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线性无阈剂量效应关系:它与辐射防护法规相关吗?

The linear no-threshold dose-effect relation: is it relevant to radiation protection regulation?

作者信息

Nussbaum R H

机构信息

Department of Physics, Environmental Sciences and Resources, Portland State University, Oregon 97207, USA.

出版信息

Med Phys. 1998 Mar;25(3):291-9; discussion 300. doi: 10.1118/1.598210.

Abstract

Official radiogenic cancer risk estimates for low-dose, protracted exposure conditions have been based on linear, no-threshold downward extrapolation from medium and high-dose effects among a population of A-bomb survivors, with the application of a downward correction for an assumed reduced biological effectiveness at low doses and low dose rates (DDREF correction). Neither in the follow-up of populations exposed to the high-dose A-bomb flash, nor from epidemiological data after low-dose occupational or medical irradiation is there any convincing evidence for this DDREF hypothesis--even less for a zero-effect threshold dose. To the contrary, for external low-dose exposures of nuclear workers or general populations, cancer risks per unit dose have been found to be about 1 order of magnitude larger than those derived from the Japanese survivors, with larger discrepancies for persons above 50 years of age, and for x-rayed fetuses. This may be due to a dose and dose-rate effect exactly opposite from that postulated by the DDREF assumption, and a dose-dependent bias due to selection for exceptionally high immune competence among the > 5 years A-bomb survivor cohort. Excess cancer mortality following occupational exposures to ingested fission products and radiation-associated teratogenic, genetic, and cancer detriment among diverse populations who had ingested small amounts of radioactivity after the precipitation of fallout at great distances from the Chernobyl nuclear explosion, suggest discrepancies of as much as 2 orders of magnitude with official risk estimates. Contrary to widely publicized statements, claiming that current regulations of population exposures are far too restrictive, thus unnecessarily costly for the radiation industries, the aggregate of radiation epidemiological evidence suggests that current standards are inadequate to protect public health.

摘要

官方对低剂量、长期暴露情况下的辐射致癌风险估计,是基于对原子弹爆炸幸存者群体中高剂量和中等剂量效应进行线性、无阈值的向下外推,并针对低剂量和低剂量率下假定的生物效应降低进行向下修正(剂量率效应修正因子,DDREF修正)。无论是对遭受高剂量原子弹闪光照射人群的后续跟踪,还是低剂量职业或医疗照射后的流行病学数据,都没有任何令人信服的证据支持这一DDREF假设——更不用说零效应阈值剂量了。相反,对于核工业工人或普通人群的外部低剂量照射,发现每单位剂量的癌症风险比日本幸存者得出的风险大约高1个数量级,对于50岁以上的人和接受过X光检查的胎儿,差异更大。这可能是由于剂量和剂量率效应与DDREF假设所假定的效应完全相反,以及在原子弹爆炸幸存者队列中超过5年的人群中,由于选择了免疫能力异常高的个体而导致的剂量依赖性偏差。职业性摄入裂变产物后的额外癌症死亡率,以及在距离切尔诺贝利核爆炸很远的地方沉降放射性尘埃后摄入少量放射性物质的不同人群中与辐射相关的致畸、遗传和癌症损害,表明与官方风险估计相差多达2个数量级。与广泛宣传的说法相反,即声称目前对人群照射的规定限制过多,因此对辐射行业来说成本过高且不必要,辐射流行病学证据的总体情况表明,目前的标准不足以保护公众健康。

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