Consideration of hereditary effects in the radiological protection system: evolution and current status.

PURPOSE: The purpose of this paper is to provide an overview of the methodology used to estimate radiation genetic risks and quantify the risk of hereditary effects as outlined in the ICRP Publication 103. It aims to highlight the historical background and development of the doubling dose method for estimating radiation-related genetic risks and its continued use in radiological protection frameworks. RESULTS: This article emphasizes the complexity associated with quantifying the risk of hereditary effects caused by radiation exposure and highlights the need for further clarification and explanation of the calculation method. As scientific knowledge in radiation sciences and human genetics continues to advance in relation to a number of factors including stability of disease frequency, selection pressures, and epigenetic changes, the characterization and quantification of genetic effects still remains a major issue for the radiological protection system of the International Commission on Radiological Protection. CONCLUSION: Further research and advancements in this field are crucial for enhancing our understanding and addressing the complexities involved in assessing and managing the risks associated with hereditary effects of radiation.

Ethical and societal aspects of radiological protection for offspring and next generations.

PURPOSE: Over the last decade or so, ethical and societal aspects of radiological protection have received increasing attention. This is also reflected in the publications of the International Commission on Radiological Protection (ICRP). The current paper aims at identifying relevant ethical and societal topics which should receive attention in the context of radiological protection for offspring and next generations. MATERIALS AND METHODS: We present a non-comprehensive review of the subject, based on presentation made at an ICRP workshop in Budapest in 2022. We first discuss the ethical values promoted by ICRP, and the application of these values in cases of (potential) pre-conceptual and prenatal radiation exposures. We then consider experience gained after the Fukushima accident indicating particular societal concerns about the health effects of such exposures. RESULTS AND CONCLUSIONS: Beneficence/non-maleficence, prudence, justice and dignity, the "core values" of the system of radiological protection have special roles to play when heritable and/or in utero effects are to be considered. Prudence, in particular, must be taken account of in view of the fact that solid scientific data in humans are largely lacking in this area, and it is necessary to rely on insights from animal experiments as well as theoretical considerations. As regards societal considerations, the perception of risk among (potentially) affected populations needs to be taken seriously. Accountability, transparency, and inclusivity, the "procedural values" promoted by ICRP for the practical implementation of the system of radiological protection play a central role in overcoming skepticism and creating trust. Stakeholder involvement should emphasize cooperation and dialogue, which allows for the joint evaluation of an exposure situation by experts and affected people.

Keeping the ICRP recommendations fit for purpose.

The International Commission on Radiological Protection (ICRP) has embarked on a review and revision of the system of Radiological Protection that will update the 2007 general recommendations in ICRPPublication 103. This is the beginning of a process that will take several years, involving open and transparent engagement with organisations and individuals around the world. While the system is robust and has performed well, it must adapt to address changes in science and society to remain fit for purpose. The aim of this paper is to encourage discussions on which areas of the system might gain the greatest benefit from review, and to initiate collaborative efforts. Increased clarity and consistency are high priorities. The better the system is understood, the more effectively it can be applied, resulting in improved protection and increased harmonisation. Many areas are identified for potential review including: classification of effects, with particular focus on tissue reactions; reformulation of detriment, potentially including non-cancer diseases; re-evaluation of the relationship between detriment and effective dose, and the possibility of defining detriments for males and females of different ages; individual variation in the response to radiation exposure; heritable effects; and effects and risks in non-human biota and ecosystems. Some of the basic concepts are also being considered, including the framework for bringing together protection of people and the environment, incremental improvements to the fundamental principles of justification and optimisation, a broader approach to protection of individuals, and clarification of the exposure situations introduced in 2007. In addition, ICRP is considering identifying where explicit incorporation of the ethical basis of the system would be beneficial, how to better reflect the importance of communications and stakeholder involvement, and further advice on education and training. ICRP invites responses on these and other areas relating to the review of the System of Radiological Protection.

Lessons learnt by IRSN about the involvement of experts towards the population in contaminated areas in Fukushima Prefecture.

Since November 2011, Institut de radioprotection et de sûreté nucléaire (IRSN) experts have participated in the International Commission on Radiological Protection's (ICRP) dialogue initiative for the rehabilitation of living conditions after the Fukushima accident. In 2013, IRSN and Centre d'étude sur l'Evaluation de la Protection dans le domaine Nucléaire (CEPN) launched a study to identify the main lessons that can be learned from these dialogues, and benefit French IRSN experts in the event of a postaccident situation. The main lesson is that in order to protect the inhabitants of contaminated areas efficiently, experts must work in cooperation with local actors to develop a co-expertise process. The availability of measurement devices for inhabitants is crucial to allow them to assess their own radiological situation. Measuring radioactivity makes it visible, and allows individuals to discuss the results in their communities and develop local projects to improve their daily life. Eventually, inhabitants create a practical radiological protection culture to manage their situation. However, helping people to protect themselves does not mean that authorities and experts have no responsibilities, and this calls for strong ethical principles such as not making decisions for people about their future. To be helpful, scientists need to understand that, as necessary as radiation protection is, it is not the only problem that inhabitants are facing and it cannot control people's lives. Radiation protection experts must commit themselves to be at the service of individuals and the community, and the issues they want to address.

ICRP Publication 132: Radiological Protection from Cosmic Radiation in Aviation.

Abstract ­: In this publication, the International Commission on Radiological Protection (ICRP) provides updated guidance on radiological protection from cosmic radiation in aviation, taking into account the current ICRP system of radiological protection, the latest available data on exposures in aviation, and experience gained worldwide in the management of exposures in aviation. The publication describes the origins of cosmic radiation, how it exposes passengers and aircraft crew, the basic radiological protection principles that apply to this existing exposure situation, and the available protective actions. For implementation of the optimisation principle, the Commission recommends a graded approach proportionate to the level of exposure that may be received by individuals. The objective is to keep the exposure of the most exposed individuals to a reasonable level. The Commission also recommends that information be disseminated to raise awareness about cosmic radiation, and to support informed decisions among concerned stakeholders.

Focal role of tolerability and reasonableness in the radiological protection system.

The concepts of tolerability and reasonableness are at the core of the International Commission on Radiological Protection (ICRP) system of radiological protection. Tolerability allows the definition of boundaries for implementing ICRP principles, while reasonableness contributes to decisions regarding adequate levels of protection, taking into account the prevailing circumstances. In the 1970s and 1980s, attempts to find theoretical foundations in risk comparisons for tolerability and cost-benefit analysis for reasonableness failed. In practice, the search for a rational basis for these concepts will never end. Making a wise decision will always remain a matter of judgement and will depend on the circumstances as well as the current knowledge and past experience. This paper discusses the constituents of tolerability and reasonableness at the heart of the radiological protection system. It also emphasises the increasing role of stakeholder engagement in the quest for tolerability and reasonableness since Publication 103.

The recommendations of ICRP Publication 111 in the light of the ICRP dialogue initiative in Fukushima.

Publication 111, published by the International Commission on Radiological Protection (ICRP) in 2009, provided the first recommendations for dealing with the long-term recovery phase after a nuclear accident. Its focus is on the protection of people living in long-term contaminated areas after a nuclear accident, drawing on the experience of the Belarus population, Cumbrian sheep farmers in the UK, and Sami reindeer herders in Norway affected by the fallout from Chernobyl. The ICRP dialogue initiative in Fukushima confirmed what had been identified after Chernobyl, namely the very strong concern for health, particularly that of children, loss of control over everyday life, apprehension about the future, disintegration of family life and of the social and economic fabric, and the threat to the autonomy and dignity of affected people. Through their testimonies and reflections, the participants of the 12 dialogue meetings shed light on this complex situation. The ICRP dialogue initiative also confirmed that the wellbeing of the affected people is at stake, and radiological protection must focus on rehabilitation of their living conditions. The challenge is to incorporate the important clarifications resulting from the ICRP dialogue initiative into the updated version of Publication 111 that is currently in development. This paper does not necessarily reflect the views of the International Commission on Radiological Protection.

Application of the Commission's recommendations: the 2013-2017 Committee 4 programme of work.

Committee 4 of the International Commission on Radiological Protection (ICRP) is responsible for developing principles, recommendations, and guidance on the protection of people against radiation exposure, and to consider their practical application in all exposure situations. Currently, the Committee's efforts are focused on the completion of a series of future ICRP publications on the implementation of its 2007 Recommendations to the various existing exposure situations. A report on protection against radon exposure was published recently (ICRP Publication 126), and two documents on protection against cosmic radiation in aviation, and naturally occurring radioactive material are under development. The programme of work for the forthcoming 2013-2017 period comprises the update of ICRP Publication 109 on protection of people in emergency exposure situations, and the update of ICRP Publication 111 on protection of people living in long-term contaminated areas after a nuclear accident, as well as the development of a future ICRP publication on the ethics of radiological protection. It also includes the preparation of task groups on the application of the Commission's recommendations for contaminated sites from past activities and for surface and near-surface disposal of radioactive waste. Another important task for Committee 4 will be to develop a reflection on the tolerability of risk from radiation.

ICRP Publication 124: Protection of the Environment under Different Exposure Situations.

In this report, the Commission describes its framework for protection of the environment and how it should be applied within the Commission's system of protection. The report expands upon its objectives in relation to protection of the environment, in so far as it relates to the protection of animals and plants (biota) in their natural environment, and how these can be met by the use of Reference Animals and Plants (RAPs); their Derived Consideration Reference Levels (DCRLs), which relate radiation effects to doses over and above their normal local background natural radiation levels; and different potential pathways of exposure. The report explains the different types of exposure situations to which its recommendations apply; the key principles that are relevant to protection of the environment; and hence how reference values based on the use of DCRLs can be used to inform on the appropriate level of effort relevant to different exposure situations. Further recommendations are made with regard to how the Commission's recommendations can be implemented to satisfy different forms of environmental protection objectives, which may require the use of representative organisms specific to a site, and how these may be compared with the reference values. Additional information is also given with regard to, in particular, communication with other interested parties and stakeholders. Issues that may arise in relation to compliance are also discussed, and the final chapter discusses the overall implications of the Commission's work in this area to date. Appendices A and B provide some numerical information relating to the RAPs. Annex C considers various existing types of environmental protection legislation currently in place in relation to large industrial sites and practices, and the various ways in which wildlife are protected from various threats arising from such sites.

ICRP Publication 111 - Application of the Commission's recommendations to the protection of people living in long-term contaminated areas after a nuclear accident or a radiation emergency.

In this report, the Commission provides guidance for the protection of people living in long-term contaminated areas resulting from either a nuclear accident or a radiation emergency. The report considers the effects of such events on the affected population. This includes the pathways of human exposure, the types of exposed populations, and the characteristics of exposures. Although the focus is on radiation protection considerations, the report also recognises the complexity of post-accident situations, which cannot be managed without addressing all the affected domains of daily life, i.e. environmental, health, economic, social, psychological, cultural, ethical, political, etc. The report explains how the 2007 Recommendations apply to this type of existing exposure situation, including consideration of the justification and optimisation of protection strategies, and the introduction and application of a reference level to drive the optimisation process. The report also considers practical aspects of the implementation of protection strategies, both by authorities and the affected population. It emphasises the effectiveness of directly involving the affected population and local professionals in the management of the situation, and the responsibility of authorities at both national and local levels to create the conditions and provide the means favouring the involvement and empowerment of the population. The role of radiation monitoring, health surveillance, and the management of contaminated foodstuffs and other commodities is described in this perspective. The Annex summarises past experience of longterm contaminated areas resulting from radiation emergencies and nuclear accidents, including radiological criteria followed in carrying out remediation measures.

The evolution of radiological risk management: an overview.

The article presents the evolution of the principles that have structured the management of the risk associated with ionising radiation. It explains how a prudent approach has been adopted to deal with the uncertainties attached to the risk linked to low exposures. It particularly addresses the way in which a dose-risk relationship and a philosophy of action have been gradually developed so that risk-taking is organised in a responsible manner. Finally, the way expertise has been structured in the framework of a cautious approach is underlined.

Chernobyl post-accident management: the ETHOS project.

ETHOS is a pilot research project supported by the radiation protection research program of the European Commission (DG XII). The project provides an alternative approach to the rehabilitation of living conditions in the contaminated territories of the CIS in the post-accident context of Chernobyl. Initiated at the beginning of 1996, this 3-y project is currently being implemented in the Republic of Belarus. The ETHOS project involves an interdisciplinary team of European researchers from the following institutions: the Centre d'etude sur l'Evaluation de la Protection dans le domaine Nucleaire CEPN (radiological protection, economics), the Institute National d'Agronomie de Paris-Grignon INAPG (agronomy, nature & life management), the Compiegne University of Technology (technological and industrial safety, social trust), and the Mutadis Research Group (sociology, social risk management), which is in charge of the scientific co-ordination of the project. The Belarussian partners in the ETHOS project include the Ministry of Emergencies of Belarus as well as the various local authorities involved with the implementation site. The ETHOS project relies on a strong involvement of the local population in the rehabilitation process. Its main goal is to create conditions for the inhabitants of the contaminated territories to reconstruct their overall quality of life. This reconstruction deals with all the day-to-day aspects that have been affected or threatened by the contamination. The project aims at creating a dynamic process whereby acceptable living conditions can be rebuilt. Radiological security is developed in the ETHOS project as part of a general improvement in the quality of life. The approach does not dissociate the social and the technical dimensions of post-accident management. This is so as to avoid radiological risk assessment and management being reduced purely to a problem for scientific experts, from which local people are excluded, and to take into consideration the problems of acceptability of decisions and the distrust of the population towards experts. These cannot be solved merely by a better communication strategy. This paper presents the main features of the methodological approach of the ETHOS project. It also explains how it is being implemented in the village of Olmany in the district of Stolyn (Brest region) in Belarus since March 1996, as well as its initial achievements.

Return to normality after a radiological emergency.

Some preliminary considerations from the management of post-accident situations connected to large scale and high land contamination are presented. The return to normal, or at least acceptable living conditions, as soon as reasonably achievable, and the prevention of the possible emergence of a post-accident crisis is of key importance. A scheme is proposed for understanding the dynamics of the various phases after an accident. An attempt is made to characterize some of the parameters driving the acceptability of post-accident situations. Strategies to return to normal living conditions in contaminated areas are considered.

[Acute post-stress pancreatitis (apropos of 7 cases)]. / Les pancréatites aiguës post-agressives (à propos de sept observations).

The authors report 7 cases of acute non-primary pancreatitis occurring in trauma patients without any initial abdominal injury. Six of the patients were male and the age range 38 to 80 years. Four were hospitalized for trauma with a severe state of shock on admission. In 5 cases there was a thoracic trauma. The complication developed within a period of 3 to 45 days. The clinical picture was scanty, examination of the patient invariably revealing abdominal distension. The diagnosis was based above all on laboratory findings: high blood glucose, independent of carbohydrate instake and insulin therapy. Treatment should first be medical, but if clinical and laboratory abnormalities persist after 12 hours treatment should be surgical: pancreatectomy of adequate extent to deal with the lesions. Pancreatic findings are characterised by their necrotico-haemorrhagic appearance. Lesions of the gland were partial, total or multifocal. The pathogenesis is not defined. Numerous factors have been suggested. The prognosis is grave: five deaths amongst the seven cases.