A Risk Comparison of Non-cancer Mortality between Lifestyle, Socioeconomic Status, and Radiation among Japanese Nuclear Workers (J-EPISODE).

ABSTRACT: Many epidemiological studies have been conducted to investigate the health effects of low-dose radiation. Most of these investigations have focused on cancer, and fewer studies have examined non-cancer topics than cancer subjects. The purpose of this study is to compare the relative risks of non-cancer mortality from low-dose radiation with lifestyle factors (such as smoking habits) and socioeconomic status (such as years of education). The cohort consisted of 43,692 males who responded to a lifestyle questionnaire survey conducted from 2003 to 2004 among nuclear workers in Japan. Missing questionnaire data were imputed by multiple imputation, each variable was categorized, and the relative risks for the reference group were calculated using Poisson regression. The total number of observed person-years was 300,000, and the mean age and dose were 55.2 y and 24.5 mSv (10-y lagged dose), respectively. For many of the causes of death in this analysis, significantly high risks existed for lifestyle differences, such as smoking, alcohol consumption, frequency of medical examination, breakfast intake, sleep, and BMI, but few for socioeconomic status. Radiation showed no significantly high risks. Taken together, the risk of non-cancer mortality from low-dose radiation is likely smaller than that from lifestyle factors.

A Risk Comparison between Lifestyle, Socioeconomic Status, and Radiation: A Cohort Study of Cancer Mortality among Japanese Nuclear Workers (J-EPISODE).

ABSTRACT: The health effects of low-dose radiation exposure have been a source of controversy. One possible reason is that epidemiological studies that compare radiation risk with other factors, such as lifestyle or socioeconomic status, have been limited. The aim of this study is to conduct a comparison of the cancer risk of mortality between radiation, lifestyle habits (such as smoking), and socioeconomic status (such as years of education) among Japanese nuclear workers. We assembled a cohort of 41,742 male nuclear workers in Japan who answered a lifestyle questionnaire survey conducted during 2003-2004. To exclude systematic errors caused by missing values, we used multiple imputation and Poisson regression to estimate relative risks and confidence intervals for lifestyle habits, socioeconomic status, and radiation. The total person-y from 2005 to 2010 were 215,000. The mean age and cumulative dose were 54.9 y and 24.8 mSv (10-y lagged dose), respectively. Significantly high relative risks were determined for smoking, alcohol consumption, frequency of medical examination, breakfast intake, sleep, and body mass index. Further, significantly high relative risks of radiation were shown for lung cancer and smoking-related cancers. Since the simultaneous inclusion of radiation and non-radiation variables in the model for relative risk (RR) calculation means that the calculated radiation RR is the result of adjustment by other variables, the risk of cancer from low-dose radiation, if any, is less than smoking and probably less than other lifestyle factors.

Reanalysis of cancer mortality using reconstructed organ-absorbed dose: J-EPISODE 1991‒2010.

The Japanese Epidemiological Study on Low-Dose Radiation Effects (J-EPISODE) has been conducted since 1990 by the Radiation Effects Association to analyse health effects for nuclear workers. It uses the recorded doses, i.e. dosimeter readings, evaluated inHp(10) for estimation of radiation risk; however, the International Commission on Radiological Protection does not recommend the use of effective doses for epidemiological evaluation and instead recommends the use of organ-absorbed doses for assessing cancer risk. Recently, the J-EPISODE has developed a conversion factor that can convert dosimeter readings to organ-absorbed doses following, in principle, the approach adopted by the International Agency for Research on Cancer 15-Country Collaborative Study. The approach was modified based on recent dosimeter usage practices and the Japanese physique. The aim of this study was to reanalyse the excess relative risk (ERR) of cancer mortality for the J-EPISODE using the previous analysis method but substituting the organ-absorbed dose for the recorded dose to confirm the adaptability and relevance of organ-absorbed doses for the J-EPISODE. The organ-absorbed doses from 1957 to 2010 were reconstructed for the whole cohort. The cancer mortality risk was reanalysed with Poisson regression methods, first by comparing the ERR/Gy for all cancers excluding leukaemia with the risk after excluding lung cancer for the whole cohort of 204 103 participants. In the whole cohort, all cancers excluding leukaemia, lung cancer and non-Hodgkin's lymphoma had statistically significant positive ERR/Gy estimates; leukaemia excluding chronic lymphocytic leukaemia had negative but not statistically significant estimates. Gallbladder cancer and pancreatic cancer showed statistically significant negative. Then, a subcohort of 71 733 respondents was selected based on lifestyle surveys with data on qualitative smoking status as well as quantitative smoking information on pack-years. Pack-years for current smokers and former smokers and years since the cessation of smoking for former smokers were used for the smoking-adjusted model. The most important feature of the J-EPISODE revealed to date was a decreasing tendency of the ERR/Sv by the smoking adjustment. For almost all causes of death such as lung cancer and stomach cancer, the estimated ERR/Gy decreased by the smoking adjustment, although those for the colon, prostate and kidney and other urinary organs were almost the same after the adjustment. This tendency remained unchanged even when using the organ-absorbed dose, indicating the appropriateness of using organ-absorbed doses for further risk analysis. At the same time, it indicated that confounding by smoking seriously biased the radiation risk estimates in the J-EPISODE and thus should be accounted even if organ dose is used.

Organ Dose Reconstruction Applicable for a Japanese Nuclear Worker Cohort: J-EPISODE.

ABSTRACT: An evaluation of cancer risk based on organ-absorbed dose is underway for the Japanese Epidemiological Study on Low-Dose Radiation Effects (J-EPISODE), which has analyzed health effects in association with radiation exposure evaluated with the personal dose equivalent Hp(10). Although the concept of effective dose and its operational definition of Hp(10) are widely used for radiological protection purposes, effective dose is not recommended for epidemiological evaluation. Organ-absorbed dose was instead adopted for the IARC 15-Country Collaborative study (15-Country study), the International Nuclear Workers Study (INWORKS), the Mayak worker study, and the Life Span Study (LSS) of atomic bomb survivors. The reconstruction method in J-EPISODE followed in principle the approach adopted in the 15-Country Study. As part of the approach of J-EPISODE, a conversion factor from photon dosimeter reading to air kerma was developed using dosimeter response data, which were measured by the experiment using an anthropomorphic phantom, and it was confirmed that the 15-Country study's assumption of photon energy and geometry distribution in a work environment applied to Japanese nuclear workers. This article focuses on a method for reconstructing the conversion factor from photon dosimeter reading to organ-absorbed photon dose for a Japanese nuclear worker cohort. The model for estimating the conversion factor was defined under the assumption of a lognormal distribution from three concerned bias factors: (1) a dosimeter reading per air kerma, i.e., dosimeter response; (2) an organ-absorbed dose per air kerma; and (3) a factor relating to the differences in dose concepts and calibration practices between the roentgen dosimeter era and the present. Dosimeter response data were cited from the companion paper. Data on organ-absorbed photon dose per air kerma were estimated using a voxel phantom with the average Japanese adult male height and weight. The bias factor for the recorded dose in the roentgen era was defined, considering the backscatter radiation from the human body. The estimated values of organ-absorbed photon dose per air kerma were almost the same as those in ICRP Publication 116, revealing that the effect of differences in body size was almost negligible. The conversion factors from dosimeter reading to organ-absorbed dose were estimated by period (the roentgen era or from then), nuclear facility type (nuclear power plant or other), dosimeter type, and tissue or organ. The estimated conversion factors ranged from 0.7 to 0.9 (Gy Sv-1). The estimated cumulative organ-absorbed photon dose for the participants of J-EPISODE demonstrated that organ-absorbed dose values were approximately 0.8 times the recorded doses if neglecting dose-unit differences. J-EPISODE reconstructed an organ-absorbed dose conversion factor and will evaluate the risk of cancer mortality and morbidity using the organ-absorbed dose in the future.

ESTIMATION OF PHOTON ENERGY AND DIRECTION DISTRIBUTIONS AT JAPANESE NUCLEAR POWER PLANTS BASED ON LITERATURE SURVEY FOR J-EPISODE STUDY.

In order to reconstruct organ-absorbed dose from recorded dose for risk estimation in nuclear worker cohort, the preceding study of the International Agency for Research on Cancer (IARC) 15-Country Collaborative Study estimated the organ dose conversion factor from the recorded dose of Hp(10) under the assumption that on average, in the nuclear power plants (NPPs), 10% of the dose received by workers was due to photon energies ranging from 100 to 300 keV and 90% from photon energies ranging from 300 to 3000 keV, with the average geometry being 50% in the antero-posterior geometry and 50% in the isotropic geometry. Similar examination was conducted at the Japanese Epidemiological Study on Low-Dose Radiation Effects (J-EPISODE). Literature survey disclosed that Japanese electric power companies had jointly conducted the research on energy distribution and incidence direction distribution of gamma rays in working environments during periodical inspection and maintenance as well as during operation in the 1980s. The analysis of the survey results on photon energy and geometry distribution of Japanese NPPs demonstrated appropriateness in applying the IARC study assumption for nuclear workers in Japan and reconstructing organ-absorbed dose in the J-EPISODE. These results in Japan also provide strong evidence to support the robustness and generality of the IARC study assumption, which was estimated based on the judgment of experts at nuclear facilities around the world.

CONVERSION FACTOR FROM DOSEMETER READING TO AIR KERMA FOR NUCLEAR WORKER USING ANTHROPOMORPHIC PHANTOM FOR FURTHER CONVERSION FROM AIR KERMA TO ORGAN-ABSORBED DOSE.

Estimation of cancer risk based on the organ-absorbed dose is underway for the Japanese Epidemiological Study on Low-Dose Radiation Effects (J-EPISODE). The reconstruction method for the organ-absorbed dose follows the approach adopted in the IARC 15-Country Collaborative Study, which examined the dosemeter response to photon exposure for the old film badge (FB) type, a multi-element FB and a thermoluminescence dosemeter. Until 2000, the dosemeters used in Japan were almost the same in the IARC study, so IARC study data could be used as they were. However, since 2000, the type of dosemeter has been replaced with active personal dosemeters (hereafter called electronic personal dosemeters), radio-photoluminescent glass dosemeters (Glass badge) and optically stimulated luminescence dosemeters (Luminess badge). Hence, it was necessary to collect these data again. A dosemeter response experiment was conducted using a device that irradiated an anthropomorphic phantom in the Japan Atomic Energy Agency calibration laboratories. The aim of the paper is to provide a conversion factor from reading in terms of Hp(10) to air kerma for realistic conditions for further conversion from air kerma to organ-absorbed dose. The obtained dosemeter responses for the dosemeter types currently used in Japan were consistent with those in the IARC study. These data will be utilized for J-EPISODE in reconstructing the organ-absorbed dose.

Distribution of artificial radionuclides in abandoned cattle in the evacuation zone of the Fukushima Daiichi nuclear power plant.

The Fukushima Daiichi Nuclear Power Plant (FNPP) accident released large amounts of radioactive substances into the environment. In order to provide basic information for biokinetics of radionuclides and for dose assessment of internal exposure brought by the FNPP accident, we determined the activity concentration of radionuclides in the organs of 79 cattle within a 20-km radius around the FNPP. In all the specimens examined, deposition of Cesium-134 ((134)Cs, half-life: 2.065 y) and (137)Cs (30.07 y) was observed. Furthermore, organ-specific deposition of radionuclides with relatively short half-lives was detected, such as silver-110m ((110m)Ag, 249.8 d) in the liver and tellurium-129m ((129m)Te, 33.6 d) in the kidney. Regression analysis showed a linear correlation between the radiocesium activity concentration in whole peripheral blood (PB) and that in each organ. The resulting slopes were organ dependent with the maximum value of 21.3 being obtained for skeletal muscles (R(2) = 0.83, standard error (SE) = 0.76). Thus, the activity concentration of (134) Cs and (137)Cs in an organ can be estimated from that in PB. The level of radioactive cesium in the organs of fetus and infants were 1.19-fold (R(2) = 0.62, SE = 0.12), and 1.51-fold (R(2) = 0.70, SE = 0.09) higher than that of the corresponding maternal organ, respectively. Furthermore, radiocesium activity concentration in organs was found to be dependent on the feeding conditions and the geographic location of the cattle. This study is the first to reveal the detailed systemic distribution of radionuclides in cattle attributed to the FNPP accident.

Development, beam characterization and chromosomal effectiveness of X-rays of RBC characteristic X-ray generator.

A characteristic hot-filament type X-ray generator was constructed for irradiation of cultured cells. The source provides copper K, iron K, chromium K, molybdenum L, aluminium K and carbon K shell characteristic X-rays. When cultured mouse m5S cells were irradiated and frequencies of dicentrics were fitted to a linear-quadratic model, Y = alphaD + betaD2, the chromosomal effectiveness was not a simple function of photon energy. The alpha-terms increased with the decrease of the photon energy and then decreased with further decrease of the energy with an inflection point at around 10 keV. The beta-terms stayed constant for the photon energy down to 10 keV and then increased with further decrease of energy. Below 10 keV, the relative biological effectiveness (RBE) at low doses was proportional to the photon energy, which contrasted to that for high energy X- or gamma-rays where the RBE was inversely related with the photon energy. The reversion of the energy dependency occurred at around 1-2 Gy, where the RBE of soft X-rays was insensitive to X-ray energy. The reversion of energy-RBE relation at a moderate dose may shed light on the controversy on energy dependency of RBE of ultrasoft X-rays in cell survival experiments.