Radiation and cataract risk: Impact of recent epidemiologic studies on ICRP judgments

Shore, Roy E.

doi:10.1016/j.mrrev.2016.06.006

Cited by 52 publications

(21 citation statements)

References 42 publications

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“…Hladik and Tapio review the epidemiology and biology of brain effects [3]. Shore provides an overview of cataract epidemiology [4], whereas Ainsbury et al reviews the biology of cataractogenesis following low linear energy transfer (LET) radiation exposures [5]; Hamada and Sato also review high-LET radiation cataractogenesis [6]. Grubber and Dörr consider the radiobiology of the oral mucosa, which is important in light of the adverse reactions to radiotherapy [7].…”

Section: Introductionmentioning

confidence: 99%

Special issue: Tissue reactions to ionizing radiation exposure

Hamada

Bouffler

Woloschak

2016

Mutation Research/Reviews in Mutation Research

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Section: Introductionmentioning

confidence: 99%

Special issue: Tissue reactions to ionizing radiation exposure

Hamada

Bouffler

Woloschak

2016

Mutation Research/Reviews in Mutation Research

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“…Therefore, the NCRP committee considered the current evidence to be too weak and inconsistent to support a LNT model for CVD for the purposes of radiation protection.Studies of cataracts in the atomic bomb survivors, Chernobyl clean-up workers and other studies haverevealed minor lens opacities at doses lower than previously considered to be cataractogenic, but do not yet support an LNT interpretation or an estimate of a specific dose threshold value for effects from either acute or protracted exposures to the lens of the eye. Ophthalmologically detectable opacities are reported at doses of about 0.5 Gy and above, with large uncertainties below this dose, so the appropriateness of a linear, linear-quadratic or dose-threshold model is unresolved[64][65][66].…”

mentioning

confidence: 99%

Implications of recent epidemiologic studies for the linear nonthreshold model and radiation protection

et al. 2018

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The recently published NCRP Commentary No. 27 evaluated the new information from epidemiologic studies as to their degree of support for applying the linear nonthreshold (LNT) model of carcinogenic effects for radiation protection purposes (NCRP 2018 Implications of Recent Epidemiologic Studies for the Linear Nonthreshold Model and Radiation Protection, Commentary No. 27 (Bethesda, MD: National Council on Radiation Protection and Measurements)). The aim was to determine whether recent epidemiologic studies of low-LET radiation, particularly those at low doses and/or low dose rates (LD/LDR), broadly support the LNT model of carcinogenic risk or, on the contrary, demonstrate sufficient evidence that the LNT model is inappropriate for the purposes of radiation protection. An updated review was needed because a considerable number of reports of radiation epidemiologic studies based on new or updated data have been published since other major reviews were conducted by national and international scientific committees. The Commentary provides a critical review of the LD/LDR studies that are most directly applicable to current occupational, environmental and medical radiation exposure circumstances. This Memorandum summarises several of the more important LD/LDR studies that incorporate radiation dose responses for solid cancer and leukemia that were reviewed in Commentary No. 27. In addition, an overview is provided of radiation studies of breast and thyroid cancers, and cancer after childhood exposures. Non-cancers are briefly touched upon such as ischemic heart disease, cataracts, and heritable genetic effects. To assess the applicability and utility of the LNT model for radiation protection, the Commentary evaluated 29 epidemiologic studies or groups of studies, primarily of total solid cancer, in terms of strengths and weaknesses in their epidemiologic methods, dosimetry approaches, and statistical modelling, and the degree to which they supported a LNT model for continued use in radiation protection. Recommendations for how to make epidemiologic radiation studies more informative are outlined. The NCRP Committee recognises that the risks from LD/LDR exposures are small and uncertain. The Committee judged that the available epidemiologic data were broadly supportive of the LNT model and that at this time no alternative dose-response relationship appears more pragmatic or prudent for radiation protection purposes.

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“…Indeed among the various groups that have been studied for radiation-associated cataract, a significant ERR for cataract surgery has been reported only in the Japanese atomic bomb survivors,4 12 35 possibly a consequence of differences in exposure (dose rate) or mean follow-up period from the present cohort or the Mayak workers 35. While some of the USRT subjects may harbour vision impairing cataracts, it is likely that only a proportion of these will further receive cataract surgery, depending on various factors which may include not only the cataract size, severity and location within the eye but also socioeconomic, medical-cost and health consciousness, visual acuity in the opposite eye, the nature of the work or vocational activities affecting the need for visual acuity, and amount of ultraviolet exposure 35 36. Therefore, there is no reason to suppose that cataract surgery prevalence will be simply proportional to cataract prevalence.…”

Section: Discussionmentioning

confidence: 85%

Occupational radiation exposure and excess additive risk of cataract incidence in a cohort of US radiologic technologists

et al. 2019

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ObjectivesPrevious analyses of cataract in radiation-exposed populations have assessed relative risk; radiogenic excess additive risk (EAR), arguably of more public health importance, has not been estimated. Previous analysis of a large prospective cohort of US radiologic technologists (USRT) quantified excess relative risk of cataract in relation to occupational radiation dose. We aim to assess EARs of cataract.MethodsWe estimated EARs of cataract/cataract surgery in the USRT cohort using generalised additive models in relation to occupational radiation exposure, and assessed risk modification by a priori-selected cataract risk factors (diabetes, body mass index, smoking, race, sex, birth-year, ultraviolet B (UVB) radiation exposure).ResultsThere were 11 345 cataract diagnoses and 5440 of cataract surgery during 832 462 and 888 402 person-years of follow-up, respectively. Cumulative occupational radiation exposure was associated with self-reported cataract, but not with cataract surgery, with EAR/104 person-year Gy=94 (95% CI: 47 to 143, p<0.001) and EAR/104 person-year Gy=13 (95% CI: <0 to 57, p=0.551), respectively. There was marked (p<0.001) variation of EAR by age and by diabetes status, with risk higher among persons ≥75 years and diabetics. There were indications of elevated risk among those with higher UVB radiation (p=0.045), whites (p=0.056) and among those with higher levels of cigarette smoking (p=0.062). Elevated additive risk was observed for estimated occupational radiation eye-lens doses <100 mGy (p=0.004) with no dose–response curvature (p=0.903).ConclusionsThe elevated additive risks associated with low-dose radiation, if confirmed elsewhere, have important public health and clinical implications for radiation workers as well as regulatory measures.

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Radiation and cataract risk: Impact of recent epidemiologic studies on ICRP judgments

Cited by 52 publications

References 42 publications

Special issue: Tissue reactions to ionizing radiation exposure

Special issue: Tissue reactions to ionizing radiation exposure

Implications of recent epidemiologic studies for the linear nonthreshold model and radiation protection

Occupational radiation exposure and excess additive risk of cataract incidence in a cohort of US radiologic technologists

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