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OCR for page R1
HEALTH RISKS OF
RADON
AND OTHER
INTERNALLY DEPOSITED
ALPHA-EMITTERS
BEIR IV
Committee on the Biological Effects
of Ionizing Radiations
Board on Radiation Effects Research
Commission on Life Sciences
National Research Council
NATIONAL ACADEMY PRESS
Washington, D.C. 1988
OCR for page R2
OCR for page R3
COMMITTEE ON THE BIOLOGICAL EFFECTS
OF IONIZING RADIATIONS
Jacob I. Fabrikant (Chairman), Donner Laboratory, University of
California, Berkeley, California
William J. Bair ~ Vice-Chairman), Battelle Pacific Northwest
Laboratories, RichIand, Washington
Michael A. Bender, Brookhaven National Laboratory, Upton, New
York
Carrn~a G. Borek, College of Physicians and Surgeons, Columbia
University, New York, New York
Peter G. Groer, Center for Epidemiologic Research, Oak Ridge
Associated Universities, Oak Ridge, Tennessee
Jay H. Lubin, National Cancer Institute, Bethesda, Maryland
David C. F. Muir, McMaster University, Hamilton, Ontario, Canada
Donald A. Pierce, Department of Statistics, Oregon State
University, Corvallis, Oregon
William C. Roesch, Richiand, Washington
Jonathan M. Samet, University of New Mexico Cancer Center,
Albuquerque, New Mexico
Robert A. Schienker, Argonne National Laboratory, Argonne,
Illinois
Richard J. Waxweiler, Centers for Disease Control, Atlanta, Georgia
National Research Council Staff
William H Ellett, Project Director, Board on Radiation Effects
Research, Commission on Life Sciences
Raymond D. Cooper, Senior Program Officer, Board on Radiation
Effects Research, Commission on Life Sciences
Sponsors' Project Officers
Neal Nelson, U.S. Environmental Protection Agency
Shiomo Yaniv, U.S. Nuclear Regulatory Commission
· -—
111
OCR for page R4
National Academy Press · 2101 Constitution Avenue, N.W. · Washington, D. C. 20418
NOTICE: The project that ~ the subject of this report was approved by the Governing Board
of the National Research Council, whose members are drawn from the councils of the National
Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The
members of the committee responsible for the report were chosen for their special competences
and with regard for appropriate balance.
This report has been reviewed by a group other than the authors according to procedures
approved by a Report Review Committee consisting of members of the National Academy of
Sciences, the National Academy of Engineering, and the Institute of Medicine.
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of
distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance
of science and technology and to their use for the general welfare. Upon the authority of the
'charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to
advise the federal government on scientific and technical matters. Dr. Frank Press is president of
the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the
National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous
in its administration and in the selection of its membered, sharing with the National Academy
of Sciences the responsibility for advising the federal government. The National Academy of
Engineering also sponsors engineering programs aimed at meeting national needs, encourages
education and research, and recognizes the superior achievements of engineers. Dr. Robert M.
White is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences
to secure the services of eminent members of appropriate professions in the examination of
policy matters pertaining to the health of the public. The Institute acts under the responsibility
given to the National Academy of Sciences by its congressional charter to be an adviser to the
federal government and, upon its own initiative, to identify issues of medical care, research, and
education. Dr. Samuel O. Thier is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in
1916 to associate the broad community of science and technology with the Academy's purposes
of furthering knowledge and advising the federal government. Functioning in accordance with
general policies determined by the Academy, the Council has become the principal operating
agency of both the National Academy of Sciences and the National Academy of Engineering in
providing services to the government, the public, and the scientific and engineering communities.
The Council is administered jointly by both Academi" and the Institute of Medicine. Dr. Frank
Pre" and Dr. Robert M. White are chairman and Rice chairman, respectively, of the National
Research Council.
The study summarized in this report was supported by the U.S. Environmental Protection
Agency and the U.S. Nuclear Regulatory Commission under Contract No. 68-02-3895.
I`ibrary of Congrese Catalog~g-in-Publication Data
Health risks of radon and other internally deposited alpha-emitters.
This report was supported by the U.S. Environmental Protection Agency and the U.S.
Nuclear Regulatory Commission under Contract No. 68-02-3895.
Includes bibliographies and index.
1. Alpha rays—Health aspects. 2. Radioisotopes in the body—Health aspects. 3. Radon—
Health aspects. 4. Health risk assessment. I. National Research Council (U.S.). Committee
on the Biological Effects of Ionizing Radiations. II. United States. Environmental Protection
Agency. III. U.S. Nuclear Regulatory Commission. [DNLM: 1. Probability. 2. Radiation Effects.
3. Radioactive Pollutants—adverse effects. 4. Radon—ad~reree effects. 5. Risk WN 620 H4345]
RC95.A42H43 1987 616.9~897 87-31280
ISBN 0-309-03789-1, soft cover; ISBN 0-309-03797-2, hard cover
FRONTISPIECE: Ra~liu~dial pa'Mcre.
Copyright (if) 1988 by the National Academy of Sciences
No part of this book may be reproduced by any mechanical, photographic, or electronic process,
or in the form of a phonographic recording, nor may it be stored in a retrieval system, transmitted
or otherwise copied for public or private use, without written permission from the publisher,
except for the purposes of official use by the United States Government.
Printed in the United States of America
First Printing, January 1988
Second Printing, June 1988
Third Printing, January 1989
Fourth Printing, September 1990
OCR for page R5
Preface
BACKGROUND
In June 1984, the Environmental Protection Agency (EPA)
and the Nuclear Regulatory Commission (NRC) asked the National
Academy of Sciences,to submit a proposal in response to EPA Solici-
tation DU-84-C165 for a study of the "biological effects of internally
deposited alpha-emitting ra~lionuclides and their decay products.
The proposal constituted an extension of the work of the National
Research Council's Committees on the Biological Effects of Ionizing
Racliations (BEIR), which began in the early 1970s and most recently
culminated in the report The Effects on Populations of Exposure to
Low Levels of ionizing Radiation: 1980. That report, the so-called
BEIR ITI report, dealt mainly with the effects of radiation of low lin-
ear energy transfer flow LET), primarily external x rays and gamma
rays.
At the time of the BEIR IT! deliberations, the human and animal
studies on high-~ET radiation effects were limited, and epidemiolog-
ical surveys were only beginning to provide reliable data on potential
health effects. The reported epidemiological and laboratory animal
studies pointed to a need to extend the series of BEIR reports, to ap-
praise the state of scientific knowledge concerning the biological and
health effects of alpha radiation (internally deposited alpha-emitting
radionuclides and their decay products). This will enable govern-
ment officials and the public to make decisions about the potential
community and workplace health hazards associated with exposure
v
OCR for page R6
PREFACE
to internal alpha-emitters, such as those from indoor radon and ura-
· · —
mum mmmg.
The task before the current BEIR committee was specified in
detail in the contract agreement between the National Academy of
Sciences and the EPA and NRC signed on October 1, 1984.
CHARGE TO THE COMMITTEE
In response to the EPA and NRC request, the Committee on the
Biological Effects of Ionizing Radiations was established within the
National Research Council's Commission on Life Sciences. This com-
mittee, the fourth in a series originally established in 1969, was asked
for a comprehensive assessment of available knowledge of the risks
associated with internally deposited alpha-emitters. Radiobiological
and animal data were to be reviewed, but relevant epidemiological
data were also to be used to the greatest possible extent in estimating
the risks.
The first phase of the study was to be a review of current knowI-
edge of the somatic and genetic effects of internal alpha-emitters,
including clinical and epidemiological evidence of human effects, re-
sults of animal studies, alpha-particle damage at the cellular level,
metabolic pathways for internal alpha-emitters, dosimetry and mi-
crodosimetry of alpha-emitters deposited in specific tissues, and the
possible chemical toxicity of low-specific-activity alpha-emitters. The
committee was also asked to review the evidence of dependence of
the biological effects on age, sex, route of entry, dose, dose rate,
physical and chemical properties of the radioactive materials, and
similar factors.
During the second phase of the study, the committee was re-
quested to suggest methods for estimating the risks to human health,
with their related uncertainties, associated with internally deposited
alpha-emitters and then to apply the methods to the principal alpha-
emitters in the environment. This phase was to include the provision
of formulas and coefficients to estimate individual and population
risks associated with single and chronic exposure to internal alpha-
emitters and, where appropriate, threshold formulas and coefficients
for nonstochastic effects. This information was to be applied to esti-
mating numbers of genetic effects, risks to unborn children, and risks
of carcinogenic effects. The committee was asked to describe the
metabolic models they used and provide examples of the methods to
V1
OCR for page R7
PREFACE
be used ~ applying their risk estimates to exposed populations. Fi-
nally, the committee was asked to discuss the uncertainty in their risk
estimates and provide recommendations for further research based
on the limitations in the data available for assessing the risks which
the committee identifiecI.
The third phase of the comm~ttee's work was preparation and
submission of a report covering the results and findings of the first
two phases.
The comm~ttee's review and evaluation of the current epidemi-
ologica] and basic research involved not only an assessment of the
relevant research data and their analyses in the scientific literature,
but also an independent evaluation and analysis of relevant epidemi-
ological data considered essential to the committee's charge. The
committee critically reviewed the scientific literature on the biologi-
cal and health effects of internally deposited alpha-emitting radionu-
clides, relying wherever possible on original scientific publications
and on current data that were generously provided by investigators
in the United States, Canada, Western Europe, and Japan.
ORGANIZATION OF THE STUDY
To carry out the charge, the NRC appointed a committee of sci-
entists experienced in radiation epidemiology, radiobiology, genetics,
biostatistics, metabolism and pharmacok~netics, pathology, radia-
tion dosimetry, inhalation physics, chemistry, biology, radiology and
nuclear medicine, and mathematical modeling and risk assessment.
The study was conducted under the general guidance of the Board
on Radiation Effects Research of the Commission on Life Sciences.
To facilitate its work and to augment its expertise so as to
encompass a wider spectrum of scientific subjects, the committee
solicited specific contributions from a number of scientific experts
other than its own members. These experts participated in the
committee's deliberations throughout the course of its work.
The committee held eight meetings over a period of 24 months-
six in Washington, D.C., one in Berkeley, California, and one in
Woods Hole, Massachusetts. The second meeting, on May 15, 1985,
included a public meeting, at which open discussion and contribu-
tions from interested scientists and the public at large were invited.
Several additional meetings of subgroups of the committee were held,
to plan and outline specific work assignments.
·.
V11
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PREFACE
The committee organized its work according to the main objec-
tives of the charge and divided the study into the following main
categories:
~ Genetic, teratogenic, and fetal effects of internally deposited
alpha-em~tting radionuclides.
Carcinogenic and other health effects of radon, radium, tho-
rium, polonium, uranium, and the transuranic radionuclides.
~ The scientific basis and mechanisms underlying the biological
and health effects, including the relevant physics and dosimetry,
radiobiology, anatomy and physiology, and method of risk analysis.
The structure, composition, and expertise of the committee, in-
cluding its invited participants, permitted considerable overlapping
of assignments among the different categories, ensuring the interac-
tion of scientific disciplines.
The committee also conducted two informal workshops that fo-
cused on radon. These workshops were designed to review with a
number of investigators the current scientific knowledge with respect
to uranium-miner epidemiology, lung modeling and dosimetry, and
risk estimation.
JACOB I. FABRIKANT
Chairman
Committee on the Biological Effects
of Ionizing Radiations
· -—
van
OCR for page R9
Acknowledgments
During this study the committee was aided by many experts
from the scientific community. Scientific data, advice, and help in
the preparation of the text were freely offered, and the committee
wishes to acknowledge this very important assistance. Special thanks
are due to Richard Hornung, Geoffrey Howe, Jan Muller, and their
respective government authorities in the United States and Canada,
and Edward Radford for providing their data tapes on the followup
of miners exposed to radon progeny for reanalysis by this committee.
The resulting combined data base of radon effects in uranium miners
is the largest that has been analyzed.
The preparation of the report required expertise in many disci-
plines. The committee gratefully acknowledges the help it received
from Victor P. Bond, Anthony L. Brooks, Fred Cross, Carter Den-
niston, William H. DuMouchel, Marvin Goldman, Douglas Grahn,
Webster Jee, Robert E. Rowland, Charles L. Sanders, Melvin R.
Sikov, Newell Stannard, and McDonald E. Wrenn. These invited
participants provided invaluable aid in the preparation and review
of specific chapters; they are not responsible for errors that might
have crept in to the final report. In addition, several other scientists,
including Bernarc} Cohen, Richard Cuddihy, Leonard Hamilton, and
Charles Land, provided useful information on lung dosimetry, epi-
demiological studies, and risk modeling. The analyses of the radon-
exposed cohorts presented in this report were made possible by the
IX
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x
A CKNO BLED GMENTS
use of the AMFIT program developed by Dale Preston and his col-
leagues at the Radiation Effects Research Foundation, Hiroshima.
We wish to acknowledge also the help and support of Stephen
L. Brown and William L. Lappenbusch, formerly of the National Re-
search Council, who were instrumental in getting this study started.
Special appreciation is extended to Colette A. Carmi and Dorm E.
Taylor for handling the myriad administrative details associated with
this committee's work and for preparing the many drafts of the re-
port. Their patience and good cheer helped the committee over the
innumerable difficulties that inevitably arise during the course of its
work.
