Table of contents

Radioactive waste management requires planned and systematic actions to provide confidence that the entire system, processes and final products will satisfy given requirements for quality. The characterisation process is dependent on setting clear characterisation objectives and gathering the right information to underpin the decisions that need to be taken to manage the waste safely. This paper reviews experience of characterisation of waste generated from past nuclear activities that were not conducted in compliance consistent with current criteria, or from unexpected situations that were not planned for. This experience shows that the development of a reliable and efficient characterisation and categorisation methodology is a common challenge for such wastes, referred to here as unconventional and legacy (UL) waste. Through the activites of the Nuclear Energy Agency Expert Group on the Characterisation of Unconventional and Legacy Waste, consideration has been given to widely used waste stream characterisation procedures and methods that were originally developed primarily for application in conventional decommissioning work. Although they provide a substantial basis for characterisation, there are various additional factors that commonly need to be taken into account in the case of UL waste. By analysing the challenges and lessons learned from a variety of case studies and other international experience, it has been possible to identify opportunities for adaptations and enhancements to these characterisation methologies, and these are set out and explained. The need for integration of waste characterisation with other aspects of strategic planning for UL waste management is discussed, including characterisation to address any non-radiological hazards. The analysed case studies have also highlighted the importance of developing a robust legislative and regulatory framework in parallel with an appropriate waste infrastructure to treat, store and dispose of UL waste. Finally, the basic features of a UL waste characterisation roadmap are presented, including the interactions within a wider UL waste management programme and key areas for further consideration and possible development. It is anticipated such work can be supported by continued international cooperation.

The IAEA's model testing programmes have included a series of Working Groups concerned with modelling radioactive contamination in urban environments. These have included the Urban Working Group of Validation of Environmental Model Predictions (1988–1994), the Urban Remediation Working Group of Environmental Modelling for Radiation Safety (EMRAS) (2003–2007), the Urban Areas Working Group of EMRAS II (2009–2011), the Urban Environments Working Group of (Modelling and Data for Radiological Impact Assessments) MODARIA I (2013–2015), and most recently, the Urban Exposures Working Group of MODARIA II (2016–2019). The overarching objective of these Working Groups has been to test and improve the capabilities of computer models used to assess radioactive contamination in urban environments, including dispersion and deposition processes, short-term and long-term redistribution of contaminants following deposition events, and the effectiveness of various countermeasures and other protective actions, including remedial actions, in reducing contamination levels, human exposures, and doses to humans. This paper describes the exercises conducted during the MODARIA I and MODARIA II programmes. These exercises have included short-range and mid-range atmospheric dispersion exercises based on data from field tests or tracer studies, hypothetical urban dispersion exercises, and an exercise based on data collected after the Fukushima Daiichi accident. Improvement of model capabilities will lead to improvements in assessing various contamination scenarios (real or hypothetical), and in turn, to improved decision-making and communication with the public following a nuclear or radiological emergency.

The International Atomic Energy Agency has coordinated an international project addressing enhancements of methods for modelling in post-closure safety assessments of solid radioactive waste disposal. The project used earlier published work from the IAEA biosphere modelling and assessment (BIOMASS) project to further develop methods and techniques. The task was supported by a parallel on-going project within the BIOPROTA forum. The output from the project is described in detail in a forthcoming IAEA report. Here an overview of the work is given to provide researchers in the broader fields of radioecology and radioactive waste disposal with a summarised review of the enhanced BIOMASS methodology and the work that has been undertaken during the project. It is hoped that such dissemination will support and promote integrated understanding and coherent treatment of the biosphere component within the overall assessment process. The key activities undertaken in the project were: review and identification of those parts of the original BIOMASS methodology that needed enhancement, discussions on lessons learned from applying the BIOMASS method, using real examples to assess the methodology and its usefulness, and writing of those parts of the methodology that were considered could benefit from refinement or for which new guidance was required to take account of scientific developments. The work has shown that the overall approach in the original BIOMASS methodology has proven sound. However, the enhanced version clarifies the need for an iterative and holistic approach with system understanding central to the approach. Specifically, experience, especially in site-specific contexts, has emphasised that adequate system understanding is essential in underpinning safety assessments for radioactive waste disposal. The integral role of the biosphere within safety assessment is also emphasised in the enhanced methodology.

The international community has come a long way in developing a consensus that the remediation and management of naturally occurring radioactive materials and nuclear legacy sites will benefit from the use of the framework for risk-informed decision-making. Such a framework should ideally integrate risk assessment and decision-making. The framework presented in this paper specifically addresses the needs and expectations in the wider socio-economic and environmental context, as well as a narrower human health context. The framework was demonstrated as part of the International Atomic Energy Agency's second Modelling and Data for Radiological Impact Assessments Programme. Three case studies, which have used or could use this integrative approach, are used for illustration. The first concerns remediation from uranium mining activities at Beaverlodge Lake in northern Saskatchewan, Canada, engaging stakeholders (also called 'interested parties') in the decision-making process on further options. The second case study suggests how decision analysis could support the selection of the best option for waste disposal for uranium ore processing at Žirovski vrh, Slovenia, taking into account a potential landslide and migration of waste throughout the adjacent valley in the event of flooding. The third case study presents the process and results of radiological safety assessment of the Kepkensberg sludge basin in Tessenderlo area, Belgium both before and after the disposal of material from remediation of the nearby Winterbeek River. It illustrates how such assessments could interface with decision analysis for the purpose of supporting the regulatory decisions related to future approval of a waste disposal option. Results show that formal stakeholder engagement in decision analysis provides a strong contribution to objective, robust, and transparent decision-making not only for radiation protection area but also in others where health and environmental impacts are of concern. A number of recommendations for future work have also been made.

The International Atomic Energy Agency (IAEA) has organised programmes on the development, comparison and testing of environmental assessment models and approaches for estimating the radiation exposure of humans and wildlife since the 1980s. The latest of these programmes was called MODARIA (Modelling and Data for Radiological Impact Assessment) and was run in two phases from 2012 to 2015 (MODARIA I) and 2016 to 2019 (MODARIA II). Both phases of the MODARIA programme had the overall objective to improve capabilities in the field of environmental transfer of radionuclides and public and non-human biota exposures assessment, by means of acquisition of improved data for model testing and comparison, reaching consensus on modelling philosophies, approaches and parameter values and building an international forum for the exchange of information. This paper provides an overview of the work undertaken during both phases of the MODARIA programme and its outputs. The overall aims and objectives of a new programme to follow on from MODARIA are described.

Wildlife protection has become of regulatory interest since the International Commission on Radiological Protection (ICRP) developed an approach to assess the level of radiological protection specifically for animals and plants. For the purpose of demonstrating compliance with regulation to protect the environment against routine authorised discharges from nuclear facilities, the wide variety of biota inhabiting an ecosystem needs to be condensed to a limited set of representative organisms, as proposed by the ICRP with a set of 'reference animals and plants' which can be considered representative of many other species. It is now recommended in the International Atomic Energy Agency Safety Standards, and internationally accepted, that the use of such a limited number of organisms to represent a pool of species is adequate for radiation protection purposes, particularly in planned exposure situations. Adding site-specific species to that set of surrogate species can respond to various interests, such as ensuring a site-specific context to the assessment that addresses stakeholder interests and can aid in stakeholder consultation and risk communication. Moreover, there is a need to question whether the use of the set of surrogate organisms is conservative enough to cover a wider range of biodiversity. Previous studies partially answered this question and this paper adds a range of test cases. A selection of hypothetical representations of possible site-specific species are assessed on the basis of possible variations in size (mass) and occupancy habits. Dose rates are evaluated to determine the greatest difference between hypothetical organisms and those for reference organisms (ROs), considering radionuclides (RNs) potentially discharged in atmospheric routine release from different nuclear facilities. Differences observed in the results between hypothetical organisms and ROs were less than one order of magnitude in all cases, the difference being dependent on the RNs considered. These findings do not preclude the inclusion of site-specific species in environmental radiological assessments if it is considered necessary, but they provide reassurance that using ROs for radiological impact assessments in the case of routine atmospheric discharges is sufficient.

The emphasis of the international system of radiological protection of the environment is to protect populations of flora and fauna. Throughout the MODARIA programmes, the United Nations' International Atomic Energy Agency (IAEA) has facilitated knowledge sharing, data gathering and model development on the effect of radiation on wildlife. We present a summary of the achievements of MODARIA I and II on wildlife dose effect modelling, extending to a new sensitivity analysis and model development to incorporate other stressors. We reviewed evidence on historical doses and transgenerational effects on wildlife from radioactively contaminated areas. We also evaluated chemical population modelling approaches, discussing similarities and differences between chemical and radiological impact assessment in wildlife. We developed population modelling methodologies by sourcing life history and radiosensitivity data and evaluating the available models, leading to the formulation of an ecosystem-based mathematical approach. This resulted in an ecologically relevant conceptual population model, which we used to produce advice on the evaluation of risk criteria used in the radiological protection of the environment and a proposed modelling extension for chemicals. This work seeks to inform stakeholder dialogue on factors influencing wildlife population responses to radiation, including discussions on the ecological relevance of current environmental protection criteria. The area of assessment of radiation effects in wildlife is still developing with underlying data and models continuing to be improved. IAEA's ongoing support to facilitate the sharing of new knowledge, models and approaches to Member States is highlighted, and we give suggestions for future developments in this regard.

The International Atomic Energy Agency has coordinated an international project addressing enhancements of methods for modelling the biosphere in post-closure safety assessments of solid radioactive waste disposal. This has resulted in the enhanced BIOMASS methodology that is described elsewhere in this special issue. To a large degree, the enhancements to the BIOMASS methodology arose from experience gained in applying the original methodology, both in the context of other international projects and in assessments of existing or proposed disposal facilities for solid radioactive wastes. Here, this experience is used, together with information on the status of solid radioactive waste disposal programmes worldwide, to identify opportunities for applying the enhanced methodology and for learning from those applications. This provides a basis for identifying research and development to support application of the enhanced methodology in a variety of environmental settings. These research and development requirements include aspects related to climate change under a variety of forcing scenarios, landform development in climatic regimes ranging from cold, polar to arid, tropical, modelling of groundwater flow and contaminant transport in surface-water catchments where both fractured rock and porous sediments are present, and studies of the transport of key radioisotopes of elements central to major biogeochemical cycles, such as those of carbon, chlorine, sulphur and iodine. In addition, some remarks are made on aspects of the application of the enhanced methodology that could imply review and updating of regulations and regulatory guidance, e.g. in relation to the definition of representative persons or groups to be considered in assessments and in respect of approaches to the assessment of radiological impacts on non-human biota. Furthermore, consideration is given as to how the scientific and technical experience that has been gained and methods that have been developed in the context of solid radioactive disposal facilities could support management of contaminated sites and legacy facilities that are likely to require long-term management and stewardship.

An international review of radioecological data derived after the accident at the Fukushima Daiichi nuclear power plant was an important component of activities in working group 4 of the IAEA Models and data for radiological impact assessment, phase II (MODARIA II) programme. Japanese and international scientists reviewed radioecological data in the terrestrial and aquatic environments in Japan reported both before and after the accident. The environmental transfer processes considered included: (a) interception and retention radionuclides by plants, (b) loss of radionuclides from plant and systemic transport of radionuclides in plants (translocation), (c) behaviour of radiocaesium in soil, (d) uptake of radionuclides from soil by agricultural crops and wild plants, (e) transfer of radionuclides from feedstuffs to domestic and wild animals, (f) behaviour of radiocaesium in forest trees and forest systems, (g) behaviour of radiocaesium in freshwater systems, coastal areas and in the ocean, (h) transport of radiocaesium from catchments through rivers, streams and lakes to the ocean, (i) uptake of radiocaesium by aquatic organisms, and (j) modification of radionuclide concentrations in food products during food processing and culinary preparation. These data were compared with relevant global data within IAEA TECDOC-1927 'Environmental transfer of radionuclides in Japan following the accident at the Fukushima Daiichi Nuclear Power Plant'. This paper summarises the outcomes of the data collation and analysis within MODARIA II work group 4 and compares the Japan-specific data with existing radioecological knowledge acquired from past and contemporary radioecological studies. The key radioecological lessons learned are outlined and discussed.

Risk assessment provides a key input for determining the need for and extent of remedial actions necessary for sites contaminated with naturally occurring radioactive material or nuclear legacy sites. The choice of a modelling approach for risk assessment, and the corresponding toolsets should fit the assessment context, taking account of the complexity, and be clearly related to the questions to be addressed in the decision-making process. One of the objectives of Working Group 1 of IAEA Modelling and Data for Radiological Impact Assessments II (MODARIA II) Programme is to perform intermodel comparisons for case studies of selected sites, in particular, to help illustrate the applicability of different models and approaches as inputs to decision-making processes. This intercomparison exercise, which included the analysis of potential consequences on the management strategy for contaminated sites, has been performed for two sites: The former uranium mill tailings facility at Zapadnoe, Ukraine, and the phosphate processing facility at Tessenderlo, Belgium. Several models and computer codes have been used for one or both of these cases: AMBER, GoldSim, NORM And LegacY Site Assessment, Preliminary Remediation Goals (PRG)-dose compliance concentration calculator, and RESRAD-OFFSITE. The assessments explore the implications of using differing assessment frameworks and assumptions, as well as alternative modelling tools, on model outputs and as input for corresponding decisions on remediation strategy. This paper reviews both similarities and differences in the results of assessments performed using these different models. It discusses how different approaches can complement one another to help build confidence in the evidence base underpinning decisions. It also discusses the appropriateness of the different modelling approaches in a given assessment context. In one of the case studies in particular (Tessenderlo case study), the remediation strategy is essentially driven by the contamination of the site with heavy metals, such as cadmium. This has significant consequences on the choice of the most adequate approaches and scenarios for assessing the radiological risk and balancing their relative importance with other impacts. The development of a holistic approach to risk assessment is, therefore, highlighted.

Under the International Atomic Energy Agency (IAEA) Modelling and Data for Radiological Impact Assessments (MODARIA II) Programme, Working Group 4 activities included collating radionuclide transfer data from Japan following the Fukushima Daiichi Nuclear Power Plant accident and separately collating concentration ratio (CR) data for root uptake of radionuclides by crops grown in tropical and arid climates. In this paper, the newly compiled radiocaesium CR data for fruit from Japan, tropical and arid climates have been combined with the data originally compiled for the IAEA Technical Reports Series No. 472 (TRS 472) and additional data identified from the literature to produce an enhanced MODARIA II dataset of fruit radiocaesium CR values. Statistical analysis of the MODARIA II dataset by climate class (based on the Köppen–Geiger climate classification) indicated that the CR values for tropical climates were significantly higher (p < 0.05) than those for arid, temperate and cold climates. Statistical analysis of the MODARIA II dataset by soil group (based on soil texture) indicated that the CR values for coral sand soil (tropical climates only) and organic soil (temperate climates only) were significantly higher (p < 0.05) than those for the clay, loam and sand soil groups. Statistical analysis of the MODARIA II dataset by plant group (based on plant morphology) indicated that the CR values for non-woody trees (tropical climate bias) were significantly higher (p < 0.05) than those for herbaceous plants, shrubs and woody trees. Comparison of the MODARIA II dataset with original TRS 472 values showed only small changes in the fruit radiocaesium CR values for herbaceous plants and shrubs in temperate climates. There was a decrease in the CR values for woody trees in temperate climate across all soil groups. There was also a decrease in the CR values for tropical climates for all comparable soil groups.

In response to changing international recommendations and national requirements, a number of assessment approaches, and associated tools and models, have been developed over the last circa 20 years to assess radiological risk to wildlife. In this paper, we summarise international intercomparison exercises and scenario applications of available radiological assessment models for wildlife to aid future model users and those such as regulators who interpret assessments. Through our studies, we have assessed the fitness for purpose of various models and tools, identified the major sources of uncertainty and made recommendations on how the models and tools can best be applied to suit the purposes of an assessment. We conclude that the commonly used tiered or graded assessment tools are generally fit for purpose for conducting screening-level assessments of radiological impacts to wildlife. Radiological protection of the environment (or wildlife) is still a relatively new development within the overall system of radiation protection and environmental assessment approaches are continuing to develop. Given that some new/developing approaches differ considerably from the more established models/tools and there is an increasing international interest in developing approaches that support the effective regulation of multiple stressors (including radiation), we recommend the continuation of coordinated international programmes for model development, intercomparison and scenario testing.

The IAEA fundamental safety objective is 'to protect people and the environment from harmful effects of ionizing radiation' and this must be done 'without unduly limiting the operation of facilities or the conduct of activities that give rise to radiation risks', while ensuring that people and the environment, present and future are protected against radiation risks (IAEA 2006 Fundamental Safety Principles, Safety Fundamentals No. SF-1). In addition, 'protective actions to reduce existing or unregulated radiation risks must be justified and optimized' (IAEA 2006 Fundamental Safety Principles, Safety Fundamentals No. SF-1). An international system of radiological protection can be applied such that processes, such as remediation, can be systematically undertaken to address the wide range of 'existing exposure situations' present globally. In doing so, decisions made regarding actions undertaken can be demonstrated to be 'justified' and 'optimized' (i.e. balanced), such that the amount of effort should be commensurate with the risk (applying a 'graded approach'). In addition, protection of people and the environment can be demonstrated by comparing the actual exposure to appropriate criteria over the lifetime of remediation. This paper provides an overview of the current IAEA safety standards on remediation of sites or areas contaminated with residual radioactive material within the international system of radiological protection and provides practical examples of their application through case studies considered in IAEA international model validation programs.

Judgements on tolerability and reasonableness are central to the optimisation of protection. There are currently several international developments regarding these key considerations which will contribute to the review and evolution of the system of radiological protection. The IRPA15 International Congress brought together the principal issues currently under discussion, and the outcome of these discussions is presented.

A methodology for addressing the biosphere in safety assessments for solid radioactive waste disposal was developed through theme 1 of the IAEA coordinated research project on BIOsphere Modelling and ASSessment (BIOMASS) that ran from 1996 to 2001. This methodology provided guidance on how the biosphere can be addressed in safety assessments for disposal of solid radioactive waste. Since the methodology was developed, it has proven useful and has been widely referenced in assessments in a diversity of contexts encompassing both near-surface and deep geological disposal of solid radioactive waste. The principles that could be adopted for defining potentially exposed groups (PEGs) were an important aspect in the original BIOMASS methodology as the endpoint of an assessment usually includes the evaluation of individual dose or risk to human health. Identification of PEGs and definition of their characteristics are usually made to be consistent with the biosphere system description being developed, acknowledging that due to inherent uncertainties in projecting future human behaviour, the biosphere models adopted for assessing safety of a disposal system can only be illustrative. Since the publication of the original BIOMASS methodology, consideration has been extended to include potentially exposed populations of biota (PEPs), in the context of dose assessment and protection of the environment. Considering the need for the development of transfer pathways from a source term to an end point (for either PEGs or PEPs), the exposure modes that may occur and those to be assessed quantitatively should be identified. Within an expert working group (WG6) of the second phase of the IAEA coordinated project Modelling and Data for Radiological Impact Assessments (MODARIA II), the experience of participating organisations has been collected on topics associated with the definition of PEGs and PEPs using a questionnaire. The objective of the questionnaire was to review the current status and on-going discussions on the handling of issues related to definitions of PEGs and PEPs as an input to the development of biosphere models for assessing radiological impacts on human health and the environment. The answers received to the questionnaire provided a clear overview of the progress that has been made since the original BIOMASS methodology was published, together with the lessons learned from the application of that methodology in the development of safety cases. This paper summarises the questionnaire responses in five subject areas: (1) environment of the PEGs and its evolution; (2) linking the choice of PEGs to these environments; (3) food habits and consumption rates; (4) populations of non-human biota (PEPs) and (5) national and international regulations and guidance. We illustrate how the results of the questionnaire have been used to enhance the original BIOMASS methodology (IAEA Enhanced BIOMASS Methodology Report in press).

A series of modelling exercises, based on field tests conducted in the Czech Republic, were carried out by the 'Urban' Working Groups as part of the International Atomic Energy Agency's Environmental Modelling for Radiation Safety II, Modelling and Data for Radiological Impact Assessment (MODARIA) I and MODARIA II international data compilation and model validation programmes. In the first two of these programmes, data from a series of field tests involving dispersion of a radiotracer, ^99mTc, from small-scale, controlled detonations were used in a comparison of model predictions with field measurements of deposition. In the third programme, data from a similar field test, involving dispersion of ¹⁴⁰La instead of ^99mTc, were used. Use of longer-lived ¹⁴⁰La as a radiotracer allowed a greater number of measurements to be made over a greater distance from the dispersion point and in more directions than was possible for the earlier tests involving shorter-lived ^99mTc. The modelling exercises included both intercomparison of model predictions from several participants and comparison of model predictions with the measured data. Several models (HotSpot, LASAIR, ADDAM/CSA-ERM, plus some research models) were used in the comparisons, which demonstrated the challenges of modelling dispersion of radionuclides from detonations and the need for appropriate meteorological measurements.

State-of-the-art dose assessment models were applied to estimate doses to the population in urban areas contaminated by the Fukushima Daiichi Nuclear Power Plant accident. Assessment results were compared among five models, and comparisons of model predictions with actual measurements were also made. Assessments were performed using both probabilistic and deterministic approaches. Predicted dose distributions for indoor and outdoor workers from a probabilistic approach were in good agreement with the actual measurements. In addition, when the models were applied to assess the doses to the representative person, based on a concept recommended by the International Commission on Radiological Protection and in the International Atomic Energy Agency Safety Standards, it was evident that doses to the representative person obtained with a deterministic approach were always higher than those obtained with a probabilistic approach using the same model.

It is established that moderate-to-high doses of ionising radiation increase the risk of subsequent cancer in the exposed individual, but the question arises as to the risk of cancer from higher doses, such as those delivered during radiotherapy, accidents, or deliberate acts of malice. In general, the cumulative dose received during a course of radiation treatment is sufficiently high that it would kill a person if delivered as a single dose to the whole body, but therapeutic doses are carefully fractionated and high/very high doses are generally limited to a small tissue volume under controlled conditions. The very high cumulative doses delivered as fractions during radiation treatment are designed to inactivate diseased cells, but inevitably some healthy cells will also receive high/very high doses. How the doses (ranging from <1 Gy to tens of Gy) received by healthy tissues during radiotherapy affect the risk of second primary cancer is an increasingly important issue to address as more cancer patients survive the disease. Studies show that, except for a turndown for thyroid cancer, a linear dose–response for second primary solid cancers seems to exist over a cumulative gamma radiation dose range of tens of gray, but with a gradient of excess relative risk per Gy that varies with the type of second cancer, and which is notably shallower than that found in the Japanese atomic bomb survivors receiving a single moderate-to-high acute dose. The risk of second primary cancer consequent to high/very high doses of radiation is likely to be due to repopulation of heavily irradiated tissues by surviving stem cells, some of which will have been malignantly transformed by radiation exposure, although the exact mechanism is not known, and various models have been proposed. It is important to understand the mechanisms that lead to the raised risk of second primary cancers consequent to the receipt of high/very high doses, in particular so that the risks associated with novel radiation treatment regimens—for example, intensity modulated radiotherapy and volumetric modulated arc therapy that deliver high doses to the target volume while exposing relatively large volumes of healthy tissue to low/moderate doses, and treatments using protons or heavy ions rather than photons—may be properly assessed.

The Šoštanj exercise of the Modelling and Data for Radiological Impact Assessments I Urban Environments Working Group took advantage of a set of measurement data from a 1991 tracer experiment to test atmospheric dispersion models for emissions from point sources over complex terrain. The data set included emissions of SO₂ from the stacks of the Šoštanj Thermal Power Plant in Slovenia, measurements of the SO₂ at a number of locations in the surrounding area up to 7 km from the plant, and meteorological data from several monitoring stations, all as measured half-hour average values. Two sets of meteorological conditions were modelled: (a) a simple situation with a strong wind blowing from a point source directly towards a monitoring station; and (b) a complex situation involving a temperature inversion and convective mixing. The modelling results enable the assessment of the capabilities of various dispersion models in handling both complex terrain and complex meteorological situations.

Radioprotectors are agents that have the potential to act against radiation damage to cells. These are equally invaluable in radiation protection, both in intentional and unintentional radiation exposure. It is however, complex to use a universal radioprotector that could be beneficial in diverse contexts such as in radiotherapy, nuclear accidents, and space travel, as each of these circumstances have unique requirements. In a clinical setting such as in radiotherapy, a radioprotector is used to increase the efficacy of cancer treatment. The protective agent must act against radiation damage selectively in normal healthy cells while enhancing the radiation damage imparted on cancer cells. In the context of radiotherapy, plant-based compounds offer a more reliable solution over synthetic ones as the former are less expensive, less toxic, possess synergistic phytochemical activity, and are environmentally friendly. Phytochemicals with both radioprotective and anticancer properties may enhance the treatment efficacy by two-fold. Hence, plant based radioprotective agents offer a promising field to progress forward, and to expand the boundaries of radiation protection. This review is an account on radioprotective properties of phytochemicals and complications encountered in the development of the ideal radioprotector to be used as an adjunct in radiotherapy.

The in situ technique for measuring radionuclides in the soil using a portable Ge detector is a highly versatile tool for both the radiological characterisation and for the monitoring of operating nuclear power plants. The main disadvantage of this technique is related to the lack of knowledge of the geometry of the source whose activity concentration is to be determined. However, its greatest advantage is the high spatial representability of the samples and the reduced time and resource consumption compared to gamma spectrometry laboratory measurements. In this study, the possibilities and limits offered by in situ gamma spectrometry with a high-resolution gamma portable detector in two common uses are shown. First, the radiological background characterisation and its relationship with the geology of an area of 2700 km² are assessed. Second, its potential for monitoring man-made activity concentration in soils located around an operating nuclear power plant in Spain for surveillance purposes is evaluated. Finally, high-accuracy radiation maps were prepared from the measurements that were carried out. These radiation maps are essential tools to know the radioactive background of an area, especially useful to assess artificial radioactive deposits produced after a nuclear accident or incident.

The International Commission on Radiological Protection (ICRP) recently updated its biokinetic models for workers in a series of reports called the OIR (occupational intakes of radionuclides) series. A new biokinetic model for astatine (At), the heaviest member of the halogen family, was adopted in OIR Part 5 (ICRP in press). Occupational intakes of radionuclides: Part 5). This paper provides an overview of available biokinetic data for At; describes the basis for the ICRP's updated model for At; and tabulates dose coefficients for intravenous injection of each of the two longest lived and most important At isotopes, ²¹¹At and ²¹⁰At. At-211 (T_1/2 = 7.214 h) is a promising radionuclide for use in targeted α-particle therapy due to several favourable properties including its half-life and the absence of progeny that could deliver significant radiation doses outside the region of α-particle therapy. At-210 (T_1/2 = 8.1 h) is an impurity generated in the production of ²¹¹At in a cyclotron and represents a potential radiation hazard via its long-lived progeny ²¹⁰Po (T_1/2 = 138 days). Tissue dose coefficients for injected ²¹⁰At and ²¹¹At based on the updated model are shown to differ considerably from values based on the ICRP's previous model for At, particularly for the thyroid, stomach wall, salivary glands, lungs, spleen, and kidneys.

Based on ground gamma ray spectrometry surveys conducted from 2007 to 2010 in populated areas across Canada (i.e. in southern Canada, excluding the northern territories), and with consideration of the exposure outdoors and indoors in various types of buildings as well as exposure to radionuclides in building materials (assuming most building materials are of local origin), the population-weighted annual effective dose from exposure to terrestrial gamma rays was estimated to be 167 ± 43 μSv. Under Canadian-specific average occupancy times, indoor exposures at home contribute 69% of the total annual effective dose, followed by 19% from indoor exposures other than at home, 6.2% from outdoor exposures and 5.8% from exposures inside vehicles. This assessment with measurements in a total of 1057 sites in populated areas across Canada is in general agreement with earlier assessments based on airborne gamma surveys mostly over unpopulated areas of Canada and truck-borne radiometric surveys along paved urban roads in four cities.

The main purpose of this study was to establish for the first time national diagnostic reference levels (NDRLs) for common computed tomography (CT) procedures in Sri Lanka. Patient morphometric data, exposure parameters and dose data such as volume CT dose index (CTDI$_{vol}$) and dose–length product (DLP) were collected from 5666 patients who underwent 22 types of procedure. The extreme dose values were filtered before analysis to ensure that the data come from standard size patients. The median of the dose distribution was calculated for each institution, and the third quartile value of the median distribution was considered as the NDRL. Based on the inclusion and exclusion criteria, data from 4592 patients and 17 procedure types were considered for establishment of a NDRL, covering 41% of the country's CT machines. The proposed NDRLs based on CTDI$_{vol}$ and DLP were: non-contrast-enhanced (NC) head, 82.2 mGy/1556 mGy cm; contrast-enhanced (CE) head, 82.2 mGy/1546 mGy cm; chest NC, 7.4 mGy/350 mGy cm; chest CE, 8.3 mGy/464 mGy cm; abdomen NC, 10.5 mGy/721 mGy cm; abdomen arterial (A) phase, 13.4 mGy/398 mGy cm; abdomen venous (V) phase, 10.8 mGy/460 mGy cm; abdomen delay (D) phase, 12.6 mGy/487 mGy cm; sinus NC, 30.2 mGy/452 mGy cm; lumbar spine NC, 24.1 mGy/1123 mGy cm; neck NC, 27.5 mGy/670 mGy cm; high-resolution CT of chest, 10.3 mGy/341 mGy cm; kidneys ureters and bladder NC, 19.4 mGy/929 mGy cm; chest to pelvis (CAP) NC, 10.8 mGy/801 mGy cm; CAP A, 10.4 mGy/384 mGy cm; CAP V, 10.5 mGy/534 mGy cm; CAP D, 16.8 mGy/652 mGy cm. Although the proposed NDRLs are comparable with those of other countries, the observed broad dose distributions between the CT machines within Sri Lanka indicate that dose optimisation strategies for the country should be implemented for most of the CT facilities.

To evaluate the usefulness of commercially available scatter reduction drapes in mitigating staff exposure in interventional radiology and the potential harmful effects of drape malpositioning in terms of exposure levels to both patients and staff. An anthropomorphic phantom was irradiated on an angiography device under three scenarios: no drape and correct and incorrect drape positioning. Different levels of incorrect drape positioning relative to the field-of-view (FOV) were evaluated: slight, mild and severe. Real-time dosimeter systems (positioned on the operator's eye, chest and thyroid) were used to evaluate accumulative doses and dose rates. Different obstruction levels were evaluated and compared to the observer's perception. Additionally, patient exposure was evaluated for all scenarios using a dose area product (DAP). Up to a mild obstruction, by using the drape a dose reduction of up to 86% was obtained while a severe obstruction produced a 1000% increase in exposure, respectively for all dosimeter positions compared to the use of no drape. A similar order of magnitude was observed for patient exposure. Good agreement was obtained for the observer perception of the FOV obstruction up to 25% of the FOV; for larger obstructions, an overestimate of the obstruction was observed. Patient lead drapes can reduce staff doses in interventional radiology procedures even when mildly malpositioned and obscuring the FOV. Special attention to protective drape positioning is necessary, since the severe obstruction of the FOV results in a large increase in both operator and patient exposure.

To comply with the Ionising Radiations (Medical Exposures) Regulations 2017, patients need to be adequately informed of medical radiation risks prior to exposure. This study used a survey developed in partnership with patients and members of the public to explore patient preferences for radiation risk communication. It was distributed through social media between 28/4/2020 and 18/7/2020. All respondents (N = 376) wanted to be informed about radiation risk, though the threshold at which they wished to be informed varied. The current practice of displaying posters in waiting areas does not meet the expressed preference of the patients if used in isolation. Only 6% of respondents were satisfied with the commonly used statement that the 'risk is low' if used in isolation. The majority of respondents (73%) said they would not be concerned about an increase in the risk of cancer of less than 1 in 10 000. The level of risk at which patients express a concern and the methodology for risk communication has been evaluated and based on these findings, and pre-existing literature, a graded approach to radiation risk communication based on modality is proposed. Patients must be involved throughout the evolution of this practice.

This study examines the mortality and cancer incidence experience among men who took part in the United Kingdom's atmospheric nuclear weapon tests between 1952–67. A cohort of 21 357 servicemen and male civilians from the UK who participated in the tests and a group of 22 312 controls were followed between 1952 and 2017. Analyses of mortality and cancer incidence were conducted. The overall mortality rate in the test participants was slightly higher relative risk (RR = 1.02, 90% CI 1.00–1.05, p = 0.04) than that in the control group. This difference was driven by similar increased risks for both all cancers combined (RR 1.03, 90% CI 1.00–1.07) and all non-cancer diseases (RR = 1.02, 90% CI 1.00–1.05). Leukaemia excluding chronic lymphatic incidence showed evidence of being raised relative to controls (RR = 1.38, 90% CI 1.10–1.75, p = 0.01). Leukaemia risks were driven by increased risks for chronic myeloid leukaemia (CML) (RR = 2.43, 90% CI 1.43–4.13, p = 0.003). Among non-cancer outcomes only cerebrovascular diseases showed increases in participants relative to controls. UK nuclear weapon tests participants have lower mortality rates compared to the national population although rates are slightly (2%) higher than in the study control group. Variation in background characteristics, that could not be accounted for in the analysis (e.g. smoking habits, diet), are a possible explanation for this difference. For leukaemia evidence of increased risk in the early years after the test has generally continued to diminish with time although for CML risks have persisted. There was some evidence that participants had higher mortality rates from cerebrovascular diseases than those in the control group. Assuming recorded radiation exposures (generally very low) are a true reflection of actual exposures then it is unlikely that any observed health effect will have been caused by radiation exposure.

It is relevant to estimate the uncertainties in the measurement of eye lens doses from a personal dosimeter over the protective apron without using additional dosimetry near the eyes. Additional dosimetry for interventionists represents a difficulty for routine clinical practice. This study analyses the estimated eye doses from dosimeter values taken at chest level over the apron and their uncertainties. Measurements of H_p(0.07) using optically stimulated luminescence dosimeters located on the chest over the apron and on the glasses (in the inner and outer part of the protection) were taken from ten interventionalists in a university hospital, in the period 2018–2019 during standard clinical practice. For a total sample of 133 interventional procedures included in our study, the ratio between the H_p(0.07) on the glasses (left-outer side) and on the chest over the apron had an average of 0.74, with quartiles of 0.47, 0.64, 0.88. Statistically significant differences were found among operators using the U-Mann–Whitney test. The average transmission factor for the glasses was 0.30, with quartiles of 0.21, 0.25, and 0.32. Different complexity in the procedures, in the quality of the scatter radiation and in the individual operational practices, involve a relevant dispersion in the results for lens dose estimations from the over apron dosimeter. Lens doses may be between a 64% and an 88% of the over apron dosimeter values (using median or 3rd quartile). The use of 88% may be a conservative approach.

This work aimed to estimate the radiation doses to humans and non-human biota arising from the operation of the atomic centre Centro Atómico Ezeiza (CAE), Buenos Aires, Argentina. To this end, atmospheric and liquid average discharges for the period 2014–2016, corresponding to all the facilities of the CAE in normal operation were considered. The PC-CREAM 08 and CROM8 codes were applied taking into account local characteristics and reference values. The radiation doses to both humans and non-human biota estimated were considerably lower than the values recommended to protect people and the environment. Thus, it is possible to conclude that both the environment and the human population near the CAE are extremely unlikely to experience any harmful radiological effects caused by the operation of this atomic centre.

To implement typical doses (TD) and typical values (TV) for fluoroscopic diagnostic and interventional procedures. A total of 3811 fluoroscopic procedures performed within 34 months on three devices were included in this retrospective study. Dose-, patient- and procedure-related information were extracted using the institutional dose management system (DMS). TD/TV were defined as median dose and calculated for the five most frequent procedures per device for dose area product (DAP), cumulative air kerma (CAK) and fluoroscopy time (FT). National diagnostic reference levels and other single facility studies were compared to our results. Additionally, the five procedures with the highest doses of each device were analysed. To evaluate the data coverage of the DMS compared to the picture archiving and communication system (PACS), procedure lists were extracted from the PACS and compared to the procedure information extracted from the DMS. TD/TV for 15 procedures were implemented. Among all devices, TD for DAP ranged between 0.6 Gycm² for port catheter control (n = 64) and 145.9 Gycm² for transarterial chemoembolisation (n = 84). TD for CAK ranged between 5 mGy for port catheter control and 1397 mGy for aneurysm treatment (n = 129) and TV for FT ranged between 0.3 min for upper cavography (n = 67) and 51.4 min for aneurysm treatment. TD for DAP and CAK were lower or within the range of other single facility studies. The five procedures with the highest median DAP per device were identified, 6 of 15 procedures were also found to be among the most frequent procedures. Data coverage of the DMS compared to the PACS ranged between 71% (device 2, stroke treatment) and 78% (device 1, lower limb angiography) for the most common procedure per device. Thus, in 22%–29% of cases dose data of the performed procedure was not transferred into the DMS. We implemented TD/TV for fluoroscopic diagnostic and interventional procedures which enable a comprehensive dose analysis and comparison with previously published values.

This paper reports on the findings from the study of mortality from diseases of the circulatory system (DCS) in Russian nuclear workers of the Mayak Production Association (22 377 individuals, 25.4% female) who were hired at the facility between 1948 and 1982 and followed up until the end of 2018. Using the AMFIT module of the EPICURE software, relative risks (RRs) and excess RRs per unit absorbed dose (ERR/Gy) for the entire Mayak cohort, the subcohort of workers who were residents of the dormitory town of Ozyorsk and the subcohort of migrants from Ozyorsk were calculated based on maximum likelihood. The mean cumulative liver absorbed gamma-ray dose from external exposure was 0.45 (0.65) Gy (mean (standard deviation)) for men and 0.37 (0.56) Gy for women. The mean cumulative liver absorbed alpha dose from internal exposure to incorporated plutonium was 0.18 (0.65) Gy for men and 0.40 (1.92) Gy for women. By the end of the follow-up, 6019 deaths with DCS as the main cause of death were registered among Mayak Production Association workers (including 3828 deaths in the subcohort of residents and 2191 deaths in the subcohort of migrants) over 890 132 (622 199/267 933) person-years of follow-up. The linear model that took into account non-radiation factors (sex, attained age, calendar period, smoking status and alcohol drinking status) and alpha radiation dose (via adjusting) did not demonstrate significant associations of mortality from DCS, ischaemic heart disease (IHD) and cerebrovascular disease with gamma-ray exposure dose in the entire cohort, the resident subcohort or the migrant subcohort (either in men or women). For the subcohort of residents, a significant association with gamma dose was observed for mortality from ischaemic stroke in men with ERR/Gy = 0.43 (95% CI 0.08; 0.99); there were no significant associations with liver absorbed gamma dose for any other considered outcomes. As for internal exposure, for men no significant associations of mortality from any DCS with liver absorbed alpha dose were observed, but for women positive associations were found for mortality from DCS (the entire cohort and the resident subcohort) and IHD (the entire cohort). No significant associations of mortality from various types of DCS with neutron dose were observed either in men or women, although neutron absorbed doses were recorded in only 18% of the workers.

In this article, the proposal of the International Commission on Radiation Units and Measurements/International Commission on Radiological Protection (ICRU/ICRP), that the ISO slab phantom should continue to be used as a calibration phantom for the new ICRU Report 95 operational quantity personal dose should be legitimised by simulation and performance of experiments to determine backscatter factors on the ISO slab phantom and, in comparison, on an anthropomorphic Alderson Rando phantom. The scope of this work was restricted to the photon energy range of radiation qualities commonly used in x-ray diagnostics. For this purpose, a shadow-free diagnostic (SFD) ionisation chamber was used to measure backscatter factors for X radiation in the energy range of 24 keV to 118 keV. The Monte Carlo code MCNP 6.2 was used to validate measurement results on the ISO slab phantom. Additionally, the influence of varying the SFD position on the Rando phantom on the backscatter factor was determined. Since backscatter factors on the ISO slab phantom differ only up to $\pm$5% from those on the Rando phantom, it could be concluded that it is not necessary to develop a new phantom for calibrations in terms of personal dose. A position variation of the detector by a few centimeters on the surface of the Rando phantom causes similarly large deviations and thus alone represents an equally large uncertainty contribution in practical personal dosimetry than that arising from the dissimilarity of the real human body to the ISO slab phantom.

Central to applying the principle of optimisation in the system of radiological protection is the evaluation of what level of radiation exposure should be considered 'as low as reasonably achievable' (ALARA), after taking into account the prevailing circumstances. Determining what is 'reasonable' is an abstract, although somewhat intuitive concept with many potential interpretations depending on both the situation and those involved, whether individuals or organisations. There are common themes in the types of considerations that need to be addressed to determine 'reasonableness' regardless of the exposure situation. However, despite the consistent and agreeable nature of these themes, there remains a gap in how to apply them in real situations. For example, without measurable goalposts (or a clear process for setting such goalposts) for determining what constitutes ALARA, we can find ourselves misinterpreting the optimisation process as keeping exposures 'as low as possible'. We propose herein, by consolidating and building on existing ideas, an easily understandable and actionable 'reasonableness' framework. This simple, yet broadly applicable tool is intended to help radiation protection experts in the systematic, deliberative, and collaborative reflection on all of the factors that make up 'reasonable' before making a decision—whether it be a proposed medical treatment or clean-up of a contaminated site. Each process execution and decision itself will necessarily retain the complexity of the prevailing circumstance. The proposed 'Rs' of Reasonable represent Relationships (stakeholders, empathy, and trust), Rationale (contextual, technical, and ethical), and Resources (technological, financial, and time).

In Portugal, computed tomography (CT) exposures for adult routine head, adult routine abdomen and paediatric abdomen (5 years old) were evaluated between 2019 and 2020 in 92 CT units. The third quartile value for CTDI_vol was 63.2 mGy for adult head exams, 15.9 mGy for adult abdomen and 5.2 mGy for paediatric abdomen. However, the CTDI_vol for head examination in 7.6% of units exceeded the suspension level proposed in EU report 162 while the number of units exceeding suspension levels for adult and paediatric abdomen were 3.2% and 0.0%, respectively. The used acquisition parameters and the referred CT unit's specifications were studied to understand how radiation dose relates with tube voltage, tube current, rotation time, detector width, slice width, pitch value and the use of automatic exposure control (AEC). The axial acquisition mode was predominant (67%) in the head exams. However, the helical scanning was commonly used in abdomen exams. Dose reduction from adult to paediatric exams was achieved using a lower tube current (a 60% average reduction). AEC is preferably used in abdomen protocols (84% in adult exams and 96% in paediatric exams). Nonetheless, in adult routine head protocols only 27% used this system. Data was gathered from clinics and hospitals covered by this study which allowed an estimate of an annual frequency of 206 CT examinations per 1000 population in Portugal. The estimated dose index (CTDI_vol) and frequency of CT examinations for the Portuguese population agreed with data from other countries.

Large-scale radiological accidents or nuclear terrorist incidents involving radiological or nuclear materials can potentially expose thousands, or hundreds of thousands, of people to unknown radiation doses, requiring prompt dose reconstruction for appropriate triage. Two types of dosimetry methods namely, biodosimetry and physical dosimetry are currently utilized for estimating absorbed radiation dose in humans. Both methods have been tested separately in several inter-laboratory comparison exercises, but a direct comparison of physical dosimetry with biological dosimetry has not been performed to evaluate their dose prediction accuracies. The current work describes the results of the direct comparison of absorbed doses estimated by physical (smartphone components) and biodosimetry (dicentric chromosome assay (DCA) performed in human peripheral blood lymphocytes) methods. For comparison, human peripheral blood samples (biodosimetry) and different components of smartphones, namely surface mount resistors (SMRs), inductors and protective glasses (physical dosimetry) were exposed to different doses of photons (0–4.4 Gy; values refer to dose to blood after correction) and the absorbed radiation doses were reconstructed by biodosimetry (DCA) and physical dosimetry (optically stimulated luminescence (OSL)) methods. Additionally, LiF:Mg,Ti (TLD-100) chips and Al₂O₃:C (Luxel) films were used as reference TL and OSL dosimeters, respectively. The best coincidence between biodosimetry and physical dosimetry was observed for samples of blood and SMRs exposed to γ-rays. Significant differences were observed in the reconstructed doses by the two dosimetry methods for samples exposed to x-ray photons with energy below 100 keV. The discrepancy is probably due to the energy dependence of mass energy-absorption coefficients of the samples extracted from the phones. Our results of comparative validation of the radiation doses reconstructed by luminescence dosimetry from smartphone components with biodosimetry using DCA from human blood suggest the potential use of smartphone components as an effective emergency triage tool for high photon energies.

The threat caused by ionising radiation has resulted in the establishment of strict radiation protection guidelines. This is especially true for severe nuclear power plant (NPP) accident scenarios, which may involve the release of significant amounts of ionising radiation. However, we believe that the fine balance between the benefit of a certain protective action (e.g. evacuation) and its risks is not always accounted for properly. Deaths and mental health problems have been associated with protective actions (e.g. evacuation) implemented in the response to the Fukushima Daiichi (NPP) accident in 2011. The protective actions were implemented consistent with international recommendations, to reduce radiation-induced health effects, even though the off-site effective doses were too low to indicate that there would be any discernible radiation-induced health effects. In this paper, we will provide a first step for the development of tools to evaluate the risk of protective actions versus the radiation-induced health risk. Over 50 papers were selected as useful from more than 600 reviewed papers to characterise the health impact of protective actions taken during different emergencies (including, technical and natural emergencies). An analysis was performed comparing the radiation-induced health effects averted by protective actions with the health effects associated with the protective actions. We concentrated our analysis on deaths and mental health problems associated with protective actions compared with the inferred radiation-induced deaths averted by the protective actions. Our analysis is stated in terms of absolute risk (cases per 1000) of health effects to allow for a direct comparison. It indicates that taking protective actions consistent with dose criteria typically used in many countries could result in more excess deaths than the inferred radiation-induced deaths prevented, as well as resulting in mental health problems. We identified that residents of facilities for long stays and the elderly are particularly vulnerable and a significant number of the deaths among the general public are associated with a lack of emergency preparedness provisions.

In the few years leading up to this research, CLEAPSS noticed a small but steadily increasing number of calls from UK schools regarding a red-brown discolouration on the surface of the foil of their radium source. There were no reports of this type of discolouration on foils of other radionuclides. CLEAPSS and the University of Liverpool collaborated to investigate the nature and cause of this discolouration and the likelihood that the foils were becoming unsafe. The evidence indicates that the discolouration is principally caused by some combination of silicon, sulfur and possibly lead from within the foil diffusing into the face layer. There is no indication currently that the face layers are fragmenting on these foils, but the longer-term integrity of the discoloured foils now becomes questionable. Given the age of the foils and the radiotoxicity of radium, the recommendation from this research is that discoloured foils should be taken out of service and disposed.

This work aims to investigate the changes in the linear energy transfer (LET) spectra distribution and the beam spot width of a therapeutic carbon ion beam in density heterogeneous phantoms. Three different heterogeneous phantoms were fabricated using a combination of solid water, lung, and bone tissue slabs and irradiated by a single energy carbon beam (276.5 MeV u⁻¹). CR-39 detectors were used for experimental measurements and the Monte Carlo toolkit Geant4 was employed for theoretical simulations. The results demonstrated that the measured LET spectra agree well with the simulation results. The lung and bone tissues displayed no obvious effect on the spectral distribution of LET. The dose-average LET was invariant and showed no obvious difference in the different materials, while the track-average LET increased in the lung and decreased in the bone materials. Similarly, the beam spot size increased in the lung, and decreased in the bone materials. Additionally, the fluence of the secondary fragments varied in different tissues. These findings are expected to provide cross-validation data for the quality assurance of carbon ion therapy and to be beneficial for validating the base data in treatment planning systems.

Research is an integral part of radiological and nuclear activities; thus, workers may receive different levels of occupational exposure. In the present study, occupational external exposure of workers was studied at the largest radiological and nuclear research institute of Iran from 2015–2020. The activities included research reactors, nuclear fuel cycle, development on radiopharmaceuticals and radioisotopes, particle accelerators, plasma and fusion, and nuclear agriculture. The average doses of the monitored and exposed workers were calculated to be 0.095 and 0.575 mSv, respectively, which were around their corresponding worldwide values. Moreover, the results showed that in comparison with other research activities, the workers in research reactors, nuclear fuel cycle, and development of radiopharmaceuticals and radioisotopes may face higher occupational risks. It could be, therefore, concluded that all the radiation protection measures have been effective at achieving safe research activities in Iran.

The International Commission on Radiation Units and Measurements recently proposed new operational quantities for external radiation exposure. Among those, the ambient dose is intended to replace the ambient dose equivalent as estimator for the effective dose. Following its definition, the measurement of the ambient dose requires a much more detailed knowledge about the radiation field than the ambient dose equivalent. The implications for radiation protection in aviation concerning galactic cosmic radiation that would follow the adoption of the ambient dose as operational quantity at flight altitudes were investigated in this work using model calculations. It was found that the ambient dose is about 10% higher than the ambient dose equivalent for conditions relevant in commercial aviation and overestimates the effective dose by about 30%.

We aimed to evaluate the impact of a low-dose whole-body computed tomography (WBCT) protocol on radiation doses in paediatric major trauma patients. Retrospective cohort study of paediatric trauma patients (<16 years) at a national level 1 paediatric trauma centre (PTC) over a 6 year period prior and post introduction of a low-dose WBCT protocol (2014–2019). Demographic data, patient characteristics, CT device, and exposure information including scan range, dose-length product, and volume CT dose index were collected. Effective dose (ED) and exposure parameters were compared before and after protocol introduction. Forty-eight patients underwent WBCT during the study period. Prior to introduction of the low-dose protocol (n = 18), the ED was 20.6 mSv (median 20.1 ± 5.3 mSv [range 12.5–30.7]). After introduction of the low-dose WBCT protocol (n = 30), mean ED was 4.8 mSv (median 2.6 ± 5.0 [range: 0.8–19.1]). This resulted in a reduction of 77% in mean ED (p value <0.001). Significant radiation dose reduction of 77% can be achieved with low-dose WBCT protocols in PTCs.

Since 2010, positron emission tomography/magnetic resonance (PET/MR) has been increasingly used as clinical routine in nuclear medicine departments. One advantage of PET/MR over PET/computed tomography (CT) is the lower dose of ionising radiation delivered to patients. However, data on the radiation dose delivered to staff operating PET/MR compared with the new generation of PET/CT equipment are still lacking. Our aim was to compare the radiation dose to nuclear medicine technologists performing routine PET/MR and PET/CT in the same department. We retrospectively measured the daily radiation dose received by PET technologists over 13 months by collecting individual dosimetry measurements (from electronic personal dosimeters). Data were analysed taking into account the total number of studies performed with each PET modality (PET/MR with Signa 3T, General Electric Healthcare versus PET/CT with Biograph mCT flow, Siemens), the type of exploration (brain versus whole-body PET), the ¹⁸F activity injected per day and per patient as well as the time spent in contact with patients after tracer injection. Our results show a significantly higher whole-body exposure to technologists for PET/MR compared with PET/CT (10.3 ± 3.5 nSv versus 4.7 ± 1.2 nSv per ¹⁸F injected MBq, respectively; p < 0.05). This difference was related to prolonged contact with injected patients during patient positioning with the PET/MR device and MR coil placement, especially in whole-body studies. For an equal injected activity, radiation exposure to PET technologists for PET/MR was twice that of PET/CT. To minimise the radiation dose to staff, efforts should be made to optimise patient positioning, even in departments with extensive PET/CT experience.

Space research seems to be object of a renewed interest, also considering that human missions to the Moon, and possibly Mars, are being planned. Among the risks affecting such missions, astronauts' exposure to space radiation is a major concern. In this work, the question of the evaluation of biological damage by Galactic Cosmic Rays (GCR) was addressed by a biophysical model called BIophysical ANalysis of Cell death and chromosome Aberrations (BIANCA), which simulates the induction of cell death and chromosome aberrations by different ions. While previously BIANCA has been validated for calculating cell death along hadrontherapy beams up to oxygen, herein the approach was extended up to Fe ions. Specifically, experimental survival curves available in literature for V79 cells irradiated by Si-, Ne-, Ar- and Fe-ions were reproduced, and a reference radiobiological database describing V79 cell survival as a function of ion type (1 ⩽ Z ⩽ 26), energy and dose was constructed. Analogous databases were generated for Chinese hamster ovary hamster cells and human skin fibroblasts, finding good agreement between simulations and data. Concerning chromosome aberrations, which are regarded as radiation risk biomarkers, dicentric data in human lymphocytes irradiated by heavy ions up to iron were reproduced, and a radiobiological database allowing calculation of lymphocyte dicentric yields as a function of dose, ion type (1 ⩽ Z ⩽ 26) and energy was constructed. Following interface between BIANCA and the FLUKA Monte Carlo transport code, a feasibility study was performed to calculate the relative biological effectiveness (RBE) of different GCR spectrum components, for both dicentrics and cell death. Fe-ions, although representing only 10% of the total absorbed dose, were found to be responsible for about 35%–40% of the RBE-weighted dose. Interestingly, the RBE for dicentrics was higher than that for cell survival. More generally, this work shows that BIANCA can calculate RBE values for cell death and lymphocyte dicentrics not only for ion therapy, but also for space radiation.

The purpose of this IAEA-coordinated international study was to understand aspects related to the communication of radiation risk from imaging studies, such as how often imaging department personnel and referring physicians are asked about radiation risks in diagnostic imaging, who asks about these risks, how often professionals are able to provide satisfactory answers using qualitative metrics and how often quantitative risk estimates are needed. A web-based questionnaire with ten questions was completed by 386 healthcare professionals from 63 countries from all four continents, including clinicians/referring physicians (42.5%), radiologists or nuclear medicine physicians (26.7%), medical physicists (23.1%), radiographers/radiological technologists (6.2%) and others (1.6%). The results indicate that radiation risk-related questions are largely asked by patients (73.1%) and parents of child patients (38.6%), and 78% of the professionals believe they are able to answer those questions using qualitative metrics such as very small/minimal, small, medium rather than number of cancers likely occurring. The vast majority, with over three times higher frequency, indicated the purpose of knowing previous radiological exams as 'both clinical information and radiation exposure history' rather than 'only clinical information'. Nearly two-thirds of the clinicians/referring physicians indicated that knowing the radiation exposure history of the patient will affect their decision-making for the next exam, as against only about one-fifth who said 'no, it will not affect their decision-making'. The same question, when addressed to radiologists, resulted in a slightly larger fraction of about three-quarters who said 'yes', as opposed to a smaller fraction of about 12% who said 'no, it will not affect their decision-making'. Mapping the present situation of communication of benefits and risks for patients is important and may be the basis of further analysis, regular monitoring and possibly a target for clinical audits. Further studies focused on specific professional groups might help in obtaining á deeper understanding of the need for practical communication tools.

In whole-body positron emission tomography (PET)/computed tomography (CT), it is important to optimise the CT radiation dose. We have investigated factors affecting the dose-length product (DLP) of the CT component of whole-body PET/CT and derived equations to predict the DLP. In this retrospective study, 1596 whole-body oncology PET/CT examinations with ¹⁸F-fluorodeoxyglucose were analysed. Automatic exposure control was used to modulate radiation dose in CT. Considering age, weight, sex, arm position (up, down, one arm up), scan range (up to the mid-thigh or feet), scan mode (spiral or respiratory-triggered nonspiral) and the presence of a metal prosthesis as potential factors, multivariate analysis was performed to identify independent predictors of DLP and to determine equations to predict DLP. DLP values were predicted using the obtained equations, and compared with actual values. Among body size indices, weight best correlated with DLP in examinations performed under the standard imaging conditions (arms: up; scan range: up to the mid-thigh; scan mode: spiral; and no metal prosthesis). Multivariate analysis indicated that weight, arm position, scan range and scan mode were substantial independent predictors; lowering the arms, extending the scan range and using respiratory-triggered imaging, as well as increasing weight, increased DLP. The degree of the DLP increase tended to increase with increasing weight. The DLP values were predicted using equations that considered these parameters were in excellent agreement with the actual values. The DLP for the CT component of whole-body PET/CT is affected by weight, arm position, scan range and scan mode, and can be predicted with excellent accuracy using these factors.

Appropriate training of the related personnel is one of the most important aspects in nuclear and radiological emergency preparedness and response. The use of simulation training could provide the trainees learning experience of a lifelike, hands-on scenario without associated radiation safety restrictions. In this study, we established a radiation field simulation system that includes two separate parts. For small-area radiation field simulation, a set of simulation sources and detectors was designed based on ultra wide band distance measurement technology. For large-area field simulation, a Gaussian plume model was used to simulate the dispersion of released radioactive aerosols and calculate the consequent radiation field. Also, a Global Position System positioning and wireless transmission technique was used for simulation instruments' data acquisition. This system could create a verisimilar but also safe and radiation-free environment and can be used in the training of nuclear emergency first responders, rescue teams or radiation protection personnel.

This study aims to optimise the protocol for the low-dose pulmonary computed tomography (CT) scanning of infants by studying the effects of the selective photon shield (SPS) technique of the third-generation dual-source CT (DSCT) on the image quality and radiation dose of a chest CT in white rabbits under different tube currents. Twelve white rabbits of a similar weight to an infant were selected and randomly divided into an experimental group and a control group. The experimental groups (A1–A5) were scanned at low dose by the third-generation DSCT using SPS under different tube current × time (60, 50, 40, 30, and 20 mAs). The control group (B) was scanned under a conventional tube voltage (100 kV) and current × time (20 mAs). Advanced model iterative reconstruction at strength three was used for the objective and subjective evaluation of the image quality and radiation dose of the lung and mediastinal windows. With the standard deviation of the air in the trachea as image noise, the signal-to-noise ratio (SNR), contrast-to-noise ratio, and CT values of each site were evaluated. Radiation doses were compared using the volume CT dose index, dose length product, and effective dose. The differences in subjective image quality between groups A2 and B were not statistically significant (P = 0.34). The differences in the SNRs of the lung and mediastinal windows between groups A2 and B were not statistically significant (P > 0.05). The radiation dose of group A2 was 83.2% lower than that of group B. The SPS of the third-generation DSCT under 50 mAs might be applied in the pulmonary CT examination of infants.

The risk of radiation effects in children of individuals exposed to ionising radiation remains an ongoing concern for aged veterans of the British nuclear testing programme. The genetic and cytogenetic family trio (GCFT) study is the first study to obtain blood samples from a group of British nuclear test veterans and their families for the purposes of identifying genetic alterations in offspring as a consequence of historical paternal exposure to ionising radiation. In this report, we describe the processes for recruitment and sampling, and provide a general description of the study population recruited. In total, blood samples were received from 91 (49 test and 42 control) families representing veteran servicemen from the army, Royal Air Force and Royal Navy. This translated to an overall response rate of 14% (49/353) for test veterans and 4% (42/992) for control veterans (excluding responders known to be ineligible). Due to the lack of dose information available, test veterans were allocated to a three-point exposure rank. Thirty (61%) test veterans were ranked in the lower group. Nineteen (39%) of the 49 test veterans were classified in the mid (5 veterans; 10%)/high (14 veterans; 29%) exposure ranks and included 12 veterans previously identified as belonging to the special groups or listed in health physics documents. An increased number of test veteran families (20%), compared with control families (5%), self-reported offspring with congenital abnormalities (p = 0.03). Whether this observation in this small group is reflective of the entire UK test veteran cohort or whether it is selection bias requires further work. The cohort described here represent an important and unique family trio grouping whose participation is enabling genetic studies, as part of the GCFT study, to be carried out. The outcomes of these studies will be published elsewhere. ISRCTN Registry: 17461668.

In computed tomography (CT) examinations, the usefulness of protective glasses for reducing lens exposure to assistants has been reported. The present study aimed to compare the dose reduction effect for assistants with lead-acrylic shields and protective glasses (0.07 mm Pb, 0.5 mm Pb) during CT examination. The air dose distribution in a CT examination room with and without a lead-acrylic shield was compared. It was found that the amount of scattered radiation was significantly reduced by installing a lead-acrylic shield at the CT gantry aperture. Moreover, the reduction rate of air kerma at the assistant's lens was higher using the lead acrylic shield than with the protective glasses—95.7% during head holding and 76.1% during assisted ventilation.

In this work, we conducted experiments to validate the proton physics models of Geant4 (version 10.6). The stopping power ratios (SPRs) of 11 inserts, such as acrylic, delrin, high density polyethylene, and polytetrafluoroethylene, etc, were measured using a superconducting synchrocyclotron that produces a scattering proton beam. The SPRs of the inserts were also calculated based on Geant4 simulation with six physics lists, i.e. QGSP_ FTFP_ BERT, QGSP_BIC_HP, QGSP_BIC, QGSP_FTFP_BERT, QSGP_BERT, and QBBC. The calculated SPRs were compared to the experimental SPRs, and relative per cent error was used to quantify the accuracy of the simulated SPRs of inserts. The comparison showed that the five physics lists generally agree well with the experimental SPRs with a relative difference of less than 1%. The lowest overall percentage error was observed for QGSP_FTFP_BERT and the highest overall percentage error was observed for QGSP_BIC_HP. The 0.1 mm range cut value consistently led to higher percentage error for all physics lists except for QGSP_BIC_HP and QBBC. Based on the validation, we recommend QGSP_BERT_HP physics list for proton dose calculation.

The objective of the work described is the development of a software tool to provide the calculation routines for structural radiation protection from positron and gamma emitters, for example, ¹⁸F. The calculation of the generated local annual dose in the vicinity of these radioactive sources supports the engineering of structural measures necessary to meet regulatory guidelines. In addition to accuracy and precision, a visual and intuitive presentation of the calculation results enables fast evaluation. Finally, the calculated results are presented in a contour plot for design, evaluation, and documentation purposes. A python program was used to provide the calculation routines for structural radiation protection. For simplicity, the radiating sources can be considered as point sources. The attenuation of structural elements can be specified or, in the case of lead, calculated by virtue of its thickness. The calculated attenuation for the lead shielding is always slightly underestimated, which leads to a marginally higher calculated local dose rate than would be physically present. With the conservatively determined value, the structural radiation protection can be optimised in accordance with the general rule of as low as reasonably achievable. The pointwise comparison between the software results and the standard procedure for calculating the dose of points in space leads to similar values. In comparison with the general approach of calculating single representative points in the radiation protection area, the visual and intuitive presentation of the results supports the design and documentation of the measures required for structural radiation protection. In the present version of the software, the local dose rate and local annual dose are overestimated by a maximum of 4.5% in the case of lead shields. The proposed software, termed RadSoft, was successfully used to develop the structural radiation protection of a controlled area for hybrid magnetic resonance - positron emission tomography imaging, with the focus herein being on the requirements for PET.

Cancer incidence risks, lifetime effects and radiation detriments are determined for the whole population and various subpopulations as a result of acute and chronic exposure to low-LET radiation, taking into account the risk models, procedures and representative populations provided by ICRP. The results are given for solid cancers in different organs, as well as for soft tissue cancer in bone marrow. For most cancer sites a good agreement is obtained between the results of this study and the values published by the ICRP. The agreement with ICRP values is better for the whole population than for the working age population, where the results are systematically elevated. For chronic exposure, the years of life lost per radiation-induced cancer incidence are generally higher. In particular, this results in a radiation detriment for the whole population that is 30% higher than for acute exposure. The study reveals that risk quantities show a pronounced age dependence. The highest radiation risks are attributed to young persons; the lowest to persons in advanced ages. The total detriment imposed on people in different ages varies by a factor of about 30. The average values provided by the ICRP mask these variations and considerably underestimate radiation risks in childhood and adolescence. This also concerns the determination of the effective dose for persons in these age groups. Unlike the ICRP, which provides different nominal detriments for the whole population and the working age population, the results of this study do not support the use of different detriments for these populations.

This study aimed to estimate the additional dose the cone-beam computed tomography (CBCT) system integrated into the Varian TrueBeam linear accelerator delivers to a patient with head and neck cancer using mesh-type International Commission on Radiological Protection reference computational phantoms. In the first part, for use as a benchmark for the accuracy of the Monte Carlo geometry of CBCT, Particle and Heavy Ion Transport code System (PHITS) calculations were confirmed against measured lateral and depth dose profiles using a computed tomography dose profiler. After obtaining good agreement, organ dose calculations were performed by PHITS using mesh-type reference computational phantom (MRCP) and irradiating the neck region; the effective dose was calculated utilising absorbed organ doses and tissue weighting factors for male and female MRCP. Substantially, it has been found that the effective doses for male and female MRCP are 0.81 and 1.06 mSv, respectively. As this study aimed to assess the imaging dose from the CBCT system used in image-guided radiation therapy, it is required to take into account this dose in terms of both the target organ and surrounding tissues. Although the absorbed organ dose values and effective dose values obtained for both MRCP males and females were small, attention should be paid to the additional dose resulting from CBCT. This study can create awareness on the importance of doses arising from imaging techniques, especially CBCT.

Dual-energy contrast-enhanced spectral mammography (DE-CESM) is a recently developed advanced technique in digital mammography that uses an iodinated intravenous contrast agent to assess tumor angiogenesis. The aim of this study was to investigate the diagnostic potential of DE-CESM recombined images in terms of radiation dose and image quality. A 50% fibroglandular—50% adipose, custom-made phantom with iodine inserts of 1.0 mgI cm⁻³, 2.0 mgI cm⁻³, 4.0 mgI cm⁻³ was used for the estimation of mean glandular dose (MGD) and the image quality. Low-energy (LE) images were acquired with the W/Rh, W/Rh + 0.01 mm Cu and W/Rh + 0.5 mm Al while high energy images (HE) are acquired with the W/Rh, W/Rh + 0.06 mm Ba, W/Rh + 0.01 mm Cu, and W/Rh + 0.03 mm Ce anode filter combinations. The total MGD was reduced up to a maximum from 1.75 mGy to 1.45 mGy by using Rh + 0.01 mm Cu double-layer filter for both LE and HE imaging of 50 mm, standard 50% fibroglandular phantom compared to Rh single-layer filter with W target. The minimum total MGD reduction (1.69 mGy) was observed when Rh + 0.5 mm Al was used for LE and Rh + 0.06 mm Ba was used for HE exposure. The image quality was comparable with the single-layer filter. The use of W/Rh + 0.01 mm Cu or W/Rh + 0.5 mm Al as target/filter combination for LE exposure and W/Rh + 0.01 mm Cu for HE exposure can reduce the additional radiation dose delivered by DE-CESM without degrading the image quality.

Radiation detriment is a concept to quantify the burden of stochastic effects from exposure of the human population to low-dose and/or low-dose-rate ionising radiation. As part of a thorough review of the system of radiological protection, the International Commission on Radiological Protection (ICRP) has compiled a report on radiation detriment calculation methodology as Publication 152. It provides a historical review of the detriment calculation with details of the procedure used in ICRP Publication 103. A selected sensitivity analysis was conducted to identify the parameters and calculation conditions that can be major sources of variation and uncertainty. It has demonstrated that sex, age at exposure, dose and dose-rate effectiveness factor, dose assumption in the lifetime risk calculation, and lethality fraction have a substantial impact on the calculated values of radiation detriment. Discussions are also made on the issues to be addressed and possible ways for improvement toward the revision of general recommendations. These include update of the reference population data and cancer severity parameters, revision of cancer risk models, and better handling of the variation with sex and age. Finally, emphasis is placed on transparency and traceability of the calculation, along with the need to improve the way of expressing and communicating the detriment.

The International Commission on Radiological Protection (ICRP) has embarked on a process to review and revise the current System of Radiological Protection ('the System'). To stimulate discussion, the ICRP published two open-access articles: one on aspects of the System that might require review, and another on research that might improve the scientific foundation of the System. Building on these articles, the ICRP organized a Workshop on the Future of Radiological Protection as an opportunity to engage in the review and revision of the System. This digital workshop took place from 14 October–3 November 2021 and included 20 live-streamed and 43 on-demand presentations. Approximately 1500 individuals from 100 countries participated. Based on the subjects covered by the presentations, this summary is organized into four broad areas: the scientific basis, concepts and application of the System; and the role of the ICRP. Some of the key topics that emerged included the following: classification of radiation-induced effects; adverse outcome pathway methodologies; better understanding of the dose–response relationship; holistic and reasonable approaches to optimization of protection; radiological protection of the environment; ethical basis of the System; clarity, consistency and communication of the System; application of the System in medicine and application of the principles of justification and optimization of protection.

The 2021 United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) report summarises the knowledge on biological mechanisms of radiation action at low doses where, due to low statistical power of epidemiological investigations, the level of cancer risk must be inferred. It is the fourth UNSCEAR report since 1994 that looks into biological effects following low dose exposure with the aim of examining whether they support the assumption of the linear non-threshold (LNT) dose response for radiation-induced cancers. The conclusions of all four reports are affirmative. The new aspect of the 2021 report is that it focuses on the process of cancer risk inference. The aim of this article is to discuss the consequences of the conclusions regarding LNT and the possibilities of inferring risks from biological studies.

Mesenchymal stromal cells (MSCs) are a stem cell product with good safety that demonstrate significant clinical efficacy in the treatment of different pathologies, including radiation diseases (e.g. radiological burns, pelvic radiation disease). While the first results for some first human applications for the treatment of radiation disease suggest benefit, larger trials with clinically important endpoints are needed before definitive conclusions can be drawn. However, the supply and cost of MSCs remain the two main limitations for this innovative therapeutic product. Exosomes (EXOs), a stem cell product associated with MSC therapy, have shown promising efficacy and safety in humans. MSC-EXO therapeutics represent a promising next-generation approach for treating radiation diseases involving a primary (major) inflammatory component. Provided that conditions for MSC-EXO production and bio-banking are agreed in the near future, the transition to industrial production of MSC-EXOs will be possible, and this is required to initiate well-controlled clinical trials for approval by the European Medicines Agency (EMA) and US Food and Drug Administration (FDA).

The dose limits recommended by the International Commission on Radiological Protection have undergone considerable changes in the course of the past 90 years, and different arguments have been put forward for their justification. This has been largely due to new insights of radiation research, but changing perceptions of the related ethical values have also played a role. The current paper reviews important stages in this development and attempts to derive some implications for the Commission's next general recommendations. Above all, it suggests that it is essential to present clear and consistent justification strategies for dose limits (and related values), compatible with the core values of the system of radiological protection, especially prudence and justice.