Implications of recent epidemiologic studies for the linear nonthreshold model and radiation protection.

The recently published NCRP Commentary No. 27 evaluated the new information from epidemiologic studies as to their degree of support for applying the linear nonthreshold (LNT) model of carcinogenic effects for radiation protection purposes (NCRP 2018 Implications of Recent Epidemiologic Studies for the Linear Nonthreshold Model and Radiation Protection, Commentary No. 27 (Bethesda, MD: National Council on Radiation Protection and Measurements)). The aim was to determine whether recent epidemiologic studies of low-LET radiation, particularly those at low doses and/or low dose rates (LD/LDR), broadly support the LNT model of carcinogenic risk or, on the contrary, demonstrate sufficient evidence that the LNT model is inappropriate for the purposes of radiation protection. An updated review was needed because a considerable number of reports of radiation epidemiologic studies based on new or updated data have been published since other major reviews were conducted by national and international scientific committees. The Commentary provides a critical review of the LD/LDR studies that are most directly applicable to current occupational, environmental and medical radiation exposure circumstances. This Memorandum summarises several of the more important LD/LDR studies that incorporate radiation dose responses for solid cancer and leukemia that were reviewed in Commentary No. 27. In addition, an overview is provided of radiation studies of breast and thyroid cancers, and cancer after childhood exposures. Non-cancers are briefly touched upon such as ischemic heart disease, cataracts, and heritable genetic effects. To assess the applicability and utility of the LNT model for radiation protection, the Commentary evaluated 29 epidemiologic studies or groups of studies, primarily of total solid cancer, in terms of strengths and weaknesses in their epidemiologic methods, dosimetry approaches, and statistical modelling, and the degree to which they supported a LNT model for continued use in radiation protection. Recommendations for how to make epidemiologic radiation studies more informative are outlined. The NCRP Committee recognises that the risks from LD/LDR exposures are small and uncertain. The Committee judged that the available epidemiologic data were broadly supportive of the LNT model and that at this time no alternative dose-response relationship appears more pragmatic or prudent for radiation protection purposes.

Voxel modeling of rabbits for use in radiological dose rate calculations.

Radiation dose to biota is generally calculated using Monte Carlo simulations of whole body ellipsoids with homogeneously distributed radioactivity throughout. More complex anatomical phantoms, termed voxel phantoms, have been developed to test the validity of these simplistic geometric models. In most voxel models created to date, human tissue composition and density values have been used in lieu of biologically accurate values for non-human biota. This has raised questions regarding variable tissue composition and density effects on the fraction of radioactive emission energy absorbed within tissues (e.g. the absorbed fraction - AF), along with implications for age-dependent dose rates as organisms mature. The results of this study on rabbits indicates that the variation in composition between two mammalian tissue types (e.g. human vs rabbit bones) made little difference in self-AF (SAF) values (within 5% over most energy ranges). However, variable tissue density (e.g. bone vs liver) can significantly impact SAF values. An examination of differences across life-stages revealed increasing SAF with testis and ovary size of over an order of magnitude for photons and several factors for electrons, indicating the potential for increasing dose rates to these sensitive organs as animals mature. AFs for electron energies of 0.1, 0.2, 0.4, 0.5, 0.7, 1.0, 1.5, 2.0, and 4.0 MeV and photon energies of 0.01, 0.015, 0.02, 0.03, 0.05, 0.1, 0.2, 0.5, 1.0, 1.5, 2.0, and 4.0 MeV are provided for eleven rabbit tissues. The data presented in this study can be used to calculate accurate organ dose rates for rabbits and other small rodents; to aide in extending dose results among different mammal species; and to validate the use of ellipsoidal models for regulatory purposes.

Accumulation of plutonium in mammalian wildlife tissues following dispersal by accidental-release tests.

We examined the distribution of plutonium (Pu) in the tissues of mammalian wildlife inhabiting the relatively undisturbed, semi-arid former Taranaki weapons test site, Maralinga, Australia. The accumulation of absorbed Pu was highest in the skeleton (83% ± 6%), followed by muscle (10% ± 9%), liver (6% ± 6%), kidneys (0.6% ± 0.4%), and blood (0.2%). Pu activity concentrations in lung tissues were elevated relative to the body average. Foetal transfer was higher in the wildlife data than in previous laboratory studies. The amount of Pu in the gastrointestinal tract was highly elevated relative to that absorbed within the body, potentially increasing transfer of Pu to wildlife and human consumers that may ingest gastrointestinal tract organs. The Pu distribution in the Maralinga mammalian wildlife generally aligns with previous studies related to environmental exposure (e.g. Pu in humans from worldwide fallout), but contrasts with the partitioning models that have traditionally been used for human worker-protection purposes (approximately equal deposition in bone and liver) which appear to under-predict the skeletal accumulation in environmental exposure conditions.

Handedness in blood donors: no association with blood group or twinning.

There has been considerable interest in the contribution of inheritance to determination of handedness and in observed associations between hand laterality and twinning, gender and age. Unpublished data from a study of children born preterm suggested an association between AB0 blood group and handedness. A questionnaire filled in by 3815 blood donors, gave information on blood group, age, gender, whether they were a twin, hand used for writing and perceived handedness. There was no association between AB0 blood group or rhesus group and handedness. Significantly more females than males considered themselves right handed (82.5% versus 79.9%) and more subjects aged 50+ wrote with the right hand (90.6% versus 87.6% if younger). Twins did not differ from other subjects in this study and we hypothesise that the generally inconsistent findings relating to twins may be explained by population differences in the proportion of twins born preterm.

Factors affecting the yield of cardiac valve allografts from living unrelated donors.

OBJECTIVE: Allografts are the valve of choice for fertile women, patients with infective endocarditis and those with small aortic roots. However, the supply of valves is problematic and widespread usage is restricted by limited availability. Allograft valves are available from cadaveric donors and from the explanted hearts of transplant recipients. Potentially, hearts from these patients could be an excellent source of usable aortic and pulmonary valves. However, little information is available on the suitability of such donors, the procurement rate of allograft valves from this source, or the factors that limit the yield of implantable valves from explanted hearts. METHOD: In order to examine some of these issues, we have carried out a retrospective study on the explanted hearts offered to the East Anglian Tissue Bank by Papworth hospital. Papworth hospital carries out approximately 90 heart and heart/lung transplants per year. Over a 2 year period, the tissue bank was offered 72 hearts from this programme. RESULTS: Of the 72 hearts offered, 58 were accepted for subsequent dissection and further examination. A total of 14 hearts were refused. The main reasons for refusal were extensive cardiectomy trauma (4 hearts) and abnormal valve morphology (four hearts). Of the 116 valves from those hearts accepted for dissection, 55 valves were rejected upon further examination. Reasons for rejection included: cardiectomy trauma (26 valves), abnormal morphology (22 valves), procurement/dissection trauma (7 valves). Of the 61 valves banked, four were subsequently rejected due to positive or incomplete microbiology. Procurement trauma fell to 0% in the last 12 months of the study but cardiectomy trauma remained constant and was related to previous cardiac surgery. Overall, the yield of implantable valves was 0.8 valves/donor. However, the yield showed considerable variation, from 1.0 valves/donor for donors diagnosed as cardiomyopathy to 0.5 valves/donor for donors with ischaemic heart disease who had undergone previous cardiac surgery. CONCLUSION: It is possible to predict the likely yield of explanted heart valves from different groups of heart transplant recipients, based on diagnosis and previous history. The yield of usable valves could be increased by avoidance of injury, both during cardiectomy and subsequent removal of the valves; this is achievable through appropriate training.

Creation of a voxel phantom of the ICRP reference crab.

The International Commission on Radiological Protection (ICRP) has modeled twelve reference animal and plant (RAP) species using simple geometric shapes in Monte-Carlo (MCNP) based simulations. The focus has now shifted to creating voxel phantoms of each RAP in order to estimate doses to biota with a higher degree of confidence. This paper describes the creation of a voxel model of a Dungeness crab from CT images with shell, gills, gonads, hepatopancreas, and heart identified and segmented. Absorbed fractions were tabulated for each organ as a source and target at twelve photon and nine electron energies: 0.01, 0.015, 0.02, 0.03, 0.05, 0.1, 0.2, 0.5, 1.0, 1.5, 2.0, and 4.0 MeV for photons and 0.1, 0.2, 0.4, 0.5, 0.7, 1.0, 1.5, 2.0 and 4.0 MeV for electrons. AFs whose error exceeded 5% are marked with an underline in the data tables; AFs whose error was higher than 10% were excluded, and are shown in the tabulated data as a dashed line. A representative sample of the data is shown in Figs. 3-8; the entire data set is available as an electronic appendix. The results are consistent with previous small organism studies (Kinase, 2008; Stabin et al., 2006), and suggest that AF values are highly dependent on source organ location and mass.

Acute myeloid leukaemia after treatment with razoxane.

Two new cases of acute myeloid leukaemia occurring after razoxane therapy are recorded and further haematological and cytogenetic details of two cases previously reported are described. The need for long-term follow-up after patients discontinue razoxane therapy is emphasized.

A comparative study of plateletpheresis using Baxter Autopheresis C and Haemonetics PCS plus.

This study compared plateletpheresis on the Haemonetics PCS Plus (PCS Plus) and the Baxter Autopheresis C (Auto C) using the same 100 selected donors. The number of packs meeting UK BTS/NIBSC specification (> 2.2 x 10(11) platelets per pack) was achieved by 99% of PCS Plus and 82% of Auto C procedures. The positive correlation found between donor precount and final platelet yield was better for the PCS Plus. Both machines met U.K. specification for white-cell contamination but this was significantly greater for the Auto C. Plasma yields were similar. As a result of this study we chose to use the PCS Plus for routine plateletpheresis in our unit. This has enabled us not only to comply with UK BTS/NIBSC specifications for apheresis platelets easily and cost effectively but also to meet our own higher specification (2.75 x 10(11) platelets per pack) using existing staff and without extending the working day.