Commentary: Ethical Issues of Current Health-Protection Policies on Low-Dose Ionizing Radiation

Abstract

The linear no-threshold (LNT) model of ionizing-radiation-induced cancer is based on the assumption that every radiation dose increment constitutes increased cancer risk for humans. The risk is hypothesized to increase linearly as the total dose increases. While this model is the basis for radiation safety regulations, its scientific validity has been questioned and debated for many decades. The recent memorandum of the International Commission on Radiological Protection admits that the LNT-model predictions at low doses are "speculative, unproven, undetectable and 'phantom'." Moreover, numerous experimental, ecological, and epidemiological studies show that low doses of sparsely-ionizing or sparsely-ionizing plus highly-ionizing radiation may be beneficial to human health (hormesis/adaptive response). The present LNT-model-based regulations impose excessive costs on the society. For example, the median-cost medical program is 5000 times more cost-efficient in saving lives than controlling radiation emissions. There are also lives lost: e.g., following Fukushima accident, more than 1000 disaster-related yet non-radiogenic premature deaths were officially registered among the population evacuated due to radiation concerns. Additional negative impacts of LNT-model-inspired radiophobia include: refusal of some patients to undergo potentially life-saving medical imaging; discouragement of the study of low-dose radiation therapies; motivation for radiological terrorism and promotion of nuclear proliferation.

Donor-Specific Cell-Based Assays in Studying Sensitivity to Low-Dose Radiation: A Population-Based Perspective

“…On the other hand, the proponents of the threshold/adaptive responses argue that the existing (conservative) approach has negative economical and societal implications and, therefore, should be relaxed. It was said that LNTH model “imposes excessive costs on the society,” “inspires radiophobia” resulting in “refusal of some patients to undergo potentially life-saving medical imaging,” and in “discouragement of the studies of low-dose radiation therapies”; moreover, it “provides motivation for radiological terrorism” ( 30 ). From either point of view, the LNTH model for radiation risk–benefit analysis seems to be inadequate.…”

“…Similar logic can be applied to other medical and non-medical situations that involve ionizing radiation exposure. For example, evacuation of residents from areas of low-dose exposure due to radiologic accidents may cause “non-radiogenic disaster-related premature deaths,” such as “officially registered among the evacuated population” in Fukushima ( 30 ). Individual approach provides little help in identification of most sensitive individuals after a nuclear catastrophe; however, screening of the population working on and living around nuclear power facilities can inform the urgency of evacuation from the areas with low-dose ionizing radiation (LDIR) exposure.…”

The prospective mathematical idea satisfying both radiation hormesis under low radiation doses and linear non-threshold theory under high radiation doses

“…Certainly, a proportional relationship has been described at ≥100 mSv, but it has not been confirmed whether there is a proportional relationship for cases of < 100 mSv [1]. In addition, the radiation hormesis theory is thought to actually have beneficial effects on health [2][3][4][5][6][7][8][9][10]. Therefore, I wondered if there was an idea that LNT and hormesis could hold at the same time.…”

Reconsidering Health Consequences of the Chernobyl Accident

“…2012 ), and more than 1000 people died within two years owing to various evacuation-related non-radiogenic (mainly psychosomatic) problems ( Saji 2013 ). Additional ethical issues of radiation health over-protection are considered in a recent paper ( Socol et al . 2014 ).…”