RADIATION RISK

RADIATION RISK

When compared to activities such as driving a car, boating, or hunting,

x-ray examinations are safe or safer than many everyday activities

The probability of death from radiation-induced cancer is much higher

for smokers than diagnostic radiology procedures such as cardiac
catheterization and lumbar spine radiographs.

Radiation-induced cancer from radiographic procedures is on the order

of 0.1% compared to the normal risk of cancer of 20%.

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Probability of Death from Radiation Induced Cancer and Other Causes

Probability per
Activity (probability is based 10,000 population
on one year's activity) exposed per year
Smoking (all causes) 30 or 3,000/million
CT of kidneys 12.5
Smoking (only Cancer) 12.0
Mining 6.0
Construction 3.9
Farming 3.6
Cardiac Catheterization 3.3 or 330 per million
Driving a car 2.4
Anesthesiology (elderly
patient) 2.0
Excretory urogram 2.0
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Activity (probability is
based on one year's
activity)
Anesthesiology (all
patients)
Probability per
10,000 population
exposed per year
0.3 or 30 per million

Hunting 0.3

Anesthesiology (outpatients) 0.2

Ionic contrast media 0.2

AP lumbar spine 0.06 or 6 per million

Non-ionic contrast media 0.05

Chest (PA and lateral 0.02 or 2 per million

Commercial airline flight or 2 per 10,000,000

(one flight only) 0.002

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 Radiation and pregnancy

Pregnant workers are limited to 500 mrem over pregnancy, because the fetus
is assumed to be 2-3 times more sensitive to radiation.

A pregnant worker can work in fluoroscopy. With the use of the radiation
protection measures of time, distance, and shielding

The maximal limit dose the fetal is 5 rad

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Congenital abnormalities:
Normal incidence of congenital abnormality is 4 - 6 per 100 births
(400-600 per 10,000).
The estimated risk from 1,000 mrem during pregnancy increases risk
of congenital abnormalities by 0.05% or 5 more per 10,000.

Childhood cancer;
Normal risk is 4.3 per 100,000.
1000 mrem during pregnancy increases risk by 0.023 to 0.025% or 23-
58/100,000.

Miscarriage:
Normal risk is 25-50%.
1,000 mrem during pregnancy increases risk by 0.1%.

Sterility:
10,000 mrem causes temporary and 200,000 mrem, permanent
sterility in men. 350,000 mrem causes permanent sterility in women.

Cataracts:
lifetime cumulative dose of approximately 400 rem.
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 WHOLE BODY RESPONSE

It depends on dose rate and area of body exposed

LD50/30 (lethal dose)

*LD 50/30 is the dose of radiation expected to cause death to 50

percent of an exposed population within 30 days.
*Typically, the LD 50/30 is in the range from 400 to 450 rem (4 to 5
sieverts) received over a very short period.
*In other words, the Ld 50/30 is the mean lethal dose, or the dose
that would be lethal to 50 percent of the human population within
30 days after irradiation of x or gamma rays given in a single
exposure to the whole body.
 Acute Radiation Syndrome (ARS)

ARS, or radiation sickness, occurs in humans after whole-body reception of

large doses of ionizing radiation delivered over a short period of time.
Data from epidemiologic studies of human populations exposed to doses of
ionizing radiation sufficient to cause this syndrome have been obtained from:
• atomic bomb survivors of Hiroshima and Nagasaki
• the Marshall Islanders who were inadvertently subjected to high levels of
fallout during an atomic bomb test in 1954
• nuclear radiation accident victims such as those injured in the 1986
Chernobyl disaster
• and radiation therapy patients.

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ARS manifests itself in four major response stages:
prodromal, latent stage, manifest illness, and recovery
or death.

Initial stage

Latent stage

Manifest illness

Recovery

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Initial stage

 occurs within hours after a whole-body absorbed dose of 1 Gy

(100 rads) or more. Nausea, vomiting, diarrhea, fatigue, and
leukopenia (an abnormal decrease in white blood corpuscles,
usually below 5000/mm3) characterize this initial stage.
 The severity of these symptoms is dose-related; the higher the
dose, the more severe the symptoms.
 The length of time involved for this stage to run its course may be
hours or a few days

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Latent period

 of about 1 week occurs, during which no

visible symptoms occur.
 Actually, it is during this period that either
recovery or lethal effects begin. Toward
the end of the first week, the next stage
commences.

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 Manifest ilness stage

 is the period when symptoms that affect the hematopoietic,

gastrointestinal, and cerebrovascular systems become visible.

 Some of these symptoms are apathy, confusion, a decrease in the

number of red and white blood cells and platelets in the circulating
blood, fluid loss, dehydration, epilation, exhaustion, vomiting, severe
diarrhea, fever, headaches, infection, hemorrhage, and
cardiovascular collapse.

 In severe high-dose cases, emaciated human beings eventually die.

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Former Russian spy, Alexander Litvinenko, 43, is the
first known victim to be poisoned with polonium-210
and to die from the resulting radiation sickness. He
died on Nov. 23, three weeks after he fell ill in London.

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About a third of Hiroshima's population was killed within a
week of the bombing. Many more have since died through
radiation sickness

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If after a whole-body sublethal dose such as 2 to 3 Gy (200 to 300
rads)
- exposed persons pass through the first three stages but show
less severe symptoms than those seen after super-lethal doses
of 6 to 10 Gy (600 to 1000 rads)
-  recovery may occur in about 3 months. However, those who
recover may show some signs of radiation damage and
experience late effects.

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Syndrome is the medical term that means a collection of
symptoms. ARS is a collection of symptoms associated with
high-level radiation exposure.

Three separate dose-related syndromes occur as part of the

total-body syndrome:

hematopoietic syndrome

gastrointestinal syndrome (GI)

cerebrovascular syndrome (CNS)

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 hematopoietic syndrome

The hematopoietic form of ARS, or “bone marrow syndrome,” occurs when human
beings receive whole-body doses of ionizing radiation ranging from 350 to 1000
rems. (death 10-21 days).

The hematopoietic system manufactures the corpuscular elements of the blood

and is the most radiosensitive vital organ system in humans.
Radiation exposure causes the number of:

1. red cells
2. white cells
3. platelets
In the circulating blood to decrease

Dose levels that cause this syndrome also may damage cells in other organ
systems, causing the affected organ or organ system to fail.  

The patient initially experiences mild symptoms of the prodromal syndrome, which
appear in a matter of a few hours and may persist for several days.
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 gastrointestinal syndrome (GI)

•In human beings the gastrointestinal form of ARS appears at a

threshold dose of approximately after a dose of 1000 t0 10000
rems.
• Without medical support to sustain life, exposed persons
receiving doses of 1000 to 10000 rems, may die 3 to 5 days after
being exposed.
•Even if medical support is provided, the exposed person will live
only a few days longer. Survival time does not change with dose
in this syndrome.
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 gastrointestinal

A few hours after the dose required to cause the gastrointestinal syndrome has been
received, the initial stage occurs. Severe nausea, vomiting, and diarrhea persist for as
long as 24 hours.

*This is followed by a latent stage, which lasts as long as 5 days. During this time the
symptoms disappear.
*The manifest illness stage follows this period of false calm.

Again, the human subject experiences severe nausea, vomiting, and diarrhea. Other
symptoms that may occur include fever (as in hematopoietic syndrome), fatigue, loss
of appetite, lethargy, anemia, leukopenia (decrease in the number of white blood
cells), hemorrhage (gastrointestinal tract bleeding occurs because the body loses its
blood-clotting ability), infection, electrolyte imbalance, and emaciation.
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  cerebrovascular syndrome (CNS)

The cerebrovascular form of the ARS results when the central nervous
system and cardiovascular system receive doses of 10,000 rems or more of
ionizing radiation.
A dose of this magnitude can cause death within a few hours to 2 or 3 days
after exposure. After irradiation the initial stage begins.
Symptoms include excessive nervousness, confusion, severe nausea,
vomiting, diarrhea, loss of vision, a burning sensation of the skin, and loss
of consciousness.
A latent period lasting up to 12 hours follows. During this time, symptoms

lessen or disappear. After the latent period the manifest illness stage
occurs.
.

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