Upton A C
Environ Health Perspect. 1983 Oct;52:31-9. doi: 10.1289/ehp.835231.
The types of injury attributable to ionizing radiation are subdivided, for purposes of risk assessment and radiological protection, into two broad categories: stochastic effects and nonstochastic effects. Stochastic effects are viewed as probablistic phenomena, varying in frequency but not severity as a function of the dose, without any threshold; nonstochastic effects are viewed as deterministic phenomena, varying in both frequency and severity as a function of the dose, with clinical thresholds. Included among stochastic effects are heritable effects (mutations and chromosome aberrations) and carcinogenic effects. Both types of effects are envisioned as unicellular phenomena which can result from nonlethal injury of individual cells, without the necessity of damage to other cells. For the induction of mutations and chromosome aberrations in the low-to-intermediate dose range, the dose-response curve with high-linear energy transfer (LET) radiation generally conforms to a linear nonthreshold relationship and varies relatively little with the dose rate. In contrast, the curve with low-LET radiation generally conforms to a linear-quadratic relationship, rising less steeply than the curve with high-LET radiation and increasing in slope with increasing dose and dose rate. The dose-response curve for carcinogenic effects varies widely from one type of neoplasm to another in the intermediate-to-high dose range, in part because of differences in the way large doses of radiation can affect the promotion and progression of different neoplasms. Information about dose-response relations for low-level irradiation is fragmentary but consistent, in general, with the hypothesis that the neoplastic transformation may result from mutation, chromosome aberration or genetic recombination in a single susceptible cell.
为了进行风险评估和放射防护,可将电离辐射所致损伤的类型细分为两大类:随机效应和非随机效应。随机效应被视为概率现象,其发生频率随剂量变化,但严重程度不随剂量变化,且无任何阈值;非随机效应被视为确定性现象,其发生频率和严重程度均随剂量变化,且有临床阈值。随机效应包括遗传效应(突变和染色体畸变)和致癌效应。这两种效应都被视为单细胞现象,可能由单个细胞的非致死性损伤引起,而无需损伤其他细胞。对于低至中等剂量范围内突变和染色体畸变的诱导,高传能线密度(LET)辐射的剂量-反应曲线通常符合线性无阈值关系,且随剂量率变化相对较小。相比之下,低LET辐射的曲线通常符合线性二次关系,上升斜率比高LET辐射的曲线平缓,且随剂量和剂量率增加而斜率增大。在中高剂量范围内,不同类型肿瘤的致癌效应剂量-反应曲线差异很大,部分原因是大剂量辐射影响不同肿瘤促进和进展的方式不同。关于低水平照射剂量-反应关系的信息零碎但总体上与以下假设一致,即肿瘤转化可能源于单个易感细胞中的突变、染色体畸变或基因重组。