’s hometown. Participants discussed current knowledge about the health effects of ionizing radiation, especially in the field of low doses.

The panel concluded that a revision of current radiation protection standards is essential to reflect the current level of scientific knowledge. Ionizing radiation is capable of causing detrimental effects on health; Some can be predicted and quantified through the use of epidemiological models.

In the past, the identification of the health risks of ionizing radiation was based on studies of survivors of the Hiroshima and Nagasaki bombings. This reference group can no longer be considered appropriate in the light of the new statistical evidence. Even very low doses of radiation are likely to cause disease.

Here are the conclusions of the Ulm Symposium:

1. Even background natural radiation has detrimental effects that are measurable;

2. The use of radiation for medical diagnosis has measurable adverse health effects;

3. The use of nuclear energy and nuclear weapons tests have measurable adverse health effects;

4. The use of the collective dose concept in epidemiological studies can reliably predict and quantify the health risks of low radiation doses.

5- The use by the ICRP of basing the risk factors for low doses of radiation on the examination of Hiroshima and Nagasaki survivors should be considered outdated.

6. Improved radiation protection based on the notion of risk is necessary. It must be combined with the rigorous application of the minimization requirement of radiation exposure.

1. Even natural radiation has measurable adverse health effects.

Even low doses of natural radiation (terrestrial and cosmic radiation, inhaled radon and ingestion of natural radioisotopes) have adverse health effects that can be measured by epidemiological studies. It is therefore a deception to assert that exposure to radiation can be considered safe as long as it is at the level of the doses of “natural” background radiation. 1-17

2. The use of radiation for medical diagnosis has adverse health effects that are measurable

It has been shown that conventional CT scans and radiological examinations cause an increase in cancer cases (mainly breast cancer, leukemia, thyroid cancer and brain tumors). The risk is greater in children and adolescents than in adults and the embryo is the most vulnerable of all. 18-40

Limiting the use of diagnostic rays and the use of nuclear medicine to cases of absolute necessity is urgently recommended.It would be necessary to adhere to strict rules for the use of scanners and to use only CT scanners [Computed tomography = scanners called scanners -ndt] with low radiation emission. Whenever possible ultrasound and magnetic resonance imaging should be preferred.

Some population groups have an increased risk of developing cancer due to exposure to radiation, for example women who have a genetic predisposition to breast cancer. Therefore, it is recommended that women with such a risk not be included in X-ray screening. 41-45

3. The use of nuclear energy and nuclear weapons tests have measurable adverse health effects

Due to the use of nuclear weapons (over 2,000 tests) and serious nuclear accidents, large quantities of radionuclides have been released and widely dispersed; They expose a large part of the world’s population to increased exposure to radiation. The epidemiological studies carried out in the populations concerned, around the Nevada and Semipalatinsk nuclear weapons test sites and in the areas affected by the Chernobyl and Fukushima disasters show an increase in morbidity and mortality. 46-54

Even the routine operations of nuclear power plants have adverse effects on the health of the surrounding population. Depending on the distance, an increase in cases of leukemia and other types of cancer has been observed in children under 5 years of age in the nuclear power plant environment. (Currently, the strongest evidence is in Germany, with concordant results in studies in Switzerland, France and the United Kingdom.) 55-59

In workers exposed to ionizing radiations, there is a significant increase in cancer cases compared with the other groups even though the official limit dose has not been exceeded.

The health of their children is more impaired than that of other children. 60-64

Among employees of uranium mining companies and atomic weapons production sites, there is an increase in chronic lymphocytic leukemia. 65-68

Leukemias and many other types of cancers have been caused by low doses of ionizing radiation, in areas with increased background radiation due to nuclear weapons tests, nuclear accidents, or medical diagnostic examinations and occupational exposure. 69-92

Following exposure to low doses of radioactive iodine, thyroid diseases including cancers have been observed in children, adolescents and adults. 93-99

In addition, low doses of ionizing radiation cause serious non-malignant diseases such as meningiomas and other benign tumors, cardiac, cerebrovascular, respiratory, gastrointestinal and endocrine diseases or dysfunctions; And also psychiatric disorders and cataracts.100-113

Studies have shown that in utero and in children, brain exposure to ionizing radiation causes a decrease in cognitive development. Possible sources of radiation include, but are not limited to, diagnostic X-rays, radiotherapy and exposure to radiation due to nuclear accidents. 114-116

As a result of the nuclear accidents, teratogenic effects have been observed in both animals and humans, even in those exposed to low levels of radiation. 117-120

Some genetic effects can already be observed in the first generation of offsprings, others only appear in later generations. Late affections may be difficult to confirm.

Numerous studies have been carried out in the “dead zones” of Chernobyl and Fukushima on animals whose generations succeed one another rapidly; they showed severe genetic abnormalities related to the level of radiation in their habitat.

In humans, such abnormalities have been observed for a long time following exposure to low doses.

Transgenerational effects of radiation, that is to say genetically fixed, have often been documented, for example, in the children of the Chernobyl liquidators. 121-128. Many other studies also suggest that ionizing radiation causes long-term genetic or epigenetic damage. 129-146

4.The use of the concept of collective dose in epidemiological studies can reliably predict and quantify the health risks of low doses of radiation.

The concept of collective dose is, in the current state of knowledge, the surest way to quantitatively evaluate the stochastic risks of radiation. Significant new clinical studies confirm the linear no-threshold model; this model establishes that there is no threshold below which radiation would have no effect on health. 147,148

Using the concept of collective dose that takes into account current scientific studies, the following risk factors (excess absolute risk, EAR) should be applied:

A risk factor of 0.2 / Sv should be used to predict cancer mortality and 0.4 / Sv to predict the incidence of cancer. 149-151

The United Nations Scientific Committee for the Effects of Atomic Radiation (UNSCEAR) and the International Commission on Radiological Protection (ICRP) still use low risk factors of 0.05 / Sv for cancer mortality and 0.1 / Sv for the incidence of cancers. However, in its 2013 assessment of health risks in Fukushima, the World Health Organization (WHO) recognized that ICRP risk factors should be doubled. 152

The above risk factors apply to an exposed population whose ages have a standard distribution. However, according to the ICRP, the sensitivity to ionizing radiation of young children (less than 10 years) and fetuses is three times higher than that of adults. 153-155

Risk factors for the prediction of the incidence and mortality of non-malignant diseases (non-cancerous diseases), especially cardiovascular diseases, are of the same order as those of malignant diseases. 156-157

It would be desirable for WHO and national radiation protection institutions to adopt the risk factors mentioned above as a basis for risk assessment after nuclear accidents.

5. The use by the ICRP of studies on Hiroshima and Nagasaki survivors as a basis for determining the risks of low radiation doses should be considered an outdated practice.

In their studies, institutions such as the ICRP used as reference the survivors of the atomic bombings of Hiroshima and Nagasaki for the prediction of the effects of radiation.

Risk prediction on this basis is not transferable to other populations exposed over a long period of time to increasing levels of radiation, for the following reasons:

The Japanese survivors were briefly exposed to high energy penetrating gamma radiation.

Radiobiological investigations have shown that such exposure is less harmful to tissues than an internal alpha or Beta irradiation following the incorporation of radionuclides.

The same applies to long-term exposure to x-rays or Gamma rays from natural or artificial sources at levels comparable to normal background radiation. 158-159

The radiation delivered by the nuclear bombs has an extremely high dose level.

Previously, it was accepted that the mutagenicity would therefore be higher in this case than for low doses. Currently, the ICRP claims that this assertion always holds and divides in its calculations the risk of developing cancers by a factor of 2.

Studies on occupationally exposed cohorts of workers contradict this assertion and WHO sees no justification for dividing this risk factor into two. 160-161

Radiation doses received due to radioactive fallout and neutron activation have not been taken into account by the Radiation Effects Research Foundation (RERF), despite the fact that they have caused significant effects on the survivors of Hiroshima And Nagasaki. The actual effects of radiation have therefore been underestimated. 162

Because the RERF only began its work in 1950, there is a lack of important data on the first five years after the nuclear bombing. It should be recognized, therefore, that the assessment of teratogenic and genetic effects, as well as those of cancers with a short latency period, is incomplete.

Because of the catastrophic situation after the bombing of Hiroshima and Nagasaki, we must admit to considering the survivors as a selected cohort of specially resistant people (“the survival of the fittest”). Therefore, these studies were not representative of a normal population. This selection bias caused an underestimation of about 30% of the radiation risk. 163

The survivors of the nuclear bombing were ostracized by the Japanese society. It is very likely that information about the origin of the family or the morbidity of the descendants has been hidden or falsified so as not to endanger, for example the chances of marriage and the social integration of children. 164

Editor’s Note:

Risk factors used in the concept of collective dose describe the likelihood that additional cases of disease, higher than rates of spontaneous cancers, occur, that carcinogenesis caused by radiation, cancer incidence or mortality, Increase above the baseline of a given population.

Usually this Excess Absolute Risk (EAR) is represented by unit 1 / Sv. A risk factor (EAR) of 0.2 / Sv for cancer mortality means that a 1Sv irradiation would cause an additional 20% risk of cancer death – in addition to the 25% base risk. An EAR of 0.2 / Sv corresponds to a relative risk excess (ERR) of 0.2 / 0.25 = 0.8 / Sv.

6. Improved radiation protection based on the notion of risk is necessary. It must be combined with the rigorous application of the minimization requirement of radiation exposure.

Determining the level of radiation health risk that is acceptable and reasonable can only be achieved at the societal level by listening to the voices of those involved. To protect populations, the risks of ionizing radiation should be determined as accurately as possible and presented in a comprehensible manner. In medicine, such radiation protection criteria are already becoming more and more important.

Assessing the dangers of ionizing radiation according to a risk-based concept can help to minimize their adverse effects even at low doses. Associated with the legal minimization requirements, a set of concrete measures using such a concept could serve to further reduce the harmful effects of radiation. The concept of risk acceptability for carcinogenic materials at work already existing in German legislation is, in broad outline, a good example to follow. 165-169

The highest priority should be given to the protection of life before birth and the integrity of future generations. Radiation protection must broaden its adult-based models and adapt them to the particular vulnerability of the embryo and children.

Speakers and participants in the Ulm expert meeting,
19 October 2013:

» » Prof. Dr. med. Wolfgang Hoffmann, MPH, Professor für
bevölkerungsbezogene Versorgungsepidemiologie und
Community Health, Institut für Community Medicine,
Universitätsmedizin in Greifswald

» » Dr. rer. nat. Alfred Körblein, Dipl. Phys., selbstständiger
Wissenschaftler in Nürnberg, Wissenschaftlicher Beirat

» » Prof. Dr. med. Dr. h.c. Edmund Lengfelder, Professor
em. des Strahlenbiologisches Institutes an der Medizini-
schen Fakultät der LMU München, Leiter des Otto Hug
Strahleninstitutes für Gesundheit und Umwelt

» » Dr. rer. nat. Hagen Scherb, Dipl. Math., Helmholtz Zen-
trum, Deutsches Forschungszentrum für Gesundheit und
Umwelt in München

» » Prof. Dr. rer. nat. Inge Schmitz-Feuerhake, Professorin
em. für experimentelle Physik an der Universität in Bre-
men, Wissenschaftlicher Beirat der

» » Dr. med. Hartmut Heinz, Facharzt für Arbeitsmedizin,
ehem. leitender Werksarzt in Salzgitter, AK Atomenergie

» » Dr. med. Angelika Claußen, Fachärztin für Psychothe-
rapie in Bielefeld, AK Atomenergie der

» » Dr. med. Winfrid Eisenberg, ehem. Chefarzt der Kin-
derklinik in Herford, AK Atomenergie der

» » Dr. med. Claudio Knüsli, Leitender Arzt der Onkologie
im St. Claraspital in Basel, Vorstandsmitglied

» » Dr. med. Helmut Lohrer, Facharzt für Allgemeinmedizin
in Villingen, Int. Board der IPPNW, International Councillor

» » Henrik Paulitz, Dipl.-Biol., Atomenergie-Referent der in Seeheim

» » Dr. med. Alex Rosen, Kinderarzt in Berlin, Stellv. Vorsit-
zender der

» » Dr. med. Jörg Schmid, Facharzt für Psychotherapie in
Stuttgart, AK Atomenergie der

» » Reinhold Thiel, Facharzt für Allgemeinmedizin, Ulmer
Ärzteinitiative, AK Atomenergie der

I add a reference: Risk of cancer in 680,000 people exposed to CT scans in childhood or adolescence: a study linking data from 11 million Australians

What is IPPNW?

International Physicians for the Prevention of Nuclear War, IPPNW), is a pacifist international organization of doctors committed to nuclear disarmament. Established in 1980, the organization was awarded the Unesco Prize for Peace Education in 1984 and the Nobel Peace Prize in 1985 for its “important and competent information work”, which improved global awareness of the consequences of a nuclear war and acute radiation syndrome. The organization has close to 150,000 members in more than 50 countries.

The IPPNW website:


The text is complemented by a long list of references to download here

August 21, 2017 - Posted by | radiation | , ,

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