ducted in China, one in Great Britain, and one in India. These studies did not find any association between disease rates and indicators of high background levels of radiation, and they do not provide any quantitative estimates of disease risk.
Three ecologic studies of children of adults exposed to radiation have been published, with a focus on preconception parental exposure and the risk of leukemia and lymphoma in the offspring of exposed parents. All three studies were conducted in relation to exposures received by parents working at the Sellafield nuclear facility in Great Britain. Although there is some evidence of an increased risk associated with measures of individual dose, the findings are based on very small numbers of cases and the results across studies are not consistent. A larger number of case-control studies have been conducted to investigate the possible relationship between radiation exposure of adults and subsequent cancer in their offspring. In summary, none of the studies provide quantitative information from dose-response analyses or quantitative estimates of the risk of disease associated with exposure, and results across studies are inconsistent. There have been three cohort studies published regarding the risk of cancer in children of adults exposed to radiation. None of the three provide quantitative estimates of risk based on dose-response analyses, and the results across studies are not consistent. Thus, there is little conclusive evidence from epidemiologic studies of a link between parental preconception exposure to ionizing radiation and childhood leukemia or other cancers.
Other possible indices of the occurrence of transmissible genetic damage from preconception exposures include spontaneous abortions, congenital malformations, neonatal mortality, stillbirths, and the sex ratio of offspring. Relatively few epidemiologic studies have been conducted to evaluate these outcomes in relation to preconception radiation exposure, and there is no consistent evidence of an association of any such outcomes with exposure to environmental sources of radiation.
Studies of exposure to 131I from therapeutic and diagnostic uses provide some evidence of a small increase in thyroid cancer, but the small increase observed is likely due to the underlying thyroid condition, not to radiation exposure. Findings of an increase in thyroid neoplasia in persons exposed to fallout in the Marshall Islands are limited by the lack of individual dosimetry. No excess risk of thyroid cancer was found in residents exposed to radiation from Hanford, and only a slight excess risk of thyroid neoplasms was found associated with radioiodine exposure of Utah residents from the Nevada Test Site. In contrast, substantial increases in thyroid cancer have been reported in areas contaminated with radioactive fallout from Chernobyl, primarily among children. Recent evidence from three population-based case-control studies indicates that exposure to radiation from Chernobyl is associated with an increased risk of thyroid cancer and that the relationship is dose dependent. These findings are based on individual estimates of thyroid radiation dose and reveal strong and statistically significant dose-related increased risks that are consistent across studies. They provide important quantitative estimates of risk as a function of dose, primarily from 131I.
This chapter reviews the evidence from peer-reviewed articles published since BEIR V (NRC 1990) of the relationship between exposure to ionizing radiation from environmental sources and human health.
Ecologic studies of populations living around nuclear facilities neither contain individual estimates of radiation dose nor provide a direct quantitative estimate of risk in relation to radiation dose. Similarly, the one case-control study of congenital and perinatal conditions, stillbirths, and infant deaths in relation to exposures from uranium mines does not provide an estimate of the risk associated with any of the indicators of exposure, and two ecologic studies of populations exposed to fallout from atmospheric nuclear testing or other sources of environmental release of radiation provide no quantitative estimates of the risk associated with presumed exposure.
Several cohort studies have been reported of persons exposed to environmental radiation under various circumstances. No increased risk of developing cancer or other fatal diseases was found in persons who participated in U.K. atmospheric nuclear weapons tests, but there was some evidence of an increase in non-CLL leukemia. U.S. veterans who participated in atmospheric nuclear weapons tests reported a significant increase of death from all causes and for all lymphopoietic cancers combined. There is no evidence of a decrease in birth rate or fertility or an increased incidence of spontaneous abortions or stillbirths in residents living near the Techa River in the Russian Federation. There is some evidence of a statistically significant increase in total cancer mortality, but no evidence of an increase in cancer mortality in the offspring of exposed residents. Persons living in the town of Ozyorsk (Russia) exposed to fallout from the nearby Mayak nuclear facility reported an excess of thyroid cancer (1.5–4 times higher than expected). No increased risk of thyroid cancer was found associated with individual radiation dose to the thyroid in persons exposed as young children to atmospheric releases primarily of 131I from the Hanford Site in eastern Washington State. There is some indication that the prevalence of thyroid cancer among Marshall Island residents born before the Castle BRAVO atmospheric nuclear weapons test increased with quartile of estimated dose, but the increase was not statistically significant.
There continues to be an increasing number of cases of thyroid cancer in populations exposed to radiation from the Chernobyl accident that cannot be explained only by the aging of the cohort and the improvement in case detection and reporting. Results from three analytical studies indicate that exposure to radiation from Chernobyl is strongly associated