Medical Radiations and Leukaemia: A Retrospective Survey

Gunz, F. W.; Atkinson, H. R.

doi:10.1136/bmj.1.5380.389

Cited by 37 publications

(8 citation statements)

References 24 publications

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“…The New Zealand study found that cases had more radiographic exposure in the 10 years before diagnosis and that this excess was greatest for high-dose examinations of the spine and GI track (Gunz & Atkinson, 1964). The tristate leukaemia study found that risk among men increased with an increase in total number of films taken during the 20 years before diagnosis; the highest risk related to multiple trunk examinations (Gibson et al, 1972).…”

Section: Methodological Issuesmentioning

confidence: 99%

“…Dose estimates were based on published dosimetry surveys, which used the best radiographic technique and latest equipment. In addition, the assumption is that no Comparison with previous studies Three of the four case-control studies of adult-onset leukaemia which focused on diagnostic radiography as a possible leukaemia risk factor have positive findings for ML (Stewart et al, 1962;Gunz & Atkinson, 1964;Gibson et al, 1972). The one study which did not (Linos et al, 1980) had the smallest number of cases (63 ML cases including some children and only 9 CML cases).…”

Section: Methodological Issuesmentioning

confidence: 99%

“…mammography), led to a reduction in patient exposure, other new techniques expose patients to higher radiation doses. For example, the increased use of grids (lead strips used to absorb secondary radiation and enhance film contrast) increased per film exposure during standard abdominal examination by 30% between 1964and 1970(Public Health Service, 1973, 1977. During the same period, the rate of X-ray examinations per 100 people per year rose and the annual per capita mean active bone marrow dose to US adults from radiography increased by 24% (from 83 to 103 mrad) (Public Health Service, 1973).…”

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confidence: 99%

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Diagnostic radiography as a risk factor for chronic myeloid and monocytic leukaemia (CML)

Preston‐Martin

Thomas²,

Yu³

et al. 1989

Br J Cancer

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Summary This interview study included 136 Los Angeles County residents aged 20-69 with CML diagnosed from 1979 to 1985 (cases) and 136 neighbourhood controls. During the 3-20 years before diagnosis of the case, more cases than controls had radiographic examinations of the back, gastrointestinal (GI) tract and kidneys, and cases more often had GI and back radiography on multiple occasions (odds ratio (OR) for back X-rays on five or more occasions = 12.0; P<0.01). Published estimates were used to assign a minimum dose to the active bone marrow for various radiographic procedures. ORs were estimated for cumulative marrow doses for each of four time periods (3-5 years, 6-10 years, 11-20 years and 3-20 years before the diagnosis of the case). The ORs for exposure to 0.99, 100-999, 1000-1999 and >2000 mrad in the 3-20 years before diagnosis were 1.0, 1.4, 1.6 and 2.4 (P br highest exposure category and P for trend both <0.05). The association was strongest for the period 6-10 years before diagnosis, and the effects of radiation exposure during this period remained significant after consideration of other risk factors in a logistic regression analysis.

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Section: Methodological Issuesmentioning

confidence: 99%

Section: Methodological Issuesmentioning

confidence: 99%

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confidence: 99%

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Diagnostic radiography as a risk factor for chronic myeloid and monocytic leukaemia (CML)

Preston‐Martin

Thomas²,

Yu³

et al. 1989

Br J Cancer

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“…If the same lifetime marrow dose of 240 to 600rads of X-rays is applied to the earlier data of Lewis (Le63) on a somewhat different sample (with different controls) of the same population, then similar risk estimates of 0.3-0.7 deaths/lO" person yrlrad can be derived. Another souce of data from which risk estimates for leukemia induction can be made from low dose irradiation are the series in which the relationship between adult leukemias and diagnostic irradiation has been studied (Fa58; St62;Gu64;Gi72). These are all retrospective and involve comparisons of the diagnostic exposure rates for leukemia cases vs controls.…”

Section: Radiologistsmentioning

confidence: 99%

Distinguished Achievement Award

Brown

1976

Health Physics

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This is a review of historical trends, theoretical concepts and experimental data pertaining to the question of the shape of the dose-response curve for carcinogenesis in human beings exposed to low LETradiation. The focus of the study is on the question of whether linear extrapolation data obtained at highdosesand dose ratesisareasonable orunreasonable method of evaluating risk of concer development following irradiation at low doses and/or low dose rates.Most, but not all, of the animal data indicate that linear extrapolation from high doses overestimates the risk at low doses or dose rates. However, a review of the mechanisms and possible dose responsecurves foreach,suggests that thisgeneral principle may not be applicable to human radiation carcinogenesis. An analysis of dose-response curves for two-hit chromosome aberrations in mammalian cells shows that there is a linear component which dominates the response up to approx 100 rads. Contrary to popular belief there are quite good data on cancer induction in humans by low doses and/or low dose rates of low LET radiation. Risk estimates at these low doses were found not to be less than comparable risk estimates made from highdoses. If anything, in fact, the data suggest the opposite.It is concluded that linear extrapolation of human data from high doses (of up to around 100 rads) to low doses of low LET radiation may not overestimate the risk at low doses. Linear extrapolation of high LET radiation from high to low doses probably underestimates the risk at low doses in some cases. HISTORICAL PERSPECTIVETHE LINEAR. non-threshold model for estimating the carcinogenic risk of a given dose of ionizing radiation was developed and used subsequent to 1950. Prior to this time it had been assumed (at least for standard-setting purposes) that cancer, like other somatic effects such as erythema, epilation and lethality, was produced by radiation according to nonstochastic kinetics. That is, a certain level of damage had to be produced to initiate the event, and so the dose-response curve would be sigmoidal with a threshold (Fig. 1). It was the accumulating data on the induction of mutations in the fruit fly Drosophila melanognster which were well-fitted by a linear non-threshold dose response curve, plus the need to make quantitative estimates of the *

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“…We know that there is an increased incidence of leukfEinia following exposure to high dose ionizing radiation as in atomic explosions or deep radiotherapy for ankylosing spondylitis. Gunz and Atkinson (1964) in a retrospective survey of 590 cases of leukaemia, diaguosed in New Zealand between 1958 and 1961, found an increased incidence following high dosage X-ray therapy, but no increased incidence on low-dose irradiation. They considered that radiation clearly could not account for the steadily increasing world leukaemia mortality.…”

Section: "Does Superficial Radiotherapy For Acne Involve Any Risk Of mentioning

confidence: 99%

Superficial Radiotherapy in Acne Vulgaris

Kirk

Worthley

1971

Australas J Dermatol

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Superficial radiotherapy in benign dermatoses, and in acne vulgaris in particular, has long been a subject of controversy among members of the medical profession. Those who favour it are convinced of its therapeutic value and safety if used correctly. Those who condemn it question its efficacy and stress its carcinogenic and leukasmogenic potential. These opposing views are discussed, and the result of investigations to determine the radiation received by the thyroid gland during superficial radiotherapy for acne are presented. For the sake of uniformity all radiation dosage is stated in rads.

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Medical Radiations and Leukaemia: A Retrospective Survey

Cited by 37 publications

References 24 publications

Diagnostic radiography as a risk factor for chronic myeloid and monocytic leukaemia (CML)

Diagnostic radiography as a risk factor for chronic myeloid and monocytic leukaemia (CML)

Distinguished Achievement Award

Superficial Radiotherapy in Acne Vulgaris

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