Pediatric Exposures to Ionizing Radiation: Carcinogenic Considerations

Kutanzi, Kristy; Lumen, Annie; Koturbash, Igor; Miousse, Isabelle R.

doi:10.3390/ijerph13111057

Cited by 161 publications

(110 citation statements)

References 97 publications

(118 reference statements)

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“…Much like lead, chlordane is a developmental immunotoxicant that has in utero effects at doses that have no effect on the immune system of the mother [130]. Kutanzi et al, in a review of pediatric exposures to ionizing radiation highlighted the potential adverse health outcomes (e.g., cancers) for children following exposures to low concentration of accidental and technological radiation, implying care when treating with diagnostic radiation considering the sensitivities of children and the potential role of genetic differences [142]. …”

Section: Resultsmentioning

confidence: 99%

A Review of the Field on Children’s Exposure to Environmental Contaminants: A Risk Assessment Approach

Ferguson

Penney

Solo‐Gabriele

2017

IJERPH

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Background: Children must be recognized as a sensitive population based on having biological systems and organs in various stages of development. The processes of absorption, distribution, metabolism and elimination of environmental contaminants within a child’s body are considered less advanced than those of adults, making them more susceptible to disease outcomes following even small doses. Children’s unique activities of crawling and practicing increased hand-to-mouth ingestion also make them vulnerable to greater exposures by certain contaminants within specific environments. Approach: There is a need to review the field of children’s environmental exposures in order to understand trends and identify gaps in research, which may lead to better protection of this vulnerable and sensitive population. Therefore, explored here are previously published contemporary works in the broad area of children’s environmental exposures and potential impact on health from around the world. A discussion of children’s exposure to environmental contaminants is best organized under the last four steps of a risk assessment approach: hazard identification, dose-response assessment, exposure assessment (including children’s activity patterns) and risk characterization. We first consider the many exposure hazards that exist in the indoor and outdoor environments, and emerging contaminants of concern that may help guide the risk assessment process in identifying focus areas for children. A section on special diseases of concern is also included. Conclusions: The field of children’s exposures to environmental contaminants is broad. Although there are some well-studied areas offering much insight into children exposures, research is still needed to further our understanding of exposures to newer compounds, growing disease trends and the role of gene-environment interactions that modify adverse health outcomes. It is clear that behaviors of adults and children play a role in reducing or increasing a child’s exposure, where strategies to better communicate and implement risk modifying behaviors are needed, and can be more effective than implementing changes in the physical environment.

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Section: Resultsmentioning

confidence: 99%

A Review of the Field on Children’s Exposure to Environmental Contaminants: A Risk Assessment Approach

Ferguson

Penney

Solo‐Gabriele

2017

IJERPH

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“…A review of Gianicolo et al showed that currently there are methodological limits in the available studies and that accurate risk estimation in adolescents and children undergoing to exposition to ionizing radiations is not well estimated [27]. One of the most recent reviews by Kutanzi et al highlights the need of minimizing the negative health effects of pediatric exposure to ionizing radiations [28]. On these bases and given that the most frequent arrhythmias in pediatric population are supraventricular tachycardias [3], which are most often not fatal conditions, it seems a reasonable approach a further decrease of radiation exposure [19].…”

Section: Discussionmentioning

confidence: 99%

Electroanatomical mapping systems and cardiac arrhythmias: avoiding radiations in pediatric patients

Casale¹,

Mezzetti²,

Tulino³

et al. 2017

J Neonatal Biol

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Introduction: Cardiac arrhythmias are challenging conditions in pediatric patients, especially in the case of newborns. Most of the tachyarrhythmias in children (90.24%) are atrioventricular reentrant tachycardias (AVRT) and atrioventricular nodal reentrant tachycardias (AVNRT). Although the standard 12-lead ECG maintains high diagnostic value, an invasive electrophysiological study with catheter ablation are often required. Unfortunately these procedures are burdened by the use of radiations. Materials and methods:We performed a systematic research in PubMed and Embase. We found 257 articles of interest but we selected only 36 as the most representative. Discussion:The main concerns linked to electrophysiological procedures are the need of fluoroscopy and thus the risk of malignancy as well as dermatitis, cataracts, thyroid diseases and birth defects in the patients' offspring. Children and especially newborns have a greater life expectancy so their cumulative risk is greater than adults. For this reason the guiding principle in electrophysiological procedures involving radiations in pediatric subjects is "as low as reasonably achievable" (acronym: ALARA). The development of 3-dimensional (3-D) electroanatomical mapping systems allowed a significant reduction of radiation exposure during catheter ablations. The most recent experiences demonstrated the feasibility and the safety of fluoroless ablation procedures of the most common arrhythmias in children.Conclusions: Cardiac arrhythmias could be very challenging conditions in pediatric patients. Predictors of complications are body weight <15 kg and age <4 years so it is clear that newborns are the most difficult patients. It is reasonable, because of these evidences, to approach cardiac arrhythmias pharmacologically in younger subjects. More than 20 years of experiences conducted by the electrophysiologists allow us to encourage the use of the electroanatomical mapping systems, with the objective of reducing the radiation exposure in children, especially when accessory pathways are involved. Citation: Casale M, Mezzetti M, Tulino V, Morelli M, Ciccarelli I, et al. (2017)

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“…Only a marginal non-significant increase in a specific type of lymphoma (i.e., non-Hodgins) was observed in areas with the higher radon concentrations. The third article on radiation is a review article by Kutanzi et al This article focuses on pediatric exposures to ionizing accidental, technological and diagnostic radiation and the potential for carcinogenic outcomes given existing radiosensitivities [6]. The authors emphasize that the role of genetic sensitivities during and following radiation exposures needs to be further explored [6,7].…”

Section: Articles In This Special Issuementioning

confidence: 99%

Children’s Exposure to Environmental Contaminants: An Editorial Reflection of Articles in the IJERPH Special Issue Entitled, “Children’s Exposure to Environmental Contaminants”

Ferguson

Solo‐Gabriele

2016

IJERPH

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Abstract:Children are at increased vulnerability to many environmental contaminants compared to adults due to their unique behavior patterns, increased contaminant intake per body weight, and developing biological systems. Depending upon their age, young children may crawl on the floor and may practice increased hand to mouth activity that may increase their dose-intake of specific contaminants that accumulate in dust and other matrices. Children are also smaller in size than adults, resulting in a greater body burden for a given contaminant dose. Because children undergo rapid transitions through particular developmental stages they are also especially vulnerable during certain growth-related time windows. A Special Issue was organized focused on the latest findings in the field of children's environmental exposure for these reasons. This editorial introduces articles in this Special Issue and emphasizes their main findings in advancing the field. From the many articles submitted to this Special Issue from around the world, 23 were accepted and published. They focus on a variety of research areas such as children's activity patterns, improved risk assessment methods to estimate exposures, and exposures in various contexts and to various contaminants. The future health of a nation relies on protecting the children from adverse exposures and understanding the etiology of childhood diseases. The field of children's environmental exposures must consider improved and comprehensive research methods aimed at introducing mitigation strategies locally, nationally, and globally. We are happy to introduce a Special Issue focused on children's environmental exposure and children's health and hope that it contributes towards improved health of children.

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Pediatric Exposures to Ionizing Radiation: Carcinogenic Considerations

Cited by 161 publications

References 97 publications

A Review of the Field on Children’s Exposure to Environmental Contaminants: A Risk Assessment Approach

A Review of the Field on Children’s Exposure to Environmental Contaminants: A Risk Assessment Approach

Electroanatomical mapping systems and cardiac arrhythmias: avoiding radiations in pediatric patients

Children’s Exposure to Environmental Contaminants: An Editorial Reflection of Articles in the IJERPH Special Issue Entitled, “Children’s Exposure to Environmental Contaminants”

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