Awareness and preparedness level of medical workers for radiation and nuclear emergency response.

Radiological science and nuclear technology have made great strides in the twenty-first century, with wide-ranging applications in various fields, including energy, medicine, and industry. However, those developments have been accompanied by the inherent risks of exposure to nuclear radiation, which is a source of concern owing to its potentially adverse effects on human health and safety and which is of particular relevance to medical personnel who may be exposed to certain cancers associated with low-dose radiation in their working environment. While medical radiation workers have seen a decrease in their occupational exposure since the 1950s thanks to improved measures for radiation protection, a concerning lack of understanding and awareness persists among medical professionals regarding these potential hazards and the required safety precautions. This issue is further compounded by insufficient capabilities in emergency response. This highlights the urgent need to strengthen radiation safety education and training to ensure the well-being of medical staff who play a critical role in radiological and nuclear emergencies. This review examines the health hazards of nuclear radiation to healthcare workers and the awareness and willingness and education of healthcare workers on radiation protection, calling for improved training programs and emergency response skills to mitigate the risks of radiation exposure in the occupational environment, providing a catalyst for future enhancement of radiation safety protocols and fostering of a culture of safety in the medical community.

Mitochondrial Targeted Cerium Oxide Nanoclusters for Radiation Protection and Promoting Hematopoiesis.

Purpose: Mitochondrial oxidative stress is an important factor in cell apoptosis. Cerium oxide nanomaterials show great potential for scavenging free radicals and simulating superoxide dismutase (SOD) and catalase (CAT) activities. To solve the problem of poor targeting of cerium oxide nanomaterials, we designed albumin-cerium oxide nanoclusters (TPP-PCNLs) that target the modification of mitochondria with triphenyl phosphate (TPP). TPP-PCNLs are expected to simulate the activity of superoxide dismutase, continuously remove reactive oxygen species, and play a lasting role in radiation protection. Methods: First, cerium dioxide nanoclusters (CNLs), polyethylene glycol cerium dioxide nanoclusters (PCNLs), and TPP-PCNLs were characterized in terms of their morphology and size, ultraviolet spectrum, dispersion stability and cellular uptake, and colocalization Subsequently, the anti-radiation effects of TPP-PCNLs were investigated using in vitro and in vivo experiments including cell viability, apoptosis, comet assays, histopathology, and dose reduction factor (DRF). Results: TPP-PCNLs exhibited good stability and biocompatibility. In vitro experiments indicated that TPP-PCNLs could not only target mitochondria excellently but also regulate reactive oxygen species (ROS)levels in whole cells. More importantly, TPP-PCNLs improved the integrity and functionality of mitochondria in irradiated L-02 cells, thereby indirectly eliminating the continuous damage to nuclear DNA caused by mitochondrial oxidative stress. TPP-PCNLs are mainly targeted to the liver, spleen, and other extramedullary hematopoietic organs with a radiation dose reduction factor of 1.30. In vivo experiments showed that TPP-PCNLs effectively improved the survival rate, weight change, hematopoietic function of irradiated animals. Western blot experiments have confirmed that TPP-PCNLs play a role in radiation protection by regulating the mitochondrial apoptotic pathway. Conclusion: TPP-PCNLs play a radiologically protective role by targeting extramedullary hematopoietic organ-liver cells and mitochondria to continuously clear ROS.

Dose equivalent consideration from neutron contamination in modified radiotherapy vault: a Monte Carlo study.

Laminated barriers incorporating metal sheets provide effective protection for space-restricted radiotherapy centers. This study aimed to assess photoneutron contamination in smaller vaults protected by different compositions of multilayer barriers during simulated pelvic radiotherapy with 18 MV photon beams. Monte Carlo Simulations of 18 MV LINAC (Varian 2100 C/D) and Medical Internal Radiation Dose (MIRD) phantom were used to assess photoneutron contamination within reconstructed vaults incorporating different combinations of metal sheet and borated polyethylene (BPE) during pelvic radiotherapy. The findings highlight a 3.27 and 2.91 times increase in ambient neutron doseHn*(10) along the maze of reconstructed vaults that use lead and steel sheets, respectively, compared to concrete. TheHn*(10) outside the treatment room increased after incorporating a metal sheet, but it remained within the permissible limit of 20µSv/week for uncontrolled areas adjacent to the LINAC bunker, even with a workload of 1000Gy/week. Neutron equivalent doses in the patient's organs ranged from 0.22 to 0.96 mSv Gy-1. There is no notable distinction in the organ's neutron equivalent dose, fatal cancer risk, secondary radiation-induced cancer risk, and cancer mortality for various laminated barrier compositions. Furthermore, the use of metal sheets for vault wall reconstruction keeps the variation in cancer risk induced by photoneutrons below 6%, while risks of fatal cancer and cancer mortality vary less than 11%. While the metal portion of the laminated barrier raises the neutron dose, the addition of a BPE plate reduces concerns of increased effective dose and secondary malignancy risk.

Improving a regional project on diagnostic reference levels for interventional procedures (OPRIPALC) with the support of a dose management system for the protection of patients and staff.

Interventional radiology is a clinical practice with important benefits for patients, but which involves high radiation doses. The optimisation of radiation protection (RP) for paediatric interventional cardiology is a priority for both patients and staff. The use of diagnostic reference levels (DRLs) has been proposed by the International Commission on Radiological Protection to improve RP in imaging procedures. Dose management systems (DMSs) allow the automatic collection of dosimetric, geometric and technical data to assist the optimisation process, with a continuous audit of the procedures, generating alerts to implement corrective actions when necessary. Patient dose indicators may be analysed individually and for different radiation events (fluoroscopy and cine runs). Occupational doses per procedure may be analysed (if electronic dosimeters are available) and linked with patient doses for an integrated approach to RP. Regional optimisation programmes require data collection and processing from several countries to set and periodically update the DRLs. Patient data is anonymised, and each participating hospital has access to their data in a central computer server. Using DMSs may be one of the best ways to support these programs in the collection and analysis of data, raising alerts about high patient and occupational doses and suggesting optimisation actions.

Dose, dose, dose, but where is the patient dose?

The article reviews the historical developments in radiation dose metrices in medical imaging. It identifies the good, the bad, and the ugly aspects of current-day metrices. The actions on shifting focus from International Commission on Radiological Protection (ICRP) Reference-Man-based population-average phantoms to patient-specific computational phantoms have been proposed and discussed. Technological developments in recent years involving AI-based automatic organ segmentation and 'near real-time' Monte Carlo dose calculations suggest the feasibility and advantage of obtaining patient-specific organ doses. It appears that the time for ICRP and other international organizations to embrace 'patient-specific' dose quantity representing risk may have finally come. While the existing dose metrices meet specific demands, emphasis needs to be also placed on making radiation units understandable to the medical community.

Evaluation of uncertainty in personal dose measured using CaSO4:Dy-based TLD badge at different workplaces.

The metrological quality of a measurement is characterised by evaluating the uncertainty in the measurement. In this paper, uncertainty in personal dose measured using individual monitoring CaSO4:Dy-based thermoluminescence dosimeter badge is evaluated by application of the guide to the expression of uncertainty in measurement method. The present dose reporting quantity, whole body dose (WBD) and the proposed quantity, personal dose equivalent, Hp(10) has been used as measurands. The influence of various input quantities on the measurement were analyzed through tests that conform to the requirements of the International Electrotechnical Commission IEC 62387. The study found that the expanded uncertainties for WBD and Hp(10) measurements were 63.4% and 41.4%, respectively, corresponding to a 95% coverage probability for workplace fields covering a wide photon energy range (33-1250 keV). However, the uncertainty estimates were quite lower for the type of workplaces that are identified using the dose evaluation algorithm. The input quantities, namely, the response to a mixture of photon beam qualities and photon energy and angular dependence contribute the most to the total uncertainty.

Monte Carlo modelling of cyclotron and radioisotope center (CYRIC) at Tohoku University: a radiation protection study.

Protection against ionizing radiations is important in laboratories with radioactive materials and high energy cyclotron beams. The Cyclotron and Radioisotope Center (CYRIC) located in Tohoku University in Miyagi prefecture, Japan and is a well-known nuclear science laboratory with cyclotron beams and substantial number of high activity radioactive materials. Considering this, it is important to perform complete radiation transport computations to ensure the safety of non-occupational and occupational workers. In the present work, we have developed a complete 3-dimensional model of the main cyclotron building and radiation labs using Monte Carlo method. We have found that the dispersed photons and neutrons inside and in the surrounding of the CYRIC building pose no significant risk to occupational and non-occupational workers. The present work and the developed models would be useful in the field of radiation protection.

The difficulty of nuclear emergency prevention measures during natural disasters: ongoing challenges in Japan.

It is crucial to anticipate nuclear emergency scenarios and implement effective measures. Japan's climate and topography make it vulnerable to natural disasters; thus, it is necessary to address compounding and cascading disaster scenarios involving the simultaneous occurrence of natural and nuclear disasters. On 1 January 2024, an earthquake hit the Noto region of Ishikawa Prefecture, resulting in damage to the area around the Shika Nuclear Power Plant, located 90 km from the epicenter. This earthquake revealed that, in the event of a complex disaster, it is possible that residents living within 30 km of the Shika Nuclear Power Plant will be completely unprepared for a nuclear disaster. In the event of a complex disaster, it is crucial to implement appropriate countermeasures while balancing responses to both nuclear and natural disasters and optimizing radiation disaster prevention measures.

[Advances in research on organ-at-risk protection in pelvic tumor external beam radiotherapy].

The simultaneous objectives of destroying tumor cells while protecting normal pelvic organs present a dual clinical and technical challenge within the realm of pelvic tumor radiotherapy. This article reviews the latest literatures, focusing on technological innovations in key aspects of radiotherapy such as positioning, planning, and delivery. These include positioning fixation techniques, organ-at-risk avoidance irradiation, non-coplanar irradiation techniques, as well as organ displacement protection and image-guided adaptive techniques. It summarizes and discusses the research progress made in the protection of critical organs during pelvic tumor radiotherapy. The paper emphasizes technological advancements in the protection of critical organs throughout the processes of radiotherapy positioning, planning, and implementation, aiming to provide references for further research on the protection of critical organs in the external irradiation treatment of pelvic tumors.

Validity of the 1984 Interim Guidelines on Airborne Ultrasound and Gaps in the Current Knowledge.

ABSTRACT: Airborne ultrasound is used for various purposes both in industrial and public settings, as well as being produced as a by-product by a range of sources. The International Radiation Protection Association (IRPA) published interim guidelines on limiting human exposure to airborne ultrasound in 1984, based on the limited scientific evidence that was available at that time. In order to investigate whether research since 1984 requires the development of revised exposure guidelines we considered (a) within the context of ultrasound exposure the relevance to health of the biological endpoints/mechanisms listed in the IRPA guidelines, (b) the validity of the exposure limits, and (c) whether there are biological endpoints/mechanisms not covered in the guidelines. The analysis of the available evidence showed that the biological endpoints that form the basis of the guidelines are relevant to health and the guidelines provide limits of exposure based on the evidence that was available at the time. However, the IRPA limits and their associated dosimetry were based on limited evidence, which may not be considered as scientifically substantiated. Further, there is no substantiated evidence of biological endpoints/mechanisms not covered by the IRPA guidelines. These two observations could mean that IRPA's limits are too low or too high. Research since the IRPA guidelines has made some improvements in the knowledge base, but there are still significant data gaps that need to be resolved before a formal revision of the guidelines can be made by ICNIRP, including research needs related to health outcomes and improved dosimetry. This statement makes a number of recommendations for future research on airborne ultrasound.

Radiation Adverse Outcome pathways (AOPs): examining priority questions from an international horizon-style exercise.

PURPOSE: The Organisation for Economic Co-operation and Development (OECD) Adverse Outcome Pathway (AOP) Development Programme is being explored in the radiation field, as an overarching framework to identify and prioritize research needs that best support strengthening of radiation risk assessment and risk management strategies. To advance the use of AOPs, an international horizon-style exercise (HSE) was initiated through the Radiation/Chemical AOP Joint Topical Group (JTG) formed by the OECD Nuclear Energy Agency (NEA) High-Level Group on Low Dose Research (HLG-LDR) under the auspices of the Committee on Radiological Protection and Public Health (CRPPH). The intent of the HSE was to identify key research questions for consideration in AOP development that would help to reduce uncertainties in estimating the health risks following exposures to low dose and low dose-rate ionizing radiation. The HSE was conducted in several phases involving the solicitation of relevant questions, a collaborative review of open-ended candidate questions and an elimination exercise that led to the selection of 25 highest priority questions for the stated purpose. These questions were further ranked by over 100 respondents through an international survey. This final set of questions was judged to provide insights into how the OECD's AOP approach can be put into practice to meet the needs of hazard and risk assessors, regulators, and researchers. This paper examines the 25 priority questions in the context of hazard/risk assessment framework for ionizing radiation. CONCLUSION: By addressing the 25 priority questions, it is anticipated that constructed AOPs will have a high level of specificity, making them valuable tools for simplifying and prioritizing complex biological processes for use in developing revised radiation hazard and risk assessment strategies.

Commissioning of the first hospital-based PET radiopharmaceutical cyclotron in Greece: personnel dose assessment.

The role of18F-fluoro-deoxy-glucose in positron emission tomography (PET) imaging is well established in diagnosis and management of cancer patients. Installations of on-site self-shielded mini cyclotrons are increasing. The Dose on Demand Biomarker Generator BG-75 was installed at Metaxa Cancer Hospital, Greece, in May 2021 and is the first hospital-based PET radiopharmaceutical cyclotron in the country. Personnel expected external exposure was established during commissioning; internal exposure is not expected. Personnel dose was estimated with two methods: survey meter measurements in various locations combined with the time spent in each location, and direct measurement using electronic personal dosemeters. Gamma and neutron radiation readings outside the cyclotron vault were at background levels. Inside the cyclotron vault, the highest recorded radiation readings by the target were 18µSv h-1for both gammas and neutrons with cyclotron in operational mode; at one meter, the values were 5µSv h-1and 4µSv h-1, respectively. The annual expected whole body dose per cyclotron operator is 0.6 mSv, and the respective extremity dose 16 mSv. The annual expected whole body and extremity dose for the radiochemist is 0.3 mSv and 25 mSv, respectively. The respective annual dose estimates for the medical physicists are < 1 mSv. The expected personnel doses are well below the regulatory limits and local as low as reasonably achievable (ALARA) levels. With experience and a robust ALARA program, personnel exposure could be further reduced.

Accurate machine-specific reference and small-field dosimetry for a self-shielded neuro-radiosurgical system.

BACKGROUND: The newly available ZAP-X stereotactic radiosurgical system is designed for the treatment of intracranial lesions, with several unique features that include a self-shielding, gyroscopic gantry, wheel collimation, non-orthogonal kV imaging, short source-axis distance, and low-energy megavoltage beam. Systematic characterization of its radiation as well as other properties is imperative to ensure its safe and effective clinical application. PURPOSE: To accurately determine the radiation output of the ZAP-X with a special focus on the smaller diameter cones and an aim to provide useful recommendations on quantification of small field dosimetry. METHODS: Six different types of detectors were used to measure relative output factors at field sizes ranging from 4 to 25 mm, including the PTW microSilicon and microdiamond diodes, Exradin W2 plastic scintillator, Exradin A16 and A1SL ionization chambers, and the alanine dosimeter. The 25 mm cone served as the reference field size. Absolute dose was determined with both TG-51-based dosimetry using a calibrated PTW Semiflex ion chamber and measurements using alanine dosimeters. RESULTS: The average radiation output factors (maximum deviation from the average) measured with the microDiamond, microSilicon, and W2 detectors were: for the 4 mm cone, 0.741 (1.0%); for the 5 mm cone: 0.817 (1.0%); for the 7.5 mm cone: 0.908 (1.0%); for the 10 mm cone: 0.946 (0.4%); for the 12.5 mm cone: 0.964 (0.2%); for the 15 mm cone: 0.976 (0.1%); for the 20 mm cone: 0.990 (0.1%). For field sizes larger than 10 mm, the A1SL and A16 micro-chambers also yielded consistent output factors within 1.5% of those obtained using the microSilicon, microdiamond, and W2 detectors. The absolute dose measurement obtained with alanine was within 1.2%, consistent with combined uncertainties, compared to the PTW Semiflex chamber for the 25 mm reference cone. CONCLUSION: For field sizes less than 10 mm, the microSilicon diode, microDiamond detector, and W2 scintillator are suitable devices for accurate small field dosimetry of the ZAP-X system. For larger fields, the A1SL and A16 micro-chambers can also be used. Furthermore, alanine dosimetry can be an accurate verification of reference and absolute dose typically measured with ion chambers. Use of multiple suitable detectors and uncertainty analyses were recommended for reliable determination of small field radiation outputs.

High-radiation-exposure tasks in Korean pressurized heavy-water reactors.

This study analysed the occupational dose in Korean pressurized heavy-water reactors (PHWRs) and identified tasks involving high radiation exposure. The average individual dose was sufficiently low to be below the annual effective dose limit for radiation workers and is even lower than the dose limit for the general public. However, some workers received relatively higher doses than others. Furthermore, most PHWR workers are exposed to radiation during planned maintenance periods. In this study, the radiation dose was normalized (radiation dose per unit time) to determine the high-radiation-exposure tasks in Korean PHWRs. Consequently, end-fitting lapping, delayed neutron tube work and fuel channel fixed-end change tasks were identified as high-radiation-exposure tasks in Korean PHWRs. If appropriate radiation protection measures are prioritized for the identified high-dose exposure tasks, optimization of radiological protection will be effectively achieved by reducing the dose that is relatively higher than the average.

Biomaterials-mediated radiation-induced diseases treatment and radiation protection.

In recent years, the intersection of the academic and medical domains has increasingly spotlighted the utilization of biomaterials in radioactive disease treatment and radiation protection. Biomaterials, distinguished from conventional molecular pharmaceuticals, offer a suite of advantages in addressing radiological conditions. These include their superior biological activity, chemical stability, exceptional histocompatibility, and targeted delivery capabilities. This review comprehensively delineates the therapeutic mechanisms employed by various biomaterials in treating radiological afflictions impacting the skin, lungs, gastrointestinal tract, and hematopoietic systems. Significantly, these nanomaterials function not only as efficient drug delivery vehicles but also as protective agents against radiation, mitigating its detrimental effects on the human body. Notably, the strategic amalgamation of specific biomaterials with particular pharmacological agents can lead to a synergistic therapeutic outcome, opening new avenues in the treatment of radiation- induced diseases. However, despite their broad potential applications, the biosafety and clinical efficacy of these biomaterials still require in-depth research and investigation. Ultimately, this review aims to not only bridge the current knowledge gaps in the application of biomaterials for radiation-induced diseases but also to inspire future innovations and research directions in this rapidly evolving field.

A survey of the radiation safety practices of veterinary practitioners during portable equine radiography in Ireland.

Veterinary practitioners and other personnel involved in the examination are exposed to ionizing radiation while performing portable radiographs on horses. An online survey was distributed to all Veterinary Council of Ireland-registered practices where the self-reported practice profile is at least 20% equine work. The survey contained questions relating to radiation safety training, protocols, personal dosimetry and lead protection usage, repeat exposures, sedation, and personnel roles during the examination. The aim of the survey was to document the current radiation safety practices of equine veterinary practitioners during portable radiography. The results showed that although adherence to guidance set out by the Environmental Protection Agency (EPA) is reasonably good, compliance rates can be improved. Personal dosemeter usage and repeat rate reduction could particularly benefit from further improvement. This is of the utmost importance in ensuring that occupational radiation exposure to veterinary practitioners is kept to an absolute minimum during their daily practice.

Efficacy of gonadal shielding in dose reduction for female pelvic radiography.

This study aimed to evaluate the dose reduction using gonad shielding (GS) during pelvic imaging. Three types of pelvic images (radiography, magnetic resonance and computed tomography) were fused to elucidate the three-dimensional relationship between the position of ovaries and GS. To estimate the dose received by the ovaries, the off-axis dose at any given depth was measured under two different imaging conditions using thermoluminescence dosemeters and a polymethyl methacrylate phantom. The mean ovarian depth was 8.4 cm. The mean estimated ovarian dose without an additional filter was 0.36 mGy without GS and 0.14 mGy with GS. The mean estimated ovarian dose with an additional filter was 0.24 mGy without GS and 0.10 mGy with GS. The efficacy of ovarian dose reduction should be evaluated based on the achieved ovarian dose, considering the ovarian depth and use of additional filtration, rather than the ovarian protection rate of GS.

Simulating the head of a TrueBeam linear particle accelerator and calculating the photoneutron spectrum on the central axis of a 10-MV photon using particle and heavy-ion transport system code.

Photon energy is higher than the (γ,n) threshold, allowing it to interact with the nuclei of materials with high z properties and liberate fast neutrons. This represents a potentially harmful source of radiation for humans and the environment. This study validated the Monte Carlo simulation, using the particle and heavy-ion transport code system (PHITS) on a TrueBeam 10-MV linear particle accelerator's head shielding model and then used this PHITS code to simulate a photo-neutron spectrum for the transport of the beam. The results showed that, when comparing the simulated to measured PDD and crosslines, 100% of the γ-indexes were <1 (γ3%/3mm) for both simulations, for both phase-space data source and a mono energy source. Neutron spectra were recorded in all parts of the TrueBeam's head, as well as photon neutron spectra at three points on the beamline.