Abstract
The use of nuclear and other radioactive materials presents both benefits and risks to human health and development. Benefits, many of which would not be possible without the use of radioactive materials, include, inter alia, medical diagnosis and therapy, industrial applications, crop development and pest control, fundamental research, and low-carbon electricity. Risks include, inter alia, the potential for increased cancer incidence, nuclear reactor accidents and nuclear war. These benefits and risks have long been discussed. However, as technology evolves and societal values and needs change, such as the increased importance of carbon-free electricity, the balance between risks and benefits with regards to using nuclear and other radioactive materials can also change. To inform the debate regarding the extent to which nuclear and other radioactive materials should be used in light of their risks and benefits, this chapter presents a very brief, but up-to-date, overview of applications of nuclear and other radioactive materials for human health and development. The chapter also describes the extent to which these applications are reliant on uranium mining and enrichment and the availability of modern alternatives. It concludes by placing the benefits that arise from these materials in the context of recent research regarding the health risks of exposure to radiation.
Chief Operating & Science Officer, Post Road Foundation, https://www.postroadfoundation.org.
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Notes
- 1.
Nuclear material is used here as defined by the IAEA. It includes source material, uranium, depleted uranium and thorium, and also special fissionable material, including enriched uranium and plutonium.
- 2.
There is a debate regarding the extent to which exposure to very low doses of radiation poses a health risk. This debate is briefly outlined at the end of this chapter.
- 3.
On the basis of mouse mutation studies, recent research suggests that an exposure of 1 Sv raises the risk of a genetic mutation by approximately 0.5%, from 73.8 to 74.3%. National Research Council 2006, p. 117. However, exposure to low-doses has not be demonstrated to cause heritable genetic mutations in humans. Preston et al. 2013, p. 583. Observations of 30,000 children of atomic bomb survivors in Japan with an estimated dose of 0.4 Sv or less have been unable to identify a heritable adverse effect. National Research Council 2006, p. 118; United Nations and Scientific Committee on the Effects of Atomic Radiation 2013, pp. vi, 38.
- 4.
Radiation exposures can also occur without the use or presence of radioactive materials. For example, particle accelerators, radiation therapy machines, and X-ray machines all produce radiation that can, in some circumstances, be harmful or deadly. However, electronic means of producing radiation is generally less controversial than the use of radioactive materials because such machines typically only produce radiation when they are energized, and thus, are not generally dangerous when not in use. In contrast, radioactive materials are potentially dangerous during their full life-cycle, from production through disposal. Note that accelerators may also create low-level radioactive waste that must be disposed of. Such low-level waste is far less dangerous than spent nuclear fuel from nuclear reactors.
- 5.
See U.S. National Institute for Occupational Safety and Health Division of Surveillance, Hazard Evaluations and Field Studies, Aircrew Safety & Health, https://www.cdc.gov/niosh/topics/aircrew/cosmicionizingradiation.html.
- 6.
Accelerators do not displace the need for radiation, they rather create the radiation through electronic means so that the source of radiation can be switched of—minimizing the need to mine or enrich uranium and minimizing the risk of theft or other misuse.
- 7.
For example, there is a worldwide deficit of 7,000 external beam radiotherapy machines for cancer therapy, mostly in developing countries. Yap et al. 2016. Although there are accelerator-based solutions that do not use radioactive materials, the most expedient means of meeting this deficit in many developing countries may be cobalt-60 based machines. Page et al. 2014.
- 8.
The radiation is typically in the form of γ-rays. For example, technetium-99m emits a single 140 keV γ-ray while fluorine-18 gives rise to the emission of two 511 keV γ-rays through the emission of a positron.
- 9.
Underwood et al. 2004.
- 10.
Id.
- 11.
Duhaylongsod et al. 1995.
- 12.
Id.
- 13.
Id.
- 14.
Hoedl and Updegraff 2015, p. 123.
- 15.
Hoedl and Updegraff 2015, pp. 129–130.
- 16.
Id.
- 17.
https://www.iaea.org/About/Policy/GC/GC54/GC54InfDocuments/English/gc54inf-3-att7_en.pdf. Historically, the production of technetium-99 has used highly-enriched uranium targets. In order to reduce nuclear security and proliferation risks, efforts are underway to switch to targets containing low-enriched uranium, which cannot be used in nuclear explosives. Efforts to eliminate the use of high-enriched uranium in research reactors are long-standing and well established.
- 18.
Hoedl and Updegraff 2015.
- 19.
Hoedl and Updegraff 2015, p. 129. Two isotopes currently in diagnostic use, iodine-131 and xenon-133, and eight isotopes that have been investigated but are not commonly used, americium-241, gadolinium-153, iodine-132, iron-59, osmium-191, tellurium-123m, tin-113, ytterbium-169, are presently made with reactors but could, in principle, be either replaced with another isotope, produced using a cyclotron, or produced using another type of accelerator, called a spallation neutron source. Id.
- 20.
Cells that rapidly divide are generally more sensitive to radiation exposure than cells that are not dividing. Thus, radiation tends to be much more deadly to malignant cells than healthy cells.
- 21.
Nag et al. 1999.
- 22.
Banerjee and Kamrava 2014.
- 23.
Bauman et al. 2005.
- 24.
National Research Council 2008, p. 117.
- 25.
National Research Council 2008, p. 117.
- 26.
- 27.
- 28.
IAEA, Directory of Radiotherapy Centres, https://dirac.iaea.org/.
- 29.
Hoedl and Updegraff 2015, pp. 131–132.
- 30.
Id.
- 31.
Id.
- 32.
Immunotherapy is a technique in which a patient’s immune system is unleashed to attach the disease-causing malignancy. Sharma and Allison 2015.
- 33.
For example, the standard of care for the treatment of advanced cervical cancer includes the use of brachytherapy. Banerjee and Kamrava 2014, p. 555.
- 34.
Dalnoki-Veress and Pomper 2017.
- 35.
Whitaker et al. 2015, p. 68.
- 36.
International Atomic Energy Agency 2008. For a comprehensive list of equipment and supplies that are sterilized using cobalt-60 by a commercial company, see https://www.steris-ast.com/tech-tip/products-commonly-treated-irradiation/.
- 37.
International Atomic Energy Agency 2008.
- 38.
Hoedl and Updegraff 2015, p. 132.
- 39.
http://www.radsource.com/blood-irradiation/. Note that the U.S. National Nuclear Security Agency is engaged in a program to replace cesium-137 to minimize risks of theft for nefarious purposes. See https://nnsa.energy.gov/aboutus/ourprograms/dnn/gms/rs/cesium-irradiator-replacement-project-fact-sheet.
- 40.
- 41.
Cobalt-60 sterilizers are able to sterilize products with a wider range of geometries, packaging styles and material densities. See International Atomic Energy Agency 2008.
- 42.
National Research Council 2008, p. 135.
- 43.
International Atomic Energy Agency 2005, p. 2.
- 44.
International Atomic Energy Agency 2005, pp. 3–10.
- 45.
National Research Council 2008, p. 135.
- 46.
International Atomic Energy Agency 2005, p. 11.
- 47.
National Research Council 2008, p. 140.
- 48.
National Research Council 2008, p. 135.
- 49.
International Atomic Energy Agency 2005, p. 22.
- 50.
National Research Council 2008, p. 147.
- 51.
Id.
- 52.
Id.
- 53.
Id.
- 54.
Hoedl and Updegraff 2015, see online supplement.
- 55.
Hoedl and Updegraff 2015, p. 132.
- 56.
- 57.
Id.
- 58.
Id.
- 59.
Hoedl and Updegraff 2015, see on-line supplement.
- 60.
- 61.
- 62.
National Research Council 2008, pp. 115–116.
- 63.
Cleland 2004.
- 64.
Xu 2015.
- 65.
Zheng et al. 2016.
- 66.
Lisowski 1997.
- 67.
Zheng et al. 2016.
- 68.
Kharkwal 2012.
- 69.
IAEA, Mutant Variety Database, https://mvd.iaea.org.
- 70.
Ahloowalia et al. 2004.
- 71.
- 72.
Ahloowalia et al. 2004.
- 73.
Jankowicz-Cieslak et al. 2016, pp. 4–5.
- 74.
Mba et al. 2012.
- 75.
Jankowicz-Cieslak et al. 2016, pp. 12–13.
- 76.
Mba et al. 2012, p. 87.
- 77.
Kharkwal 2012, pp. 26–27.
- 78.
Belhaj et al. 2015.
- 79.
Klassen and Curtis 2005, p. 11.
- 80.
Vreysen et al. 2016, pp. 2–3.
- 81.
Klassen and Curtis 2005, p. 5.
- 82.
Vargas-Teran et al. 2005, p. 630.
- 83.
Enkerlin 2005, p. 672.
- 84.
Id.
- 85.
IAEA 2018.
- 86.
Klassen and Curtis 2005.
- 87.
Bakri et al. 2005.
- 88.
Bakri et al. 2005.
- 89.
Radioisotopes for fundamental research are created by either accelerators or nuclear reactors. For example, the planned Facility for Rare Isotope Beams at Michigan State University in the U.S. will create rare radioisotopes using an accelerator-based facility for fundamental research. See Facility for Rare Isotope Beams (FRIB) at Michigan State University, https://frib.msu.edu/about/index.html. Some of the earliest and most fundamental discoveries in particle physics used radioisotopes, see Wu et al. 1957.
- 90.
Slater and Slater 2002.
- 91.
Pant et al. 2011.
- 92.
For example, the U.S. National Institute for Standards and Technology will calibrate over fifty different radioisotopes for calibration purposes. https://www.nist.gov/calibrations/radioactivity-sources-calibrations.
- 93.
- 94.
- 95.
- 96.
- 97.
Blau et al. 2009.
- 98.
- 99.
- 100.
See the China Spallation Source, http://english.ihep.cas.cn/csns/, and the European Spallation Source, https://europeanspallationsource.se/.
- 101.
Coal is also causes greater radiation exposure than nuclear power on a per unit energy basis. According to the United Nations Scientific Committee on the Effects of Atomic Radiation, “The total collective dose per unit of electricity generated in the coal cycle (i.e., the does to the global public and all exposed workers combined) was larger than that found in the nuclear fuel cycle.” United Nations and Scientific Committee on the Effects of Atomic Radiation 2017, p. 13.
- 102.
See Nuclear Energy Institute, Washington D.C., https://www.nei.org/Knowledge-Center/Nuclear-Statistics/Environment-Emissions-Prevented/Emissions-Avoided-by-the-US-Nuclear-Industry.
- 103.
- 104.
Kharecha and Hansen 2013.
- 105.
Thorium itself is not fissile. However, when used as a component of an accelerator driven system or other nuclear reactor, thorium-232 becomes uranium-233, which is fissile and is the source of energy for thorium-based reactors. Thorium-based reactors, whether an accelerator driven system or otherwise, would need to be initially fueled with fissionable material, such as enriched uranium-235 or plutonium-239. See Rubbia et al. 1993.
- 106.
See ThorCon, U.S.A., http://thorconpower.com.
- 107.
Many of these designs are thought to be walk-away-safe so that continual monitoring in the event of an accident or malfunction is not required. Some of these designs are also thought to present less of a plutonium proliferation risk than light-water reactors due to the different isotopic mixture of spent fuel. However, some designs would require spent fuel reprocessing and all designs would accumulate protactinium-233 and uranium-233, isotopes that are a proliferation concern. Uranium-233 is a fissile and weapons grade material that presents a direct proliferation risk. Protactinium-233 decays directly to uranium-233 and if separated from thorium-based spent fuel can be another source of uranium-233. For a brief discussion of the proliferation risks of thorium-based reactors, see Kang and von Hippel 2001; International Atomic Energy Agency et al. 2005; Ashley et al. 2012.
- 108.
Thorium-containing ore is generally less radioactive than uranium-containing ore. Meyer et al. 1982.
- 109.
Fusion-based reactors are safer than fission-based reactors because a run-away chain reaction is not possible. Proliferation risks are lower because a fusion reactor does not use nor produce fissionable material.
- 110.
Sorbom et al. 2015.
- 111.
Zheng et al. 2016.
- 112.
Kharecha and Hansen 2013.
- 113.
Brenner 2011.
- 114.
The precautionary principle is a long standing element of environmental law world-wide. Sunstein 2005, pp. 15–18. However, there is little consensus as to what the principle means; there are at least twenty different definitions. Id. at 18 citing Morris 2000. At one extreme, the so-called ‘weak version’, the principle is interpreted as calling for action to protect the environment in light of uncertainty: ‘Where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for postponing cost-effective measures to prevent environmental degradation’. 1992 Rio Declaration, Principle 15. At the opposite extreme, the so-called ‘strong version’, the principle is interpreted as restraining action in light of uncertainty: ‘where potential adverse effects are not fully understood, the activities should not proceed’. Foster et al. 2000, citing World Charter for Nature, U.N. GA Resolution 37/7 (1982). Some argue that these competing interpretations are inherently contradictory and paralyzing. Sunstein 2005.
- 115.
Center for Disease Control and Prevention 2005a.
- 116.
- 117.
National Research Council 2006, p. 6.
- 118.
National Research Council 2006, p. 16.
- 119.
National Research Council 2006, pp. 278–281.
- 120.
McCarthy et al. 2012.
- 121.
See Centers for Disease Control and Prevention, https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm.
- 122.
Preston et al. 2013, p. 577.
- 123.
- 124.
Health Physics Society 2017, p. 10.
- 125.
Brenner et al. 2003, p. 13761.
- 126.
Brenner et al. 2003, p. 13762.
- 127.
For example, the risk of leukemia is believed to be three to five times higher in children than adults when exposed to the same radiation dose. United Nations and Scientific Committee on the Effects of Atomic Radiation 2013, p. 29. In utero exposure to human fetuses has been observed to raise the risk of cancer at doses as small as 0.01 Sv. National Research Council 2006, p. 6. Note that the ability of human fetus exposure studies to separate radiation exposure from other causes of cancer has been criticized. Tubiana et al. 2009, p. 16.
- 128.
- 129.
- 130.
- 131.
Tubiana et al. 2009.
- 132.
The hormesis hypothesis is controversial, but has not been disproved. As recently as 2012, the United Nations Scientific Committee on the Effects of Atomic Radiation stated that it could not rule out that low level radiation exposure might have some beneficial health effects. United Nations and Scientific Committee on the Effects of Atomic Radiation 2016, p. 21.
- 133.
Preston et al. 2013, p. 585.
- 134.
National Research Council 2006, p. 7.
- 135.
Brenner 2011, p. 13761.
- 136.
See Centers for Disease Control and Prevention, https://www.cdc.gov/cancer/dcpc/data/geographic.htm. In comparison, a radiation dose of about 2.6 Sv would be expected to be required to generate such a change in cancer incidence. Such a high dose would also be likely generate immediate health impacts, such as radiation sickness or radiation burns.
- 137.
Preston et al. 2013, p. 585.
- 138.
Brenner 2014.
- 139.
Id.
- 140.
Mathews et al. 2013.
- 141.
Id.
- 142.
Preston et al. 2013, p. 585.
- 143.
Tubiana et al. 2009, p. 17.
- 144.
In Fukushima, 170,000 people were evacuated. Almost 2,000 of these individuals, mostly elderly, died either during or subsequent to the evacuation, mostly from pneumonia. Hasegawa et al. 2015, p. 484.
- 145.
Cuttler and Hannum 2017, p. 37.
- 146.
The trade-off between uncertain radiation risk from nuclear power and the known risk of exposure to pollutants from fossil fuel combustion has long been recognized and discussed. See Breyer 1978, p. 1835 (‘potentially adverse health, safety, or environmental effects lie not on one side, but on all sides, of the nuclear power issue’).
- 147.
There have been suggestions that radiation exposure of patients from diagnostic scans should be more closely monitored given the risk of cancer from accumulated dose from such scans. See Fazel et al. 2009.
- 148.
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Hoedl, S. (2019). Nuclear Materials for Human Health and Development. In: Black-Branch, J., Fleck, D. (eds) Nuclear Non-Proliferation in International Law - Volume IV. T.M.C. Asser Press, The Hague. https://doi.org/10.1007/978-94-6265-267-5_3
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