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Health Risks from Exposure to Low Levels of Ionizing Radiation: Beir VII Phase 2
in themselves a form of radiation. Roentgen noted that when the electrons were being generated, a fluorescent screen on a nearby table began to glow. Roentgen theorized that invisible emissions from the cathode-ray tube were causing the fluorescent screen to glow, and he termed these invisible emissions X-rays. The electrons produced by the electrical discharge had themselves produced another form of radiation, X-rays. The next major discovery occurred when Henri Becquerel noted that unexposed photographic plates stored in a drawer with uranium ore were fogged. He concluded that the fogging was due to an invisible emission emanating from the uranium atoms and their decay products. This turned out to be naturally occurring radiation emanating from the uranium. Marie and Pierre Curie went on to purify radium from uranium ore in Becquerel’s laboratory, and in subsequent years, many other forms of radiation including neutrons, protons, and other particles were discovered. Thus, within a period of several years in the 1890s, man-made and naturally occurring radiation were discovered.
Roentgen’s discovery of X-rays resulted in the eventual invention of X-ray machines used to image structures in the human body and to treat health conditions. Adverse health effects of high levels of ionizing radiation exposure became apparent shortly after these initial discoveries. High doses to radiation workers would redden the skin (erythema), and this rough measure of radiation exposure was called the “skin erythema dose.” The use of very large doses, primitive dosimetry (dose measurement) such as the skin erythema dose, and the fact that many of these early machines were not well shielded led to high radiation exposures both to the patients and to the persons administering the treatments. The development of chronic, slow-healing skin lesions on the hands of early radiologists and their assistants resulted in the loss of extremities in some cases. These incidents were some of the first indications that radiation delivered at high doses could have serious health consequences. Subsequent studies in recent years have shown that early radiologists had a higher mortality rate than other health workers. This increased mortality rate is not seen in radiologists working in later years, presumably due to vastly improved safety conditions resulting in much lower doses to radiologists.
The early indications of health effects after high radiation exposures are too many to chronicle in this Public Summary, but the committee notes one frequently cited example. In 1896, Thomas Edison developed a fluoroscope that consisted of a tapered box with a calcium tungstate screen and a viewing port by which physicians could view X-ray images. During the course of these investigations with X-rays, Clarence Dally, one of Edison’s assistants, developed a degenerative skin disease, that progressed into a carcinoma. In 1904, Dally succumbed to his injuries in what may have been the first death associated with man-made ionizing radiation in the United States. Edison halted all of his X-ray research noting that “the x rays had affected poisonously my assistant, Mr. Dally…”3 Today, radiation is one of the most thoroughly studied potential hazards to humans, and regulatory standards have become increasingly strict over the years in an effort to protect human health.
HOW IONIZING RADIATION IS DETECTED
The detection of ionizing radiation has greatly improved since the days of Roentgen, Becquerel, and the Curies. Ionizations can be detected accurately by Geiger counters and other devices. Because the efficiency of the detector is known, one can determine not only the location of the radiation, but also the amount of radiation present. Other, more sophisticated detectors can evaluate the “signature” energy spectrum of some radiations and thus identify the type of radiation.
UNITS USED TO DESCRIBE RADIATION DOSE
Ionizing radiation can be in the form of electromagnetic radiation, such as X-rays or γ-rays, or in the form of subatomic particles, such as protons, neutrons, alpha particles, and beta particles. Radiation units can be confusing. Radiation is usually measured in dose units called grays (Gy) or sieverts (Sv), which are measures of energy deposited in living tissue. X- and γ-rays are said to have low LET. Low-LET radiation produces ionizations sparsely throughout a cell; in contrast, high-LET radiation transfers more energy per unit length as it traverses the cell and is more destructive per unit length.
Although this BEIR VII report is about low-LET radiation, the committee has considered some information derived from complex exposures that include radiation from high-LET and low-LET sources. High-LET or mixed radiations (radiation from high-LET and low-LET sources) are often described in units known as sievert. The units for low-LET radiation can be sievert or gray. For simplicity, all dose units in the Public Summary are reported in sieverts (Sv). For a more complete description of the various units of dose used in this report, see “Units Used to Express Radiation Dose” which precedes the Public Summary, as well as the terms Gray, Sievert, and Units in the glossary.
WHAT IS MEANT BY LOW DOSES OF IONIZING RADIATION
For this report, the committee has defined low dose as doses in the range of near zero up to about 100 mSv (0.1 Sv) of low-LET radiation. The committee has placed emphasis on the lowest doses where relevant data are available. The annual worldwide background exposure from natural sources of low-LET radiation is about 1 mSv.