Minimum latency effects for cancer associated with exposures to radiation or other carcinogens.

Background: In estimating radiation-associated cancer risks a fixed period for the minimum latency is often assumed. Two empirical latency functions have been used to model latency, continuously increasing from 0. A stochastic biologically-based approach yields a still more plausible way of describing latency and can be directly estimated from clinical data.

Concepts of association between cancer and ionising radiation: accounting for specific biological mechanisms.

The probability that an observed cancer was caused by radiation exposure is usually estimated using cancer rates and risk models from radioepidemiological cohorts and is called assigned share (AS). This definition implicitly assumes that an ongoing carcinogenic process is unaffected by the studied radiation exposure. However, there is strong evidence that radiation can also accelerate an existing clonal development towards cancer.

Fluoroscopy X-Ray Organ-Specific Dosimetry System (FLUXOR) for Estimation of Organ Doses and Their Uncertainties in the Canadian Fluoroscopy Cohort Study.

As part of ongoing efforts to assess lifespan disease mortality and incidence in 63,715 patients from the Canadian Fluoroscopy Cohort Study (CFCS) who were treated for tuberculosis between 1930 and 1969, we developed a new FLUoroscopy X-ray ORgan-specific dosimetry system (FLUXOR) to estimate radiation doses to various organs and tissues. Approximately 45% of patients received medical procedures accompanied by fluoroscopy, including artificial pneumothorax (air in pleural cavity to collapse of lungs), pneumoperitoneum (air in peritoneal cavity), aspiration of fluid from pleural cavity and gastrointestinal series. In addition, patients received chest radiographs for purposes of diagnosis and monitoring of disease status.

Estimation of Heights and Body Masses of Tuberculosis Patients in the Canadian Fluoroscopy Cohort Study for Use in Individual Dosimetry.

This paper documents the estimation of mean heights and body masses, by age and sex, used in development of organ-specific dose conversion coefficients for external radiation for a historical cohort of about 64,000 patients from the Canadian Fluoroscopy Cohort Study. Patients were exposed to repeated fluoroscopy and chest radiography examinations in the course of treatment for tuberculosis in residential medical facilities throughout Canada between 1930 and 1969. Using Canadian national survey data and extensive literature review, mean heights and masses were obtained for the White population of Canada during the time period of interest, and the differences in mean body mass between tuberculosis patients and the general population were estimated.

ProZES: the methodology and software tool for assessment of assigned share of radiation in probability of cancer occurrence.

ProZES is a software tool for estimating the probability that a given cancer was caused by preceding exposure to ionising radiation. ProZES calculates this probability, the assigned share, for solid cancers and hematopoietic malignant diseases, in cases of exposures to low-LET radiation, and for lung cancer in cases of exposure to radon. User-specified inputs include birth year, sex, type of diagnosed cancer, age at diagnosis, radiation exposure history and characteristics, and smoking behaviour for lung cancer.

Organ Doses from Chest Radiographs in Tuberculosis Patients in Canada and Their Uncertainties in Periods from 1930 to 1969.

This paper describes a study to estimate absorbed doses to various organs from film-based chest radiographs and their uncertainties in the periods 1930 to 1948, 1949 to 1955, and 1956 to 1969. Estimated organ doses will be used in new analyses of risks of cancer and other diseases in tuberculosis patients in Canada who had chest fluoroscopic and radiographic examinations in those periods. In this paper, doses to lungs, female breast, active bone marrow, and heart from a single chest radiograph in adults and children of ages 1, 5, 10, and 15 y in the Canadian cohort and their uncertainties are estimated using (1) data on the tube voltage (kV), total filtration (mm Al), tube-current exposure-time product (mA s), and tube output (mR [mA s]) in each period; (2) assumptions about patient orientation, distance from the source to the skin of a patient, and film size; and (3) new calculations of sex- and age-specific organ dose conversion coefficients (organ doses per dose in air at skin entrance).

Organ-specific dose coefficients derived from Monte Carlo simulations for historical (1930s to 1960s) fluoroscopic and radiographic examinations of tuberculosis patients.

This work provides dose coefficients necessary to reconstruct doses used in epidemiological studies of tuberculosis patients treated from the 1930s through the 1960s, who were exposed to diagnostic imaging while undergoing treatment. We made use of averaged imaging parameters from measurement data, physician interviews, and available literature of the Canadian Fluoroscopy Cohort Study and, on occasion, from a similar study of tuberculosis patients from Massachusetts, United States, treated between 1925 and 1954. We used computational phantoms of the human anatomy and Monte Carlo radiation transport methods to compute dose coefficients that relate dose in air, at a point 20 cm away from the source, to absorbed dose in 58 organs.

Methods to account for uncertainties in exposure assessment in studies of environmental exposures.

Background: Accurate exposure estimation in environmental epidemiological studies is crucial for health risk assessment. Failure to account for uncertainties in exposure estimation could lead to biased results in exposure-response analyses. Assessment of the effects of uncertainties in exposure estimation on risk estimates received a lot of attention in radiation epidemiology and in several studies of diet and air pollution.

Probability Distribution of Dose and Dose-Rate Effectiveness Factor for use in Estimating Risks of Solid Cancers From Exposure to Low-Let Radiation.

This paper presents an analysis to develop a subjective state-of-knowledge probability distribution of a dose and dose-rate effectiveness factor for use in estimating risks of solid cancers from exposure to low linear energy transfer radiation (photons or electrons) whenever linear dose responses from acute and chronic exposure are assumed. A dose and dose-rate effectiveness factor represents an assumption that the risk of a solid cancer per Gy at low acute doses or low dose rates of low linear energy transfer radiation, RL, differs from the risk per Gy at higher acute doses, RH; RL is estimated as RH divided by a dose and dose-rate effectiveness factor, where RH is estimated from analyses of dose responses in Japanese atomic-bomb survivors. A probability distribution to represent uncertainty in a dose and dose-rate effectiveness factor for solid cancers was developed from analyses of epidemiologic data on risks of incidence or mortality from all solid cancers as a group or all cancers excluding leukemias, including (1) analyses of possible nonlinearities in dose responses in atomic-bomb survivors, which give estimates of a low-dose effectiveness factor, and (2) comparisons of risks in radiation workers or members of the public from chronic exposure to low linear energy transfer radiation at low dose rates with risks in atomic-bomb survivors, which give estimates of a dose-rate effectiveness factor.

Exposure to Recycled Uranium Contaminants in Gaseous Diffusion Plants.

As part of an ongoing study of health effects in a pooled cohort of gaseous diffusion plant workers, organ dose from internal exposure to uranium was evaluated. Due to the introduction of recycled uranium into the plants, there was also potential for exposure to radiologically significant levels of 99Tc, 237Np and 238,239Pu. In the evaluation of dose response, these radionuclide exposures could confound the effect of internal uranium.

Internal exposure to uranium in a pooled cohort of gaseous diffusion plant workers.

Intakes and absorbed organ doses were estimated for 29 303 workers employed at three former US gaseous diffusion plants as part of a study of cause-specific mortality and cancer incidence in uranium enrichment workers. Uranium urinalysis data (>600 000 urine samples) were available for 58 % of the pooled cohort. Facility records provided uranium gravimetric and radioactivity concentration data and allowed estimation of enrichment levels of uranium to which workers may have been exposed.

Method for analyzing left-censored bioassay data in large cohort studies.

In retrospective epidemiological studies of large cohorts of workers exposed to radioactive materials, it is often necessary to analyze large numbers of bioassay data sets containing censored values, or values recorded as less than a detection limit. Censored bioassay data create problems for all bioassay analysis methods, including analytical techniques based on least-squares regression to estimate intakes. A method is presented here that uses a simple empirically-derived equation for imputing replacement values for urine uranium concentration results reported as zero or less than a detection limit, that produces minimal bias in intakes estimated using least-square regression methods with the assumption of lognormally distributed measurement errors.

RadRAT: a radiation risk assessment tool for lifetime cancer risk projection.

Risk projection methods allow for timely assessment of the potential magnitude of radiation-related cancer risks following low-dose radiation exposures. The estimation of such risks directly through observational studies would generally require infeasibly large studies and long-term follow-up to achieve reasonable statistical power. We developed an online radiation risk assessment tool (RadRAT) which can be used to estimate the lifetime risk of radiation-related cancer with uncertainty intervals following a user-specified exposure history (https://irep.

Estimation of internal exposure to uranium with uncertainty from urinalysis data using the InDEP computer code.

The National Institute for Occupational Safety and Health (NIOSH) is currently studying mortality in a cohort of 6409 workers at a former uranium processing facility. As part of this study, over 220 000 urine samples were used to reconstruct organ doses due to internal exposure to uranium. Most of the available computational programs designed for analysis of bioassay data handle a single case at a time, and thus require a significant outlay of time and resources for the exposure assessment of a large cohort.

Beyond dose assessment: using risk with full disclosure of uncertainty in public and scientific communication.

Evaluations of radiation exposures of workers and the public traditionally focus on assessments of radiation dose, especially annual dose, without explicitly evaluating the health risk associated with those exposures, principally the risk of radiation-induced cancer. When dose is the endpoint of an assessment, opportunities to communicate the significance of exposures are limited to comparisons with dose criteria in regulations, doses due to natural background or medical x-rays, and doses above which a statistically significant increase of disease has been observed in epidemiologic studies. Risk assessment generally addresses the chance (probability) that specific diseases might be induced by past, present, or future exposure.

Projected lifetime cancer risks from exposure to regional radioactive fallout in the Marshall Islands.

Radioactive fallout from nuclear test detonations during 1946-1958 at Bikini and Enewetak Atolls in the Marshall Islands (MI) exposed populations living elsewhere in the MI archipelago. A comprehensive analysis, presented in seven companion papers, has produced estimates of tissue-specific radiation absorbed dose to MI residents at all historically inhabited atolls from internal (ingested) and external irradiation resulting from exposure to radioactive fallout, by calendar year, and by age of the population at time of exposure. The present report deals, for the first time, with the implications of these doses for cancer risk among exposed members of the MI population.

Interactive RadioEpidemiological Program (IREP): a web-based tool for estimating probability of causation/assigned share of radiogenic cancers.

The Interactive RadioEpidemiological Program (IREP) is a Web-based, interactive computer code that is used to estimate the probability that a given cancer in an individual was induced by given exposures to ionizing radiation. IREP was developed by a Working Group of the National Cancer Institute and Centers for Disease Control and Prevention, and was adopted and modified by the National Institute for Occupational Safety and Health (NIOSH) for use in adjudicating claims for compensation for cancer under the Energy Employees Occupational Illness Compensation Program Act of 2000. In this paper, the quantity calculated in IREP is referred to as "probability of causation/assigned share" (PC/AS).

The Hanford Thyroid Disease Study: an alternative view of the findings.

The Hanford Thyroid Disease Study (HTDS) is one of the largest and most complex epidemiologic studies of the relation between environmental exposures to I and thyroid disease. The study detected no dose-response relation using a 0.05 level for statistical significance.

Testing prediction capabilities of an 131I terrestrial transport model by using measurements collected at the Hanford nuclear facility.

A model describing transport of 131I in the environment was developed by SENES Oak Ridge, Inc., for assessment of radiation doses and excess lifetime risk from 131I atmospheric releases from Oak Ridge Reservation in Oak Ridge, Tennessee, and from Idaho National Engineering and Environmental Laboratory in southeast Idaho. This paper describes the results of an exercise designed to test the reliability of this model and to identify the main sources of uncertainty in doses and risks estimated by this model.

Uncertainties in dose coefficients from ingestion of 131I, 137Cs, and 90Sr.

Quantification of uncertainties in doses from intakes of radionuclides is important in risk assessments and epidemiologic studies of individuals exposed to radiation. In this study, the uncertainties in the doses per unit intake (i.e.