Sadetzki Siegal, Flint-Richter Pazit
Cancer and Radiation Epidemiology Unit, Gertner Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University.
Harefuah. 2006 Jul;145(7):516-21, 550, 549.
The deleterious effects of exposure to ionizing radiation on human health have been known for many years. The main long term effect of this exposure is an increase in the risk for developing benign and malignant tumors in the exposed population. This review summarizes the existing data on the possible effects of ionizing radiation on the second generation, focusing on cancer risk. The two mechanisms through which parents' exposure to radiation could affect their children's health are intrauterine exposure of the fetus and preconception exposure of the gonads. Intrauterine exposure to ionizing radiation has teratogenic and carcinogenic effects. Most case-control studies have shown a 40-50% increase in the risk of cancer following intrauterine exposure to medical diagnostic radiation at doses of 10-20mGy. Results of these studies have greatly contributed to the strict radiation protection guidelines at pregnancy existing today. Although animal studies have shown that gonadal exposure to high doses can cause heritable genetic changes, this effect has not been demonstrated unequivocally in epidemiological studies. A case-control study suggested an association between preconception irradiation and leukemia/non-Hodgkin's lymphoma in children of male workers at a nuclear plant in the UK (the Gardner hypothesis). This report generated substantial interest and research; however, subsequent occupational studies failed to confirm the association. Negative results were also reported in studies of the atomic bomb survivors and survivors of childhood cancer. In summary, epidemiological studies do not support the association between gonadal exposure to ionizing radiation and the development of cancer and other genetic diseases among offspring.
多年来,人们已经知道接触电离辐射对人类健康有有害影响。这种接触的主要长期影响是增加受照射人群患良性和恶性肿瘤的风险。本综述总结了关于电离辐射对第二代可能产生的影响的现有数据,重点是癌症风险。父母接触辐射可能影响子女健康的两种机制是胎儿在子宫内受到照射以及性腺在受孕前受到照射。子宫内接触电离辐射具有致畸和致癌作用。大多数病例对照研究表明,子宫内接受10 - 20毫戈瑞剂量的医学诊断辐射后,患癌风险增加40 - 50%。这些研究结果对当今严格的孕期辐射防护指南做出了巨大贡献。虽然动物研究表明性腺接受高剂量辐射可导致可遗传的基因变化,但在流行病学研究中尚未明确证实这种效应。一项病例对照研究表明,英国一家核电站男性工人的子女在受孕前接受辐射与白血病/非霍奇金淋巴瘤之间存在关联(加德纳假说)。该报告引起了广泛关注和研究;然而,随后的职业研究未能证实这种关联。在原子弹幸存者和儿童癌症幸存者的研究中也报告了阴性结果。总之,流行病学研究不支持性腺接触电离辐射与后代患癌症及其他遗传疾病之间存在关联。