Mortality among individuals exposed to atomic bomb radiation in utero: 1950-2012.

We examined the mortality risks among 2463 individuals who were exposed in utero to atomic bomb radiation in Hiroshima or Nagasaki in August 1945 and were followed from October 1950 through 2012. Individual estimates of mother's weighted absorbed uterine dose (DS02R1) were used. Poisson regression method was used to estimate the radiation-associated excess relative risk per Gy (ERR/Gy) and 95% confidence intervals (CI) for cause-specific mortality. Head size, birth weight, and parents' survival status were evaluated as potential mediators of radiation effect. There were 339 deaths (216 males and 123 females) including deaths from solid cancer (n = 137), lymphohematopoietic cancer (n = 8), noncancer disease (n = 134), external cause (n = 56), and unknown cause (n = 4). Among males, the unadjusted ERR/Gy (95% CI) was increased for noncancer disease mortality (1.22, 0.10-3.14), but not for solid cancer mortality (- 0.18, < - 0.77-0.95); the unadjusted ERR/Gy for external cause mortality was not statistically significant (0.28, < - 0.60-2.36). Among females, the unadjusted ERRs/Gy were increased for solid cancer (2.24, 0.44-5.58), noncancer (2.86, 0.56-7.64), and external cause mortality (2.57, 0.20-9.19). The ERRs/Gy adjusted for potential mediators did not change appreciably for solid cancer mortality, but decreased notably for noncancer mortality (0.39, < - 0.43-1.91 for males; 1.48, - 0.046-4.55 for females) and external cause mortality (0.10, < - 0.57-1.96 for males; 1.38, < - 0.46-5.95 for females). In conclusion, antenatal radiation exposure is a consistent risk factor for increased solid cancer mortality among females, but not among males. The effect of exposure to atomic bomb radiation on noncancer disease and external cause mortality among individuals exposed in utero was mediated through small head size, low birth weight, and parental loss.

Internal exposure risk due to radiocesium and the consuming behaviour of local foodstuffs among pregnant women in Minamisoma City near the Fukushima nuclear power plant: a retrospective observational study.

OBJECTIVES: This study aimed to evaluate the internal cesium (Cs) level among pregnant women in Minamisoma City (the area straddling the evacuation zones) over a 5-year period after Japan's 2011 Fukushima nuclear accident and assess the status and transition of their food-acquiring preferences during this period. DESIGN: A retrospective observational study of a screening along with a questionnaire survey. SETTING: This study was conducted in an obstetrics and gynaecology service in Minamisoma City in Fukushima, Japan. PARTICIPANTS: Participants included pregnant women who applied for the voluntary internal radiation exposure screening programme. PRIMARY AND SECONDARY OUTCOME MEASURES: Internal radiation exposure was evaluated using the whole-body counter (WBC) in the screening programme. Data from a food acquisition preference questionnaire administered to the participants were analysed and compared across the 5-year period after adjusting for covariates. RESULTS: Overall, 804 screening programmes were conducted with 579 participants during the study period. All participants had internal contamination levels below the detection limit of the WBC unit (220 and 250 Bq/body for Cs-134 and Cs-137, respectively). Based on the most conservative assumption, their maximum annual effective doses by Cs-134 and Cs-137 together were estimated at 16 µSv/year. Contrary to limited internal contamination risks and counter-dose initiatives by the government, a considerable number of pregnant women were still concerned about consuming potentially contaminated local food products when purchasing them at supermarkets between 2012 (78.4%) and 2015 (75.0%). CONCLUSIONS: Health effects from post-accident internal radiation exposure were likely to be insignificant in pregnant women. National/local action is urgently needed to promote scientific understanding in pregnant women regarding limited internal exposure risks from local food products in the market. However, few mothers chose to participate in the internal radiation exposure screening programme, and thus, caution is required in interpreting the results of analyses.

Investigation of radiation-protection knowledge, attitudes, and practices of North Queensland dentists.

AIM: Queensland has current radiation-protection guidelines; however, with the absence of data exploring compliance and implementation, the efficacy is unknown. The aim of the present study was to investigate the knowledge and attitudes on radiation protection among private North Queensland (NQ) dentists. METHODS: A quantitative methodology was employed in an observational and descriptive study using questionnaires for data collection. RESULTS: Of the 154 questionnaires distributed, 63 were completed and returned. The respondents' knowledge concerning the technical details of their equipment was limited, with 31.5% and 47% not knowing the tube voltage and current utilized for their machines, respectively. In total, 23.8% of dentists had limited knowledge about the speed of the conventional film they used, 90.5% of respondents agreed that the role of imaging in dentistry is important, and 75.8% dentists reported the thyroid as the most important organ to protect during dental radiography. Their knowledge regarding position-distance rule was reasonably adequate; 80.3% of the dental practices appeared to follow the Australian Radiation Protection and Nuclear Safety Agency guidelines, 95.2% preferred taking radiographs if it was only urgent, and 69.8% identified a need for spreading awareness regarding radiation protection. CONCLUSIONS: An opportunity and need for further continuing education was identified among NQ dentists to ensure safety of patients.

Physical activity as an option to reduce adverse effect of EMF exposure during pregnancy.

The popularity of using wireless fidelity over the last decades increased apprehensions about impact of high frequency electromagnetic fields (EMF) on health. Most of previous studies mentioned adverse effect of EMF on cognitive processes, but so far, no study has provided a way to control adverse effects of EMF exposure. The purpose of this study was to examine the effect of Wi-Fi EMF and physical activity on spatial learning and motor function in pregnant rat's offspring. Forty Albino-Wistar pregnant rats divided randomly into four groups (EMF, physical activity, combined 2.4GHZ EMF and physical activity and control groups). For assessing spatial learning in 56 post-natal days' old (PND) male offspring, Morris Water Maze (MWM) was used and to examine motor function Open-field test was taken. Although results of MWM test revealed that Wi-Fi modem EMF caused impairment in spatial learning in rats exposed to EMF but physical activity could reduce negative effect of EMF in pregnant rat's offspring who exposed during pregnancy but performed swimming. In addition, results of open-field test showed that litter's motor function in EMF group significantly declined in comparison with physical activity and combined 2.4GHZ EMF and physical activity groups. According to our findings, it can be concluded that execution physical activity individually or along with wave-exposed pregnancy can significantly progressive effect on offspring' cognitive and motor functions.

Radiation exposure to foetus and breasts from dental X-ray examinations: effect of lead shields.

OBJECTIVES: Dental radiography may involve situations where the patient is known to be pregnant or the pregnancy is noticed after the X-ray procedure. In such cases, the radiation dose to the foetus, though low, needs to be estimated. Uniform and widely used guidance on dental X-ray procedures during pregnancy are presently lacking, the usefulness of lead shields is unclear and practices vary. METHODS: Upper estimates of radiation doses to the foetus and breasts of the pregnant patient were estimated with an anthropomorphic female phantom in intraoral, panoramic, cephalometric and CBCT dental modalities with and without lead shields. RESULTS: The upper estimates of foetal doses varied from 0.009 to 6.9 µGy, and doses at the breast level varied from 0.602 to 75.4 µGy. With lead shields, the foetal doses varied from 0.005 to 2.1 µGy, and breast doses varied from 0.002 to 10.4 µGy. CONCLUSIONS: The foetal dose levels without lead shielding were <1% of the annual dose limit of 1 mSv for a member of the public. Albeit the relative shielding effect, the exposure-induced increase in the risk of breast cancer death for the pregnant patient (based on the breast dose only) and the exposure-induced increase in the risk of childhood cancer death for the unborn child are minimal, and therefore, need for foetal and breast lead shielding was considered irrelevant. Most important is that pregnancy is never a reason to avoid or to postpone a clinically justified dental radiographic examination.

Relación entre flujometría doppler y los valores de APGAR a los 5 y 10 minutos en embarazos mayores de 34 semanas en el año 2014 en el hospital 1° de mayo / Relationship between doppler flowmetry and APGAR values at 5 and 10 minutes in pregnancies older than 34 weeks in 2014 at the "1° de mayo" hospital

Determinar la calidad del intercambio de flujo placentario que existe entre la madre y el feto es de suma importancia en situaciones que amenazan el bienestar materno-fetal, es por esto que la flujometría doppler fetal es una valiosa herramienta para prevenir daños posteriores por medio de la detección temprana y manejo oportuno de fetos con alteración del flujo placentario. La flujometría doppler es un método no invasivo que ha demostrado una mayor exactitud diagnóstica para la evaluación del bienestar fetal y una mayor sensibilidad y especificidad para diagnosticar la muerte perinatal y la baja calificación de APGAR al nacer. El presente trabajo de investigación consiste en un estudio descriptivo transversal que relacionó el resultado de la flujometría doppler fetal con los valores de APGAR a los 5 y 10 minutos en recién nacidos de embarazos mayores de 34 semanas, atendidos en el Hospital Materno Infantil 1º de Mayo en el año 2014. Los datos fueron recopilados por medio de la revisión de expedientes y procesados en la herramienta Epi InfoTM7 para su posterior interpretación. Se incluyó un total de 231 flujometrías, de las cuales se obtuvieron 209 con resultado normal y 22 alteradas, de estas últimas resultaron con APGAR debajo de 7 puntos un 40% a los 5 minutos y un 9% a los 10 minutos. En base a los resultados inferimos que la flujometría alterada tiene poco valor pronóstico de APGAR bajo al nacer, por lo que su indicación debe limitarse a embarazos con riesgo de insuficiencia placentaria, ya que realizarla de forma indiscriminada puede alterar las decisiones obstétricas e incrementar el intervencionismo médico en aquellos embarazos sin factores de riesgo

SAR exposure from UHF RFID reader in adult, child, pregnant woman, and fetus anatomical models.

The spread of radio frequency identification (RFID) devices in ubiquitous applications without their simultaneous exposure assessment could give rise to public concerns about their potential adverse health effects. Among the various RFID system categories, the ultra high frequency (UHF) RFID systems have recently started to be widely used in many applications. This study addresses a computational exposure assessment of the electromagnetic radiation generated by a realistic UHF RFID reader, quantifying the exposure levels in different exposure scenarios and subjects (two adults, four children, and two anatomical models of women 7 and 9 months pregnant). The results of the computations are presented in terms of the whole-body and peak spatial specific absorption rate (SAR) averaged over 10 g of tissue to allow comparison with the basic restrictions of the exposure guidelines. The SAR levels in the adults and children were below 0.02 and 0.8 W/kg in whole-body SAR and maximum peak SAR levels, respectively, for all tested positions of the antenna. On the contrary, exposure of pregnant women and fetuses resulted in maximum peak SAR(10 g) values close to the values suggested by the guidelines (2 W/kg) in some of the exposure scenarios with the antenna positioned in front of the abdomen and with a 100% duty cycle and 1 W radiated power.

The effect of extremely low frequency electromagnetic fields on pregnancy and fetal growth, and development.

BACKGROUND: Exposure to electromagnetic fields (EMFs) and its effects at different frequencies on living beings has been investigated for decades. However, there are fewer studies that have been conducted on humans, thus this study aims to determine the effect of extremely low frequency (ELF) -EMFs on pregnancy, fetal growth and development in humans. MATERIAL: In this epidemiologic analytical cohort study, cases included pregnant women and their newborns. There were 222 women exposed to ELF-EMFs from high voltage electricity towers and cables during pregnancy and 158 women who had no exposure during pregnancy. Data that included pregnancy duration, neonatal birth weight, length, head circumference, gender and congenital malformations were collected through direct questions, measurements and referral to the registered data of related hospital or health center documents. Collected data was analyzed by SPSS-16. P < 0.05 was considered significant. RESULTS: No significant difference was found in pregnancy duration and preterm labor, neonatal birth weight, length, head circumference and congenital malformations in the two studied groups. CONCLUSION: Although the results of this study have shown no significant effects of ELF-EMFs on human pregnancy, fetal growth and development, taking precautionary measures to reduce exposure to EMFs by pregnant women seems logical. Conducting similar studies is strongly recommended.

[Radiation effects on pregnant women, fetuses, and children].

We conducted a review of literature related to radiation effects on pregnant women, fetuses, and children from the perspective of epidemiology, pathology, and radiobiology. During 8-25 weeks post-conception the central nervous system is particularly sensitive to radiation. Fetal doses in excess of 100 mGy can result in some reduction of IQ (intelligence quotient). Fetal doses in the range of 1000 mGy can lead to severe mental retardation and microcephaly, particularly during 8-15 weeks and to a lesser extent 16-25 weeks after conception. Recent studies of cancers and chromosome aberrations indicated less radiosensitivity in prenatally exposed A-bomb survivors compared with postnatally exposed survivors, for which we provide possible hypotheses as an explanation.

SCAI consensus document on occupational radiation exposure to the pregnant cardiologist and technical personnel.

Concerns regarding radiation exposure and its effects during pregnancy are often quoted as an important barrier preventing many women from pursuing a career in Interventional Cardiology. Finding the true risk of radiation exposure from performing cardiac catheterisation procedures can be challenging and guidelines for pregnancy exposure have been inadequate. The Women in Innovations group of Cardiologists with endorsement of the Society for Cardiovascular Angiography and Interventions aim to provide guidance in this publication by describing the risk of radiation exposure to pregnant physicians and cardiac catheterisation personnel, to educate on appropriate radiation monitoring and to encourage mechanisms to reduce radiation exposure. Current data do not suggest a significant increased risk to the fetus of pregnant women in the cardiac catheterisation laboratory and thus do not justify precluding pregnant physicians from performing procedures in the cardiac catheterisation laboratory. However, radiation exposure among pregnant physicians should be properly monitored and adequate radiation safety measures are still warranted.

Exposure to diagnostic radiological procedures and the risk of childhood acute lymphoblastic leukemia.

BACKGROUND: Diagnostic irradiation of the mother during pregnancy increases the risk of childhood acute lymphoblastic leukemia (ALL). There is inconsistent evidence on associations between ALL and other parental or childhood diagnostic irradiation. The aim of this analysis is to investigate whether diagnostic X-rays of the mother before birth, of the father before conception, or of the child increased the risk of childhood ALL. METHODS: Data from 389 cases and 876 frequency-matched controls were analyzed using unconditional logistic regression, adjusting for study matching factors and potential confounders. A meta-analysis of our findings in relation to paternal X-rays before conception with the published findings of previous studies was also conducted. RESULTS: There was no evidence of an increased risk with maternal abdominal X-rays before the birth of the index child or with the child having any X-rays more than 6 months before the censoring date. The odds ratio (OR) for any paternal abdominal X-ray before conception was 1.17 [95% confidence interval (95% CI), 0.88-1.55], and 1.47 (95% CI, 0.98-2.21) for more than one X-ray. The OR for any paternal intravenous pyelogram before conception was 3.56 (95% CI, 1.59-7.98). The pooled OR for this study with previous studies of any paternal abdominal X-rays before conception was 1.17 (95% CI, 0.92-1.48). CONCLUSIONS: There was some evidence of an increased risk of ALL in the offspring if the father had more than one abdominal X-ray before conception or had ever had an intravenous pyelogram. IMPACT: We plan to repeat this analysis by using pooled data to improve precision.

Conventional barium enema in early pregnancy.

X-ray exposure, especially if directed to the abdominal region, is of major concern for pregnant women and their physicians. In this study, favourable long-term outcomes are reported in a series of babies born to women inadvertently exposed to barium enema, and associated ionising radiation, early in pregnancy. Six singleton babies were vaginally delivered without any evidence of gross malformations. There was one voluntary abortion. Follow-up on five of the babies was performed over the course of at least 4 years. All the children were deemed healthy and had developed milestones according to their age. Our findings support larger studies suggesting barium enema is not a teratogenic agent. Collectively, this research can be used to counsel women undergoing radiological procedures early in pregnancy.

Selenium and vitamin E modulates radiation-induced liver toxicity in pregnant and nonpregnant rat: effects of colemanite and hematite shielding.

The levels of liver lipid peroxidation, glutathione peroxidase, reduced glutathione, and vitamins A and E were used to follow the level of oxidative damage caused by ionizing radiation in pregnant rats. The possible protective effects of selenium and vitamin E supplemented to rats housed in concrete-protected cages using hematite and colemanite were tested and compared to untreated controls. Ninety-six rats were randomly divided into four main equal groups namely control (A), normal concrete (B), concrete containing colemanite (C), and concrete containing hematite (D). Except group A, all groups exposed to 7 Gy radiation. The four main groups were divided into four subgroups each as follows: subgroups 1 (n = 6): nonpregnant control rats. Subgroups 2 (n = 6): selenium and vitamin E combination was intraperitoneally (i.p.) given to the nonpregnant rats for 20 days. Subgroups 3 (n = 6): pregnant control rats. Subgroups 4 (n = 6): selenium and vitamin E combination was i.p. given to the pregnant rats for concessive 20 days. Lactate dehydrogenate, alkaline phosphates, and lipid peroxidation values were higher in subgroups 1 and 3 than in no radiation group although glutathione peroxidase and vitamin E levels in liver were lower in radiation group than in no radiation group. Lactate dehydrogenate activity and lipid peroxidation levels were found to be decreased in subgroups 2 and 4 protected with concrete containing hematite and colemanite when compared to subgroup 1 and 3 with normal concrete. The radiation doses in rats housed by concrete without colemanite and hematite exposed radiation clearly showed liver degeneration. In conclusion, selenium and vitamin E supplementations and housing by concrete with colemanite was found to offer protection against gamma-irradiation-induced liver damage and oxidative stress in rats, probably by exerting a protective effect against liver necrosis via its free radical scavenging and membrane stabilizing. Protective effects of colemanite in the liver seem to be more important than in hematite.

Sistema on-line para o cálculo de doses fetais de pacientes e trabalhadoras ocupacionalmente expostas em radiologia diagnóstica / On-line software for the estimation of fetal radiation dose to patients and staff members in diagnostic radiology

Neste trabalho descrevemos um sistema on-line, chamado “Dose Fetal Web”, que calcula a dose fetal e os riscos radiológicos devido a exposições clínicas ou ocupacionais de gestantes. O sistema utiliza a metodologia matemática onde são usados coeficientes de conversão de dose uterina para dose fetal, gerados por meio de simulações pelo método de Monte Carlo. Para exposição médica de uma paciente gestante, uma base de dados de informações de operação de equipamentos acompanhados por um programa de garantia de qualidade e parâmetros fetais e maternos coletados durante exames de ultrassonografia obstétrica são incorporados na estimativa da dose fetal. No caso de dose fetal de uma trabalhadora gestante sujeita à exposição ocupacional (IOE),informações de uma base de dados de monitoração pessoal como dose ocupacional e carga de trabalho são usadas nos cálculos. No primeiro caso, considerando-se uma paciente gestante de 26 semanas submetida a um procedimento abdominal AP (tensão aplicada ao tubo de 70 kVp e filtração total de 3 mmAl), a dose fetal calculada pelo sistema foi 4,61 mGy e os riscos radiológicos obtidos foram 5,0·10-4 e 0,14 para a probabilidade de indução de retardamento mental e declínio de pontos de QI, respectivamente. No segundo caso, considerando-se uma IOE gestante, e assumindo-se que ela utilize um avental de proteção de 0,5 mm de equivalência em chumbo durante cada procedimento de radiologia intervencionista, e que a leitura pessoal de um dosímetro TLD portado fora do avental foi de 2 mGy/mês, a dose fetal calculada pelo sistema foi 0,02 mSv/mês.

In this paper we describe an online software, named “Dose Fetal Web”, which calculates the dose of the fetus and the radiological risks from both medical and occupational exposures of pregnant women. The software uses a mathematical methodology where coefficients for converting uterus to fetal dose, NUD, have been calculated by using Monte Carlo simulation. In the fetal dose from diagnostic medical examination of the pregnant patient, database information regarding output and other equipment related parameters from the QA database, maternal and fetal parameters collected by ultrasound procedures were used for the fetal dose estimation. In the case of fetal dose of the pregnant staff member the database information regarding routine individual monitoring dosimetry, such as occupational dose and workload, were used for the estimation. In the first case, suppose a 26 weeks pregnant patient had to undergo a single AP Abdomen procedure (70 kVp peak tube voltage and total filtration 3 mmAl), the fetal dose calculated by the software was 4.61 mGy and the radiological risks would be 5.0·10-4 and 0.14 to the probability of mental retardation induction and decline in the IQ score, respectively. In the second case,considering that the staff member can be pregnant, and assuming that she wore a 0.5 mm lead equivalent apron during every interventional radiology procedure and a personal dosimetry reading of 2 mGyTLD/month measured with the TLDs outside the apron, the fetal dose calculated by the software was 0.02 mSv/month.

[Diagnostic imaging during pregnancy]. / Radiologische Untersuchungen in der Schwangerschaft.

If diagnostic imaging during pregnancy is performed, potential risks not only for the mother but also for the fetus have to be considered. Ultrasonography should be performed primarily because it is harmless for the fetus. Other imaging modalities like x-ray, computed tomography (CT) and magnetic resonance imaging (MRI) should be reserved for cases in which results of ultrasonography are inconclusive and patient care depends on further imaging. If pulmonary disease is suspected (e. g. pneumonia) chest x-ray should be performed. CT should be considered if chest x-ray is nondiagnostic or inadequate (e. g. suspicion of pulmonary embolism). In patients with abdominal symptoms the indication either for CT or MRI depends on the presumed disease. Every abdominal CT during pregnancy should include an estimation of radiation dose. Dose estimation is not necessary after CT of the chest. In case of pelvic disease in particular concerning the ovaries and the uterus as well as fetal imaging MRI is the method of choice. Contrast media should only given intravenously when a compelling clinical indication exists and the potential benefit to the patient outhweights the potential risk to the fetus.