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This document presents the ICRP's updated vision on “Areas of Research to Support the System of Radiological Protection”, which have been previously published in 2017. It aims to complement the research priorities promoted by other relevant international organisations, with the specificity of placing them in the perspective of the evolution of the System of Radiological Protection. This document contributes to the process launched by ICRP to review and revise the System of Radiological Protection that will update the 2007 General Recommendations in ICRP Publication 103.

Despite decades of research to understand the biological effects of ionising radiation, there is still much uncertainty over the role of dose rate. Motivated by a virtual workshop on the “Effects of spatial and temporal variation in dose delivery” organised in November 2020 by the Multidisciplinary Low Dose Initiative (MELODI), here, we review studies to date exploring dose rate effects, highlighting significant findings, recent advances and to provide perspective and recommendations for requirements and direction of future work. A comprehensive range of studies is considered, including molecular, cellular, animal, and human studies, with a focus on low linear-energy-transfer radiation exposure. Limits and advantages of each type of study are discussed, and a focus is made on future research needs.

PbO (lead oxide) particles with different sizes were incorporated into polystyrene (PS) with various weight fractions (0, 10, 15, 25, 35%). These novel PS/PbO nano-composites were produced by roll mill mixing and compressing molding techniques and then investigated for radiation attenuation of X-rays (N-series/ISO 4037) typically used in radiology. Properties of the PbO particles were studied by X-ray diffraction (XRD). Filler dispersion and elemental composition of the prepared nano-composites were characterized using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS), revealing better filler distribution and fewer agglomerations with smaller PbO particle size. Linear and mass attenuation coefficients (μ and μm), total molecular and atomic cross-sections (σmol and σatm), as well as effective atomic number and electron density (Zeff and Neff), were calculated for the energy range N40 to N200. The influence of PbO weight percentage on the enhancement of the shielding parameters of the nano-composites was expected; however, the effect of PbO particle size was surprising. Linear and mass attenuation coefficients for PS/PbO composites increased gradually with increasing PbO concentrations, and composites with a small size of nanoparticles showed best performance. In addition, increasing PbO concentration raised the effective atomic number Zeff of the composite. Hence, the electron density Neff increased, which provided a higher total interaction cross-section of X-rays with the composites. Maximum radiation shielding was observed for PS/PbO(B). It is concluded that this material might be used in developping low-cost and lightweight X-ray shielding to be used in radiology.

Mass attenuation coefficients (μm) for some nonlinear optical materials such as potassium dihydrogen phosphate, ammonium dihydrogen phosphate, zinc tris-thiourea sulphate, and zinc thiourea chloride were measured using a 2×2 NaI(Tl) scintillation detector at gamma energies of 122 keV, 356 keV, 511 keV, 662 keV, 840 keV, 1170 keV, 1270 keV, and 1330 keV. In addition, GEANT4 simulations were carried out to mimic the experiment at these energies. As a result, good agreement between the experimental and GEANT4 results was observed. The measured μm values were used to compute effective atomic numbers (Zeff) for the selected materials. It was found that the Zeff values were in the range typical for dosimetric materials.

Ionising radiation has been used for over a century for peaceful purposes, revolutionising health care and promoting well-being through its application in industry, science, and medicine. For almost as long, the International Commission on Radiological Protection (ICRP) has promoted understanding of health and environmental risks of ionising radiation and developed a protection system that enables the safe use of ionising radiation in justified and beneficial practices, providing protection from all sources of radiation. However, we are concerned that a shortage of investment in training, education, research, and infrastructure seen in many sectors and countries may compromise society’s ability to properly manage radiation risks, leading to unjustified exposure to or unwarranted fear of radiation, impacting the physical, mental, and social well-being of our peoples. This could unduly limit the potential for research and development in new radiation technologies (healthcare, energy, and the environment) for beneficial purposes. ICRP therefore calls for action to strengthen expertise in radiological protection worldwide through: (1) National governments and funding agencies strengthening resources for radiological protection research allocated by governments and international organisations, (2) National research laboratories and other institutions launching and sustaining long-term research programmes, (3) Universities developing undergraduate and graduate university programmes and making students aware of job opportunities in radiation-related fields, (4) Using plain language when interacting with the public and decision makers about radiological protection, and (5) Fostering general awareness of proper uses of radiation and radiological protection through education and training of information multipliers. The draft call was discussed with international organisations in formal relations with ICRP in October 2022 at the European Radiation Protection Week in Estoril, Portugal, and the final call announced at the 6th International Symposium on the System of Radiological Protection of ICRP in November 2022 in Vancouver, Canada.

UNSCEAR recently recommended that future research on the lung cancer risk at low radon exposures or exposure rates should focus on more contemporary uranium miners. For this purpose, risk models in the German Wismut cohort of uranium miners were updated extending the follow-up period by 5 years to 1946–2018. The full cohort (n = 58,972) and specifically the 1960 + sub-cohort of miners first hired in 1960 or later (n = 26,764) were analyzed. The 1960 + sub-cohort is characterized by low protracted radon exposure of high quality of measurements. Internal Poisson regression was used to estimate the excess relative risk (ERR) for lung cancer per cumulative radon exposure in Working Level Months (WLM). Applying the BEIR VI exposure-age-concentration model, the ERR/100 WLM was 2.50 (95% confidence interval (CI) 0.81; 4.18) and 6.92 (95% CI < 0; 16.59) among miners with attained age < 55 years, time since exposure 5–14 years, and annual exposure rates < 0.5 WL in the full (n = 4329 lung cancer deaths) and in the 1960 + sub-cohort (n = 663 lung cancer deaths), respectively. Both ERR/WLM decreased with older attained ages, increasing time since exposure, and higher exposure rates. Findings of the 1960 + sub-cohort are in line with those from large pooled studies, and ERR/WLM are about two times higher than in the full Wismut cohort. Notably, 20–30 years after closure of the Wismut mines in 1990, the estimated fraction of lung cancer deaths attributable to occupational radon exposure is still 26% in the full Wismut cohort and 19% in the 1960 + sub-cohort, respectively. This demonstrates the need for radiation protection against radon.

The aim of this cohort study was to assess the risk of developing cancer, specifically leukaemia, tumours of the central nervous system and lymphoma, before the age of 15 years in children previously exposed to computed tomography (CT) in Germany. Data for children with at least one CT between 1980 and 2010 were abstracted from 20 hospitals. Cancer cases occurring between 1980 and 2010 were identified by stochastic linkage with the German Childhood Cancer Registry (GCCR). For all cases and a sample of non-cases, radiology reports were reviewed to assess the underlying medical conditions at time of the CT. Cases were only included if diagnosis occurred at least 2 years after the first CT and no signs of cancer were recorded in the radiology reports. Standardised incidence ratios (SIR) using incidence rates from the general population were estimated. The cohort included information on 71,073 CT examinations in 44,584 children contributing 161,407 person-years at risk with 46 cases initially identified through linkage with the GCCR. Seven cases had to be excluded due to signs possibly suggestive of cancer at the time of first CT. Overall, more cancer cases were observed ( O ) than expected ( E ), but this was mainly driven by unexpected and possibly biased results for lymphomas. For leukaemia, the SIR (SIR =  O / E ) was 1.72 (95 % CI 0.89–3.01, O  = 12), and for CNS tumours, the SIR was 1.35 (95 % CI 0.54–2.78, O  = 7). Despite careful examination of the medical information, confounding by indication or reverse causation cannot be ruled out completely and may explain parts of the excess. Furthermore, the CT exposure may have been underestimated as only data from the participating clinics were available. This should be taken into account when interpreting risk estimates.

The purpose of the present work is robust calculation of effective atomic numbers (Zeffs) for photon, electron, proton, alpha particle and carbon ion interactions through the newly developed software, Phy-X/ZeXTRa (Zeff of materials for X-Type Radiation attenuation). A pool of total mass attenuation and energy absorption coefficients (for photons) and total mass stopping powers (for charged particles) for elements was constructed first. Then, a matrix of interaction cross sections for elements Z = 1–92 was constructed. Finally, effective atomic numbers were calculated for any material by interpolating adjacent cross sections through a linear logarithmic interpolation formula. The results for Zeff for photon interaction were compared with those calculated through Mayneord’s formula, which suggests a single-valued Zeff for any material for low-energy photons for which photoelectric absorption is the dominant interaction process. The single-valued Zeff was found to agree well with that obtained by other methods, in the low-energy region. In addition, Zeff values of various materials of biological interest were compared with those obtained experimentally at 59.54 keV. In general, the agreement between values calculated with Phy-X/ZeXTRa and Auto-Zeff and those measured were satisfactory. A comparison of Zeff values for photon energy absorption calculated with Phy-X/ZeXTRa and literature values for a nucleotide base, adenine, was made, and the relative difference (RD) in Zeff between Phy-X/ZeXTRa and literature values was found to be 2% < RD < 11%, at low photon energies (1–100 keV), while it was less than 1% at energies higher than 100 keV. Highest Zeff values were observed at low photon energies, where photoelectric absorption dominates photon interaction. For electrons, corresponding RD(%) values in Zeff were found to be in the range 0.4 ≤ RD(%) ≤ 1.7, while for heavy charged particle interactions it was 2.4 ≤ RD(%) ≤ 4.2 for total proton interaction and 0 ≤ RD(%) ≤ 8 for total alpha particle interaction. In view of the importance of Zeff for identifying and differentiating tissues in diagnostic imaging as well as for estimating accurate dose in radiotherapy and particle-beam therapy, Phy-X/ZeXTRa could be used for fast and accurate calculation of Zeff in a wide energy range for both photon and charged particle (electrons, protons, alpha particles and C ions) interactions.

The Life Span Study (LSS) of Japanese atomic bomb survivors has served as the primary basis for estimates of radiation-related disease risks that inform radiation protection standards. The long-term follow-up of radiation-monitored nuclear workers provides estimates of radiation-cancer associations that complement findings from the LSS. Here, a comparison of radiation-cancer mortality risk estimates derived from the LSS and INWORKS, a large international nuclear worker study, is presented. Restrictions were made, so that the two study populations were similar with respect to ages and periods of exposure, leading to selection of 45,625 A-bomb survivors and 259,350 nuclear workers. For solid cancer, excess relative rates (ERR) per gray (Gy) were 0.28 (90% CI 0.18; 0.38) in the LSS, and 0.29 (90% CI 0.07; 0.53) in INWORKS. A joint analysis of the data allowed for a formal assessment of heterogeneity of the ERR per Gy across the two studies (P = 0.909), with minimal evidence of curvature or of a modifying effect of attained age, age at exposure, or sex in either study. There was evidence in both cohorts of modification of the excess absolute risk (EAR) of solid cancer by attained age, with a trend of increasing EAR per Gy with attained age. For leukemia, under a simple linear model, the ERR per Gy was 2.75 (90% CI 1.73; 4.21) in the LSS and 3.15 (90% CI 1.12; 5.72) in INWORKS, with evidence of curvature in the association across the range of dose observed in the LSS but not in INWORKS; the EAR per Gy was 3.54 (90% CI 2.30; 5.05) in the LSS and 2.03 (90% CI 0.36; 4.07) in INWORKS. These findings from different study populations may help understanding of radiation risks, with INWORKS contributing information derived from cohorts of workers with protracted low dose-rate exposures.

The Pooled Uranium Miners Analysis (PUMA) study is the largest uranium miners cohort with 119,709 miners, 4.3 million person-years at risk and 7754 lung cancer deaths. Excess relative rate (ERR) estimates for lung cancer mortality per unit of cumulative exposure to radon progeny in working level months (WLM) based on the PUMA study have been reported. The ERR/WLM was modified by attained age, time since exposure or age at exposure, and exposure rate. This pattern was found for the full PUMA cohort and the 1960 + sub-cohort, i.e., miners hired in 1960 or later with chronic low radon exposures and exposure rates. The aim of the present paper is to calculate the lifetime excess absolute risk (LEAR) of lung cancer mortality per WLM using the PUMA risk models, as well as risk models derived in previously published smaller uranium miner studies, some of which are included in PUMA. The same methods were applied for all risk models, i.e., relative risk projection up to <95 years of age, an exposure scenario of 2 WLM per year from age 18–64 years, and baseline mortality rates representing a mixed Euro-American-Asian population. Depending upon the choice of model, the estimated LEAR per WLM are 5.38 × 10−4 or 5.57 × 10−4 in the full PUMA cohort and 7.50 × 10−4 or 7.66 × 10−4 in the PUMA 1960 + sub-cohort, respectively. The LEAR per WLM estimates derived from risk models reported for previously published uranium miners studies range from 2.5 × 10−4 to 9.2 × 10−4. PUMA strengthens knowledge on the radon-related lung cancer LEAR, a useful way to translate models for policy purposes.