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European Journal of Epidemiology

, Volume 33, Issue 12, pp 1135–1137 | Cite as

Seeing through a glass darkly and taking the next right steps

  • Lawrence T. Dauer
COMMENTARY
  • 97 Downloads

When quoting earlier phrases from Daniel Defoe and Christopher Bullock, Benjamin Franklin actually got it slightly wrong when he reaffirmed that “… in this world nothing can be said to be certain, except death and taxes.” [1]. Just ask Schrödinger’s cat (and several religions) about the death paradox [2] and ask any government who will tell you that the only thing certain about taxes is, of course, more taxes. Perhaps the only certitude is uncertainty itself, as we always have an obscure or imperfect vision of reality. While we may indeed see through a glass darkly, we are often still compelled to take actions based on fuzzy information.

The effects of radiation on the body have long been studied, but even for cancer (the most evaluated adverse outcome to date), the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) has recognized significant uncertainties, noting that nominal risk projections for uniform whole-body radiation (total for all cancer sites)...

References

  1. 1.
    Wikipedia. Death and taxes (idiom). Wikipedia, the free encyclopedia. 2018. https://en.wikipedia.org/wiki/Death_and_taxes_(idiom). Accessed 16 Oct 2018.
  2. 2.
    Schrödinger E. Die gegenwärtige Situation in der Quantenmechanik. English translation: John D. Trimmer. Proc Am Philos Soc. 1980; 124:323–38, reprint in Quantum Theory and Measurement, p. 152 (1983). Naturwissenschaftern. 1935;23:807–49.Google Scholar
  3. 3.
    UNSCEAR. Sources, effects and risks of ionizing radiation. United Nations Scientific Committee on the Effects of Atomic Radiation. UNSCEAR 2012 report to the general assembly with scientific annexes. New York: United Nations; 2015.Google Scholar
  4. 4.
    EPA. EPA Radiogenic Cancer Risk Models and Projections for the U.S. Population. EPA 402-R-11-001. Washington, D.C.: EPA2011.Google Scholar
  5. 5.
    Bouville A, Toohey RE, Boice JD Jr, et al. Dose reconstruction for the million worker study: status and guidelines. Health Phys. 2015;108(2):206–20.  https://doi.org/10.1097/HP.0000000000000231.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Till JE, Beck HL, Grogan HA, Caffrey EA. A review of dosimetry used in epidemiological studies considered to evaluate the linear no-threshold (LNT) dose-response model for radiation protection. Int J Radiat Biol. 2017;93(10):1128–44.  https://doi.org/10.1080/09553002.2017.1337280.CrossRefGoogle Scholar
  7. 7.
    NCRP. Uncertainties in the measurement and dosimetry of external radiation. NCRP Report No. 158. Bethesda, MD: National Council on Radiation Protection and Measurements; 2007.Google Scholar
  8. 8.
    NCRP. Deriving organ doses and their uncertainty for epidemiologic studies (with a focus on the One Million U.S. Workers and Veterans Study of Low-Dose Radiation Health Effects). NCRP report no. 178. Bethesda, MD: National Council on Radiation Protection and Measurements; 2018.Google Scholar
  9. 9.
    NCRP. Uncertainties in the estimation of radiation risks and probability of disease causation. NCRP report no. 171. Bethesda, MD: National Council on Radiation Protection and Measurements; 2012.Google Scholar
  10. 10.
    UNSCEAR. Sources, effects and risks of ionizing radiation. United Nations Scientific Committee on the Effects of Atomic Radiation. UNSCEAR 2017 report to the general assembly with scientific annexes. New York: United Nations; 2018.Google Scholar
  11. 11.
    NCRP. Health effects of low doses of radiation: perspectives on integrating radiation biology and epidemiology. NCRP commentary no. 24. Bethesda, MD: National Council on Radiation Protection and Measurements; 2015.Google Scholar
  12. 12.
    NCRP. SC 1-26: approaches for integrating radiation biology and epidemiology for enhancing low dose risks assessment. Bethesda, MD: National Council on Radiation Protection and Measurements. 2018. https://ncrponline.org/program-areas/sc-1-26/. Accessed 14 Oct 2018.
  13. 13.
    Thaler RH, Sunstein CR. Nudge: improving decisions about health, wealth, and happiness. New York: Pengiun Group; 2008.Google Scholar
  14. 14.
    ICRP. The 2007 recommendations of the international commission on radiological protection. ICRP Publication 103. Ann ICRP. 2007;37(2/4):1–332.Google Scholar
  15. 15.
    NCRP. Limitation of exposure to ionizing radiation. NCRP report no. 116. Bethesda, MD: National Council on Radiation Protection and Measurements; 1993.Google Scholar
  16. 16.
    NCRP. CC 1: radiation protection guidance for the United States. NCRP Council Committee 1. 2018. Bethesda, MD: NCRP. http://ncrponline.org/program-areas/cc-1/. Accessed 14 Oct 2018.
  17. 17.
    Ainsbury EA, Barnard S, Bright S, et al. Ionizing radiation induced cataracts: Recent biological and mechanistic developments and perspectives for future research. Mutat Res. 2016;770(Pt B):238–61.  https://doi.org/10.1016/j.mrrev.2016.07.010.CrossRefPubMedGoogle Scholar
  18. 18.
    Blakely EA, Kleiman NJ, Neriishi K, et al. Radiation cataractogenesis: epidemiology and biology. Radiat Res. 2010;173(5):709–17.  https://doi.org/10.1667/RRXX19.1.CrossRefPubMedGoogle Scholar
  19. 19.
    Ainsbury EA, Bouffler SD, Dorr W, et al. Radiation cataractogenesis: a review of recent studies. Radiat Res. 2009;172(1):1–9.  https://doi.org/10.1667/RR1688.1.CrossRefPubMedGoogle Scholar
  20. 20.
    Shore R. Radiation and cataract risk: impact of recent epidemiologic studies on ICRP judgments. Mut Res/Rev Mutat Res. 2016;770(Pt. B):231–7.CrossRefGoogle Scholar
  21. 21.
    Hamada N, Fujimichi Y, Iwasaki T, et al. Emerging issues in radiogenic cataracts and cardiovascular disease. J Radiat Res. 2014;55(5):831–46.  https://doi.org/10.1093/jrr/rru036.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Bouffler S, Ainsbury EA, Gilvin P, Harrison J. Radiation-induced cataracts: The Health Protection Agency’s response to the ICRP statement on tissue reactions and recommendation on the dose limit for the eye lense. J Radiol Prot. 2012;32(4):479–88.CrossRefPubMedGoogle Scholar
  23. 23.
    Blakely EA, Lauriston S. Taylor Lecture on radiation protection and measurements: what makes particle radiation so effective? Health Phys. 2012;103(5):508–28.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Little MP. A review of non-cancer effects, especially circulatory and ocular diseases. Radiat Environ Biophys. 2013;52(4):435–49.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    NCRP. Guidance on radiation dose limits for the lens of the eye. NCRP Commentary No. 26. Bethesda, MD: National Council on Radiation Protection and Measurements.2016.Google Scholar
  26. 26.
    ICRP. ICRP Statement on TIssue Reactions and Early and Late Effects of Radiation in Normal Tissues and Organs - Threshold Doses for Tissue Reactions in a Radiation Protection Context. ICRP Publication 118. Ann ICRP. 2012;41(1-2).Google Scholar
  27. 27.
    IAEA. Radiation protection and safety of radiation sources: international basic safety standards: general safety requirements, part 3. Interim edition. Vienna: International Atomic Energy Agency; 2011.Google Scholar
  28. 28.
    Cantone MC, Ginjaume M, Miljanic S, et al. Report of IRPA task group on the impact of the eye lens dose limits. J Radiol Prot. 2017;37:527–50.CrossRefPubMedGoogle Scholar
  29. 29.
    Little MP, Kitahara CM, Cahoon EK, et al. Occupational radiation exposure and risk of cataract incidence in a cohort of US radiologic technologists. Eur J Epidemiol. 2018.  https://doi.org/10.1007/s10654-018-0435-3.CrossRefPubMedGoogle Scholar
  30. 30.
    Azizova TV, Hamada N, Grigoryeva ES, Bragin EV. Risk of various types of cataracts in a cohort of Mayak workers following chronic occupational exposure to ionizing radiation. Eur J Epidemiol. 2018.  https://doi.org/10.1007/s10654-018-0450-4.CrossRefPubMedGoogle Scholar
  31. 31.
    Ainsbury EA. Cataract following low dose ionising radiation exposures: mechanistic understanding and current research. Presented at Webinar-Scientific basis for the recommended dose limits for the lens of the eye. March 21. Canadian Nuclear Safety Commission. 2018. http://www.nuclearsafety.gc.ca/eng/pdfs/Presentations/other/lens-of-the-eye-presentation-ainsbury.pdf. Accessed 16 Oct 2018.
  32. 32.
    Vano E, Miller DL, Dauer LT. Implications in medical imaging of the new ICRP thresholds for tissue reactions. Ann ICRP. 2015;44(1 Suppl):118–28.CrossRefPubMedGoogle Scholar
  33. 33.
    Dauer LT, Yorke E, Williamson M, et al. Radiotherapeutic implications of the updated ICRP thresholds for tissue reactions related to cataracts and circulatory diseases. Ann ICRP. 2018;47(3–4):196–213.CrossRefPubMedGoogle Scholar
  34. 34.
    IAEA. Implications for occupational radiation protection of the new dose limit for the lens of the eye. IAEA-TECDOC-1731. Vienna: International Atomic Energy Agency; 2013.Google Scholar
  35. 35.
    ICRU/ICRP. Operational quantities for external radiation exposure. Final draft. July. International Commission on Radiological Units and International Commission on Radiological Protection. 2017. http://www.icrp.org/docs/ICRU%20and%20ICRP%20Draft%20Joint%20Report%20Operational%20Quantities%20for%20External%20Radiation%20Exposure.pdf. Accessed 16 Oct 2018.

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Department of Medical PhysicsMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkUSA

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