Brent R L
Division of Developmental Biology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Teratology. 1999 Apr;59(4):182-204. doi: 10.1002/(SICI)1096-9926(199904)59:4<182::AID-TERA2>3.0.CO;2-H.
The subject of the reproductive toxicity of various forms of radiation can be anxiety provoking to the public on two accounts, since reproductive failure engenders an unusual level of guilt and anger in the affected families, and radiation effects are misunderstood and feared by the public. Reproductive problems include an array of genetic and acquired diseases affecting parents and their offspring. Many of these problems are associated with the risk of being induced by preconception and/or postconception exposures to environmental agents. For the various forms of radiation, namely, ionizing radiation, ultrasound, low-frequency electromagnetic fields (EMF), and microwaves, the potential for producing reproductive effects varies considerably with the form of "radiation" and, of course, the dose. Whether the exposure occurs preconceptionally or postconceptionally is another major consideration. In evaluating the actual reproductive risks, we rely on accurate dosimetry and information obtained in epidemiological studies and animal studies. Epidemiological studies must demonstrate consistency of the reproductive finding, and animal studies should be designed to add to the findings of the epidemiological studies. Most importantly, the conclusions must not contradict the basic principles of teratology, genetics, and reproductive biology, and they should be biologically plausible. But frequently important basic science principles are ignored in the evaluation process. Yet developmental basic science principles can be instrumental in refuting or supporting the concern about possible risks. Although there is some overlap with regard to the preconception and intrauterine effects of ionizing radiation, there are significant differences. Preconception effects are mainly stochastic effects, while intrauterine effects are mainly deterministic effects. The stochastic genetic risks are lower than the deterministic risks at equivalent exposures. Thus, it is frequently difficult to demonstrate the occurrence of stochastic effects in populations that have received low preconception exposures to ionizing radiation. The reproductive effects from preconception and intrauterine exposures to electromagnetic fields (low-frequency EMF, video display terminals, microwaves) and ultrasound represent much different problems, since the main effects of microwaves and ultrasound occur because of their hyperthermic effects at high exposures. Low-frequency EMF does not have the capacity to produce hyperthermia, and none of these forms of nonionizing radiation has the specificity to damage the DNA comparable to the specificity of ionizing radiation. Not only do they not have targeted mutagenic effects at the usual exposures that populations receive, they are not cytotoxic at these exposure levels as well. From the viewpoint of biological plausibility, these other forms of radiation are much less likely to have the potential for producing reproductive toxicity at the usual population exposures.
各种形式辐射的生殖毒性问题可能会在两个方面引发公众的焦虑,一方面生殖功能衰竭会在受影响的家庭中引发异常程度的内疚和愤怒,另一方面公众对辐射影响存在误解和恐惧。生殖问题包括一系列影响父母及其后代的遗传和后天疾病。其中许多问题与孕前和/或孕后接触环境因素而被诱发的风险有关。对于各种形式的辐射,即电离辐射、超声波、低频电磁场(EMF)和微波,产生生殖影响的可能性会因“辐射”形式的不同而有很大差异,当然,剂量也是一个重要因素。暴露发生在孕前还是孕后是另一个主要的考虑因素。在评估实际的生殖风险时,我们依赖于准确的剂量测定以及在流行病学研究和动物研究中获得的信息。流行病学研究必须证明生殖方面的发现具有一致性,动物研究的设计应能补充流行病学研究的结果。最重要的是,结论不能与致畸学、遗传学和生殖生物学的基本原则相矛盾,而且应该在生物学上是合理的。但在评估过程中,重要的基础科学原则常常被忽视。然而,发育基础科学原则有助于反驳或支持对可能风险的担忧。虽然电离辐射的孕前和宫内影响存在一些重叠,但也有显著差异。孕前影响主要是随机效应,而宫内影响主要是确定性效应。在同等暴露水平下,随机遗传风险低于确定性风险。因此,对于孕前接受低剂量电离辐射的人群,往往很难证明随机效应的发生。孕前和宫内接触电磁场(低频EMF、视频显示终端、微波)以及超声波所产生的生殖影响代表了截然不同的问题,因为微波和超声波的主要影响主要是由于高暴露时的热效应。低频EMF没有产生热疗的能力,而且这些形式的非电离辐射都没有与电离辐射特异性相当的损伤DNA的能力。它们不仅在人群通常接受的暴露水平下没有靶向诱变作用,在这些暴露水平下也没有细胞毒性。从生物学合理性的角度来看,在人群通常的暴露水平下,这些其他形式的辐射产生生殖毒性的可能性要小得多。