UDK 61 Медицина. Охрана здоровья
GRNTI 76.03 Медико-биологические дисциплины
GRNTI 76.33 Гигиена и эпидемиология
OKSO 14.04.02 Ядерные физика и технологии
OKSO 31.06.2001 Клиническая медицина
OKSO 32.08.12 Эпидемиология
OKSO 31.08.08 Радиология
BBK 51 Социальная гигиена и организация здравоохранения. Гигиена. Эпидемиология
BBK 534 Общая диагностика
TBK 5708 Гигиена и санитария. Эпидемиология. Медицинская экология
TBK 5712 Медицинская биология. Гистология
TBK 5734 Медицинская радиология и рентгенология
TBK 6212 Радиоактивные элементы и изотопы. Радиохимия
Purpose: The aim of the paper is to review the genesis and evolution of the concept termed dose and dose rate effectiveness factor or DDREF, to expose critiques on the concept and to suggest some curse of action on its use. Material and methods: Mainly using the UNSCEAR reporting and ICRP recommendations as the main reference material, the paper describes the evolution (since the 70’s) of the conundrum of inferring radiation risk at low dose and dose-rate. People are usually exposed to radiation at much lower doses and dose rates than those for which quantitative evaluations of incidence of radiation effects are available – a situation that tempted experts to search for a factor relating the epidemiological attribution of effects at high doses and dose-rates with the subjective inference of risk at low doses and dose-rates. The formal introduction and mathematical formulation of the concept by UNSCEAR and ICRP (in the 90’s), is recalled. It is then underlined that the latest UNSCEAR radiation risk estimates did not use a DDREF concept, making it de facto unneeded for purposes of radiation risk attribution. The paper also summarizes the continuous use of the concept for radiation protection purposes and related concerns as well as some current public misunderstandings and apprehension on the DDREF (particularly the aftermath of the Fukushima Dai’ichi NPP accident). It finally discusses epistemological weaknesses of the concept itself. Results: It seems that the DDREF has become superseded by scientific developments and its use has turned out to be unneeded for the purposes of radiation risk estimates. The concept also appears to be arguable for radiation protection purposes, visibly controversial and epistemologically questionable Conclusions: It is suggested that: (i) the use of the DDREF can be definitely abandoned for radiation risk estimates; (ii) while recognizing that radiation protection has different purposes than radiation risk estimation, the discontinuation of using a DDREF for radiation protection might also be considered; (iii) for radiation exposure situations for which there are available epidemiological information that can be scientifically tested (namely which is confirmable and verifiable and therefore falsifiable), radiation risks should continue to be attributed in terms of frequentistic probabilities; and, (iv) for radiation exposure situations for which direct scientific evidence of effects is unavailable or unfeasible to obtain, radiation risks may need to be inferred on the basis of indirect evidence, scientific reasoning and professional judgment aimed at estimating their plausibility in terms of subjective probabilities.
DDREF, low-dose, low-dose-rate, radiation-risk, linear-relationship, threshold-dose
The paper is aimed at reviewing the genesis and evolution of the concept termed dose and dose rate effectiveness factor (which is usually represented in all languages by the English acronym, DDREF). It will expose critiques on the concept and to suggest some course of action on its use1.
The concept had been internationally introduced more or less simultaneously in the 90’s by the United Nations Scientific Committee on the Effects of Atomic Radiation, UNSCEAR [USCEAR, 1993] and the International Commission on Radiological Protection, ICRP [ICRP, 1991]. It should be emphasized, however, that the aims of UNSCEAR and ICRP in defining a DDREF were subtly different: while UNSCEAR used the concept for estimating risk of radiation exposure globally, ICRP recommended its use for purposes of radiation protection.
1. Beninson, 1996. Beninson Dan J. Risk of radiation at low doses. Sievert Lecture. IRPA 9. Proceedings of the 9th Congress of the International Radiation Protection Association. IRPA, Vienna, Austria, April 1996, http://www2000.irpa.net/irpa9/cdrom/VOL.1/V1_1.PDF.
2. Boice et al., 1979. Boice, J.D. Jr., Land C.E., Shore R.E. et al. Risk of breast cancer following low dose radiation exposure // Radiology. 1979. Vol. 131. P. 589-597.
3. Brooks, 2011. Brooks A.L. Is a dose dose-rate effectiveness factor (DDREF) needed following exposure to low total radiation doses delivered at low dose-rates? // Health Phys. 2011. Vol. 100. № 3. P. 262
4. Fry, 2013. Fry RJM. A Note On The Dose-Rate-Effectiveness Factor and its Progeny DDREF. https://three.jsc.nasa.gov/articles/DDREF.pdf. Date posted: 01-07-2013.
5. González et al., 2013. González A.J., Akashi M., Boice J.D. et al. Radiological Protection Issues Arising During and After the Fukushima Nuclear Reactor Accident // J. Radiol. Prot. 2013. Vol. 33. № 3. P. 497-571.
6. Holm et al., 1988. Holm L.E., Wiklund K.E., Lundell G.E. et al. Thyroid cancer after diagnostic doses of iodine-131 // J. Natl. Cancer lnst. 80. P. 1132-1137.
7. IAEA, 2007. IAEA safety glossary: terminology used in nuclear safety and radiation protection : 2007 edition. STI/PUB/1290. ISBN 92-0-100707-8. International Atomic Energy Agency. - Vienna. 2007.
8. IAEA, 2015. The Fukushima Daiichi Accident. Report by the Director General. Document GOV/2015/26. International Atomic Energy Agency. - Vienna. 2015.
9. ICRP, 1977. Recommendations of the International Commission on Radiological Protection. ICRP Publication 26 // Ann. ICRP. 1977. Vol. 1. № 3.
10. ICRP, 1991. 1990 ICRP. Recommendations of the International Commission on Radiological Protection. ICRP Publication 60 // Ann. ICRP. 1990. Vol. 21. № 1-3.
11. ICRP, 2005. Low dose extrapolation of radiation-related cancer risk. ICRP Publication 99 // Ann. ICRP. 2005. Vol. 35. № 4.
12. ICRP, 2007. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP Publication 103 // Ann. ICRP. 2007. Vol. 37. № 2-4.
13. ICRP, 2015. ICRP Task Group 91 on Radiation Risk Inference at Low-dose and Low-dose Rate Exposure for Radiological Protection Purposes. Readable at: http://www.icrp.org/icrp_group.asp?id=83
14. ILO, 2010. Approaches to attribution of detrimental health effects to occupational ionizing radiation exposure and their application in compensation programmes for cancer: A practical guide. Edited by Shengli Niu, Pascal Deboodt, Hajo Zeeb; jointly prepared by the International Atomic Energy Agency, the International Labour Organization and the World Health Organization. Occupational Safety and Health Series, No. 73. ISBN 978-92-2-122413-6 (print). ISBN 978-92-2-122414-3 (web pdf). International Labour Office, Geneva, 2010.
15. Liniecki J. Mortality risk coefficients for radiation induced cancer at high doses and dose rates and extrapolation to the low dose domain // Polish J. Occup. Med. 1989. Vol. 2, P. 132-146 (in English).
16. Mendeley, 2017. https://www.mendeley.com/groups/6468811/ddref-paper/
17. Miller et al., 1989. Miller A.B., Howe G.R., Sherman G.J. et al. Mortality from breast cancer after irradiation during fluoroscopic examinations in patients being treated for tuberculosis // New Engl. J. Med. 1989. Vol. 321. P. 1285-1289.
18. Müller, 2015. Wolfgang-Ulrich Müller. Current discussions of DDREF, cataracts, circulatory diseases and dose limits. Radiat Prot Dosimetry (2015) 164 (1-2): 34-37. DOI: https://doi.org/10.1093/rpd/ncu311.
19. NAS, 1980. The Effects on Populations of Exposure to Low Levels of Ionizing Radiation: 1980. BEIR III Report. National Academy of Sciences. National Academy Press, Washington, DC.
20. NAS, 1990. Health Effects of Exposure to Low Levels of Ionizing Radiation. BEIR V Report. National Academy of Sciences. National Academy Press, Washington, DC.
21. NAS, 2006. National Research Council Committee to Assess Risks from Exposure to Low Levels of Ionizing Radiation. Health Risks from Exposure to Low Levels of Ionizing Radiation. Biological Effects of Ionizing Radiation: BEIR VII Phase 2. National Academies Press, Washington, DC, 2006.
22. NUREG, 1989. Health Effect Models for Nuclear Power Plant Accident Consequence Analysis-NUREGICR-4214. Rev. 1. Part II. Scientific Bases for Health Effects Models. U.S. Nuclear Regulatory Commission, Washington DC.
23. NCRP, 1980. Influence of Dose and its Distribution in Time on Dose-Response Relationships for Low-LET Radiation. Report No. 64, National Council on Radiation Protection and Measurements, Bethesda, MD, 1980.
24. NRPB, 1988. National Radiological Protection Board. Risk of Radiation- Induced Cancer at Low doses and Low Dose-Rates For Radiation Protection Purposes. Document of the NRPB, Vol 6 (1) (195) NRPB, Chilton, Oxford. 1988.
25. Pierce, D.A. and M. Vaeth, 1989. Pierce D.A., Vaeth M. The shape of the cancer mortality dose-response curve for atomic bomb survivors // RERF TRn-89. 1989; and Pierce D.A., Vaeth M. Cancer risk estimation from the A-bomb survivors: extrapolation to low doses, use of relative risk models and other uncertainties. in: Low Dose Radiation: Biological Bases of Risk Assessment. (K.F. Haverstock and J.W. Stather, eds.) Taylor and Francis, London, 1989, P. 54-69.
26. Preston, 2011. From epidemiology to risk factors aka DDREF: lights and shadows. Third MELODI Workshop. Rome, 2-4 November 2011. http://www.melodi-online.eu/ws3_pres.html
27. Rail et al., 1985. Rail J. E., Beebe G. W., Hoel D. G. et al. Report of the National Institutes of Health Ad Hoc Working Group to Develop the Radioepidemiological Tables. US Government Printing Office, Washington, DC. 1985.
28. Rühm, 2015. Rühm W., Helmholtz Center Munich, Germany. Third International Symposium on the System of Radiological Protection. Seoul, Korea. October 22. 2015
29. Rühm et al., 2015. Rühm W., Woloschak G.E., Shore R.E. et al. Dose and dose-rate effects of ionizing radiation: a discussion in the light of radiological protection // Radiat. Environ. Biophys. 2015. Vol. 54. № 4. P. 379-401. doi:https://doi.org/10.1007/s00411-015-0613-6. Epub 2015 Sep 5.
30. SSK, 2014. Dosis- und Dosisleistungs-Effektivitätsfaktor (DDREF). Empfehlung der Strahlenschutzkommission mit wissenschaftlicher Begründung. Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (Adopted at the 268th meeting of the German Commission on Radiological Protection on 13 and 14 February 2014)
31. Thomson J.F., Grahn D., Life shortening in mice exposed to fission neutrons and gamma rays. VIII. Exposures to continuous gamma radiation // Radiat. Res. 1989. № 118, P. 151-160.
32. UNGA, 1993. United Nations General Assembly. Report of the United Nations Scientific Comité on the Effects of Atomic Radiation. Official Records of the forty-eighth session of the United Nations General Assembly, Supplement No. 46. Document A/48/46. 23 September 1993.
33. UNGA, 2006. United Nations General Assembly. Report of the fifty-fourth session (29 May-2 June 2006) of the United Nations Scientific Committee on the Effects of Atomic Radiation. Sixty-first session of the United Nations General Assembly, Official Records, Supplement, No. 46 (A/61/46).
34. UNGA, 2016. United Nations General Assembly. Report of the sixty-third session (27 June-1 July 2016) of the United Nations Scientific Committee on the Effects of Atomic Radiation. Seventy-first session of the United Nations General Assembly, Official Records, Supplement No. 46, Document A/71/46.
35. UNSCEAR, 1958. UNSCEAR. Official Records of the General Assembly, Thirteenth Session, Supplement No. 17 (A/3838). UNSCEAR 1958 Report. United Nations Scientific Committee on the Effects of Atomic Radiation. United Nations, New York, 1958.
36. UNSCEAR, 1962. UNSCEAR. Official Records of the General Assembly, Seventeenth Session, Supplement No. 16 (A/5216). UNSCEAR 1962 Report. United Nations Scientific Committee on the Effects of Atomic Radiation, United Nations, New York, 1962.
37. UNSCEAR, 1964. UNSCEAR. Official Records of the General Assembly, Nineteenth Session, Supplement No. 14 (A/5814). UNSCEAR 1964 Report. United Nations Scientific Committee on the Effects of Atomic Radiation, United Nations, New York, 1964.
38. UNSCEAR, 1969. UNSCEAR. Official Records of the General Assembly, Twenty-Fourth Session, Supplement No. 13 (A/7613). UNSCEAR 1969 Report. United Nations Scientific Committee on the Effects of Atomic Radiation, United Nations, New York, 1969.
39. UNSCEAR, 1972. Ionizing Radiation: Levels and Effects. Volume I: Levels. UNSCEAR 1972 Report. United Nations Scientific Committee on the Effects of Atomic Radiation, 1972 Report to the General Assembly, with annexes. United Nations sales publication E.72.IX.17 and 18. United Nations, New York, 1972.
40. UNSCEAR, 1977. Sources and Effects of Ionizing Radiation. UNSCEAR 1977 Report. United Nations Scientific Committee on the Effects of Atomic Radiation, 1977 Report to the General Assembly, with annexes. United Nations sales publication E.77.IX.1. United Nations, New York, 1977.
41. UNSCEAR, 1982. Ionizing Radiation: Sources and Biological Effects. UNSCEAR 1982 Report. United Nations Scientific Committee on the Effects of Atomic Radiation, 1982 Report to the General Assembly, with annexes. United Nations sales publication E.82.IX.8. United Nations, New York, 1982.
42. UNSCEAR 1986. Genetic and Somatic Effects of Ionizing Radiation. UNSCEAR 1986 Report. United Nations Scientific Committee on the Effects of Atomic Radiation, 1986 Report to the General Assembly, with annexes. United Nations sales publication E.86.IX.9. United Nations, New York, 1986.
43. UNSCEAR, 1993. Sources and Effects of Ionizing Radiation. UNSCEAR 1993 Report. United Nations Scientific Committee on the Effects of Atomic Radiation, 1993 Report to the General Assembly, with scientific annexes. United Nations sales publication E.94.IX.2. United Nations, New York, 1993.
44. UNSCEAR, 1994. UNSCEAR. Sources and Effects of Ionizing Radiation. UNSCEAR 1994 Report. United Nations Scientific Committee on the Effects of Atomic Radiation, 1994 Report to the General Assembly, with scientific annexes. United Nations sales publication E.94.IX.11. United Nations, New York, 1994.
45. UNSCEAR, 1996. Effects of Ionizing Radiation. UNSCEAR 2006 Report. Volume I: Report to the General Assembly, Scientific Annexes A and B. and Volume II: Scientific Annexes C, D and E. United Nations Scientific Committee on the Effects of Atomic Radiation. United Nations sales publication E.08.IX.6 and E.09.IX.5. United Nations, New York, 2008 & 2009.
46. UNSCEAR, 2000. UNSCEAR. Sources and Effects of Ionizing Radiation. Volume II: Effects. UNSCEAR 2000 Report. United Nations Scientific Committee on the Effects of Atomic Radiation, 2000 Report to the General Assembly, with scientific annexes. United Nations sales publication E.00.IX.4. United Nations, New York, 2000.
47. UNSCEAR, 2010. Summary of low-dose radiation effects on health UNSCEAR 2010 Report. Report of the fifty-seventh session of the United Nations Scientific Committee on the Effects of Atomic Radiation., United Nations sales publication M.II.IX.4. United Nations, New York, 2011.
48. UNSCEAR, 2012. Biological mechanisms of radiation actions at low doses. White Paper to guide the Scientific Committee’s future programme of work. United Nations, New York, 2012
49. UNSCEAR, 2014. Sources, Effects and Risks of Ionizing Radiation. Volume I: Report to the General Assembly and Scientific Annex A. UNSCEAR 2013 Report. United Nations Scientific Committee on the Effects of Atomic Radiation. United Nations sales publication E.14.IX.1. United Nations, New York, 2014.
50. UNSCEAR, 2015. Sources, Effects and Risks of Ionizing Radiation UNSCEAR 2012 Report. Report to the General Assembly and Scientific Annexes A and B. Report. United Nations Scientific Committee on the Effects of Atomic Radiation. United Nations sales publication E.16.IX.1. United Nations, New York, 2015.
51. USNRC, 2005. Staff Review Of The National Academies Study Of The Health Risks From Exposure To Low Levels Of Ionizing Radiation (BEIR VII). Luis A. Reyes (Director for Operations). Nuclear Regulatory Commission. SECY-05-0202. October 29, 2005.
52. USNRC, 2017. United States Nuclear Regulatory Commission. Code of Federal Regulations; Title 42; Chapter I; Subchapter G; Part 81; Subpart B; Section 81.4, (b) Definition of Dose and dose rate effectiveness factor (DDREF). [https://www.law.cornell.edu/cfr/text/42/81.4]
53. WHO, 2013. Health risk assessment from the nuclear accident after the 2011 Great East Japan earthquake and tsunami based on a preliminary dose estimation. World Health Organization, Geneva
