Comparison of lifetime mortality risk, incidence risk, and DALYs of baseline cancer rates among countries as a benchmark for radiation-related cancer risk.

Statistical benchmark data are necessary when considering the basis for radiation protection criteria based on calculated risks. We herein focused on baseline mortality and incidence cancer rates as benchmark data collected from 33 countries. Furthermore, we calculated the lifetime mortality and incidence risks and disability-adjusted life years (DALYs) for all solid cancers, colon cancer, lung cancer, breast cancer, thyroid cancer, and leukemia using the baseline cancer rates and compared them among the countries. The results showed that the lifetime mortality and incidence risks and DALYs for all solid cancers differed among the countries by a factor of 2-4 for males and 2-3 for females; these were low in less-developed countries. Our study proposed that health risk based on baseline cancer rates should be the benchmark for comparing radiation cancer risks.

Temporal changes in cumulative mortality risks of cancer, by occupation, in the working population of Japan from 1995 to 2020: a benchmark for radiation risk comparison.

The purpose of this study was to provide benchmark data for discussing the tolerability of cancer risk associated with occupational radiation exposure. It focused on differences in cancer mortality risk by occupation among Japan's working population and examined baseline cancer mortality risks and its variations from 1995 through 2020. Data were collected every five years from national vital statistics sources. By focusing on the same types of cancer among radiation induced effects, cumulative mortality risks were calculated for colorectal, lung, and breast cancer (females only) for those aged 15-74. The average cumulative mortality risk for the working population in Japan has decreased by 30%-60% over the past 25 years. Service workers and male managers were at an average risk, among all workers, while clerical workers and transportation and manufacturing workers had about half the average risk. The risks were higher for professionals and female managers, about 1.5-2 times the average for professionals and up to 5 times the average for female managers. The decrease in the average cancer mortality risk in the working population as a baseline suggests that risk tolerance in society might have changed over time. Since differences in mortality by occupation were confirmed, the usefulness of occupational data as a benchmark needs further investigation, as high-risk/low-risk occupations vary by country and region. The results of this study contribute to put radiation risks into perspective with the background risk of cancer.

The ICRP, MELODI, and ALLIANCE workshop on effects of ionizing radiation exposure in offspring and next generations: a summary of discussions.

PURPOSE: Task Group 121 - Effects of ionizing radiation exposure in offspring and next generations - is a task group under the Committee 1 of the International Commission on Radiological Protection (ICRP), approved by the Main Commission on 18th November 2021. The main goals of Task Group 121 are to (1) review and update the scientific literature of relevance to radiation-related effects in the offspring of parent(s) exposed to ionizing radiation in both human and non-human biota; (2) to assess preconceptional and intrauterine effects of radiation exposure and related morbidity and mortality; and, (3) to provide advice about the level of evidence and how to consider these preconceptional and postconceptional effects in the system of radiological protection for humans and non-human biota. METHODS: The Task Group is reviewing relevant literature since Publication 90 'Biological effects after prenatal irradiation (embryo and fetus)' (2003) and will include radiation-related effects on future generations in humans, animals, and plants. This review will be conducted to account for the health effects on offspring and subsequent generations in the current system of radiological protection. Radiation detriment calculation will also be reviewed. Finally, preliminary recommendations will be made to update the integration of health effects in offspring and next generations in the system of radiological protection. RESULTS: A Workshop, jointly organized by ICRP Task Group 121 and European Radiation Protection Research Platforms MELODI and ALLIANCE was held in Budapest, Hungary, from 31st May to 2nd June 2022. Participants discussed four important topics: (1) hereditary and epigenetic effects due to exposure of the germ cell line (preconceptional exposure), (2) effects arising from exposure of the embryo and fetus (intrauterine exposure), (3) transgenerational effects on biota, and (4) its potential impact on the system of radiological protection. CONCLUSIONS: Based on the discussions and presentations during the breakout sessions, newer publications, and gaps on the current scientific literature were identified. For instance, there are some ongoing systematic reviews and radiation epidemiology reviews of intrauterine effects. There are newer methods of Monte Carlo simulation for fetal dosimetry, and advances in radiation genetics, epigenetics, and radiobiology studies. While the current impact of hereditary effects on the global detriment was reported as small, the questions surrounding the effects of radiation exposure on offspring and the next generation are crucial, recurring, and with a major focus on exposed populations. This article summarizes the workshop discussions, presentations, and conclusions of each topic and introduces the special issue of the International Journal of Radiation Biology resulting from the discussions of the meeting.

Resilience after a nuclear accident: readiness in using mobile phone applications to measure radiation and health indicators in various groups (SHAMISEN SINGS project).

An anonymous web-based survey was developed to check different aspects (SHAMISEN SINGS project): stakeholder awareness and perceptions of available mobile applications (apps) for measuring ionising radiation doses and health/well-being indicators; whether they would be ready to use them in the post-accidental recovery; and what are their preferred methodologies to acquire information etc. The results show that participation of the citizens would be most beneficial during post-accident recovery, providing individual measurements of external ionizing dose and health/well-being parameters, with possible follow-up. Also, participants indicated different preferences for sources to gain knowledge on ionising radiation and for the functions that an ideal app should have. The level of awareness and readiness to use apps to measure ionising radiation dose depended on two main aspects: individual differences (age & gender) and whether people were from countries affected by the previous major accidents. We concluded that stakeholders could have benefits from the data management plan: (1) it potentiates resilience at individual and community level; (2) citizens' measurements contribute to environmental monitoring and public health screening; (3) linkages between different types of data (environmental exposure, individual behavioural diaries, and measurements of health indicators) allow to perform more rigorous epidemiological studies.

Response to Tsuda et al. "demonstrating the undermining of science and health policy after the Fukushima nuclear accident by applying the toolkit for detecting misused epidemiological methods".

BACKGROUND: The SHAMISEN (Nuclear Emergency Situations - Improvement of Medical And Health Surveillance) European project was conducted in 2015-2017 to review the lessons learned from the experience of past nuclear accidents and develop recommendations for preparedness and health surveillance of populations affected by a nuclear accident. Using a toolkit approach, Tsuda et al. recently published a critical review of the article by Cléro et al. derived from the SHAMISEN project on thyroid cancer screening after nuclear accident. MAIN BODY: We address the main points of criticism of our publication on the SHAMISEN European project. CONCLUSION: We disagree with some of the arguments and criticisms mentioned by Tsuda et al. We continue to support the conclusions and recommendations of the SHAMISEN consortium, including the recommendation not to launch a mass thyroid cancer screening after a nuclear accident, but rather to make it available (with appropriate information counselling) to those who request it.

Assessment of Radiation Risk Perception and Interest in Tritiated Water among Returnees to and Evacuees from Tomioka Town within 20 km of the Fukushima Daiichi Nuclear Power Plant.

In this study, we aimed to investigate radiation risk perception, mental health, and interest in tritiated water among evacuees from and returnees to Tomioka town, Japan, as well as to evaluate the intention to return (ITR) among evacuees living inside and outside Fukushima Prefecture. Of the 1728 respondents, 318 (18.4%) and 1203 (69.6%) participants reported living outside and inside Fukushima Prefecture, and 207 (12.0%) reported living in Tomioka. The ITR was not significantly different between those who lived inside and outside the prefecture among the evacuees. Similarly, there were no significant differences in radiation risk perception, mental health, and interest in tritiated water. However, the evacuees were independently associated with a motivation to learn about tritiated water (OR = 1.242, 95%Cl: 1.041-1.438, p = 0.016), reluctance to consume food from Tomioka (OR = 1.635, 95%Cl: 1.372-1.948, p < 0.001), and concern that adverse health effects would occur because of the Fukushima Daiichi Nuclear Power Plant accident (OR = 1.279, 95%Cl: 1.055-1.550, p = 0.012) compared to returnees, according to logistic regression analysis. Interestingly, the returnees were found to have better mental health but lower life satisfaction than the evacuees. These findings suggest the importance of ongoing risk communication about radiation exposure and tritiated water among residents regardless of their place of residency.

The three R's of reasonable in radiological protection: relationships, rationale, and resources.

Central to applying the principle of optimisation in the system of radiological protection is the evaluation of what level of radiation exposure should be considered 'as low as reasonably achievable' (ALARA), after taking into account the prevailing circumstances. Determining what is 'reasonable' is an abstract, although somewhat intuitive concept with many potential interpretations depending on both the situation and those involved, whether individuals or organisations. There are common themes in the types of considerations that need to be addressed to determine 'reasonableness' regardless of the exposure situation. However, despite the consistent and agreeable nature of these themes, there remains a gap in how to apply them in real situations. For example, without measurable goalposts (or a clear process for setting such goalposts) for determining what constitutes ALARA, we can find ourselves misinterpreting the optimisation process as keeping exposures 'as low as possible'. We propose herein, by consolidating and building on existing ideas, an easily understandable and actionable 'reasonableness' framework. This simple, yet broadly applicable tool is intended to help radiation protection experts in the systematic, deliberative, and collaborative reflection on all of the factors that make up 'reasonable' before making a decision-whether it be a proposed medical treatment or clean-up of a contaminated site. Each process execution and decision itself will necessarily retain the complexity of the prevailing circumstance. The proposed 'Rs' of Reasonable represent Relationships (stakeholders, empathy, and trust), Rationale (contextual, technical, and ethical), and Resources (technological, financial, and time).

Tailoring Digital Tools to Address the Radiation and Health Information Needs of Returnees after a Nuclear Accident.

Digital tools are increasingly used for health promotion, but their utility during recovery from a nuclear disaster has yet to be established. This study analysed differences in knowledge, attitude, and practice (KAP) toward digital tools for radiation protection and health promotion, and preferences for specific application functions, among cohorts living within and outside areas affected by the Fukushima Daiichi nuclear power station (FDNPS) accident. A needs assessment was conducted by internet survey, and responses from those affected (N = 86) and not affected (N = 253) were compared and quantified by an adjusted odds ratio (aOR), using logistic regression analyses. KAP toward the radiation-related application in the affected group had an aOR of 1.95 (95% confidence interval (CI) = 1.12-3.38) for knowledge, and 5.71 (CI = 2.55-12.8) for practice. Conversely, toward the health-related application, the aOR of the affected group was 0.50 (CI = 0.29-0.86). The preference in the affected group was significantly lower for two application functions related to radiation measurement and two health-related functions (one about the effects of radiation in general and another about personal health advice in general): aOR range 0.43-0.50. Development of specific applications incorporating the findings from this survey was intended to foster a locally appropriate eHealth environment during recovery from the FDNPS accident.

Systematic review and meta-analysis of circulatory disease from exposure to low-level ionizing radiation and estimates of potential population mortality risks.

BACKGROUND: Although high doses of ionizing radiation have long been linked to circulatory disease, evidence for an association at lower exposures remains controversial. However, recent analyses suggest excess relative risks at occupational exposure levels. OBJECTIVES: We performed a systematic review and meta-analysis to summarize information on circulatory disease risks associated with moderate- and low-level whole-body ionizing radiation exposures. METHODS: We conducted PubMed/ISI Thomson searches of peer-reviewed papers published since 1990 using the terms "radiation" AND "heart" AND "disease," OR "radiation" AND "stroke," OR "radiation" AND "circulatory" AND "disease." Radiation exposures had to be whole-body, with a cumulative mean dose of < 0.5 Sv, or at a low dose rate (< 10 mSv/day). We estimated population risks of circulatory disease from low-level radiation exposure using excess relative risk estimates from this meta-analysis and current mortality rates for nine major developed countries. RESULTS: Estimated excess population risks for all circulatory diseases combined ranged from 2.5%/Sv [95% confidence interval (CI): 0.8, 4.2] for France to 8.5%/Sv (95% CI: 4.0, 13.0) for Russia. CONCLUSIONS: Our review supports an association between circulatory disease mortality and low and moderate doses of ionizing radiation. Our analysis was limited by heterogeneity among studies (particularly for noncardiac end points), the possibility of uncontrolled confounding in some occupational groups by lifestyle factors, and higher dose groups (> 0.5 Sv) generally driving the observed trends. If confirmed, our findings suggest that overall radiation-related mortality is about twice that currently estimated based on estimates for cancer end points alone (which range from 4.2% to 5.6%/Sv for these populations).