Calibration of medical gamma cameras for estimation of internal contamination from137Cs.

Calibration of 22 gamma camera units was performed at 15 hospitals in southern and western Sweden to estimate137Cs contamination in humans in a supine static geometry, with a new developed calibration protocol and phantom. The minimum detectable activities (MDAs) and the estimated committed effective doses (CEDs) were calculated for each calibration. Generic calibration factors were calculated for five predetermined groups based on the detector type and manufacturer. Group 1 and 2 included NaI-based gamma cameras from General Electrics (GEs) with a crystal thickness of 5/8'' and 3/8'' respectively. Group 3 and 4 included NaI-based gamma cameras from Siemens Healthineers with a crystal thickness of 3/8'', with a similar energy window as the GE NaI-based cameras and a dual window respectively. Group 5 included semiconductor-based gamma cameras from GE with a CdZnTe (CZT) detector. The generic calibration factors were 60.0 cps kBq-1, 52.3 cps kBq-1, 50.3 cps kBq-1, 53.2 cps kBq-1and 48.4 cps kBq-1for group 1, 2, 3, 4, and 5 respectively. The MDAs ranged between 169 and 1130 Bq for all groups, with measurement times of 1-10 min, corresponding to a CED of 4.77-77.6µSv. A dead time analysis was performed for group 1 and suggested a dead time of 3.17µs for137Cs measurements. The dead time analysis showed that a maximum count rate of 232 kcps could be measured in the calibration geometry, corresponding to a CED of 108-263 mSv. It has been shown that semiconductor-based gamma cameras with CZT detectors are feasible for estimating137Cs contamination. The generic calibration factors derived in this study can be used for gamma cameras of the same models in other hospitals, for measurements in the same measurement geometry. This will increase the measurement capability for estimating internal137Cs contamination in the recovery phase following radiological or nuclear events.

Heterogeneity of pathological prion protein accumulation in the brain of moose (Alces alces) from Norway, Sweden and Finland with chronic wasting disease.

Prion diseases are a group of neurodegenerative, transmissible, and fatal disorders that affect several animal species. They are characterized by the conformational conversion of the cellular prion protein (PrPC) into the pathological prion protein (PrPSc). In 2016, chronic wasting disease (CWD) gained great importance at European level due to the first disease detection in a wild reindeer (Rangifer tarandus) in Norway. The subsequent intensive CWD surveillance launched in cervids resulted in the detection of CWD in moose (Alces alces), with 11 cases in Norway, 3 in Finland and 4 in Sweden. These moose cases differ considerably from CWD cases in North American and reindeer in Norway, as PrPSc was detectable in the brain but not in lymphoid tissues. These facts suggest the occurrence of a new type of CWD. Here, we show some immunohistochemical features that are clearly different from CWD cases in North American and Norwegian reindeer. Further, the different types of PrPSc deposits found among moose demonstrate strong variations between the cases, supporting the postulation that these cases could carry multiple strains of CWD.

Does surgeon sex and anthropometry matter for tool usability in traditional laparoscopic surgery? A systematic review and meta-analysis.

INTRODUCTION: Hand size, strength, and stature all impact a surgeon's ability to perform Traditional Laparoscopic Surgery (TLS) comfortably and effectively. This is due to limitations in instrument and operating room design. This article aims to review performance, pain, and tool usability data based on biological sex and anthropometry. METHODS: PubMed, Embase, and Cochrane databases were searched in May 2023. Retrieved articles were screened based on whether a full-text, English article was available in which original results were stratified by biological sex or physical proportions. Article quality was discussed using the Mixed Methods Appraisal Tool (MMAT). Data were summarized in three main themes: task performance, physical discomfort, and tool usability and fit. Task completion times, pain prevalence, and grip style results between male and female surgeons formed three meta-analyses. RESULTS: A total of 1354 articles were sourced, and 54 were deemed suitable for inclusion. The collated results showed that female participants, predominantly novices, took 2.6-30.1 s longer to perform standardized laparoscopic tasks. Female surgeons reported pain at double the frequency of their male colleagues. Female surgeons and those with a smaller glove size were consistently more likely to report difficulty and require modified (potentially suboptimal) grip techniques with standard laparoscopic tools. CONCLUSIONS: The pain and stress reported by female or small-handed surgeons when using laparoscopic tools demonstrates the need for currently available instrument handles, including robotic hand controls, to become more size-inclusive. However, this study is limited by reporting bias and inconsistencies; furthermore, most data was collected in a simulated environment. Additional research into how anthropometric tool design impacts the live operating performance of experienced female surgeons would further inform this area of investigation.

Medical gamma cameras in radiological emergency preparedness: determination of calibration factors and MDA for the GE Discovery NM/CT 670 Pro.

A survey was performed of the available gamma camera models and whole-body counters (WBCs) in Sweden, revealing that there are about 75 gamma cameras and 15 WBCs currently in operation in Sweden. One of the most common gamma camera models (GE Discovery NM/CT 670 Pro), with the collimators removed, was calibrated for152Eu,137Cs,60Co and40K in three different measurement geometries (supine, close-up sitting and distant sitting) for six different phantom sizes (12-110 kg). Minimum detectable activities (MDAs) were calculated for the gamma camera and a typical WBC, both at the Sahlgrenska University Hospital in Gothenburg, Sweden. An energy window of 30-510 keV was used to calibrate the gamma camera. The calibration factors for this gamma camera for supine and close-up sitting geometry, including all phantom sizes, were 138-208 cps kBq-1for152Eu, 63-83 cps kBq-1for137Cs and 99-126 cps kBq-1for60Co; the MDAs were 50-73 Bq for152Eu, 125-198 Bq for137Cs and 83-105 Bq for60Co. The International Commission on Radiological Protection dose coefficients for members of the public were used to calculate the committed effective doses (CEDs) corresponding to the MDAs, showing that CEDs down to a fewµSv can be estimated with this gamma camera for the inhalation of aerosols of absorption type M. The distant sitting geometry was used to enable the estimation of higher contamination levels, and a hypothetical maximum CED was calculated. This was shown to be 256-2000 mSv, depending on the radionuclide and phantom size. However, further investigations are needed into the dead time losses for higher activity levels for the radionuclides studied. The results show that the use of gamma cameras for radiological triage and, in some cases, to estimate the internal activity of relevant radionuclides in radiological and nuclear events, is feasible.

Lead aprons and thyroid collars: to be, or not to be?

Wearing lead aprons and thyroid collars for long periods of time has a subjective component: to balance the effective dose reduction with the effort of carrying a heavy load. Occupational radiation exposure has decreased dramatically in the last century within the health care system. During the same period the use of lead aprons and thyroid collars has also gone up. Therefore, a question that may be raised is: how safe is safe enough? In order to promote stakeholder involvement, the aim of the present study was to investigate staff's experience of discomforts associated with wearing lead aprons and thyroid collars for long periods of time, and also to investigate staff's willingness to tolerate personal dose equivalent (expressed as radiation dose) and the corresponding increase in future cancer risk to avoid wearing these protective tools. A questionnaire was developed and given to staff working in operating or angiography rooms at Skaraborg Hospital in Sweden. The results from the 245 respondents showed that 51% experienced bothersome warmth, 36% experienced fatigue and 26% experienced ache or pain that they believed was associated with wearing lead aprons. One third of the respondents would tolerate a personal dose equivalent of 1 mSv per year to avoid wearing lead aprons, but only a fifth would tolerate the corresponding increase in future cancer risk (from 43% to 43.2%). In conclusion, discomforts associated with wearing lead aprons and thyroid collars for long periods of time are common for the staff using them. At the same time, only a minority of the staff would tolerate a small increase in future cancer risk to avoid wearing them. The present study gives an example of stakeholder involvement and points at the difficulties in making reasonable decisions about the use of these protective tools.

A case study of cost-benefit analysis in occupational radiological protection within the healthcare system of Sweden.

The aim of the present study was to demonstrate cases of cost-benefit analysis within healthcare, of how economic factors can be considered in occupational radiological protection, in agreement with the as low as reasonably achievable principle and present Swedish legislations. In the first part of the present study, a comparison of examples within health economics used by authorities and institutes in Sweden was made. The comparison focused on value of a statistical life, quality-adjusted life year, and monetary cost assigned to a unit of collective dose for radiation protection purposes (α-value). By this comparison, an α-value was determined as an interval between $45 and $450 per man-mSv, for the Swedish society in 2021. The α-value interval can be interpreted as following: Less than $45 per man-mSv is a good investment. From $45 to $450 per man-mSv, other factors than costs and collective dose are important to consider. More than $450 per man-mSv is too expensive. In the second part of the present study, seven cases of cost-benefit analyses in occupational radiological protection were provided. The present study focused specifically on cases where the relevant factors were costs and collective dose. The present case study shows a large variation in costs per collective dose from different types of occupational radiological protection, used at Skaraborg Hospital in Sweden.

Validation of 3-Space Wireless Inertial Measurement Units Using an Industrial Robot.

Inertial Measurement Units (IMUs) are beneficial for motion tracking as, in contrast to most optical motion capture systems, IMU systems do not require a dedicated lab. However, IMUs are affected by electromagnetic noise and may exhibit drift over time; it is therefore common practice to compare their performance to another system of high accuracy before use. The 3-Space IMUs have only been validated in two previous studies with limited testing protocols. This study utilized an IRB 2600 industrial robot to evaluate the performance of the IMUs for the three sensor fusion methods provided in the 3-Space software. Testing consisted of programmed motion sequences including 360° rotations and linear translations of 800 mm in opposite directions for each axis at three different velocities, as well as static trials. The magnetometer was disabled to assess the accuracy of the IMUs in an environment containing electromagnetic noise. The Root-Mean-Square Error (RMSE) of the sensor orientation ranged between 0.2° and 12.5° across trials; average drift was 0.4°. The performance of the three filters was determined to be comparable. This study demonstrates that the 3-Space sensors may be utilized in an environment containing metal or electromagnetic noise with a RMSE below 10° in most cases.

Absorbed dose rate coefficients for134Cs and137Cs with steady-state distribution in the human body:S-coefficients revisited.

In the event of an accidental release of radioactive elements from a nuclear power plant, it has been shown that the radionuclides contributing the most to long-term exposure are134Cs and137Cs. In the case of nuclear power plant fallout, with subsequent intake of radionuclides through the food chain, the internal absorbed dose to target tissues from protracted intake of radionuclides needs to be estimated. Internal contamination from food consumption is not caused by a single intake event; hence, the committed equivalent dose, calculated by a dose coefficient or dose per content function, cannot be easily used to calculate the cumulative absorbed dose to relevant target tissues in the body. In this study, we calculated updated absorbed dose rate coefficients for134Cs and137Cs based on data from the International Commission on Radiological Protection (ICRP) on specific absorbed fractions. The absorbed dose rate coefficients are provided for male and female adult reference phantoms, respectively, assuming a steady-state distribution of Cs that we calculated from the ICRP biokinetic model for Cs. With these coefficients, the absorbed dose to the listed target tissues, separately and to the total body, are related to the number of nuclear transitions (time-integrated activity) in each listed source region. Our new absorbed dose rate coefficients are given for the complete set of target tissues and have not been presented before. They are also provided for aggregated categories of organs to facilitate epidemiological studies.

Muscle activation during traditional laparoscopic surgery compared with robot-assisted laparoscopic surgery: a meta-analysis.

BACKGROUND: The repetitive and forceful motions used by operating surgeons increase the risk of developing musculoskeletal disorders. Most ergonomists consider the surgical environment to be incredibly harsh for its workers. Traditional Laparoscopic Surgery (TLS) in particular has a number of physical and mental challenges associated with it, and while Robotic-Assisted Laparoscopic Surgery (RALS) provides several features that improve upon TLS, some surgeons have still reported musculoskeletal symptoms they attribute to RALS. In this paper, we endeavored to systematically review muscle activation for both TLS and RALS, to compare the modalities and present the results as a meta-analysis. METHODS: A literature search was conducted using Pubmed, Embase, and Cochrane databases in November 2018 with the following inclusion criteria: full text was available in English, the paper contained original data, EMG was one of the primary measurement techniques, and the paper included EMG data for both TLS and RALS. Results from studies were compared using standardized mean difference analysis. RESULTS: A total of 379 papers were found, and through screening ten were selected for inclusion. Sample populations ranged from 1 to 31 surgeons, and a variety of study designs and metrics were used between studies. The biceps were the only muscle group that consistently and significantly demonstrated lower muscle activation for RALS for all included studies. CONCLUSIONS: The results may support the belief that RALS is ergonomically superior to TLS, shown through generally lower muscle activation scores. However, these results must be interpreted with caution due to the heterogeneity between the studies and multiple potential sources for bias within studies. This analysis would be strengthened with a higher number of homogenous, high-quality studies examining larger sample sizes.

Self-reported prevalence of injury and discomfort experienced by surgeons performing traditional and robot-assisted laparoscopic surgery: a meta-analysis demonstrating the value of RALS for surgeons.

BACKGROUND: The negative impact of traditional laparoscopic surgery (TLS) on surgeons has been well-established. Prevalence rates of discomfort and injury between 73% and 90% are regularly cited to support this, with robot-assisted laparoscopic surgery (RALS) often being presented as the solution. The purpose of this study was to systematically review pain studies of TLS and RALS surgeons, to consider the difference in the reported strain in general and concerning specific sites of the body. METHODS: PubMed, Embase, and Cochrane databases were searched in October 2019. The resulting articles were screened to ensure the full text was available in English, original data were presented, the study contained pain statistics for TLS or RALS, and the study had a long-term rather than an intra-operative focus. Quality was assessed using the SUrvey Reporting GuidelinE (SURGE). Results from studies were analyzed in two stages for TLS and RALS according to each anatomic region. RESULTS: A total of 1354 papers were found, from which 28 papers were chosen for inclusion. The average quality score of the included articles was 14.8. The risk ratio of experiencing symptoms related to TLS in comparison to RALS was 1.29; however, this was not significant. Discomfort was significantly more likely to be experienced in the back, elbows, and wrists/hands for those practicing TLS in comparison with RALS. The regions associated with the highest risk of injury for TLS and RALS were the back and neck, respectively. CONCLUSIONS: There is limited evidence in this study for the possibility that RALS is ergonomically more beneficial for the surgeon in comparison with TLS. Further analysis would be improved with the publication of larger, high-quality, homogenous studies, especially concerning injuries experienced by RALS surgeons, to overcome the limitations of heterogeneity and bias.

Echinococcus multilocularis Infection, Southern Ontario, Canada.

Alveolar echinococcosis, the disease caused by infection with the intermediate stage of the Echinococcus multilocularis tapeworm, is typically fatal in humans and dogs when left untreated. Since 2012, alveolar echinococcosis has been diagnosed in 5 dogs, 3 lemurs, and 1 chipmunk in southern Ontario, Canada, a region previously considered free of these tapeworms. Because of human and animal health concerns, we estimated prevalence of infection in wild canids across southern Ontario. During 2015-2017, we collected fecal samples from 460 wild canids (416 coyotes, 44 foxes) during postmortem examination and analyzed them by using a semiautomated magnetic capture probe DNA extraction and real-time PCR method for E. multilocularis DNA. Surprisingly, 23% (95% CI 20%-27%) of samples tested positive. By using a spatial scan test, we identified an infection cluster (relative risk 2.26; p = 0.002) in the western-central region of the province. The cluster encompasses areas of dense human population, suggesting zoonotic transmission.

Corrigendum to: A model for estimating the total absorbed dose to the thyroid in Swedish inhabitants following the Chernobyl Nuclear Power Plant accident: implications for existing international estimates and future model applications (2019 J. Rad. Prot. 39(2) 522: doi: 10.1088/1361-6498/ab0577).

Four of the equations in the article "A model for estimating the total absorbed dose to the thyroid in Swedish inhabitants following the Chernobyl Nuclear Power Plant accident: implications for existing international estimates and future model applications " were incomplete or erroneously expressed. A corrigendum is attached with the amended equations.

A small particle size diet reduces upper gastrointestinal symptoms in patients with diabetic gastroparesis: a randomized controlled trial.

OBJECTIVES: Gastroparesis is a well-known complication to diabetes mellitus (DM). Dietary advice is considered to be of importance to reduce gastrointestinal (GI) symptoms in patients with diabetic gastroparesis, but no randomized controlled trials exist. Our aim was to compare GI symptoms in insulin treated DM subjects with gastroparesis eating a diet with small particle size ("intervention diet") with the recommended diet for DM ("control diet"). METHODS: 56 subjects with insulin treated DM and gastroparesis were randomized to the intervention diet or the control diet. The patients received dietary advice by a dietitian at 7 occasions during 20 weeks. GI symptom severity, nutrient intake and glycemic control were measured before and after the intervention. RESULTS: A significantly greater reduction of the severity of the key gastroparetic symptoms-nausea/vomiting (P=0.01), postprandial fullness (P=0.02) and bloating (P=0.006)-were seen in patients who received the intervention diet compared with the control diet, and this was also true for regurgitation/heartburn (P=0.02), but not for abdominal pain. Anxiety was reduced after the intervention diet, but not after the control diet, whereas no effect on depression or quality of life was noted in any of the groups. A higher fat intake in the intervention group was noted, but otherwise no differences in body weight, HbA1c or nutrient intake were seen. CONCLUSIONS: A small particle diet improves the key symptoms of gastroparesis in patients with diabetes mellitus. (ClinicalTrials.gov NCT01557296).

Perceived comfort and tool usability during robot-assisted and traditional laparoscopic surgery: a survey study.

It is known that over half of previously surveyed surgeons performing Robot-Assisted Laparoscopic Surgery (RALS) and three-quarters of those performing Traditional Laparoscopic Surgery (TLS) experience intraoperative pain. This survey study aimed to expand upon the ongoing impact of that pain as well as perceived tool usability associated with TLS and RALS, for which considerably less documentation exists. A survey regarding the presence and impact, either immediate or ongoing, of intraoperative pain and Likert scale questions regarding tool usability was administered to TLS and RALS surgeons on the European Association for Endoscopic Surgery (EAES) mailing list. Prevalence statistics as well as trends based on biological sex and glove size were obtained from the 323 responses. Most respondents were right-handed European males (83-88%) with a medium glove size (55.8%). Moderate or severe shoulder symptoms were experienced by one-third of TLS surgeons. Twenty-one percent of RALS surgeons experienced neck symptoms that impacted their concentration. Small-handed surgeons experienced wrist symptoms significantly more frequently than large-handed surgeons, regardless of modality. RALS was associated with a significantly more optimal back and wrist posture compared to TLS. TLS surgeons reported increased ease with applying and moderating force while operating. These results suggest that intraoperative pain may be severe enough in many cases to interfere with surgeon concentration, negatively impacting patient care. Continuing to understand the relationship between tool usability and comfort is crucial in guaranteeing the health and well-being of both surgeons and patients.

An Estimation of the Monetary Value of the Person-Sievert Useful for Occupational Radiological Protection within the Healthcare System of Sweden.

ABSTRACT: The As Low As Reasonably Achievable (ALARA) principle includes taking into account economic and societal factors. To consider these factors, decision-aiding techniques such as cost-benefit analysis were introduced by the International Commission on Radiological Protection (ICRP) 50 y ago. Over the years, developments in health economics have led to new ways of deriving the concept of a value of a statistical life (VSL), which now is influencing the monetary value assigned to a unit of collective dose for radiological protection purposes (the α value) used in cost-benefit analyses. The aim of the present study was to estimate an α value useful for occupational radiological protection within the healthcare system of Sweden. A survey based on the stated preference approach was developed and sent to staff who are exposed to ionizing radiation at their work in Region Västra Götaland (Sweden). The survey essentially contained two scenarios: the respondents' willingness to pay for measures against radon exposure at home and their willingness to accept compensation for x-ray exposure at work. Answers from 718 respondents were collected. In the sensitivity analysis of the survey, the overall median VSL based on the two scenarios was calculated to be $50 million (IQR $10 to 363 million). The corresponding α value was established to $1,600 person-mSv -1 ($2,100 person-mSv -1 if excess burden of taxes is excluded). The recommended α value is in the high end compared to other studies but within the interval of values being used by nuclear utilities today. The α value should be seen in the light of ICRP's recommendation about stakeholder involvement as an important part of the optimization process.

Average uranium bedrock concentration in Swedish municipalities predicts male lung cancer incidence rate when adjusted for smoking prevalence: Indication of a cumulative radon induced detriment.

Bedrock U has been used as a proxy for local indoor radon exposure. A preliminary assessment of cancer incidence rate in a cohort of 809,939 adult males living in 9 different Swedish counties in 1986 has been used to correlate the cumulative lung cancer and total cancer (excluding lung) incidence rates between 1986 and 2020, respectively with the municipality average value of bedrock U concentration obtained from Swedish geological Survey (SGU). To control for regional difference in tobacco smoking, data on county average smoking prevalence, obtained from a survey conducted by the Public Health Agency of Sweden from 2001 to 2004, was used. Regression analysis shows that there is a significant positive correlation between smoking prevalence adjusted lung cancer incidence rate in males and the municipality bedrock U concentration (R2 = 0.273 with a slope 5.0 ±â€¯0.87·10-3 ppm-1). The correlation is even more significant (R2 = 0.759 with a slope = 4.8 ±â€¯0.25·10-3 ppm-1) when assessed on population weighted cancer incidence data binned in nine intervals of municipality average bedrock U concentration (ranging from 0.97 to 4.9 ppm). When assessing the corresponding correlations for total cancer incidence rate (excluding cancer of the lung) with adjustment for smoking prevalence, there appears to be no or little correlation with bedrock U concentration (R2 = 0.031). We conclude that an expanded future study needs age-standardized cancer incidence data to obtain a more consistent exposure-response model. Such model could be used to predict future lung cancer cases based on geological survey maps of bedrock U as an alternative to laborious indoor radon measurements, and to discern what future lung cancer rates can be expected for a population nearing zero smoking prevalence, with and without radon prevention.

LARCalc, a tool to estimate sex- and age-specific lifetime attributable risk in populations after nuclear power plant fallout.

A tool called LARCalc, for calculating the radiological consequences of accidental large scale nuclear power plant releases based on estimates of 137Cs ground deposition, is presented. LARCalc is based on a previously developed models that has been further developed and packaged into an easy-to-use decision support tool for training of decision makers. The software visualises the radiological impact of accidental nuclear power plant releases and the effects of various protective measures. It is thus intended as a rapid alternative for planning protective measures in emergency preparedness management. The tool predicts projected cumulative effective dose, projected lifetime attributable cancer risk, and residual dose for some default accidental release scenarios. Furthermore, it can predict the residual dose and avertable cumulative lifetime attributable risk (LAR) resulting from various protective measures such as evacuation and decontamination. It can also be used to predict the avertable collective dose and the increase in cancer incidence within the specified population. This study presents the theoretical models and updates to the previous models, and examples of different nuclear fallout scenarios and subsequent protective actions to illustrate the potential use of LARCalc.

Current Applications of Robot-Assisted Ultrasound Examination.

Despite advances in miniaturization and automation, the need for expert acquisition of a full echocardiogram, including Doppler, has restricted access in remote areas. Recent developments in robotics, teleoperation, and upgraded telecommunications infrastructure may provide a solution to this deficiency. Robot-assisted teleoperated ultrasound examination can aid medical diagnosis in remote locations and may improve health inequalities between rural and urban settings. This review aimed to analyze the status of teleoperated robotic systems for ultrasound examinations, evaluate clinical and preclinical applications, identify limitations, and outline future directions for clinical use. Overall, robot-assisted teleoperated ultrasound is feasible and safe in the reported clinical and preclinical studies, with the robots able to follow the hand movements performed by sonographers and researchers from a distance or in local networks. Moreover, multiple types of ultrasound examinations have been performed in remote areas, with a high success rate nearly comparable to that of conventional sonography. The studies showed that although a low-bandwidth link can be used to control a robot, the bandwidth requirements for real-time transmission of video and ultrasound images are significantly higher. Furthermore, if haptic feedback is implemented, the bandwidth requirements are increased. Haptically enabled systems that improve robotic control are necessary for accelerating the introduction to clinical use. Haptic feedback and enhanced front-end interface control for remote users are vital aspects required for clinical application. The incorporation of artificial intelligence through either aiding in window acquisition (knowledge of anatomical landmarks to adjust scanning planes) or through measurement and disease identification is yet to be researched. However, it has the potential to lead to dramatic advances. A new generation of robots is in development, and several projects in the preclinical stage reveal a promising future to overcome the shortage of health professionals in remote areas.

Dose-response analysis of protracted absorbed organ dose and site-specific cancer incidence in Sweden after the Chernobyl nuclear power plant accident.

Background: Adult males in Sweden exhibit an increased risk of cancer associated with an increased absorbed dose to the colon from the Chernobyl accident. Methods: A closed cohort, with information on hunter status, included all individuals living in northern Sweden in 1986. Complete annual information on exposure to 137Cs at the dwelling coordinate was available for a total of 2,104,101 individuals. A nested case-control method with four controls matched for year of cancer diagnosis and year of birth, was used. Individual absorbed organ doses were calculated between 1986 and 2020 including external and internal exposure. Hazard ratios (HR) per mGy with 95% confidence intervals (95% CI) were calculated using conditional logistic regression adjusted for rural/nonrural habitat, education level and pre-Chernobyl cancer incidence 1980 to 1985. A total of 161,325 cancer cases in males and 144,439 in females were included. Results: The adjusted HR per mGy for all cancer sites combined was 1.027 (95% CI = 1.022, 1.031) in males and 1.011 (95% CI = 1.006, 1.017) in females. In a post hoc analysis accounting for both remaining confounding from hunter lifestyle and the pre-Chernobyl cancer incidence by county, the adjusted HR per mGy for all cancer sites combined was 1.014 (95% CI = 1.009, 1.019) in males and 1.000 (95% CI = 0.994, 1.006) in females. The post hoc analysis suggested an increased risk of cancer in the colon, pancreas, and stomach, respectively, in males, and lymphoma in females. Conclusions: Increased cancer risk estimates were found for some specific cancer sites but remaining uncontrolled confounding due to hunter lifestyle could not be ruled out.

Analysis of radioactivity in commercially available products aiming to improve health and wellness.

There are products available on the online market that are claim to contain unique 'energies' that can improve health and wellness by eliminating toxins and pains and energising food and drinking water. We investigated these products by alpha and gamma spectrometry, and the analysis showed that they contained a few to hundreds of kilobecquerels per kilogram of naturally occurring radionuclides from the 232Th and 238U series. The committed effective dose for an adult drinking water that had been in contact with these products just once was estimated to 12 nSv. Considering a worst-case scenario for the workers inhaling the radioactive substance, 1 d of work would result in an effective dose of 0.39 mSv. The product descriptions do not mention the radionuclide content, and concerns are raised for the consumers and workers exposed to these products with no knowledge of the radioactive content.