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百万工人研究的剂量重建:现状与指南

Dose reconstruction for the million worker study: status and guidelines.

作者信息

Bouville André, Toohey Richard E, Boice John D, Beck Harold L, Dauer Larry T, Eckerman Keith F, Hagemeyer Derek, Leggett Richard W, Mumma Michael T, Napier Bruce, Pryor Kathy H, Rosenstein Marvin, Schauer David A, Sherbini Sami, Stram Daniel O, Thompson James L, Till John E, Yoder Craig, Zeitlin Cary

机构信息

*National Cancer Institute (retired), 9609 Medical Center Drive, Room 7E590, MSC 9778, Rockville, MD 20850; †M. H. Chew & Associates, Oak Ridge, TN; ‡National Council on Radiation Protection and Measurements, Bethesda, MD; §U.S. Department of Energy (retired), New York, NY; **Memorial Sloan Kettering Cancer Center, New York, NY; ††Oak Ridge National Laboratory, Oak Ridge, TN; ‡‡Oak Ridge Associated Universities, Oak Ridge, TN; §§International Epidemiology Institute, Rockville, MD; ***Pacific Northwest National Laboratory, Richland, WA; †††Clarksburg, MD; ‡‡‡U.S. Nuclear Regulatory Commission, Washington, DC; §§§University of Southern California, Los Angeles, CA; ****U.S. Nuclear Regulatory Commission, Arlington, TX; ††††Risk Assessment Corporation, Neeses, SC; ‡‡‡‡Landauer, Inc., Glenwood, IL; §§§§Southwest Research Institute, Boulder, CO.

出版信息

Health Phys. 2015 Feb;108(2):206-20. doi: 10.1097/HP.0000000000000231.

Abstract

The primary aim of the epidemiologic study of one million U.S. radiation workers and veterans [the Million Worker Study (MWS)] is to provide scientifically valid information on the level of radiation risk when exposures are received gradually over time and not within seconds, as was the case for Japanese atomic bomb survivors. The primary outcome of the epidemiologic study is cancer mortality, but other causes of death such as cardiovascular disease and cerebrovascular disease will be evaluated. The success of the study is tied to the validity of the dose reconstruction approaches to provide realistic estimates of organ-specific radiation absorbed doses that are as accurate and precise as possible and to properly evaluate their accompanying uncertainties. The dosimetry aspects for the MWS are challenging in that they address diverse exposure scenarios for diverse occupational groups being studied over a period of up to 70 y. The dosimetric issues differ among the varied exposed populations that are considered: atomic veterans, U.S. Department of Energy workers exposed to both penetrating radiation and intakes of radionuclides, nuclear power plant workers, medical radiation workers, and industrial radiographers. While a major source of radiation exposure to the study population comes from external gamma- or x-ray sources, for some of the study groups, there is a meaningful component of radionuclide intakes that requires internal radiation dosimetry assessments. Scientific Committee 6-9 has been established by the National Council on Radiation Protection and Measurements (NCRP) to produce a report on the comprehensive organ dose assessment (including uncertainty analysis) for the MWS. The NCRP dosimetry report will cover the specifics of practical dose reconstruction for the ongoing epidemiologic studies with uncertainty analysis discussions and will be a specific application of the guidance provided in NCRP Report Nos. 158, 163, 164, and 171. The main role of the Committee is to provide guidelines to the various groups of dosimetrists involved in the MWS to ensure that certain dosimetry criteria are considered: calculation of annual absorbed doses in the organs of interest, separation of low and high linear-energy transfer components, evaluation of uncertainties, and quality assurance and quality control. It is recognized that the MWS and its approaches to dosimetry are a work in progress and that there will be flexibility and changes in direction as new information is obtained with regard to both dosimetry and the epidemiologic features of the study components. This paper focuses on the description of the various components of the MWS, the available dosimetry results, and the challenges that have been encountered. It is expected that the Committee will complete its report in 2016.

摘要

对100万美国辐射工作者和退伍军人开展的流行病学研究[百万工作者研究(MWS)]的主要目的是,提供有关辐射风险水平的科学有效信息,该风险是在一段时间内逐渐受到照射时出现的,而非像日本原子弹幸存者那样在数秒内受到照射。该流行病学研究的主要结果是癌症死亡率,但也将评估其他死因,如心血管疾病和脑血管疾病。这项研究的成功取决于剂量重建方法的有效性,以便尽可能准确和精确地提供器官特异性辐射吸收剂量的实际估计值,并正确评估其附带的不确定性。MWS的剂量测定方面具有挑战性,因为它们涉及在长达70年的时间里对不同职业群体的各种照射情况。在不同的受照人群中,剂量测定问题有所不同,这些人群包括:原子弹退伍军人、接触穿透性辐射和摄入放射性核素的美国能源部工作人员、核电站工作人员、医学辐射工作者和工业放射技师。虽然研究人群的主要辐射暴露源来自外部伽马射线或X射线源,但对于一些研究组而言,放射性核素摄入是一个重要组成部分,需要进行内照射剂量测定评估。美国国家辐射防护与测量委员会(NCRP)设立了科学委员会6-9,以编写一份关于MWS全面器官剂量评估(包括不确定性分析)的报告。NCRP剂量测定报告将涵盖正在进行的流行病学研究实际剂量重建的具体内容,并进行不确定性分析讨论,它将是NCRP第158号、163号、164号和171号报告中提供的指导的具体应用。委员会的主要作用是为参与MWS的各类剂量测定人员提供指导方针,以确保考虑某些剂量测定标准:计算感兴趣器官的年吸收剂量、区分低线性能量传递和高线性能量传递成分、评估不确定性以及质量保证和质量控制。人们认识到,MWS及其剂量测定方法仍在不断完善之中,随着在剂量测定和研究组成部分的流行病学特征方面获得新信息,将会有灵活性和方向上的变化。本文重点描述MWS的各个组成部分、现有的剂量测定结果以及所遇到的挑战。预计委员会将在2016年完成其报告。

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