Health Effects of Medical Exposures

Natural and Artificial Radiation Sources

In general, radiation exposures from medical diagnostic examinations are low (especially in diagnostic uses). Doses may be also high (only for therapeutic uses), but in each case, they must be always justified by the benefits of accurate diagnosis of possible disease conditions or by benefits of accurate treatment. These doses include contributions from medical and dental diagnostic radiology (diagnostic X-rays), clinical nuclear medicine and radiation therapy.

The medical use of ionizing radiation remains a rapidly changing field. In any case, usefulness of ionizing radiation must be balanced with its hazards. Nowadays a compromise was found and most of uses of radiation are optimized. Today it is almost unbelievable that x-rays was, at one time, used to find the right pair of shoes (i.e. shoe-fitting fluoroscopy). Measurements made in recent years indicate that the doses to the feet were in the range 0.07 – 0.14 Gy for a 20 second exposure. This practice was halted when the risks of ionizing radiation were better understood.

In the following points we try to express enormous ranges of radiation exposure as well as a few doses from medical sources.

  • 1 µSv – Eating one banana
  • 1 µSv – Extremity (hand, foot, etc.) X-ray
  • 5 µSv – Dental X-ray
  • 10 µSv – Average daily dose received from natural background
  • 40 µSv – A 5-hour airplane flight
  • 100 µSv – Chest X-ray
  • 600 µSv – mammogram
  • 1 000 µSv – Dose limit for individual members of the public, total effective dose per annum
  • 3 650 µSv – Average yearly dose received from natural background
  • 5 800 µSv – Chest CT scan
  • 10 000 µSv – Average yearly dose received from natural background in Ramsar, Iran
  • 20 000 µSv – single full-body CT scan
  • 80 000 µSv – The annual local dose to localized spots at the bifurcations of segmental bronchi in the lungs caused by smoking cigarettes (1.5 packs/day).
  • 175 000 µSv – Annual dose from natural radiation on a monazite beach near Guarapari, Brazil.
  • 5 000 000 µSv – Dose that kills a human with a 50% risk within 30 days (LD50/30), if the dose is received over a very short duration.

As can be seen, low-level doses are common for everyday life.

Health Effects of Medical Exposures

The medical use of ionizing radiation remains a rapidly changing field. In each case, usefulness of ionizing radiation must be balanced with its hazards. Nowadays a compromise was found and most of uses of radiation are optimized. We must emphasize, eating bananas, working as airline flight crew or living in locations with, also increase your annual dose. Some medical treatments and diagnostic examinations also cause radiation doses. But it does not mean, that it must be dangerous. In each case, intensity of radiation also matters. It is very similar as for heat from a fire (less energetic radiation). If you are too close, the intensity of heat radiation is high and you can get burned. If you are at the right distance, you can withstand there without any problems and moreover it is comfortable. If you are too far from heat source, the insufficiency of heat can also hurt you. This analogy, in a certain sense, can be applied to radiation also from radiation sources.

LNT Model and Hormesis Model
Alternative assumptions for the extrapolation of the cancer risk vs. radiation dose to low-dose levels, given a known risk at a high dose: LNT model, and hormesis model.

In some cases of medical exposures, we are talking (except radiotherapy) about so called “low doses”. Low dose here means additional small doses comparable to the normal background radiation (10 µSv = average daily dose received from natural background). The doses are very very low and therefore the probability of cancer induction could be almost negligible. Secondly, and this is crucial, the truth about low-dose radiation health effects still needs to be found. It is not exactly known, whether these low doses of radiation are detrimental or beneficial (and where is the threshold). Government and regulatory bodies assume a LNT model instead of a threshold or hormesis not because it is the more scientifically convincing, but because it is the more conservative estimate. Problem of this model is that it neglects a number of defence biological processes that may be crucial at low doses. The research during the last two decades is very interesting and show that small doses of radiation given at a low dose rate stimulate the defense mechanisms. Therefore the LNT model is not universally accepted with some proposing an adaptive dose–response relationship where low doses are protective and high doses are detrimental. Many studies have contradicted the LNT model and many of these have shown adaptive response to low dose radiation resulting in reduced mutations and cancers. This phenomenon is known as radiation hormesis.

 

References:

Radiation Protection:

  1. Knoll, Glenn F., Radiation Detection and Measurement 4th Edition, Wiley, 8/2010. ISBN-13: 978-0470131480.
  2. Stabin, Michael G., Radiation Protection and Dosimetry: An Introduction to Health Physics, Springer, 10/2010. ISBN-13: 978-1441923912.
  3. Martin, James E., Physics for Radiation Protection 3rd Edition, Wiley-VCH, 4/2013. ISBN-13: 978-3527411764.
  4. U.S.NRC, NUCLEAR REACTOR CONCEPTS
  5. U.S. Department of Energy, Nuclear Physics and Reactor Theory. DOE Fundamentals Handbook, Volume 1 and 2. January 1993.

Nuclear and Reactor Physics:

  1. J. R. Lamarsh, Introduction to Nuclear Reactor Theory, 2nd ed., Addison-Wesley, Reading, MA (1983).
  2. J. R. Lamarsh, A. J. Baratta, Introduction to Nuclear Engineering, 3d ed., Prentice-Hall, 2001, ISBN: 0-201-82498-1.
  3. W. M. Stacey, Nuclear Reactor Physics, John Wiley & Sons, 2001, ISBN: 0- 471-39127-1.
  4. Glasstone, Sesonske. Nuclear Reactor Engineering: Reactor Systems Engineering, Springer; 4th edition, 1994, ISBN: 978-0412985317
  5. W.S.C. Williams. Nuclear and Particle Physics. Clarendon Press; 1 edition, 1991, ISBN: 978-0198520467
  6. G.R.Keepin. Physics of Nuclear Kinetics. Addison-Wesley Pub. Co; 1st edition, 1965
  7. Robert Reed Burn, Introduction to Nuclear Reactor Operation, 1988.
  8. U.S. Department of Energy, Nuclear Physics and Reactor Theory. DOE Fundamentals Handbook, Volume 1 and 2. January 1993.
  9. Paul Reuss, Neutron Physics. EDP Sciences, 2008. ISBN: 978-2759800414.

See above:

Medical Exposures