Concerning the health effects of internally deposited radionuclides.

The ionizing radiation dose-response relationships for internally deposited radionuclides are examined using data from humans involving 226 Ra and laboratory animal studies involving alpha-emitters 224 Ra, 226 Ra, 228 Ra, 228 Th, 238 Pu, 239 Pu, and 241 Am and beta-emitters 90 Y, 90 Sur, 91 Y, and 144 Ce. Intake routes included ingestion, inhalation, and injection. The lifetime effects are best described by three-dimensional average-dose-rate/time/response surfaces that compete with other causes of death during an individual's lifetime. Using maximum likelihood survival regression methods, the characteristic logarithmic slope for cancer induction was found to be about negative one-third for alpha-emitters or about negative two-thirds for beta-emitters. At the higher average dose-rates the principal deleterious effects were those associated with radiation-induced injury while at intermediate average dose-rates radiation-induced cancer predominates. The relative biological effectiveness for cancer induction of high linear energy transfer alpha radiation with respect to low linear energy transfer beta radiation is a strong function of dose-rate. As average dose-rate decreases, the effectiveness of the beta irradiation drops off more rapidly than that of the alpha irradiation. The cumulative dose yielding a specific level of induced cancer risk is less at lower dose-rates than at higher dose-rates showing an apparent inverse dose-rate effect (up to a factor of about 10 for high linear energy transfer alpha radiation and a factor of about 2 for low linear energy transfer beta radiation). The cumulative radiation dose is neither an accurate nor an appropriate measure of cancer risk associated with protracted ionizing radiation exposure. Cancer risk associated with protracted ionizing radiation exposure is a non-linear function of lifetime average dose-rate to the affected tissues. At low average dose-rates the long latency time required for radiation-induced cancer may exceed the natural lifespan. This long latency results in a lifespan virtual threshold (cancer riskp < 0.001) for each internally deposited radionuclide. For young adult beagles, bone sarcoma induction from alpha-emitting radionuclides was unlikely for cumulative doses below about 1 Gy (20 Sv) delivered specifically to the sensitive tissues at bone surfaces in a manner associated with radionuclide relative potency from highest for 228 Th, 239 Pu, and 238 Pu to lowest for 226 Ra. Bone sarcoma induction from ingested 90 Sr was unlikely for cumulative beta radiation doses below about 20 Gy (20 Sv), but beta irradiation of tissues adjacent to bone also induced leukemia and soft tissue carcinomas above 10 Gy (10 Sv). Inhaled radionuclides tended to be most potent in producing lung carcinoma when the radiation dose was most uniformly distributed in the lung. In young adult beagles lung carcinoma from inhaled alpha-emitting 239 Pu in the dispersible nitrate form was unlikely for cumulative doses below about 0.5 Gy (10 Sv) and below higher cumulative doses for other forms of 238 Pu and 239 Pu depending on relative potency. Lung carcinoma from inhaled beta-emitting 90 Y in relatively insoluble fused aluminosilicate particles was unlikely for cumulative doses below about 5 Gy (5 Sv) and below higher doses for inhaled particles with 91 Y, 144 Ce, or 90 Sr in order of deceasing potency.