Radiation Protection:
Principles, Methods and
Monitoring
Moderator: Mr Anoop BharadwajRetrospective
+ “..the surgeons of Vienna and Berlin believe that the
Roentgen photograph is destined to render inestimable
services to surgery.”
— JAMA, 1896
+ “(Radiation is) the most serious agent of pollution of the
environment and the greatest threat to man’s survival on
earth.”
— E.F. Shumacher, in Small is Beautiful, 1973Introduction
+ The acceptance by society of the risks associated with
radiation is conditional on the benefits to be gained from the
use of radiation.
+ Nonetheless, the risks must be restricted and protected
against by the application of radiation safety standards.
* Itis therefore essential that activities involving radiation
exposure be subject to certain standards of safety in order to
protect the individuals who are exposed to radiation:
— Occupationally,
— For medical diagnostic or therapeutic purposes
— As members of the public.Radiation EffectsEffects of Radiation Exposure
Vv
Radiation Exposure
y
Stochastic Effects /
Probablistic
Have no threshold levels of
radiation dose.
The probablity of the effects
is proportional to the dose.
A latent period is seen
between the time of
exposure and the events to
manifest
Severity independant of dose
received
Seen when the cells are
modified rather than killed.
Vv
v
Vv
v
Non stochastic effects/
Deterministic
Have definite threshold levels
of radiation dose.
The probablity of the effects
is proportional to the dose.
A latent period is seen
between the time of
exposure and the events to
manifest
Severity may be proportional
to the dose received.
Seen when the cells are killed
or loose capability to divide.Deterministic
Stochastic, Quadratic
Stochastic, LinearStochastic Effects
+ These are primarily of two types:
— Carcinogenesis
— Hereditary effects
+ Both have:
A random nature of appearance.
No threshold dose for appearance.
Definite latent period for appearance after exposure.
Probablity of induction increases with the dose received.
Severity of the effect is independent of the dose received.
A risk that can be defined on epidemiological studies only.Radiation Induced Carcinogenesis
* Data from BIER V (US population) and the UNSCEAR
(Japanese Atomic Bomb survivors) show that:
— Relative risk of radiation induced cancers is a linear function of
doses upto 2 Sv
— At lower dose range of 0 -0.5 Sv risks are slightly higher than
the extrapolated risk.
— Risk of radiation induced cancers varies with age with patients
at younger age being more susceptible.
— Females < 15 years are most susceptible.Risk Estimates for Carcinogenesis
* Cancer accounts for ~ 25% of all deaths in developed
nations
* The annual risk of fatality from cancer is shown in the table
below.
+ ICRP estimates that for each radiation induced cancer 13 -15
years of life will be lost (but most will occur at ages of 68 -
70 yrs)
Working Population 8 x 10° per Sv 4x 10° per Sv
Whole Population 10 x 10° per Sv 5 x 10? per SvRadiation induced Hereditary effects
« Radiation induced hereditary effects are secondary to
mutations which are passed on to the progeny
* Radiation doesnot cause new types of mutations but
increases the frequency of naturally occuring mutations
* Three classes of hereditary effects are known:
— Gene mutations
— Chromosomal abberations ( Down's Syndrome)
— Multifactorial (Neural tube defects)
+ ICRP estimates that risk of hereditary effects due to radiation
exposure is:
— 0.2% per Sv in general population
— 0.1% per Sv in working populationRadiation induced Mutations
+ Radiosensitivity of different mutations vary widely - so an
average mutation risk is considered.
+ Low dose rate radiation is less effective in inducing
mutations
* Time interval between exposure and conception plays an
important protective role.
— A period of 6 months is therefore recommended between
radiation exposure and conception.
* Radiation induced mutations can be transmitted across the
generations.
+ Average “doubling dose” for humans is considered to be 1.56
SvRisk estimates of Hereditary effects
Mendelian mutations
Chronic multifactorial
diseases
Congenital abnormal-
ities
Total
Total risk per Gy
16500
65000
60000
738000
NA
750 - 1500
250 - 1200
2000
3000 - 4700
0.41 - 0.64 %
1300 - 2500
250 -1200
2400 - 3000
3950 - 6700
0.53 - 0.91%Fetal Effects
« Radiation risks to fetus are related to:
— Exposure magnitude
— Time of pregnancy
+ Radiation risks are most significant during
organogenesis and in the early fetal period.
+ Threshold for malformations:
— 100 - 200 mGy (Malformations)
— 100 mGy (Mental Retardation): Risk coeffecient
is 0.4 per Sv
+ A exposure 1mSv is safe for a fetus - normal
exposure from background radiation
+ Adose > 0.1 Sv is considered the threshold
beyond which an MTP should be considered.Fetal Effects
* Time of radiation vs effect:
— 2-3 weeks: Most embryos are aborted
-— 4-11 weeks: Severe abnormalities in most organs
— 11 - 16 weeks: Mental retardation and stunting more common
- 16 - 25 weeks: Mild degree of mental retardation and
microcephaly
— > 30 weeks: Usually leads to functional disabilities in later life
* Carcinogenesis:
— Most exposures implicated occur in 3" trimester
— Doses more than 1 mSv will increase the risk - but no
threshold apparent.
— Excess absolute risk - 6% per Sv.ICRP quantities for Stochastic effects
+ The concept of detriment as recommended by the ICRP for
stochastic effects includes the following quantities:
— The probability of fatal cancer attributable to radiation
exposure;
— The weighted probability of incurring a non-fatal cancer
— The weighted probability of severe hereditary effects
— The length of lifetime lost, if the harm occurs.
Detrimen: (107? Sv“ i)!
Non-fatal Severe hereditary
Exposed population Fatal cancer? cancer effects Toul
Adult workers 40 08 08 55
Whole population 50 10 13 13
Rounded values.
"For fatal cancer, thedetsiicat is equa to the probability coefficientSafety Standards
+ These are defined based on the knowledge of the knowledge
of effects of radiation and the principles of radiation
protection.
+ The UNSCEAR (United Nations Scientific Committee on the
Effects of Atomic Radiation, 1955) is the central body which
collects the data regarding this.
* The IAEA uses the data from ICRP in designing the safety
standards.
+ Consensus guidelines on these safety standards are
published as International Basic Safety Standards for
Protection against Ionizing Radiation and for the Safety of
Radiation rces (referred to as BSS)
+ Latest version - 1996 (IAEA safety series 115)Types of Radiation
ExposuresICRP Reference Man
The concept of a ‘reference human’ to help manage the
many different situations in which human beings would or
could be exposed to ionising radiations.
ICRP published comprehensive report on Reference Man in
1975 (ICRP, 1975) - recent revision is in ICRP 2002.
The purpose of Reference Man was:
— Create points of reference for the procedure of dose
estimations to humans.
— Derivation of relevant quantities and units for their
interpretation
— Considering the relationships between doses to different parts
of the human body and their effects.
Most countries have modified the concept of reference man —
e.g. Indian Reference ManICRP Reference Man
+ ICRP 89 has given definitions and data for reference humans
of both sexes in 6 different age groups:
— Newborn
-—1Yr
- 5Yr
- 10Yr
- 15Yr
— Adult
+ Reference man is defined as being between 20-30 years of
age, weighing 70 kg, is 170 cm in height, and lives in a
climate with an average temperature of from 10 to 20 C. He
isa Caucasian and is a Western European or North American
in habitat and custom.”
+ Recently weight has been revised to 73 Kgs.Indian Reference Man
Indian Adult* | ICRP Reference Man Indian RF’,
Body mass (kg) 52 10 oot
it (cua) a 170 015
Marenals(g) m0 01
Brait(g) 1400 Om
Hears) 330 008
Kidneys(g) 310 7)
Livei(g) TS ous
Tungs(@i 1000 Cevophagus om
Pancieasig) 1 Sin O01
Spleenig) TR) Stomaci 008
% ‘Thyroid 004
D 1 Remainder 001
Gonad 0
10)
1.00
“Jain S.C, Mehta S.C., Kumar B., Reddy A.R. and Nagaratnam A . (1995) Formulation of the Reference Indian
Adult: Anatomical and Physiological Data. Health Phys. 68, 509-522.Types of exposure
* 2 types of exposure have been defined by the ICRP:
— Normal exposures
— Potential exposures
« Humans can be exposed to radiation while:
— Persuing their normal occupation (Occupational exposure)
— Undergoing some medical or dental procedures for diagnosis
or evaluation (Medical exposure)
— During normal daily life (Public exposure)Normal Exposures
+ These are defined as the radiation exposure that will occur as
a matter of course in the industry or in the medical
procedures.
« The exposure will have a predictable magnitude albiet with
certain degree of uncertainity.
* Controlling the doses delivered in these normal exposures
is the method specified by IAEA.Potential Exposures
+ These are exposures that are feasible but not certain to
occur.
* These can become actual exposures if there is equipment
malfunction, design flaws of operating failures.
* The primary means for controlling potential exposures is by
optimizing the design of installations, equipment and
operating procedures with the following aims:
— To restrict the probability of occurrence of events that could
lead to unplanned exposures
— To restrict the magnitudes of the exposures that could result if
such events were to occur.Occupational Exposures
+ Occupational exposure which is defined as all exposures
of workers incurred in the course of their work (with the
exception of exposures excluded from the BSS and
exposures from practices or sources exempted by the BSS).Medical Exposures
+ Medical exposure which is defined as exposure incurred:
— By patients as part of their own medical or dental diagnosis
or treatment
— By persons, other than those occupationally exposed,
knowingly while voluntarily helping in the support and
comfort of patients
— By volunteers in a programme of biomedical research
involving their exposure.
« Three broad classes:
— Patients
— Caregivers
— Medical test subjectsPublic Exposure
+ Public exposure, which is defined as exposure incurred by
members of the public from radiation sources,
— Excludes any occupational or medical exposure and the
normal local natural background radiation
— But includes exposure to authorized sources and practices
and from intervention situations.Radiation Protection
QuantitiesQuantities for radiation protection
The absorbed dose is the basic physical dosimetry quantity,
but it is not entirely satisfactory for radiation protection
purposes because the effectiveness in damaging human
tissue differs for different types of ionizing radiation.
So other qunatities that have been proposed to quantify the
biological and physical effect of the radiation dose are:
— Organ dose (Mean Physical Dose, D,)
— Equivalent dose (Modifier for radiation type, H,)
— Effective dose (Modifier for organ type, E)
— Committed dose (Modifier for the time of exposure)
— Collective dose (Modifier for the population exposed)+ The organ dose (D_) is defined as the mean dose ina
specified tissue or organ of the human body.
+ Unit is cGy / Kg or joules / Kg
D,=+- fo dm=£"
OT ny my
mz isthe mass of the organ or tissue under consideration;
& _ isthe total energy imparted by radiation to that tissue or organ.Equivalent Dose
+ The extent of biological effect produced by radiation depends
on:
— The physical organ dose
— The characteristics of the radiation beam employed.
— The pattern of dose deposition.
+ The equivalent dose (H,) is the organ dose multiplied by a
radiation weighting factor w, to account for the effectiveness
of the given radiation in inducing health effects.
Hy = weD rp Ay YirgDre
If more than one type of radiation is
used.Equivalent Dose
+ The SI unit for equivalent dose is joules/kg or sievert
* One Sievert = 100 rem (radiation equivalent man)
+ Older ICRP recommendations used the quantity of dose
equivalent (H)
* This was the dose to the a point in the organ multiplied by
the radiation weighting factor (w,).
* Radiation Weighting factor is a somewhat arbitrarily
chosen conservative value based on a range of RBEs related
to the linear energy transfer (LET) of the radiation.Radiation Weighting Factors
Photons all energies 1
Electrons all energies 1
Protons, other than fission fragments, energy more than 2 MeV 5
Neutrons energy < 10 KeV 5
10 KeV to 100 Kev 10
100 KeV to 2 MeV. 20
> 2 MeV to 20 Mev 10
> 20 Mev 5
Alpha particles, fission fragments, heavy nuclei 20
1) Quality factors for various radiation types; Source: ICRP publication 60
2) Excludes Auger electrons
3) All values relate ta radiation incident on the hody for external radiation and for
internal sources, emitted from the sourceEffective Dose
+ The probablity of stochastic effect in a tissue depends on the
type of tissue irradiated.
+ For the same equivalent dose the probablity of stochastic
effects in two organs will vary — so the concept of effective
dose.
Previously the concept of Effective dose equivalent was used
which defined the effective dose to a point (as in Dose
Equivalent)Effective Dose: Definition
+ The Effective dose (E) is defined as the summation of
tissue equivalent doses, each multiplied by the appropriate
tissue weighting factor (w,), to indicate the combination
of different doses to several different tissues in a way that
correlates well with all stochastic effects combined (ICRP
Publication 60)
+ The unit for effective dose is also Joules / Kg or Seivert (Sv)
E= SiwyEffective Dose: Tissue Weighting Factors
+ Tissue weighting factors w-_ should represent the relative
contribution of an organ or tissue to the total detriment
due to the effects resulting from a uniform irradiation of
the whole body.
* They represent the likely proportionate risks of stochastic
events when tissues are irradiated.
« For low doses, individual organ or tissue detriments can be
treated as additive and the total detriment to the whole
body is the summation of individual detriments.
+ For the whole body w, = 1 ; soa uniform equivalent whole
body radiation dose has a effective dose EF = 1 x H,= H,Tissue Weighting Factors
(MNTISSHe NM Weighting)Factors) For purposes of calculation, the
Gonads 0.20 remainder is composed of the following
Breast 0.12 additional tissues and organs:
Red Bone Marrow 0.12 : parenals
Colon 0.12 rn
Upper large intestine,
Lung 0.12 + Small intestine,
Stomach 0.05 + Kidney,
Breast 0.05 : fuscle,
Bladder 0.05 > Spleen.”
Liver 0.05 + Thymus and
Esophagus 0.05 * Uterus
Thyroid 0.05 These organs are choosen as they are
likely to be selectively irradiated.
Remainder 0.05
Total 1.00
Source ICRP Publication 60Tissue Weighting factors
Those exceptional cases in which a single one of the remainder
tissues or organs receives an equivalent dose in excess of the
highest dose in any of the twelve organs for which a weighting
factor is specified, a weighting factor of 0.025 should be applied
to that tissue or organ and a weighting factor of 0.025 to the
average dose in the rest of the remainder as defined above.Effective dose: Use and Limitations
+ Effective dose is a useful concept as:
— It measures the degree of harm from a given dose of
radiation
— It can be used to compared different types of radiation
— Can be used to compare the dose from various types of
exposures.
+ Limitation:
— Tissue weighting factors are defined based on flawed
estimates of stochastic effects
+ For the whole body the ICRP recommends the use of
Effective doses for defining safety standards e.g. annual
dose limits.
— For individual organs and extremities, however equivalent
doses are used.Committed Dose
+ Useful concept for nuclear medicine
* Relates to the time which a radionuclide will remain inside
the body.
* Itis defined as the specific time integral of the dose received
by the body after exposure to a specific radionuclide.
« Acommitted effective dose and equivalent dose may also be
defined by multiplying the tissue and radiation weighting
factors with the committed dose.Collective Dose
The collective dose relates to exposed groups or populations
Is defined as the summation of the products of the mean
dose in the various groups of exposed people and the
number of individuals in each group.
Can be defined for effective (E) or equivalent doses (H).
The unit of collective dose is the man-sievert (man-Sv).
eee —- = eee
ee t+ + eee0e@
) @ ee
E,x6 E,x4 E,x9