Picano et al. BMC Cancer 2012, 12:157 http://www.biomedcentral.com/1471-2407/12/157 Page 8 of 13 Figure 5 Scatter dose rate values during fluoroscopy in interventional cardiologists without protection (as is was standard practice in many laboratories until some years ago). The use of lead cap protection or total body protection with radioprotection cabin or ceiling suspended screen reduces the scatter dose to less than 1%. From the International Atomic Energy Agency collection of slides (Radiation Protection of Patients, on the dedicated and continuously updated website: http://rpop.iaea.org.website), ref 96 (Kuon 2003) and ref. 18 (Dragusin, 2007). survivors [84]. Less reassuring data are available regarding occupational exposures in the low-to-moderate dose range (< 500 mSv). Death from dementia was significantly asso- ciated with total lifetime radiation doses in 69,976 female nuclear power plant workers [85], pre-senile dementia was more frequent in dentists [86], and elevated mortality from intentional self-harm, alcoholism and drowning was found in 11,311 former US flight attendants [87]. In 100 Chernobyl liquidators and 100 patients who suffered the acute radiation sickness in Chernobyl, schizophrenia-like disorders were more frequent in presence of over- irradi- ation (> 300 mSv) [88]. Mental disorders (including mental retardation and behavioral disorders) were most frequent in 544 Chernobyl prenatally irradiated children (with an esti- mated dose > 0.30 Sv to pregnant mothers) compared to non-irradiated controls born in radioecological “clear” regions [89]. There is no doubt that Chernobyl had an effect on mental health of adults directly affected by the event, es- pecially the liquidators and women with young children, which is why the 2006 Chernobyl Forum report regarded mental health as the major public health consequence [90]. However, the scope and magnitude of the mental health effects cannot be specified with the data at hand [91]. The interpretation of these findings remains difficult due to con- founding factors such as environmental mental stress, other possible chemical or physical contaminants in work habitat, night shift, and socio-economic confounders. Radiation is only a potential - but unproven - source of bioeffects, but certainly more data are warranted [92]. Other non-cancer effects: cataract The radiation protection standards formulated by the United States National Council on Radiation Protection and Measurements (NCRP) and the International Commission on Radiological Protection (ICRP) are all based on the belief that lens opacities (cataracts) are deterministic radiation- induced effects and appear only if a dose threshold is exceeded. Cataract, or opacification of the lens, is often associated with visual impairment and may be classified into three main categories: nuclear, cortical, and posterior sub- capsular, according to their anatomic location [93]. Among the three major areas of age-related cataracts, posterior sub- capsular is the least common but it is the one most fre- quently associated with ionizing radiation exposure. The