Multidisciplinary European Low Dose Initiative (MELODI): strategic research agenda for low dose radiation risk research

Abstract

MELODI (Multidisciplinary European Low Dose Initiative) is a European radiation protection research platform with focus on research on health risks after exposure to low-dose ionising radiation. It was founded in 2010 and currently includes 44 members from 18 countries. A major activity of MELODI is the continuous development of a long-term European Strategic Research Agenda (SRA) on low-dose risk for radiation protection. The SRA is intended to identify priorities for national and European radiation protection research programs as a basis for the preparation of competitive calls at the European level. Among those key priorities is the improvement of health risk estimates for exposures close to the dose limits for workers and to reference levels for the population in emergency situations. Another activity of MELODI is to ensure the availability of European key infrastructures for research activities, and the long-term maintenance of competences in radiation research via an integrated European approach for training and education. The MELODI SRA identifies three key research topics in low dose or low dose-rate radiation risk research: (1) dose and dose rate dependence of cancer risk, (2) radiation-induced non-cancer effects and (3) individual radiation sensitivity. The research required to improve the evidence base for each of the three key topics relates to three research lines: (1) research to improve understanding of the mechanisms contributing to radiogenic diseases, (2) epidemiological research to improve health risk evaluation of radiation exposure and (3) research to address the effects and risks associated with internal exposures, differing radiation qualities and inhomogeneous exposures. The full SRA and associated documents can be downloaded from the MELODI website (http://www.melodi-online.eu/sra.html).

Clinical and epidemiological observations on individual radiation sensitivity and susceptibility

“…As mentioned in the MELODI strategic research agenda (Kreuzer et al 2018a) and the HLEG report (HLEG 2009), differences in radiation susceptibility between individuals, or groups, may relate to genetic constitution (determining sex and other phenotypic features), but also to other characteristics such as age at exposure, attained age, health status and comorbidity, epigenetic factors, lifestyle, and co-exposures to other (non-radiological) stressors. Age at exposure clearly affects the radiation-induced risk of certain cancers, such as for instance leukemia (Wakeford 2013) or thyroid cancer (Cardis et al 2005), for which exposure at younger ages are associated with higher radiation related-risks (expressed as excess relative risk per Gy).…”

Technologist Approach to Global Dose Optimization

“…Additionally, the Multidisciplinary European Low Dose Initiative, which EANM joined in 2016 in a coordinated effort to research the effects and health risks after exposures to low-dose radiation (73,74), provides valuable research resources for nuclear medicine technologists. Another EANM consortium specifically for the investigation of low-dose medical exposures, the MEDIRAD project, aims to increase the scientific bases and clinical practice of radiation protection in the medical field both in diagnostic and in therapeutic applications.…”

Bilan de la surveillance épidémiologique des travailleurs du cycle électronucléaire en France

“…des données administratives nominatives, indispensables au croisement de certaines informations provenant de sources différentes (détaillées ci-dessous) ; des données d'historiques de (Hoffmann et al, 2017), dans l'estimation des relations exposition-risque. Ces analyses fournissent des résultats d'un intérêt primordial pour répondre aux questionnements de recherche en radioprotection (Kreuzer et al, 2018).…”

“…Parmi les forces principales de ces cohortes, outre leur pertinence pour étudier des questions de recherche prioritaires en radioprotection (HLEG, 2009 ;ICRP, 2017 ;Kreuzer et al, 2018), elles fournissent des connaissances précieuses à l'expertise en santé au travail et en santé publique (Laurier and Hill, 2013 ;Zerbib, 2018).…”

“…Si ces normes de radioprotection et les réglementations nationales en ayant résulté sont essentielles et ont fait la preuve de leur utilité, certains questionnements scientifiques demeurent concernant les effets des rayonnements ionisants à des doses dites faibles (typiquement, lorsque des rayonnements de faibles transferts linéiques d'énergie sont considérés, doses aux tissus ou au corps entier inférieures à 100 milliGrays) (UNSCEAR, 2015). Parmi ces questionnements, recensés et priorisés par plusieurs organismes internationaux (HLEG, 2009 ;ICRP, 2017 ;Repussard, 2017 ;Kreuzer et al, 2018), figurent l'éventualité de risques de pathologies non cancéreuses (notamment de pathologies du système circulatoire), les effets des expositions chroniques (par comparaison avec les expositions très brèves, à haut débit de dose, subies par les survivants d'Hiroshima et de Nagasaki), la forme de la relation dose-risque aux faibles doses, les effets des différentes natures de rayonnements (photons, particules alpha, neutrons...), les effets des contaminations internes par différents radionucléides ou encore les différences interindividuelles de radiosusceptibilité (Kreuzer et al, 2018). Les questions portant sur les effets des expositions chroniques et par contamination interne à faibles doses sont d'autant plus importantes en radioprotection que la plupart des expositions environnementales et professionnelles aux rayonnements ionisants correspondent à ces modes d'exposition (UNSCEAR, 2008 ;IRSN, 2017a).…”