The acute radiation syndrome-need for updated medical guidelines.

The major immediate and severe medical consequences in man following exposure to high doses of ionising radiation can be summarised within the concept of the acute radiation syndrome (ARS). In a dose-dependent fashion, a multitude of organ systems can be affected by such irradiation, presenting considerable medical challenges to treating physicians. Accidents or malevolent events leading to ARS can provoke devastating effects, but they occur at a low frequency and in a highly varying manner and magnitude. Thus, it is difficult to make precise medical predictions and planning, or to draw conclusive evidence from occurred events. Therefore, knowledge from on-going continuous developments within related medical areas needs to be acknowledged and incorporated into the ARS setting, enabling the creation of evidence-based guidelines. In 2011 the World Health Organization published a first global consensus on the medical management of ARS among patients subjected to nontherapeutic radiation. During the recent decade the understanding of and capability to counteract organ damage related to radiation and other agents have improved considerably. Furthermore, legal and logistic hurdles in the process of formally approving appropriate medical countermeasures have been reduced. We believe the time is now ripe for developing an update of internationally consented medical guidelines on ARS.

Mental health and psychosocial consequences linked to radiation emergencies-increasingly recognised concerns.

A major radiological or nuclear emergency may, apart from causing a substantial loss of life and physical damage, also put a substantial strain on affected societies with social, economic and political consequences. Although such emergencies are relatively uncommon, it is now being increasingly recognised that their subsequent psychosocial impact can be widespread and long lasting. Mental health effects, such as depression, anxiety and post-traumatic stress disorder, are highly represented in a population affected by a radiation disaster. In order to reach the majority of the people affected by radiation accidents, we need to be aware of how to distribute relevant and accurate information related to both short- and long-term medical effects. Effective risk communication is associated with improved compliance with any given recommendations. It is important to protect the public from physical radiation damage, but it is also essential to take into account the social and mental health effects that radiation disasters may induce. This article provides a brief review of recent reporting on the psychological consequences after a major radiation emergency.

Humans and ecosystems over the coming millennia: overview of a biosphere assessment of radioactive waste disposal in Sweden.

This is an overview of the strategy used to describe the effects of a potential release from a radioactive waste repository on human exposure and future environments. It introduces a special issue of AMBIO, in which 13 articles show ways of understanding and characterizing the future. The study relies mainly on research performed in the context of a recent safety report concerning a repository for spent nuclear fuel in Sweden (the so-called SR-Site project). The development of a good understanding of on-site processes and acquisition of site-specific data facilitated the development of new approaches for assessment of surface ecosystems. A systematic and scientifically coherent methodology utilizes the understanding of the current spatial and temporal dynamics as an analog for future conditions. We conclude that future ecosystem can be inferred from a few variables and that this multidisciplinary approach is relevant in a much wider context than radioactive waste.

Land use and food intake of future inhabitants: outlining a representative individual of the most exposed group for dose assessment.

The radiation doses to humans resulting from a potential release of radionuclides from a geological repository for long-lived waste are assessed over tens or even hundreds of thousands of years. Ingestion is expected to be the major exposure pathway, and the group with the highest exposures will be those that consume the most contaminated food. In this paper, we characterize the group of individuals with the highest exposures by considering the physical and biological characteristics of the contaminated area and human requirements for energy and nutrients. We then calculate intake rates based on land-use scenarios drawn from self-sustained communities spanning prehistoric times to an industrial-age agrarian culture. The approach is illustrated by simulating groundwater release of four radionuclides to an expected discharge area. We argue that the derived intake rates may serve as credible bounding cases when projected doses are evaluated for compliance with regulatory criteria.

A history of the international commission on radiological protection.

Within twelve months of the discovery of x rays, papers appeared in the literature reporting adverse effects from high exposure. By the time of the First World War, several countries were proposing restrictions for the exposure of radiation workers. In 1925, the first International Congress of Radiology, held in London, considered the need for a protection committee, which it established at its second Congress in Stockholm in 1928. This paper traces the history of the development, by ICRP, of its policies and the personalities involved in their development from its inception up to the modern era. The paper follows the progress from the early controls on worker doses to avoid deterministic effects, through the identification of stochastic effects to the concerns about increasing public exposure. The key features of the Recommendations made by ICRP from 1928 up to the current 1990 version are identified.

A history of the international commission on radiological protection.

Within twelve months of the discovery of x rays, papers appeared in the literature reporting adverse effects from high exposure. By the time of the First World War, several countries were proposing restrictions for the exposure of radiation workers. In 1925, the first International Congress of Radiology, held in London, considered the need for a protection committee, which it established at its second Congress in Stockholm in 1928. This paper traces the history of the development, by ICRP, of its policies and the personalities involved in their development from its inception up to the modern era. The paper follows the progress from the early controls on worker doses to avoid deterministic effects, through the identification of stochastic effects to the concerns about increasing public exposure. The key features of the Recommendations made by ICRP from 1928 up to the current 1990 version are identified.

A biosphere assessment of high-level radioactive waste disposal in Sweden.

Licence applications to build a repository for the disposal of Swedish spent nuclear fuel have been lodged, underpinned by myriad reports and several broader reviews. This paper sketches out the technical and administrative aspects and highlights a recent review of the biosphere effects of a potential release from the repository. A comprehensive database and an understanding of major fluxes and pools of water and organic matter in the landscape let one envisage the future by looking at older parts of the site. Thus, today's biosphere is used as a natural analogue of possible future landscapes. It is concluded that the planned repository can meet the safety criteria and will have no detectable radiological impact on plants and animals. This paper also briefly describes biosphere work undertaken after the review. The multidisciplinary approach used is relevant in a much wider context and may prove beneficial across many environmental contexts.

ICRP publication 109. Application of the Commission's Recommendations for the protection of people in emergency exposure situations.

This report was prepared to provide advice on the application of the Commission's 2007 Recommendations. The advice includes the preparedness for, and response to, all radiation emergency exposure situations defined as: 'situations that may occur during the operation of a planned situation, or from a malicious act, or from any other unexpected situation and require urgent action in order to avoid or reduce undesirable consequences'. An emergency exposure situation may evolve, in time, into an existing exposure situation. The Commission's advice for these types of situation is published in two complementary documents (that for emergency exposure situations in this report, that for existing exposure situations following emergency exposure situations in a forthcoming report entitled 'Application of the Commission's recommendations to the protection of individuals living in long-term contaminated territories after a nuclear accident or a radiation emergency'). The Commission's 2007 Recommendations re-state its principles of justification and optimisation, and the requirement to protect against severe deterministic injury, as applying to emergency exposure situations. For the purpose of protection, reference levels for emergency exposure situations should be set in the band of 20-100 mSv effective dose (acute or per year). The reference level represents the level of residual dose or risk above which it is generally judged to be inappropriate to plan to allow exposures to occur. The Commission considers that a dose rising towards 100 mSv will almost always justify protective measures. Protection against all exposures, above or below the reference level, should be optimised. More complete protection is offered by simultaneously considering all exposure pathways and all relevant protection options when deciding on the optimum course of action in the context of an overall protection strategy. Such an overall protection strategy must be justified, resulting in more good than harm. In order to optimise an overall strategy, it is necessary to identify the dominant exposure pathways, the time scales over which components of the dose will be received, and the potential effectiveness of individual protective options. If, in application of an overall protection strategy, protection measures do not achieve their planned residual dose objectives, or worse, result in exposures exceeding reference levels defined at the planning stage, a re-assessment of the situation is warranted. In planning and in the event of an emergency, decisions to terminate protective measures should have due regard for the appropriate reference level. The change from an emergency exposure situation to an existing exposure situation will be based on a decision by the authority responsible for the overall response. This transition may happen at any time during an emergency exposure situation, and may take place at different geographical locations at different times. The transfer should be undertaken in a co-ordinated and fully transparent manner, and should be understood by all parties involved.

Forty years on: how radiological protection has evolved internationally.

In the 40 years since the Society for Radiological Protection (SRP) was founded, the international scene has changed considerably. The United Nations bodies primarily involved, the United Nations Scientific Committee on the Effects of Atomic Radiation and the International Atomic Energy Agency, have evolved from fledgling organisations to indispensable major resources. A similar development characterises regional entities such as Euratom and the OECD Nuclear Energy Agency. The International Commission on Radiological Protection (ICRP), once interested in occupational health in the practice of medicine only, has shifted its emphasis towards protection of members of the public and of patients exposed to ionising radiations and is currently looking at protection of non-human species. The International Radiation Protection Association, the federation that is now the 'mother society' of the SRP, had not even been launched formally when the SRP started. At that time, non-ionising radiation was on nobody's mind, and the forerunner of today's International Commission on Non-Ionizing Radiation Protection (ICNIRP) was not formed until 1977. Basically, the developments during this period must be described as a great success story. Average occupational exposures to ionising radiation have decreased markedly, the number of accidents is small, almost all countries now regulate exposures roughly in line with ICRP and ICNIRP recommendations, and quite a large number of countries also have reasonable regulatory infrastructures. An area where problems appear to be on the increase, perhaps in part because of increasing awareness, concerns 'orphan sources' and lack of source security. This may indicate a need for closer attention to security outside the nuclear fuel cycle, e.g. in hospitals and non-nuclear industry.