Mole R H
Br J Radiol. 1984 May;57(677):355-69. doi: 10.1259/0007-1285-57-677-355.
Previously published estimates of the whole-body radiation dose expected to kill 50% of a normal human population, the LD50, have rarely been based explicitly on evidence. The difference which might result from medical treatment seems to have been markedly over-valued. The available and relevant evidence about severe haematopoietic damage in man uncomplicated by tissue necrosis is indeed very scanty. It comes from 20 cases of therapeutic whole-body exposure to gamma rays and from two criticality accidents involving nine subjects, one of whom died, and when exposure was to neutrons as well as gamma rays. The observations suggest a judgment that 4.5 Gy (450 rad) absorbed dose in the bone marrow for energetic and therefore penetrating gamma rays giving reasonably uniform irradiation of the marrow could be regarded as the LD50 in circumstances where those irradiated were protected from thermal radiation and blast damage and from neutrons and beta rays. Examination of all the available experimental data on acute lethality following whole-body exposure to low LET radiation shows a remarkably similar co-efficient of variation of the LD50 in five species of large animal. If the same value is adopted for the human species, a quantitative estimate of the human LD50 can be inferred from the human evidence discussed. This reinforces the judgement that it is about 4.5 Gy. The use of observations after criticality accidents is examined in detail in an Appendix. The Vinca accident does not clearly meet the criteria for relevancy but there is no other instance of death in man from an uncomplicated brief whole-body exposure to ionising radiation where the bone-marrow dose can be estimated, and a possible judgment made of the value for the LD50.
先前发表的关于预期能导致50%正常人群死亡的全身辐射剂量(即半数致死剂量,LD50)的估计,很少明确基于证据。医疗治疗可能产生的差异似乎被显著高估了。关于人体严重造血损伤且无组织坏死并发症的现有相关证据确实非常稀少。它来自20例全身接受γ射线治疗性照射的病例,以及两起临界事故,涉及9名受试者,其中1人死亡,且照射同时包含中子和γ射线。这些观察结果表明,在受照者免受热辐射、爆炸伤害、中子和β射线影响的情况下,对于能有效穿透且能使骨髓得到合理均匀照射的γ射线,骨髓吸收剂量4.5 Gy(450拉德)可被视为LD50。对全身暴露于低传能线密度辐射后急性致死率的所有现有实验数据进行检查发现,五种大型动物的LD50变异系数非常相似。如果对人类采用相同的值,就可以从所讨论的人类证据中推断出人类LD50的定量估计值。这强化了其约为4.5 Gy的判断。附录中详细审查了临界事故后的观察结果使用情况。文卡事故并不完全符合相关性标准,但在可估计骨髓剂量并可能判断LD50值的无并发症的短暂全身暴露于电离辐射导致人类死亡的情况中,没有其他实例。