Organ dose reconstruction for the radiation epidemiological study of Korean radiation workers: the first dose evaluation for the Korean Radiation Worker Study (KRWS).

The Korea Institute of Radiological and Medical Sciences has started a radiation epidemiological study, titled "Korean Radiation Worker Study," to evaluate the health effects of occupational exposure to radiation. As a part of this study, we investigated the methodologies and results of reconstructing organ-specific absorbed doses based on personal dose equivalent, Hp(10), reported from 1984 to 2019 for 20,605 Korean radiation workers. For the organ dose reconstruction, representative exposure scenarios (i.e., radiation energy and exposure geometry) were first determined according to occupational groups, and dose coefficients for converting Hp(10) to organ absorbed doses were then appropriately taken based on the exposure scenarios. Individual annual doses and individual cumulative doses were reconstructed for 27 organs, and the highest values were observed in the thyroid doses (on average 0.77 mGy/y and 10.47 mGy, respectively). Mean values of individual cumulative absorbed doses for the red bone marrow, colon, and lungs were 7.83, 8.78, and 8.43 mSv, respectively. Most of the organ doses were maximum for industrial radiographers, followed by nuclear power plant workers, medical workers, and other facility workers. The organ dose database established in this study will be utilized for organ-specific risk estimation in the Korean Radiation Worker Study.

Experience and performance of In Vivo Monitoring Laboratory of NIRP in 2017 thyroid measurement intercomparison.

Determination of the 131I activity in the thyroid of exposed people or workers is one of the major concerns that needs to be addressed following a nuclear or radiological emergency. International intercomparison exercises on bioassay measurements are one of the effective methods to improve the capability and quality of internal dose assessment. In 2017, Working Group 1 (Internal Dosimetry) of the Asian Radiation Dosimetry Group (ARADOS) organized an intercomparison exercise on the thyroid measurement, aiming at enhancing and coordinating the radiation dosimetry capabilities of Asian countries. This paper describes the measurement experience and results of In Vivo Monitoring Laboratory of NIRP in the 2017 intercomparison exercise, which can provide technical reference for laboratories that have not yet participated in such thyroid measurement intercomparsion. It covers technical aspects such as calibration, measurement and data processing. The results presented in this intercomparison are within an acceptable range of performance criteria on the bioassay measurements. In addition, further research work considered in the field of thyroid measurement is described in the discussion section.

Uncertainty quantification of bioassay functions for the internal dosimetry of radioiodine.

Bioassay functions, which are provided by the International Commission on Radiological Protection, are used to estimate the intake activity of radionuclides; however, they include considerable uncertainties in terms of the internal dosimetry for a particular individual. During a practical internal dose assessment, the uncertainty in the bioassay function is generally not introduced because of the difficulty in quantification. Therefore, to clarify the existence of uncertainty in the bioassay function and provide dosimetrists with an insight into this uncertainty, this study attempted to quantify the uncertainty in the thyroid retention function used for radioiodine exposure. The uncertainty was quantified using a probabilistic estimation of the thyroid retention function through the propagation of the distribution of biokinetic parameters by the Monte Carlo simulation technique. The uncertainties in the thyroid retention function, expressed in terms of the scattering factor, were in the ranges of 1.55-1.60 and 1.40-1.50 for within 24 h and after 24 h, respectively. In addition, the thyroid retention function within 24 h was compared with actual measurement data to confirm the uncertainty due to the use of first-order kinetics in the biokinetic model calculation. Significantly higher thyroid uptakes (by a factor of 1.9) were observed in the actual measurements. This study indicates that consideration of the uncertainty in the thyroid retention function can avoid a significant over- and under-estimation of the internal dose, particularly when a high dose is predicted.

Evaluation of performance characteristics of portal monitor for radiation emergency.

For evaluating the counting efficiency of a portal monitor, we use a137Cs radiation point source (1 µCi) to subsequently establish it effective measurable area. Through simulation, we estimate the appropriate distance from potentially contaminated individuals in the scanning queue to the monitoring individual. When this distance is over 10 m, the counting efficiency was below 0.01%. We find that the triage can be applied to roughly 180 individuals per hour during mass casualties.

PRACTICAL METHODS FOR INTERNAL DOSE ASSESSMENT FOR RADIOIODINE INTAKE AFTER THYROID BLOCKING: CLASSIFICATION OF DEGREE OF BLOCKAGE AND DETERMINATION OF INSENSITIVE MEASUREMENT POINT.

Iodine thyroid blocking (ITB) suppresses the uptake of iodine to the thyroid and reduces internal doses after radioiodine intake; however, its disturbance of thyroid biokinetics causes considerable uncertainty in the use of dosimetric data intended for assessment of unblocked normal thyroid. To more accurately assess internal dose after ITB, practical dosimetry methods were proposed that consider the ITB effect in a dosimetric manner. A method using the ratio of urine excretion to thyroid retention activity was proposed to retrospectively determine individual-specific ITB levels; bioassay functions and dose coefficients corresponding to ITB levels were calculated separately using the latest biokinetic model and fundamental data. Moreover, insensitive measurement points of time, which led to similar results regardless of ITB level, were determined based on the dose per unit content. Proposed insensitive points for inhalation of vapour forms and particulate forms, respectively, were 1.5 days and 2 days after exposure.

Internal Dose Assessment after 131I-Iodide Misadministration in a Patient With Incompletely Blocked Thyroid Uptake: Personalized Internal Dose Assessment by Estimating Individual-Specific Biokinetics.

In July 2017, a medical accident occurred in South Korea, in which I-iodide solution was misadministered to the wrong patient. Although the International Commission on Radiological Protection provided internal dose coefficients for iodine for blocked thyroid, they were not reliable enough for determining the dose to the patient (whose thyroid uptake was incompletely blocked) due to a discrepancy in biokinetics. Therefore, a personalized dose assessment was performed to derive the individual-specific dose coefficients for the patient. Initially, the thyroid biokinetics of the patient were statistically clarified by fitting bioassay monitoring results and the corresponding predicted bioassay values, which were calculated repeatedly for varying iodine transfer rates in an iodine biokinetic model. After determining the transfer rate for the patient, the individual-specific dose coefficients were then calculated in accordance with latest recommendations of the International Commission on Radiological Protection. According to the individual-specific biokinetics, the 24 h thyroid uptake fraction of iodine was estimated as 0.52%. The thyroid absorbed dose of the patient was evaluated as 21.2 Gy, which differed greatly (by about 9 Gy) from the dose evaluated simply using the reference data for blocked thyroid uptake. The personalized dose assessment carried out for the patient not only reduced considerable uncertainties in the internal dose calculation, but also improved the reliability of the calculated internal dose by adopting the latest dosimetric data, including specific absorbed fraction values based on voxel phantoms. Through the dose assessment of the patient, the methodology of personalized dose assessment considering individual-specific biokinetics was developed.

Counting Efficiencies Determined by Monte Carlo Methods for In Vivo Measurement of 131I Activity in Thyroid.

The counting efficiencies obtained using a physical neck phantom are typically used in the measurement of I activity in the thyroid. It is well known, however, that the geometrical discrepancies between the physical neck phantom and the anatomy of the subject can significantly influence the counting efficiencies. Thus, it is necessary to consider the anatomical characteristics of individuals if we need to accurately determine the activity of I in the thyroid. This study aims to produce individualized counting efficiencies for thyroid measurement, considering the age, sex, and overlying tissue thickness of the subject being measured by Monte Carlo simulation. Simulations were performed using a series of computational human phantoms of different ages and sexes. The difference in counting efficiencies, depending on the age and sex of the phantom, were found to range from -26 to 3% for the phantoms and monitoring systems considered in the present study. The overlying tissue thickness of the computational phantoms was also modified to find the relationship between the counting ratio of the 80.2 and 364 keV gammas from I and the overlying tissue thickness. The equations for estimating the overlying tissue thickness of a subject were then derived from the relationships between counting ratios and overlying tissue thickness. Finally, in the present study, a set of equations representing the variation in counting efficiencies for the 364 keV peak as a function of the overlying tissue thickness were derived, which can be used to determine individualized counting efficiencies for the subject being measured. These individualized counting efficiencies considering the overlying tissue thickness given a subject's age and sex can provide accurate estimates of I activity for internal dosimetry.

Health effects of exposure to radon: implications of the radon bed mattress incident in Korea.

Radon is a naturally occurring radioactive material formed by the slow decay of uranium and thorium found in the earth's crust or construction materials. Internal exposure to radon accounts for about half of the natural background radiation dose to which humans are exposed annually. Radon is a carcinogen and is the second leading cause of lung cancer following smoking. An association between radon and lung cancer has been consistently reported in epidemiological studies on mine workers and the general population with indoor radon exposure. However, associations have not been clearly established between radon and other diseases, such as leukemia and thyroid cancer. Radiation doses are assessed by applying specific dose conversion coefficients according to the source (e.g., radon or thoron) and form of exposure (e.g., internal or external). However, regardless of the source or form of exposure, the effects of a given estimated dose on human health are identical, assuming that individuals have the same sensitivity to radiation. Recently, radiation exceeding the annual dose limit of the general population (1 mSv/yr) was detected in bed mattresses produced by D company due to the use of a monazite-based anion powder containing uranium and thorium. This has sparked concerns about the health hazards for mattress users caused by radiation exposure. In light of this event, this study presents scientific information about the assessment of radon and thoron exposure and its human implications for human health, which have emerged as a recent topic of interest and debate in society.

Screening Criteria for the General Public in Radiation Emergencies From Liquid Scintillation Urinalysis.

Gross alpha/beta screening of urine samples was performed to evaluate internal contamination and dose assessment. Data on background radioactivity concentration were extracted by analyzing the urine samples of non-contaminated individuals who had visited a radiation effect medical clinic since 2012. Screening criteria were studied and established for radiation emergencies based on these results. In particular, pure beta-emitting radionuclides (H and Sr) with a high dose conversion factor were considered to be the source of contamination. Moreover, the screening criteria for the general public were determined based on age groups. The liquid scintillation counting method was used for gross alpha/beta radiation counting. A standardized procedure of correction for chemical and color quenching was performed and validated. The gross beta counting method was validated by analyzing standard urine samples. The fluctuation of the screening criteria was large, based on the time elapsed after intake. A screening criterion of 150 Bq L can be applied within 5 d after intake considering the minimum detectable activity. A standard screening criterion set to 250 Bq L will be used as an important reference for decision making and additional monitoring. Although early evaluation and accurate identification of contaminated radionuclides is preferred, these relatively simple criteria were proposed to address radiation emergency situations involving several casualties.

RAPID MONITORING OF INTERNAL CONTAMINATION USING A MOBILE RADIOBIOASSAY LABORATORY FOLLOWING RADIATION EMERGENCIES.

In any radiation emergency, it may be necessary to monitor large numbers of people for internal contamination resulting from inhalation/ingestion of radionuclides released from the accident. The National Radiation Emergency Medical Center of the Korea Institute of Radiological and Medical Sciences constructed a mobile radiobioassay laboratory for rapid field-based monitoring of internal contamination. The main features of the mobile laboratory were designed and the results of performance were tested for rapid monitoring in this paper. We found that maximum throughput for internal contamination monitoring using the whole body counter installed in the laboratory was about 200 people per day. The minimum detectable activities were estimated for the in-vivo and in-vivo radiobioassay systems in the mobile unit. This mobile unit will improve the population monitoring capabilities for internal contamination of individuals affected following nuclear or radiological emergencies.

Measurement and Simulation of the Counting Efficiency of a Whole-body Counter Using a BOMAB Phantom Inserted with Rod Sources Containing Mixed Radionuclides.

The examination of internal contamination is important for providing an adequate medical response during a radiological emergency. A whole-body counting system can assess gamma-emitting radionuclides in a human body when monitoring internal contamination. It is necessary to calibrate whole-body counting systems by using a calibration phantom, such as a Bottle Manikin Absorption phantom, to properly assess internal contamination. However, the total weight of the Bottle Manikin Absorber phantom is high, and there can be leakage of radioactive sources, which are disadvantages of using such a phantom. This study proposes a calibration phantom that is designed to overcome these disadvantages. The proposed phantom consists of rod sources that are inserted in each part of the phantom. The counting efficiency of the rod-source-inserted calibration phantom was acquired using a Monte Carlo simulation method, but the results were evaluated by comparing the experimental efficiencies with those of a conventional Bottle Manikin Absorption phantom by using two commercial whole-body counting systems (stand-up type and bed type). The efficiency curve of the rod-source-inserted phantom matched well that of the conventional calibration phantom. The relative deviation between the efficiencies of the conventional Bottle Manikin Absorption phantom and the proposed calibration phantom in both whole-body counting systems was less than 11%, and the total weight of the phantom was also reduced. These results suggest that the proposed phantom can be manipulated more easily and replace the conventional Bottle Manikin Absorption calibration phantom for these two types of whole-body counting systems.

Development of a minipig physical phantom from CT data.

Quantification of pathological progression of radiation-induced injury is essential in development of treatment methods, and a proper animal model is necessary for relevant radiological and medical studies. A minipig is a current animal model selected because of its similarities to humans in anatomy and pathology. In the present study, a minipig physical phantom was developed using computed tomography (CT) data. For dosimetry purposes, the minipig physical phantom was constructed on a slice-by-slice basis, with an array of holes to accommodate dosimeters. The phantom is constituted of three major organs, i.e. bone, lung, and remaining soft tissue, and the organs are clearly distinguishable on each 20-mm-thick axial slice. The quality of the tissue-equivalent (TE) substitutes was analyzed in terms of the atomic compositions and Hounsfield units (HUs). The density (in g/cm3) and effective atomic number of TE substitutes for the bone, lung, and soft tissue are 1.4 and 7.9, 0.5 and 10.0, and 1.0 and 5.9, respectively. Although the TE substitutes have slightly different physical properties, we think the phantom is acceptable because the HU values of the TE substitutes lie in the HU range of real tissues.

Estimation of counting efficiencies of a portable NaI detector using Monte Carlo simulation for thyroid measurement following nuclear accidents.

Radioiodine can be released in nuclear accidents and can cause internal contamination of the thyroid gland in members of the public. For population monitoring in radiation emergencies, measurement of counting efficiency is very important to accurately determine thyroid activity. Here, we estimate the counting efficiencies of a portable NaI detector using Monte Carlo simulations. Two different types of neck phantoms and a 7.62 cm long by 7.62 cm diameter NaI detector were modeled and the counting efficiencies were calculated depending on the thyroid size and distance from the neck phantom to the detector. We found that distance is a more important parameter than thyroid size. The optimal distance of the NaI detector from the neck surface was determined to be greater than 12 cm, beyond which the counting efficiency was not affected by thyroid size.

Rapid Analysis of 239,238Pu, 241Am, and 90Sr for Nasal Smear Samples in Radiation Emergency and Evaluation of Intake Retention Fraction.

The efficiency of the nasal smear method was reviewed to perform a method of sample collection, analysis and initial dose estimation. The screening method of alpha-emitting radionuclides using chemical separation and alpha spectrometry was also studied. To rapidly conduct the appropriate response to victims, special monitoring for Pu, Am, and Sr using sequential analysis was established, and the method was successfully validated through participation in an international inter-comparison program. The duration of the analysis method was evaluated with regard to application in emergency situations because of its relatively rapid treatment and counting time. The intake retention fraction was calculated and evaluated to review the characteristics of each radionuclide in the anterior nasal passage of the extra-thoracic region. No large difference was observed among the four radionuclides. However, the values of the intake retention fraction were affected by age groups because of the different respiratory rates. The effects of the Y ingrowth and particle size were also discussed.

Monitoring and Dose Assessment for Children Following a Radiation Emergency Part I: Reference Values for In Vitro Bioassay.

Following a radiation emergency, children may be internally contaminated by the radionuclide(s) involved. Timely assessment of the contamination informs the need for medical treatment for those persons who had significant intakes and reassures those whose intakes are not a medical concern. In vitro bioassay reference values for children of all ICRP age groups are derived for 30 contamination scenario/radionuclide combinations involving 13 radionuclides. These bioassay values are derived from an intake that leads to a 70-y committed effective dose of 50 mSv or a 30-d RBE-weighted absorbed dose to the lungs of 0.2 Gy-Eq, depending on which criterion is more strict. These values are presented in a collection of lookup tables that can be used directly as references.

Effective dose evaluation of NORM-added consumer products using Monte Carlo simulations and the ICRP computational human phantoms.

The aim of this study is to evaluate the potential hazard of naturally occurring radioactive material (NORM) added consumer products. Using the Monte Carlo method, the radioactive products were simulated with ICRP reference phantom and the organ doses were calculated with the usage scenario. Finally, the annual effective doses were evaluated as lower than the public dose limit of 1mSv y(-1) for 44 products. It was demonstrated that NORM-added consumer products could be quantitatively assessed for the safety regulation.

Estimates of Radiation Doses and Cancer Risk from Food Intake in Korea.

The aim of this study was to estimate internal radiation doses and lifetime cancer risk from food ingestion. Radiation doses from food intake were calculated using the Korea National Health and Nutrition Examination Survey and the measured radioactivity of (134)Cs, (137)Cs, and (131)I from the Ministry of Food and Drug Safety in Korea. Total number of measured data was 8,496 (3,643 for agricultural products, 644 for livestock products, 43 for milk products, 3,193 for marine products, and 973 for processed food). Cancer risk was calculated by multiplying the estimated committed effective dose and the detriment adjusted nominal risk coefficients recommended by the International Commission on Radiation Protection. The lifetime committed effective doses from the daily diet are ranged 2.957-3.710 mSv. Excess lifetime cancer risks are 14.4-18.1, 0.4-0.5, and 1.8-2.3 per 100,000 for all solid cancers combined, thyroid cancer, and leukemia, respectively.

Feasibility study for the assessment of the exposed dose with TENORM added in consumer products.

Consumer products including naturally occurring radioactive material have been distributed widely in human life. The potential hazard of the excessively added technically enhanced naturally occurring radioactive material (TENORM) in consumer products should be assessed. The aim of this study is to evaluate the organ equivalent dose and the annual effective dose with the usage of the TENORM added in paints. The activities of gammas emitted from natural radionuclides in the five types of paints were measured with the high-purity germanium detector, and the annual effective dose was assessed with the computational human phantom and the Monte Carlo method. The results show that uranium and thorium series were mainly measured over the five paints. Based on the exposure scenario of the paints in the room, the highest effective dose was evaluated as <1 mSv y(-1) of the public dose limit.

Retrospective biodosimetry using translocation frequency in a stable cell of occupationally exposed to ionizing radiation.

Two cases of hematological malignancies were reported in an industrial radiography company over a year, which were reasonably suspected of being consequences of prolonged exposure to ionizing radiation because of the higher incidence than expected in the general population. We analyzed chromosomal aberrations in the peripheral blood lymphocytes from the other workers who had been working under similar circumstances as the patients in the company. Among the subjects tested, 10 workers who belonged to the highest band were followed up periodically for 1.5 years since the first analysis. The aim of this study was to clarify pertinence of translocation analysis to an industrial set-up where chronic exposure was commonly expected. To be a useful tool for a retrospective biodosimetry, the aberrations need to be persistent for a decade or longer. Therefore we calculated the decline rates and half-lives of frequency for both a reciprocal translocation and a dicentric chromosome and compared them. In this study, while the frequency of reciprocal translocations was maintained at the initial level, dicentric chromosomes were decreased to 46.9% (31.0-76.5) of the initial frequency over the follow-up period. Our results support the long-term stability of reciprocal translocation through the cell cycle and validate the usefulness of translocation analysis as a retrospective biodosimetry for cases of occupational exposure.

Effective dose conversion coefficients for health care provider exposed to pediatric and adult victims in radiological dispersal device incident.

After an incident of radiological dispersal devices (RDD), health care providers will be exposed to the contaminated patients in the extended medical treatments. Assessment of potential radiation dose to the health care providers will be crucial to minimize their health risk. In this study, we compiled a set of conversion coefficients (mSv MBq(-1) s(-1)) to readily estimate the effective dose from the time-integrated activity for the health care providers while they deal with internally contaminated patients at different ages. We selected Co-60, Ir-192, Am-241, Cs-137, and I-131 as the major radionuclides that may be used for RDD. We obtained the age-specific organ burdens after the inhalation of those radionuclides from the Dose and Risk Calculation Software (DCAL) program. A series of hybrid computational phantoms (1-, 5-, 10-, and 15 year-old, and adult males) were implemented in a general purpose Monte Carlo (MC) transport code, MCNPX v 2.7, to simulate an adult male health care provider exposed to contaminated patients at different ages. Two exposure scenarios were taken into account: a health care provider (a) standing at the side of patients lying in bed and (b) sitting face to face with patients. The conversion coefficients overall depended on radionuclides, the age of the patients, and the orientation of the patients. The conversion coefficient was greatest for Co-60 and smallest for Am-241. The dose from the 1 year-old patient phantom was up to three times greater than that from the adult patient phantom. The conversion coefficients were less dependent on the age of the patients in the scenario of a health care provider sitting face to face with patients. The dose conversion coefficients established in this study will be useful to readily estimate the effective dose to the health care providers in RDD events.