An Estimation of the Monetary Value of the Person-Sievert Useful for Occupational Radiological Protection within the Healthcare System of Sweden.

ABSTRACT: The As Low As Reasonably Achievable (ALARA) principle includes taking into account economic and societal factors. To consider these factors, decision-aiding techniques such as cost-benefit analysis were introduced by the International Commission on Radiological Protection (ICRP) 50 y ago. Over the years, developments in health economics have led to new ways of deriving the concept of a value of a statistical life (VSL), which now is influencing the monetary value assigned to a unit of collective dose for radiological protection purposes (the α value) used in cost-benefit analyses. The aim of the present study was to estimate an α value useful for occupational radiological protection within the healthcare system of Sweden. A survey based on the stated preference approach was developed and sent to staff who are exposed to ionizing radiation at their work in Region Västra Götaland (Sweden). The survey essentially contained two scenarios: the respondents' willingness to pay for measures against radon exposure at home and their willingness to accept compensation for x-ray exposure at work. Answers from 718 respondents were collected. In the sensitivity analysis of the survey, the overall median VSL based on the two scenarios was calculated to be $50 million (IQR $10 to 363 million). The corresponding α value was established to $1,600 person-mSv -1 ($2,100 person-mSv -1 if excess burden of taxes is excluded). The recommended α value is in the high end compared to other studies but within the interval of values being used by nuclear utilities today. The α value should be seen in the light of ICRP's recommendation about stakeholder involvement as an important part of the optimization process.

Restoring areas after a radioactive fallout: A multidisciplinary study on decontamination.

Land remediation is an important part of restoration measures after a radioactive fallout containing long-lived fission products such as 137Cs. In this multidisciplinary study, we focused on three main issues related to remediation of contaminated urban areas. First, we assessed how much decontamination contributes to reducing resident radiation exposure and how much this reduction depends on the timing of implemented measures. Second, we calculated direct and indirect costs of decontamination in an industrialized country such as Sweden. Finally, in a survey study, we considered reactions of Swedish citizens to being given the hypothetical option of moving to a site decontaminated after radioactive fallout and how this predicted response might influence the design of contingency plans. The main findings are that clean-up operations must be done within the first few years after a fallout to contribute significantly to reducing residual dose. If conducted within 1-2 years, large-scale decontamination can, on average, avert 20-200 manSv per km2 residential area and unit ground deposition of 137Cs (1 MBq). The estimated direct costs (in 2020 purchasing power) would amount to 100 million Euro per km2 decontaminated residential area (comparable to Japanese estimates after the Fukushima accident), generating 39,000 m3 of radioactive waste on average, mainly in the form of 137Cs-contaminated topsoil. In our survey study of 2291 Swedish respondents about their willingness to return to decontaminated homes, women, families with resident children, and high-income earners exhibited more skepticism about returning, even if authorities were to deem it safe. The demographic pattern in attitudes was similar to that found among evacuees in the Fukushima prefecture after 2011. We conclude that predefined ranges of measured 137Cs ground deposition can be used as guidance for rescue leaders in the early post-accident phase in long-term planning for affected areas. This planning should include timing and intensity of decontamination measures, duration of evacuation, and risk communication to citizens. Because some citizens expressed both high risk perception and risk aversion, however, timely and dialogic communication is unlikely to limit a shift after the incident to an older and more male-dominated population composition. There is a risk that those who can afford to do so will move away, whereas people whose wealth is locked in property (houses or businesses) will feel stuck. Perceptions of unfairness may fray the social fabric and complicate resettlement, which in some cases may mean inefficient outlay of decontamination costs. We believe that the issue of monetary compensation to affected residents requires priority in future work.

Microplastic occurrence in selected aquatic species of the Persian Gulf: No evidence of trophic transfer or effect of diet.

Microplastic (MP) contamination in the aquatic ecosystems is a growing global environmental issue that can cause detrimental effects on aquatic species. In this study, MPs in fish (six species, 195 specimens), molluscs (one species, 21 specimens), and crustaceans (three species, 264 specimens) with various biometry, trophic levels, feeding habits, and habitat characteristics were investigated in three habitats: a river, an estuary, and a harbor in the Persian Gulf. Gastrointestinal tracts, gills and skin of targeted samples were chemically digested and the MPs recovered were counted and analyzed with optical microscopy, Raman spectroscopy and SEM/EDX. MPs counted in species of the Bushehr Port (11.4 ± 4.4 MPs/10 g) were significantly higher than in the other locations. The total abundance of MPs ranged from 4.0 ± 2.3 MPs/10 g for Metapenaeus affinis to 28.0 ± 6.4 MPs/10 g for Sepia pharaonis. Importantly, no significant relationships were found between the number of MPs in different inedible tissues, trophic levels, and types of feeding habit. Nevertheless, MPs were more abundant (p < 0.05) in benthos (34.7 MPs/10 g) than benthopelagic (25.9 MPs/10 g) and pelagic species (22.6 MPs/10 g). A total of 96.6 % of the identified MPs were fibers, these were generally ≥1000 µm and were mainly black/grey. Fibers may come from municipal wastewater effluents and fishing activities. The findings of this study present new insights into MP contamination routes in aquatic species.

Effect of land use on microplastic pollution in a major boundary waterway: The Arvand River.

The occurrence of microplastics (MPs) was investigated in the Arvand River (Iran). The Arvand River (200 Km) is a major water body that flows through land with diverse use and it meets the Persian Gulf. This study constitutes the first assessment of MP pollution (prevalence and physico-chemical characteristics) in the Arvand river, both in the sediment and in the water. MP monitoring has been carried out in 24 stations located along the river. The MP pollution found ranged between 1 and 291 items·L-1 and 70 to 15,620 items·kg-1 (dw), in water and sediment, respectively. The majority of MPs were fibres, black/grey and yellow/orange in colour, and mainly 250-500 µm and >1000 µm in size. Polyethylene terephthalate (PET), polypropylene (PP), nylon (NYL), high-density polyethylene (HDPE), and polystyrene (PS) were found in sediment samples. All these polymers, except HDPE, were also identified in the water samples. PET and PP were dominant in the water samples; whereas PET and PS were the most abundant in the sediments. The vicinity of urban wastewater effluents could be behind MP pollution in both water and sediments. Significant differences (p < 0.05) of MP concentrations were affected by different land uses when comparing MP levels in undisturbed natural area with urban areas. A strong correlation between MP fibres and fragments found with PCA biplots revealed their similar distribution in water. In the sediment samples, fibre and fragment MP particles were significantly correlated with colloidal particles (e.g., clay and organic matter) suggesting a relevant role of colloidal particles in the aquatic ecosystem of the Arvand River in transporting MPs. This study contributes to the better understanding of the presence of MP in major rivers, which are systems that have been scarcely investigated for this type of pollution, and it can inform interventions to reduce MP inputs to the river and sea.

A case study of cost-benefit analysis in occupational radiological protection within the healthcare system of Sweden.

The aim of the present study was to demonstrate cases of cost-benefit analysis within healthcare, of how economic factors can be considered in occupational radiological protection, in agreement with the as low as reasonably achievable principle and present Swedish legislations. In the first part of the present study, a comparison of examples within health economics used by authorities and institutes in Sweden was made. The comparison focused on value of a statistical life, quality-adjusted life year, and monetary cost assigned to a unit of collective dose for radiation protection purposes (α-value). By this comparison, an α-value was determined as an interval between $45 and $450 per man-mSv, for the Swedish society in 2021. The α-value interval can be interpreted as following: Less than $45 per man-mSv is a good investment. From $45 to $450 per man-mSv, other factors than costs and collective dose are important to consider. More than $450 per man-mSv is too expensive. In the second part of the present study, seven cases of cost-benefit analyses in occupational radiological protection were provided. The present study focused specifically on cases where the relevant factors were costs and collective dose. The present case study shows a large variation in costs per collective dose from different types of occupational radiological protection, used at Skaraborg Hospital in Sweden.

Patient related factors affecting in-hospital costs of a TURP procedure.

Introduction: Treatment costs of lower urinary tract symptoms secondary to benign prostatic enlargement (BPE) are a substantial economic burden that will continue to increase in the future as a result of the ageing male population and increasing health awareness. The true costs for surgical interventions against BPE have been difficult to quantify as treatment costs strongly depend on the performance setting and may also vary among different healthcare systems, regions and institutions. The purpose of this study was to disclose the in-hospital costs and main expense items associated with a transurethral resection of the prostate (TURP).Methods: A cohort of men subjected to TURP due to BPE was analysed during a 3-year period (2017-2019). All in-hospital expenses were registered using an electronic spreadsheet. Patient background and perioperative variables were registered using retrospective chart reviews.Results: A total of 122 men were available for final analysis. Of these, 70 men were operated on due to bothersome LUTS and 52 men due to urinary retention. The mean and median (inter quartile range) cost per patient was €4025 and €3702 (2961 - 4390), respectively. The main drivers of total cost were length of stay, the surgical procedure and anaesthesia related costs. Factors associated with increasing total cost per patient were increasing age, prostate volume, presence of urinary retention, occurrence of complications, increasing catheter time and length of stay.Conclusion: The main factor that influences total cost for an elective TURP procedure is the occurrence of postoperative complications. Our findings firmly underscore the indispensability to employ every possible means to avoid and prevent complications of any kind.

Potentially toxic elements (PTEs) and polycyclic aromatic hydrocarbons (PAHs) in fish and prawn in the Persian Gulf, Iran.

This study aimed to speciate and quantify potentially toxic elements (PTEs) and polycyclic aromatic hydrocarbons (PAHs), in addition to estimate potential human health risk of PTEs (As, Cd, Co, Cr, Cu, Hg, Mn, Ni, Pb, Se, V, and Zn) through the consumption of three edible fish species (Leuciscus vorax, Liza abu, and Coptodon zillii) and two prawn species (Metapenaeus affinis and Penaeus semisulcatus) collected from Arvand River and Musa Estuary in the Persian Gulf. The concentration of As in prawn species exceeded permissible limit set by international organizations. PAHs were dominated by low molecular weight species such as naphthalene, phenanthrene, and, fluorene but generally exhibited low mean concentrations in fish and prawn samples. The human health hazard posed by PTEs was assessed using methods that consider estimated daily intake (EDI), estimated weekly intake (EWI), target hazard quotients (THQ), and combined THQ. The results suggested that elevated As concentrations in almost all prawn samples may pose a probable health hazard to local inhabitants.