Study of the tools available in biological dosimetry to estimate the dose in cases of accidental complex overexposure to ionizing radiation: the Lilo accident.

PURPOSE: To compare the efficiency of different cytogenetic tools in estimating the doses received by four people involved in the Lilo accident and to monitor the dose estimate over 4.5 years. MATERIALS AND METHODS: Several young Georgian frontier guards handled at least one of the 12 Caesium sources found in a former Russian military camp. Overexposure lasted from July 1996 to May 1997. The Institute for Radiological Protection and Nuclear Safety (IRSN) obtained blood samples taken at several intervals post-exposure from the four most highly-exposed people. Dose estimation was performed using dicentric and translocation scoring. RESULTS: The first dose estimations performed by dicentric scoring gave whole-body doses ranging from 0.4 to 1.3 Gy. Overexposure was complex and several mathematical models were used to take this complexity into account. This could provide information concerning the circumstances of overexposure. Concerning follow-up, the yield of dicentrics decreased by about 50% in the first 4 months following the end of overexposure whereas translocations were stable over the period of analysis. CONCLUSION: It has been useful to compare cytogenetic results with clinical results. The results presented here reveal good stability of translocations. However the first dose estimation was not attempted until 6 months after the last exposure.

Is FISH painting an appropriate biological marker for dose estimates of suspected accidental radiation overexposure? A review of cases investigated in France from 1995 to 1996.

From 1995 to 1996 about 15 people suspected of being overexposed to ionizing radiation were referred to the Institute for Nuclear Safety and Protection in Fontenay-aux-Roses, France, for investigation by chromosome aberration analysis. Biological estimates of accidental overexposure were first obtained by scoring radio-induced unstable structural chromosome aberrations (dicentrics, centric rings, and fragments) in peripheral blood lymphocytes. For dose estimates, the yield of these chromosomal aberrations observed in 500 metaphases was compared with the laboratory dose-response relationship established from human blood irradiated in vitro (gamma-rays, 60Co, 0.5 Gy/min). To extend the possibilities of detecting DNA damage from earlier exposures by visualizing stable chromosome aberrations, chromosome painting by fluorescence in situ hybridization (FISH painting) was developed using a cocktail of three composite whole human chromosome-specific DNA probes (numbers 2, 4, and 12). A laboratory calibration curve for scoring terminal and/or reciprocal translocations was established for the same radiation quality and dose rate as those used for conventional cytogenetics (gamma-rays, 60Co, 0.5 Gy/min). For dosimetry purposes, it was also important to verify whether FISH painting could be applied to each human blood sample assessed for conventional expertise. For each individual, 2000 metaphases were scored for the presence or absence of reciprocal and terminal translocations. We present here a comparison between the results obtained by the two technologies for each of the cases studied separately. We describe their similarities or differences and discuss the suitability of using FISH painting for routine expertise analysis.

Is micronuclei yield variability a problem for overexposure dose assessment to ionizing radiation?

Scoring of micronuclei (Mni) in cytokinesis-blocked human blood peripheral lymphocytes after an accidental radiation overexposure appears an easier and faster alternative for biological dosimetry than dicentrics analysis. However, an increase of Mni rate could be difficult to interpret particularly at low doses, because of the known variability of individual dose response and the unknown background frequency. Moreover, in case of nuclear emergency, there are the added problems of large samples numbers for processing and so screening time. In this paper, we wish to propose some solutions using both methodological and statistical approaches. Firstly, we have tried to check the micronuclei assay in order to obtain a sufficient number of micronuclei in binucleated cells in the shortest time possible, even at higher exposition dose. Two techniques were compared using frequencies of binucleated cells and micronuclei in normal lymphocytes and after exposure to gamma-irradiation (60 Co) for doses up to 6 Gy. Secondly, we have supposed that, if the individual radiosensitivity was a critical problem for dose estimation, conversely, it would be not possible to build a reference curve combining many individuals. Thus, we have assessed the Mni response from 47 carefully selected healthy male blood donors for gamma-irradiation between 0 and 4 Gy. We show in this study that a realistic dose-effect relationship could be always fitted. In addition, the related coefficients could be compared with other published dose-effect relationships for gamma rays. However, the background incidence calculated from these 47 healthy individuals were found to be larger as expected so that this approach increases the detection limit for which an overexposure suspicion could be significantly detected to 0.32 Gy.

International intercomparison for criticality dosimetry: the case of biological dosimetry.

The Institute of Radiation Protection and Nuclear Safety (IRSN) organized a biological dosimetry international intercomparison with the purpose of comparing (i) dicentrics yield produced in human lymphocytes; (ii) the gamma and neutron dose estimate according to the corresponding laboratory calibration curve. The experimental reactor SILENE was used with different configurations: bare source 4 Gy, lead shield 1 and 2 Gy and a 60Co source 2 Gy. An increasing variation of dicentric yield per cell was observed between participants when there were more damages in the samples. Doses were derived from the observed dicentric rates according to the dose-effect relationship provided by each laboratory. Differences in dicentric rate values are more important than those in the corresponding dose values. The doses obtained by the participants were found to be in agreement with the given physical dose within 20%. The evaluation of the respective gamma and neutron dose was achieved only by four laboratories, with some small variations among them.

The cytogenetic dosimetry of recent accidental overexposure.

When accidental exposure to ionizing radiations is suspected, optimal choice of a treatment strategy requires, in addition to information about the clinical signs and physical dosimetry, a determination by biological parameters of the dose received. The scoring of unstable chromosomal aberrations in peripheral blood lymphocytes is the current reference method. Preparation of these samples depends on the goal sought--an exact assessment of several irradiations or rapid triage in the case of a large-scale accident. Moreover, some adaptation may be necessary if the irradiation is either heterogenous or not recent. Despite the robustness and adaptability of this procedure, conventional cytogenetics remains a tedious and time-consuming technique, and it requires specialized staff. Scoring micronuclei in binucleated lymphocytes may be an easier, simpler altemative to a dicentric assay. This paper, which is based on the experience acquired by the IPSN in recent years in expert assessment of suspected radiations, has as its goal to provide a succinct technical guideline of these different approaches, as they are adapted to suspected recent irradiation and triage.