An Epidemiological Assessment of Lens Opacifications That Impaired Vision in Patients Injected with Radium-224

Chmelevsky, D.; Mays, Charles W.; Spiess, H; Stefani, F. H.; Kellerer, Albrecht M.

doi:10.2307/3577161

Cited by 12 publications

(5 citation statements)

References 22 publications

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“…(287) In comparison with the previous study documenting radiation cataracts following brief but chronic external (low-LET) radium exposure, Chmelevsky et al (1988) reported radiation cataracts arising in a population therapeutically treated with 224 Ra for tuberculosis and anklyosing spondylitis some 20 years earlier. Due to the nature of the Ra source, lenses were primarily exposed to alpha particles, and there are large uncertainties associated with dose estimates (Taylor et al, 1988).…”

Section: Radium Exposuresmentioning

confidence: 93%

“…The Blue Mountains Eye Study (Hourihan et al, 1999) failed to find an association between radiation exposure in individuals undergoing CT scans and cataract prevalence, although these doses were probably <0.10 Gy, and a threshold between 0.10 and 0.50 Gy cannot be excluded. Similarly, Chmelevsky et al (1988) rejected the concept of a zero threshold for lens opacification in patients treated with 224 Ra. Guskova (1999), in reviewing Russian nuclear industry data, indicated that chronic exposure to ionising radiation with a cumulative exposure of <2 Gy was not associated with cataract development.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs — Threshold Doses for Tissue Reactions in a Radiation Protection Context

Stewart¹,

Akleyev²,

et al. 2012

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This report provides a review of early and late effects of radiation in normal tissues and organs with respect to radiation protection. It was instigated following a recommendation in Publication 103 (ICRP, 2007), and it provides updated estimates of 'practical' threshold doses for tissue injury defined at the level of 1% incidence. Estimates are given for morbidity and mortality endpoints in all organ systems following acute, fractionated, or chronic exposure. The organ systems comprise the haematopoietic, immune, reproductive, circulatory, respiratory, musculoskeletal, endocrine, and nervous systems; the digestive and urinary tracts; the skin; and the eye. Particular attention is paid to circulatory disease and cataracts because of recent evidence of higher incidences of injury than expected after lower doses; hence, threshold doses appear to be lower than previously considered. This is largely because of the increasing incidences with increasing times after exposure. In the context of protection, it is the threshold doses for very long follow-up times that are the most relevant for workers and the public; for example, the atomic bomb survivors with 40-50years of follow-up. Radiotherapy data generally apply for shorter follow-up times because of competing causes of death in cancer patients, and hence the risks of radiation-induced circulatory disease at those earlier times are lower. A variety of biological response modifiers have been used to help reduce late reactions in many tissues. These include antioxidants, radical scavengers, inhibitors of apoptosis, anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, growth factors, and cytokines. In many cases, these give dose modification factors of 1.1-1.2, and in a few cases 1.5-2, indicating the potential for increasing threshold doses in known exposure cases. In contrast, there are agents that enhance radiation responses, notably other cytotoxic agents such as antimetabolites, alkylating agents, anti-angiogenic drugs, and antibiotics, as well as genetic and comorbidity factors. Most tissues show a sparing effect of dose fractionation, so that total doses for a given endpoint are higher if the dose is fractionated rather than when given as a single dose. However, for reactions manifesting very late after low total doses, particularly for cataracts and circulatory disease, it appears that the rate of dose delivery does not modify the low incidence. This implies that the injury in these cases and at these low dose levels is caused by single-hit irreparable-type events. For these two tissues, a threshold dose of 0.5Gy is proposed herein for practical purposes, irrespective of the rate of dose delivery, and future studies may elucidate this judgement further.

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Section: Radium Exposuresmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs — Threshold Doses for Tissue Reactions in a Radiation Protection Context

Stewart¹,

Akleyev²,

et al. 2012

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show abstract

“…Although radiation‐induced cataracts are a well‐known effect of exposure to radiation, recent debates focus on whether they are formed deterministically or stochastically . In previous studies, it was believed that radiation‐induced cataracts develop deterministically and a threshold dose was required for detectable lens opacities. Recent data reveal that radiation‐induced cataracts may occur stochastically; they may develop at a lower dose level or potentially with no dose threshold.…”

Section: Introductionmentioning

confidence: 99%

Influences of operator head posture and protective eyewear on eye lens doses in interventional radiology: A Monte Carlo Study

Mao

Caracappa

et al. 2019

Medical Physics

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Purpose To quantify the effects of operator head posture and different types of protective eyewear on the eye lens dose to operators in interventional radiology (IR). Methods A deformable computational human phantom, Rensselaer Polytechnic Institute (RPI) Adult Male, consisting of a high‐resolution eye model, was used to simulate a radiologist who is performing an interventional radiology procedure. The radiologist phantom was deformed to a set of different head postures. Three different protective eyewear models were incorporated into the posture‐deformed radiologist phantom. The eye lens dose of the radiologist was calculated using the Monte Carlo code, MCNP. Effects of the radiologist's head posture and different types of protective eyewear on eye lens doses were studied. The relationship between efficacy of protective eyewear and the radiologist's head posture was investigated. Effects of other parameters on efficacy of protective eyewear were also studied, including the angular position of the radiologist, the gap between the eyewear and the face of the radiologist, and the lead equivalent thickness. Results The dose to both lenses decreased by 80% as the head posture moved from looking downward to looking upward. Sports wrap glasses were found to reduce doses further than the other two studied models. The efficacy of eyewear was found to be related to radiologist's head posture as well. When the radiologist was looking up, the protective eyewear almost provided no protection to both lenses. Other factors such as the face‐to‐eyewear distance and the lead equivalent thickness were also found to have an impact on the efficacy of protective eyewear. The dose reduction factor (DRF), defined as the ratio of the dose to the lens without protection to that with protection, decreased from 4.25 to 1.07 as the face‐to‐eyewear distance increased. The DRF almost doubled when the lead equivalent thickness increased from 0.07 to 0.35 mm. However, further increase in lead equivalent thickness showed little improvement in dose reduction. Conclusion The radiologist's head posture has a significant influence on the eye lens dose in IR. Sports wrap protective eyewear which conforms to the curve of the face is essential for the radiation protection of the eye lens. However, the radiologist's head posture and other exposure parameters should be considered when evaluating the protection of the radiologist's eyes.

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“…The present summary will focus primarily on low-LET radiation, although there are a small number of studies of high-LET radiation in the literature (6,18,19). There is now a body of data suggesting that the guidelines for allowable lens dose might not be sufficiently conservative.…”

Section: Principal Data Prompting a Re-evaluation Of Cataract Risk Gumentioning

confidence: 99%

Dosimetry for a Study of Low-Dose Radiation Cataracts among Chernobyl Clean-up Workers

Chumak¹,

Worgul

Kundiyev³

et al. 2007

Radiation Research

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An Epidemiological Assessment of Lens Opacifications That Impaired Vision in Patients Injected with Radium-224

Cited by 12 publications

References 22 publications

ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs — Threshold Doses for Tissue Reactions in a Radiation Protection Context

ICRP PUBLICATION 118: ICRP Statement on Tissue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs — Threshold Doses for Tissue Reactions in a Radiation Protection Context

Influences of operator head posture and protective eyewear on eye lens doses in interventional radiology: A Monte Carlo Study

Dosimetry for a Study of Low-Dose Radiation Cataracts among Chernobyl Clean-up Workers

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