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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Appendix A

Study Methods

This appendix includes public meeting agendas, and a list of materials supplied to the committee by the National Aeronautics and Space Administration. The information-gathering sessions included public meetings and webinars held by the committee from January 2021 to April 2021, and they are listed in chronological order.

PUBLIC MEETING AGENDAS

January 25 and 26, 2021

DAY 1: Monday, January 25, 2021

11:00 AM Welcome and Opening Remarks to Public Audience

Hedvig “Hedi” Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

11:15 Session 1: Statement of Work

J. D. Polk, Chief Health and Medical Officer, National Aeronautics and Space Administration (NASA)

  • Charge to the committee (what is included and excluded)
  • Description of the NASA strategies the committee is being asked to consider
  • Why NASA is considering an update to the radiation standard
Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
11:35 Discussion with Committee

Moderator: Hedi Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

12:00 PM Session 2: Background on NASA Radiation Standard

Edward Semones, Space Radiation Analysis Group, NASA Johnson Space Center Lisa Simonsen, Radiation Technology Integration, NASA HQ

  • Space radiation overview, history, NASA Space Cancer Risk (NSCR) model, implementation
  • International partner standards
12:45 Discussion with Committee

Moderator: R. Julian Preston, U.S. Environmental Protection Agency, Committee Vice Chair

1:30 Break
1:45 Session 3: Health and Medical Risk Characterization at NASA

Erik Antonsen, Assistant Director for Human Systems Risk Management, NASA Johnson Space Center

  • Risk characterization
  • Comparison of radiation risks to health and medical risk
  • Radiation working group discussion points
2:10 Discussion with Committee

Moderator: Hedi Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

2:50 Closing Remarks

Hedi Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

3:00 Adjourn Day 1

DAY 2: Tuesday, January 26, 2021

11:00 AM Welcome and Opening Remarks to Public Audience

Hedvig “Hedi” Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
11:15 Session 4: Sex Difference Considerations

S. Robin Elgart, Space Radiation Element Scientist, NASA Johnson Space Center Marisa Covington, Bioethics Director, NASA HQ

  • Human research program radiation overview
  • Focus on studies related to sex differences/cancer incidence
  • Bioethics considerations on sex differences
11:35 Discussion with Committee

Moderator: Hedi Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

12:00 PM Session 5: Cancer Incidence Within the Astronaut Corps

Mary Van Baalen, Lead, Lifetime Surveillance for Astronaut Health, NASA Johnson Space Center

  • Assessment of crew cancer incidence/exposure
  • Comparison to similar populations
12:20 Discussion with Committee

Moderator: Julian Preston, U.S. Environmental Protection Agency, Committee Vice Chair

1:00 Break
1:15 Session 6: Astronaut Office Perspective

Serena Aunon-Chancellor, Astronaut

  • Crew perspective
1:30 Discussion with Committee

Moderator: Hedi Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

2:00 Session 7: NASA Proposed Standards and Summary

David Francisco, Technical Fellow for Human Spaceflight Standards, NASA HQ J. D. Polk, Chief Health and Medical Officer, NASA HQ Edward Semones, Space Radiation Analysis Group, NASA Johnson Space Center

  • Factors considered for modified standard: confidence level, sex/age differences, dose based, bands, effective risk informing
  • Proposed standards for consideration
  • Summary
Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
2:20 Discussion with Committee

Moderator: R. Julian Preston, U.S. Environmental Protection Agency, Committee Vice Chair

2:50 Closing Remarks

Hedi Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

3:00 Adjourn Meeting

Monday, February 22, 2021

12:00 PM Convening Open Session and Welcome

Hedvig “Hedi” Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

12:05 NASA Overview
  • Options for updating the standard
  • Description of the components of the model for calculating REID

J. D. Polk, Chief Health and Medical Officer, NASA

David Francisco, Technical Fellow for Human Spaceflight Standards, NASA HQ

Edward Semones, Space Radiation Analysis Group, NASA Johnson Space Center

12:30 Discussion with Committee

Moderator: Hedi Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

1:30 Adjourn Open Session

Wednesday, April 14, 2021

1:00 PM Convening Public Webinar and Welcome

Hedvig “Hedi” Hricak, Memorial Sloan Kettering Cancer Center, Committee Chair

Gayle Woloschak, Northwestern University, Committee Member

Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
1:05 Overview of the International Commission on Radiological Protection’s (ICRP’s) Task Group 115 (TG115) Motivation, Agenda, and Future Plans

Werner Rühm, Helmholtz Zentrum München, Germany, TG115 Chair

2:20 Overview of International Space Agencies Assessment of Dose and Risk for Astronauts

Marco Durante, GSI Helmholtz Center, Germany, TG115 Member

1:40 Discussion with Committee and ICRP’s TG115 Members

Gayle Woloschak, Northwestern University, Committee Member

ICRP discussants include
  • Chunsheng Li, Health Canada, Canada; TG115 member
  • Ulrich Schraube, European Space Agency, Germany; TG115 member
  • Vyacheslav Shursahkov, Russian Space Agency, Russian Federation; TG115 member
  • Leena Tomi, Canadian Space Agency, Canada; TG115 member
  • Alexander Ulanowski, International Atomic Energy Agency, Austria; TG115 member
  • Jing Chen, Health Canada, Canada
  • Chris Clement, ICRP Scientific Secretary
  • Mikhail Dobynde, Institute of Biomedical Problems, Russian Academy of Sciences
  • Samy El-Jaby, Canadian Nuclear Laboratory, Canada
  • Mark Shavers, International Systems Maturation Team, United States
  • Guangming Zhou, Suzhou University, China
2:30 Adjourn Open Session
Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×

OVERVIEW OF DOCUMENTS PROVIDED BY NASA

The documents below were provided or submitted by NASA to the committee during the course of the study. Copies of the documents can either be found on the NASA website1 or are deposited in the study’s public access file.2

Materials Developed by NASA for the Committee

  • Processes and Strategies Being Considered for Revising the NASA Space Permissible Exposure Limit for Spaceflight Radiation Exposure Standard, December 3, 20202

    NASA provided an example of a modified standard that NASA is considering, as well as background information for the committee, including the specific factors NASA is considering in modifying the standard, why NASA is considering a change to the standard, and the existing NASA Space Permissible Exposure Limit for Spaceflight Radiation Exposure Standard, as well as background on the space radiation environment, international partner standards, and NASA standards.

  • Background Information, January 21, 2021, White Paper2

    NASA provided updated background information for the committee, including the specific factors NASA is considering in modifying the standard, why NASA is considering a change to the standard, and the proposed update to the NASA Space Permissible Exposure Limit for Spaceflight Radiation Exposure Standard, as well as background on the space radiation environment, international partner standards, and NASA standards.

  • Proposed Standard Overview, Alternate Options, and Clarifications, February 2021, Revision A2

    NASA provided clarifying material and an updated white paper based on questions and comments from the committee at the public meeting on January 25 and 26, 2021. The material provides more detail, comparison, explanation, context, and additional options for the NASA proposed update to the Space Permissible Exposure Limit for Spaceflight Radiation Exposure Standard for cancer mortality.

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1 These materials are available on nasa.gov. Links to specific NASA webpages are noted in footnotes.

2 Copies of documents in the public access file may be requested by contacting the National Academies’ Public Access Records Office (PARO@nas.edu).

Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
  • Questions and Answers Directed to NASA from the Committee, February 21, 20212

    NASA provided answers to specific committee questions regarding the cancer risk model via email.

  • Proposed Standard Overview, Alternate Options, and Clarifications, March 2021, Revision A2

    NASA provided clarifying material and an updated white paper in response to additional questions posed by the committee at the February 2021 public session. The material provides more information on the proposed standard language, median versus mean, sex-averaged versus female-only calculations, risk communication, and the standards update process.

Supporting Materials Sent to the Committee by NASA

  • Space Radiation Cancer Risk Projections and Uncertainties—20121,3

    Report that documents NASA’s responses to the recommendations from the National Research Council’s (NRC’s) Space Science Board of the National Academy of Sciences review of the NASA Model 2010, published in March 2012. This includes several updates of the NSCR 2010 model and discussion of points of clarification.

  • Report on Virtual Radiation Risk Panel, September 24, 20202

    This report, prepared by Erik Antonsen, summarizes the results of an advisory panel of clinicians from reputable and leading academic centers who are well versed in cancer and other radiation health effects to individually advise Human System Risk Board on radiation risk characterization and the Health and Medical Technical Authority on how the standard can be aligned and viewed in context with the other clinical risks. The panel was held on August 21, 2020.

  • Ensemble Methodologies for Astronaut Cancer Risk Assessment in the Face of Large Uncertainties, October 20201,4

    Provides an overview of a new approach to NASA space radiation risk modeling that has successfully extended the current NASA probabilistic cancer risk model to an ensemble framework able to consider submodel parameter uncertainty (e.g., uncertainty in a radiation quality parameter) as well as model-form uncertainty associated with differing theoretical or empirical formalisms (e.g., combined dose-rate and radiation quality effects).

___________________

3 See https://spaceradiation.jsc.nasa.gov/irModels/TP-2013-217375.pdf (accessed April 13, 2021).

4 See https://ntrs.nasa.gov/api/citations/20205008710/downloads/NASA-TP-20205008710.pdf (accessed April 28, 2021).

Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
  • Design for Ionizing Radiation Protection NASA-STD-3001 Technical Brief, October 15, 20201,5

    During any mission, astronauts face threats of ionizing radiation from a variety of sources. Standards outlined in NASA-STD-3001 state that crews are not to be exposed to radiation that increases their risk of radiation-related mortality by 3 percent. Design choices and shielding strategies can be implemented to reduce the threat posed by radiation and ensure crew safety and health.

  • Mission-Associated Summary of Health (M.A.S.H.) for Jane Astronaut Mars Expeditions 1002

    Example M.A.S.H. document that provides a summary of test results and “details” pages containing test descriptions, the rationale for each MED-B, the preferred testing schedules, actual test dates, and select results for astronauts.

  • Office of the Chief Health and Medical Officer Human Spaceflight Standards Newsletter, March 20212

    March 2021 newsletter to all astronauts that provides updates on human spaceflight standards.

___________________

5 See https://www.nasa.gov/sites/default/files/atoms/files/radiation_protection_technical_brief_ochmo_021420.pdf (accessed April 16, 2021).

Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×

TABLE A-1 starts on the next page.

Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×

TABLE A-1 Summary of Evidence on Sex-Specific Radiation Risk Estimates of Lung Cancer Mortality from Population Studies of Radiation Exposure

Type of Exposure Studies References Mean Dose to the Lungs, Gya
High-dose rate (acute exposures delivered over a short period of time)
Low- to medium-dose A-bomb Ozasa et al., 20121 F/M: 0.2 (colon, whole cohort)
High-dose Studies of RT for cancer and benign diseases Hodgkin lymphoma: Gilbert et al., 20032 F/M: 25 (dose to specific site where LC was diagnosed)
Peptic ulcer: Little et al., 2013,3 Carr et al., 20024 F/M: 1.8 (for the left lung)
0.6 (for the right lung)
Low-dose rate (protracted exposures)
Low-dose Occupational exposures 15-country study: Cardis et al., 20075 – nuclear industry workers F/M: 0.0194 Sv (average cumulative recorded whole-body external dose for the whole cohort)
UK NRRW: Muirhead et al., 20096 – radiation workers F/M: 0.0249 Sv (mean lifetime recorded whole-body external dose for the pooled cohort)
Rocketdyne workers: Boice et al., 20117 –radiation workers F/M: 0.019 Sv (mean combined dose to the lung from external and internal radiation)
Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
Number of Subjects Number of Lung Cancer Deaths/Cases Excess Relative Risk per gray (ERR/Gy) (95% CI) for Lung Cancera,b,c
F: 50,924
M: 35,687
F: 657
M: 901
F: 1.10 (0.68, 1.60)
M: 0.40 (0.17, 0.67)
Full study population:
F: 132
M: 388

Exposed:
F: 110
M: 307
Full study population:
F: 44
M: 129

Exposed:
F: 39
M: 107
F: 0.044 (–0.009, 0.53)
M: 0.18 (0.063, 0.52)
Full cohort:
F: 788
M: 2,812

Exposed:
F: 351
M: 1,389
Full cohort:
F/M: 193
Full cohort:
F/M: 0.559 (0.221, 1.021)

Exposed:
F/M: 1.724 (0.053, 417.1)
F/M: 407,391
F: 40,739
M: 366,652
F: 65
M: 1,392
ERR/Sv
F/M: 1.86 (90% CI 0.49, 3.63)
F: –1.04 (90% CI <0, 11.1)
M: 1.88 (90% CI 0.50, 3.66)
F/M: 174,541 (<10% F) F/M: 2,230 (trachea, bronchus, lung) ERR/Sv
F/M: 0.106 (–0.43, 0.79)
(trachea, bronchus, lung)
F: 466
M: 5,335
F/M: 214 F/M: RR/100 mGy = 1.01 (0.89, 1.16)
Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
Type of Exposure Studies References Mean Dose to the Lungs, Gya
Low-dose (continued) Occupational exposures (continued) Mayak: Gilbert et al., 20138 – workers of the plutonium production facility Plutonium dose among exposed:
Whole cohort: 0.115
F: 0.165
M: 0.093
External dose among exposed:
Whole cohort: 0.397
F: 0.335
M: 0.418
Fernald: Silver et al., 20139 – uranium processing workers Mean cumulative dose to lung (μGy)

Females Caucasian
Hourly: 67.9
Salaried: 296

Females non-Caucasian
Hourly: 34.5
Salaried: 154

Males Caucasian
Hourly: 1,552
Salaried: 388

Males non-Caucasian
Hourly: 965
Salaried: 138
Mound Nuclear Facility:
Boice et al., 201410 –workers in the nuclear weapons production facility
F/M: 0.1 Sv (full cohort combined dose to the lung from internal and external radiation)
Mayak and Sellafield pooled analysis: Gillies et al., 201711 – workers of plutonium production facilities F/M plutonium dose:
Mayak: 0.1756
Sellafield: 0.0055

F/M gamma exposure:
Mayak: 0.455
Sellafield: 0.0725
Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
Number of Subjects Number of Lung Cancer Deaths/Cases Excess Relative Risk per gray (ERR/Gy) (95% CI) for Lung Cancera,b,c
Full cohort:
F: 3,703
M: 10,918

Positive plutonium dose:
F: 1,971
M: 4,569
Full cohort:
F: 40
M: 446
Plutonium lung dose:
F, age 60: 24 (11, 56)
M, age 60: 7.4 (5.0, 11)

External lung dose:
F/M: 0.13 (–0.04, 0.38)
Overall:
F: 952
M: 5,451

Females Caucasian
Hourly: 153
Salaried: 731

Females non-Caucasian
Hourly: 30
Salaried: 38

Males Caucasian
Hourly: 3,440
Salaried: 1,771

Males non-Caucasian
Hourly: 193
Salaried: 47
F:
Hourly: 5
Salaried: 17

M:
Hourly: 223
Salaried: 52

(trachea, bronchus, lung)
External dose:
M: ERR/100 mGy = 0.17 (−0.18, 0.68)

Organ dose:
M: ERR/100 μGy = 0.0021 (−0.00062, 0.0064)

Radon decay products:
M: ERR/10 WLM = −0.0061 (−0.013, 0.0046)
Full cohort:
F: 1,806
M: 5,463

Exposed:
F: 973
M: 4,004
Full cohort:
F/M: 310

Exposed: F/M: 204
F/M RR at 100 mSv: 1.00 (0.97, 1.04)
F: 8,540
M: 37,277
F: 95
M: 1,100
Mayak, plutonium lung dose:
F, at age 60: 11.62 (90% CI 6.93, 18.78)

Mayak/Sellafield, plutonium lung dose:
M, at age 60: 4.73 (90% CI 3.53, 6.18)

Mayak/Sellafield, external lung dose:
F/M, all ages: 0.37 (90% CI 0.22, 0.55)
Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
Type of Exposure Studies References Mean Dose to the Lungs, Gya
Low-dose (continued) Occupational exposures (continued) UK NRRW: Haylock et al., 201812 – radiation workers Total: 0.0253 Sv
F: 0.0056 Sv
M: 0.0275 Sv
(mean lifetime recorded whole-body external dose for the pooled cohort)
INWORKS: Richardson et al., 201813 – nuclear workers Organ-specific cumulative external dose:
F: 0.0048
M: 0.0228
Industrial radiographers: Boice et al., 201914 External radiation and iridium-192 and cobalt-60 dose:
F: 0.002
M: 0.012
Mound: Boice et al., 201914 – workers in the nuclear weapons production facility Full cohort combined dose to the lung from internal and external radiation:
F: 0.0249
M: 0.1129
Nuclear power plant: Boice et al., 201914 Full cohort combined dose to the lung from internal and external radiation:
F: 0.0179
M: 0.0413
NPP + IR: Boice et al., 201914 Full cohort combined dose to the lung from internal and external radiation:
F: 0.0061
M: 0.0278
U.S. radiation technologists: Velazquez-Kronen, 202015 Full cohort cumulative dose to the lung from external exposure:
F: 0.024
M: 0.026
Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
Number of Subjects Number of Lung Cancer Deaths/Cases Excess Relative Risk per gray (ERR/Gy) (95% CI) for Lung Cancera,b,c
F: 16,437
M: 150,566
F/M: 3,058 ERR/Sv
F/M: 0.028 (–0.44, 0.63)
(lung, trachea, bronchus)
F: 40,035
M: 268,262
F/M: 5,802 F/M: Maximum likelihood: 0.51 (90% CI 0.00, 1.09)

F/M: Hierarchical Bayes: 0.56 (90% CI 0.08, 1.02)
F: 12,933
M: 110,577
F: 55
M: 2,060
ERR/100 mGy
F: –0.33 (–0.45, 0.21)
M: 0.09 (0.02, 0.16)
F: 971
M: 3,983
F: 21
M: 182
ERR/100 mGy
F: –0.01 (–0.07, 0.07)
M: 0.01 (–0.02, 0.04)
F: 4,420
M: 130,773
F: 48
M: 3,337
ERR/100 mGy
F: 0.80 (–0.96, 2.56)
M: –0.05 (–0.10, 0.01)
F: 17,353
M: 241,350
F: 103
M: 5,397
ERR/100 mGy
F: 0.16 (–0.49, 0.81)
M: 0.01 (–0.04, 0.06)
F: 80,180
M: 25,888
F: 711
M: 379
ERR/100 mGy
F: 0.06 (<0–0.23)
M: –0.14 (<0–0.09)
Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
Type of Exposure Studies References Mean Dose to the Lungs, Gya
Medium-dose Radiation diagnostic exposures Massachusetts TB fluoroscopy: Davis et al., 198916 F/M: 0.84 (total lung tissue dose among exposed)
Canadian TB fluoroscopy:
Howe, 199517
F/M: 1.02 Sv (total lung tissue dose among exposed)
Canadian TB fluoroscopy:
Boice et al., 201914
Total lung tissue dose among exposed:
F: 1.072
M: 1.038

Abbreviations: CI = confidence interval; ERR/Gy = excess relative risk per gray; ERR/Sv = excess relative risk per sievert; F = female; F/M = combined estimate for females and males; Gy = gray; IR = industrial radiographer; LC = lung cancer; M = male; NPP = nuclear power plant; RR/100 mGy = relative risk per 100 milligray; SMR = standardized mortality ratio; Sv = sievert; TB = tuberculosis.

a In this table, the committee chose to present the results as they appeared in original publications. While the majority of studies used absorbed doses to the lungs (in gray [Gy] or mGy), some used effective doses expressed in sievert (Sievert) and averaged over entire body. All estimates presented are in Gy, unless otherwise noted.

b All estimates presented are ERR/Gy, unless otherwise noted.

c ERR/Gy is a measure of effect per unit of radiation dose. While relative risks (RRs) are traditionally used to express risks in exposure categories compared to a reference category, excess RRs are frequently used in radiation epidemiology to express excess risks (risks above 1.0) per unit of dose (1 Gy is traditionally used as a reference category). In models with a linear relationship between exposure and outcome, an estimate of RR with a reference category of 1 Gy is equivalent to a RR/Gy = ERR/Gy + 1.0. For example, an ERR/Gy = 1.88 from Cardis et al., 2007, could be expressed as RR at 1 Gy = 1.88 + 1.00 = 2.88 (women exposed to a dose of 1 Gy have 2.88 times higher risk of lung cancer compared to women with no radiation exposure [dose = 0]). ERR/100 mGy could be expressed as ERR/Gy as follows: ERR/Gy = ERR/100 mGy × 10. For example, an ERR/100 mGy = 0.09 from Boice et al., 2019, could be expressed as ERR/Gy = 0.9.

Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×
Number of Subjects Number of Lung Cancer Deaths/Cases Excess Relative Risk per gray (ERR/Gy) (95% CI) for Lung Cancera,b,c
F: 6,513
M: 6,872
Exposed:
F: 19
M: 50

Unexposed:
F: 22
M: 104
Exposed:
F: SMR = 0.8
M: SMR = 0.8

Unexposed:
F: SMR = 1.0
M: SMR = 1.4
F: 31,917
M: 32,255
F: 266
M: 912
ERR/Sv:
F: –0.08 (–0.10, 0.07)
M: 0.02 (–0.01, 0.11)
F: 31,787
M: 31,920
F: 266 M: 912 ERR/100 mGy
F: –0.007 (–0.015, 0.002)
M: 0.002 (–0.003, 0.008)
Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
×

Table A-1 References

1. Ozasa, K., Y. Shimizu, A. Suyama, F. Kasagi, M. Soda, E. J. Grant, R. Sakata, H. Sugiyama, and K. Kodama. 2012. Studies of the mortality of atomic bomb survivors, Report 14, 1950–2003: An overview of cancer and noncancer diseases. Radiation Research 177(3):229–243.

2. Gilbert, E. S., M. Stovall, M. Gospodarowicz, F. E. Van Leeuwen, M. Andersson, B. Glimelius, T. Joensuu, C. F. Lynch, R. E. Curtis, E. Holowaty, H. Storm, E. Pukkala, M. B. van’t Veer, J. F. Fraumeni, J. D. Boice, Jr., E. A. Clarke, and L. B. Travis. 2003. Lung cancer after treatment for Hodgkin’s disease: Focus on radiation effects. Radiation Research 159(2):161–173.

3. Little, M. P., M. Stovall, S. A. Smith, and R. A. Kleinerman. 2013. A reanalysis of curvature in the dose response for cancer and modifications by age at exposure following radiation therapy for benign disease. International Journal of Radiation Oncology, Biology, Physics 85(2):451–459.

4. Carr, Z. A., R. A. Kleinerman, M. Stovall, R. M. Weinstock, M. L. Griem, and C. E. Land. 2002. Malignant neoplasms after radiation therapy for peptic ulcer. Radiation Research 157(6):668–677.

5. Cardis, E., M. Vrijheid, M. Blettner, E. Gilbert, M. Hakama, C. Hill, G. Howe, J. Kaldor, C. R. Muirhead, M. Schubauer-Berigan, T. Yoshimura, F. Bermann, G. Cowper, J. Fix, C. Hacker, B. Heinmiller, M. Marshall, I. Thierry-Chef, D. Utterback, Y.-O. Ahn, E. Amoros, P. Ashmore, A. Auvinen, J.-M. Bae, J. Bernar, A. Biau, E. Combalot, P. Deboodt, A. Diez Sacristan, M. Eklöf, H. Engles, G. Engholm, G. Gulis, R. R. Habib, K. Holan, H. Hyvonen, A. Kerekes, J. Kurtinaitis, H. Malker, M. Martuzzi, A. Mastauskas, A. Monnet, M. Moser, M. S. Pearce, D. B. Richardson, F. Rodriguez-Artalejo, A. Rogel, H. Tardy, M. Telle-Lamberton, I. Turai, M. Usel, and K. Veress. 2007. The 15-country collaborative study of cancer risk among radiation workers in the nuclear industry: Estimates of radiation-related cancer risks. Radiation Research 167(4):396–416.

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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Suggested Citation:"Appendix A: Study Methods." National Academies of Sciences, Engineering, and Medicine. 2021. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks. Washington, DC: The National Academies Press. doi: 10.17226/26155.
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Next: Appendix B: Biographical Sketches of Committee Members and Staff »
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Astronauts face unique health-related risks during crewed space missions, and longer-duration missions that extend to greater distances in our solar system (including to the Moon and Mars) will likely increase those risks. Cancer risks due to ionizing radiation exposure are one of these health-related risks. Assessing, managing, and communicating radiation-induced cancer risks associated with spaceflight are challenging because of incomplete knowledge of the radiation environment in space, limited data on radiation-induced cellular damage mechanisms, lack of direct observations from epidemiological studies, and the complexities of understanding radiation risk.

At the request of the National Aeronautics and Space Administration (NASA), an ad hoc committee of the National Academies of Sciences, Engineering, and Medicine convened to provide advice on NASA's proposed updates to their space radiation health standard, which sets the allowable limit of space radiation exposure throughout the course of an astronaut's career. Space Radiation and Astronaut Health: Managing and Communicating Cancer Risks provides the committee's recommendations and conclusions regarding the updated space radiation health standard, NASA's radiation risk communication strategies, and a process for developing an ethics-informed waiver protocol for long-duration spaceflight missions.

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