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RADIATION EXPOSURE POTPOURRI
Ray Copes, MD, MScDirector, Environmental and Occupational HealthPublic Health OntarioAssociate Professor, University of Toronto
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Objectives1)Quick Review – The EMS. What sources contribute to population exposure to ionizing radiation? How many radiation agents have been reviewed by IARC and what are their ratings? 2) Radon – How risky is radon? What are we doing about it? 3) Do cell phones cause cancer? How can you reduce exposure to RF?
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Average Annual Ionizing Radiation Dose to US Residentsfrom Upton, 2010
Source Dose (mSv) % of TotalRadon 1.9 31
Cosmic 0.27 4
Terrestrial 0.28 4
Internal 0.39 7
Total Natural 2.84 46X-ray Dx 2.4 39
Nuclear Med 0.8 13
Consumer Products 0.1 2
Occup, Nucl, Misc 0.05 <1
Total Artificial 3.35 54
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Radiation agents reviewed in the International Agency for Research on Cancer’s (IARC) monograph series from Samet 2011
Agent Group IARC Monograph Volume No.
Year
Ultraviolet radiation 1 40, 55 1986, 1992Radon-222 and its decay products 1 43, 78 1988, 2001Ultraviolet radiation A (NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)
2A 55 1992
Ultraviolet radiation B (NB: Overall evaluation upgraded from 2B to 2A with supporting evidence fromother relevant data)
2A 55 1992
Ultraviolet radiation C (NB: Overall evaluation upgraded from 2B to 2A with supporting evidence from other relevant data)
2A 55 1992
Solar radiation 1 55 1992X- and Gamma (γ)-Radiation 1 75 2000Radium-224 and its decay products 1 78 2001Radium-226 and its decay products 1 78 2001Radium-228 and its decay products 1 78 2001Radioiodines, short-lived isotopes, including iodine-131, from atomic reactor accidents and nuclear weapons detonation (exposure during childhood)
1 78 2001
Radionuclides, α-particle-emitting, internally deposited (NB: Specific radionuclides for which there is sufficient evidence for carcinogenicity to humans are also listed individually as Group 1 agents)
1 78 2001
Radionuclides, β-particle-emitting, internally deposited (NB: Specific radionuclides for which there is sufficient evidence for carcinogenicity to humans are also listed individually as Group 1 agents)
1 78 2001
Magnetic fields (extremely low-frequency) 2B 80 2002Magnetic fields (static) 3 80 2002
Classification of carcinogenic hazards to humans:Group 1: Carcinogenic to humans.Group 2A: Probably carcinogenic to humans.Group 2B: Possibly carcinogenic to humans.Group 3: Not classifiable as to carcinogenicity to humans.Group 4: Probably not carcinogenic to humans.
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RadonWorth getting excited
about?
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Increase in lung cancer risk per 100 Bq m-3 increase in measured radon concentration in 13 European case-control studies
Source: Darby et al. 2005 [28].
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Risk of Developing Radon Related Lung Cancer
Copes R , Scott J CMAJ 2007;177:1229-1231
©2007 by Canadian Medical Association
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.
Copes R , Scott J CMAJ 2007;177:1229-1231
©2007 by Canadian Medical Association
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What About Workplaces?• Care taken with definition of ‘dwellings’• OSH regulator has jurisdiction• ‘Normal occupancy’ set at 4 hours/day• Some workplaces may have more than 200 Bq/m3• At grade or below, also consider potential contribution
from water in unusual work settings (e.g. hatcheries)• Some dwellings are work places and worker exposure will
be reduced as well as residents (e.g. schools)
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What is being done?• Health Canada cross country survey year 2 complete not
yet released• Federal sector buildings being tested• Provincial interest ‘variable’ (e.g. BC school testing) • Resources available for homeowners to test and
remediate at their expense • Little concerted pressure or publicity• Burden of illness not widely appreciated even by PH staff • Second only to smoking as preventable cause of lung
cancer• Estimated 5-10% of lung ca. radon attributable.
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Does cell phone use cause cancer?• May 2011 IARC meeting, 30 scientists 14 countries to
assess carcinogenicity of RF electromagnetic fields.• Frequency 30kHz-300GHz.• Sources: cell phones, cordless phones, Bluetooth,
amateur radio, dielectric and induction heaters, pulsed radar, broadcast antennas, medical applications.
• The ‘hazard’ isn’t new, the applications are. • Does one apply the Precautionary Principle to new
hazards or new applications?
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RF Exposures• Workers –highest exposures are near field• Public – Use of transmitters held close to the body, can
give greater dose to brain than work exposures• Exposures from cell phone base stations, TV, radio,
Bluetooth are all orders of magnitude lower than cell phones
• New 3G phones emit 100 times less RF than GSM phones
• For energy deposition to brain, cell phone use is unique
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Exposure Standards for RF• Based on tissue heating as mechanism for adverse
effects• Canadian (Safety Code 6) and international stds (ICNIRP)
similar• Critics argue limits set on tissue heating are not stringent
enough• Regulatory bodies argue lack of consistency in research
with non-thermal end points and whether there is link to ‘adverse’ effects on health.
• Despite proliferation of wireless technologies, measurements done in community settings are typically small fraction of current limits
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Evidence for Carcinogenicity of RF?• Time trend, case-control, cohort studies• Time trend – surveillance data have not indicated
evidence of increase in gliomas or other tumours of interest potentially linked to cell phone use
• While some interpret as reassuring, this is a relatively insensitive indicator of risk
• IARC considered one cohort and 5 case-control studies
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Cell Phone studies
Danish cohort – 257 gliomas in 420,095 subscribers between 1982 and 1995, subscriber incidence close to national average.
INTERPHONE - 2708 glioma cases, 2972 controlsOR 0.81 (95% CI 0.70 -0.94) for ever versus never users For highest decile of exposure OR 1.40 (95% CI 1.03-1.89) Suggestion of increased risk for ipsilateral and temporal lobe tumours (where RF dose would be greatest)
Hardell -pooled analysis based on cases ascertained up to 2003. OR glioma >1 year of use 1.3 (95% CI 1.1-1.6) increasing to 3.2 (95% CI 2.0-5.1) for >2000h useIpsilateral use assoc w/ higher risk, cordless phones similar Sato – some evidence ipsilateral risk of acoustic neuroma
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Animal Studies• 40 studies assessing RF incl 7 2-year rodent bioassays• Increase in total tumours in 1 of 7 chronic bioassays• 2/12 studies with tumour prone animals showed increase
cancer incidence• 1/18 studies using initiation-promotion protocol• 4/6 co-carcinogenesis studies showed increase in cancer
after exposure RF and a known carcinogen
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Conclusion?• Inconsistencies across studies; recall, selection bias
possible; inadequate observations to meet latency Findings cannot be dismissed as reflecting bias alone.• Human evidence ‘limited’, animal evidence ‘limited’ • IARC Classification 2B ‘possibly carcinogenic’ supported
by ‘large majority’ of the working group.• This is based on exposure from cell phone use.• “In reviewing studies that addressed the possible
association between environmental exposure to RF-EMF and cancer, the working group found the available evidence insufficient for any conclusion”.
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Reducing RF Exposure• Cell phone use dominates exposures• Can reduce exposure through: - reducing use -texting -selection of phone with lower SAR -use of speaker, headset -avoid use where there is weak signal• Unclear whether this reduces risk of adverse effects• Potential for exposure reduction in other settings less
clear, although using wireless laptops on desk rather than lap may also be effective
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Lessons?• Pressure to do ‘premature epidemiology’.• Easy to ignore pretty good epidemiology when outrage is
low.• Discomfort with uncertainty.• Tension between ‘Precaution’ versus adoption of
beneficial (to whom?) new technologies.• Controversy fueled by increased access to information
and misinformation. • Internet can serve as an ‘amplifier’ of minority or fringe
views.• Lack of public trust in regulators and experts.
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Thank you
Questions?