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International Atomic Energy Agency РАДИАЦИОННАЯ ЗАЩИТА В ЯДЕРНОЙ МЕДИЦИНЕ Часть 1: Биологические эффекты ионизирующего излучения

РАДИАЦИОННАЯ ЗАЩИТА В ЯДЕРНОЙ МЕДИЦИНЕ

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РАДИАЦИОННАЯ ЗАЩИТА В ЯДЕРНОЙ МЕДИЦИНЕ. Часть 1: Биологические эффекты ионизирующего излучения. ЦЕЛЬ. - PowerPoint PPT Presentation

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Radiation Protection in Nuclear Medicine 1:
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
*
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Radiation Protection in Nuclear Medicine
*
1896
1896 :
1902 ,
1911 ,
1911 94 ( 50 - )

1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
( )
(
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
1.

Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*



Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*



Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
- ,
- . .


Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*

1014 . 1 ( ) 1016 , 100 . , 1% , - .
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The figure is a theoretical calculation showing the efficiency of the repair capability. Certain enzymes are checking the DNA strings and initiate a repair process.
Nuclear Medicine
999 1000
999 1000 ( , )
( )
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Another example. These are obviously only rough estimates - however they may illustrate the magnitude of the problem. It could be pointed out that 1mGy is of the order of magnitude of the annual exposure of humans. Therefore the whole discussion above could be made for 1 year of life.
Nuclear Medicine
.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*



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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*

Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The image illustrates the differences in ionization densities and distribution between low LET radiation (photons) and high LET radiation (neutrons). Electrons or beta-particles will be somewhere in between
Nuclear Medicine
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The figure illustrates the connection between the primary effects of ionizing radiation and the clinical observable deterministic and stochastic effects. The time between the physical interaction and the detection of e.g. a cancer may be discussed.
Nuclear Medicine

-



Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Radiation Protection in Nuclear Medicine
*
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
0
1
2
3
4
5
6
7
8
9
10
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The fisure illustrates the concept of threshold dose. The threshold dose is the absorbed dose that is needed to create a clinically observed injury in the most rediosensitive individual. Example of threshold doses are given. The magnitude of these doses should be discussed. Give some example illutrating high dose rate activities in medicine e.g. Handling unshielded radioactive material etc.
Nuclear Medicine

1.

Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
This slide is useful to recap the concept of deterministic effects. Below a certain threshold there is no effect and beyond the threshold the effect becomes noticeable. There can be an increase in severity of the effect with dose, however, the notion of risk is not really applicable to deterministic effects.
When discussing threshold values it is important to state the points given on the next slide.
Nuclear Medicine
:
-



1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*

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From “Atlas de Histologia...”. J. Boya
1.


Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*


Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Sheet1
Radrisk.xls
2/10/01
Reference [47, Table 4-3], [48, Figure 4], [w-y] Cancer Excess Mortality (Attributable to Radiation Dose) and Years of Life Lost by Age at Exposure (death per Sv)
Age at exposure
Age range at exposure
Average years of life remaining (male) [42], [z]
Average years of life remaining (female) [42], [z]
Male Mortality, all cancers [x] (death per Sv)
Female Mortality, all cancers [x] (death per Sv)
Years of Life Lost (male) [aa]
Years of Life Lost (female) [aa]
<1 [w]
Weeks to Onset
Early transient erythema
20
>6
[w] The mortality risk values for ages <= 1 were obtained from reference [48, figure 4] presumably derived from reference [47, pp. 167-171].
[x] Average mortality rates for an age range are computed from linear interpolation between the discreet mortality values cited in references [47, 48].
[y] For people older than 85 years, we assume that the excess cancer mortality attributable to the radiation dose absorbed is apporximately the same as that for those 85.
[z] A mean age is assumed to characterize a corresponding range of ages, and the average number of years remaining from reference [49] is based on this mean age.
[aa] It is assumed that there is a 10-year period of latency [50] followed by a 10-year period of survival before death. The years of life lost is calculated here as the difference between the average years of remaining life at the mean age at exposure [
[47] A.C. Upton et al., Health Effects of Exposure to Low Levels of Ionizing Radiation BEIR V, National Research Council Committee on the Biological Effects of Ionizing Radiation, National Academy Press, Washington, D.C., p. 175 (1990).
[48] D.J. Brenner et al., "Estimated Risks of Radiation-Induced Fatal Cancer from Pediatric CT," American Journal of Roentgenology Vol. 176, pp. 289-296 (February 2001).
[49] National Center for Health Statistics, U.S. Decennial Life Tables for 1989-91, Vol. 1, No. 1, Hyattsville, Maryland, (1997).
[50] 1990 Recommendations of the International Commission on Radiological Protection, ICRP Publication 60, Annals of the ICRP, Vol. 21, No. 1-3 (1991).
Sheet1
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Radiation Protection in Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Radiation Protection in Nuclear Medicine
*
100,000
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The diagram shows the significant increase in the frequency of leukemia among the A-bomb survivors in Hiroshima the years following the exposure,
67.bin
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Some data concerning the stochastic effects among people affected by the Chernobyl accident.
Nuclear Medicine
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The diagram gives the number of thyroid cancers diagnosed in children 0-17 y the years following the Chernobyl accident. The various frequencies for the different regions is related to the exposure of the populations due to the fallout.
Diagr1
1990
1990
1990
1990
1991
1991
1991
1991
1992
1992
1992
1992
1993
1993
1993
1993
1994
1994
1994
1994
1995
1995
1995
1995
1996
1996
1996
1996
1997
1997
1997
1997
1998
1998
1998
1998
Belarus
Ukraine
Total


1998 0-17
35
5
22
62
86
10
27
123
90
10
55
155
130
19
49
198
137
47
59
243
147
41
79
267
136
36
82
254
146
45
73
264
160
73
Blad1
Belarus
Ukraine
Total
Year
Number
Thyroid cancer diagnosed up to 1998 among children 0-17 years at the time of the Chernobyl accident
Blad2
Blad3
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The figure should form the basis of how the risk of hereditary effects is calculated from animal experiments. E,g, select a number of groups of fruit flies and expose the groups with different absorbed dose. After a number of generations, count the number of flies that has an injury that must be a genetic defect e.g. the loss of wings. Calculate the frequency at different doses and determine the slope of this curve. This will be the risk/absorbed dose for one genetic property. The next problem is to multiply this figure with the number of genetic properties humans have. It should be the number that will lead to genetic death if they are changed. This figure is supposed to be around 30000. The slope of the dose-frequency curve is around 3*10-7 giving a risk figure for hereditary effects of about 1 %/Sv for all generations.
Nuclear Medicine

Neel et al. Am. J. Hum. Genet. 1990, 46:1053-1072
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Radiation Protection in Nuclear Medicine
*

1980-, - , .
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1.
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
1.
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Nuclear Medicine

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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*

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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Estimated threshold doses. Data are primarily based on animal experiments
Nuclear Medicine

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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*

Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
A listing of the different groups of exposed humans used to estimate the risk of stochastic effects.
Nuclear Medicine

Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
(/1 )


Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The first step is to determine the dose to the individuals and calculate a dose-response curve. It will generally have a sigmoid shape. The uncertainties are due to the limited number of people in each dose group. This is especially true for the heavily exposed individuals among which the majority probably died from deterministic effects.
71.unknown

3 0,37 ERR/
, 30 0,10 0,14
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Pierce DA et al, Rad Res 1996; 146:1-27
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
1986-1990
10 500 DS86- 86 572,
44% 1990 . , . 7 827 , 420 .

1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*

Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*


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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
0.1 ()/ ( )
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/B ( , DDREF).
= 2.0 , .
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The figure illustrates the concept of DDREF and the linear non threshold dose response curve.
Nuclear Medicine



()
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Dose (mGy)
0.1
2000
1
2000
2
10
2000
20
100
2000
200
1000
2000
2000
2000
2000
4000
10000
2000
alpha
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2
20
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1
1
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The figure illustrates the different steps in the development of a fatal cancer. It should be used in a discussion of the time projection models used in calculating the risk figures.
Nuclear Medicine
10

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Shimizu et al JAMA 1990, 264:601-604
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
1.


Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
1.

Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*




0 xo xo+l 90 0 xo xo+l 90

Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
This image show the difference between the two time projection models that can be used in order to estimate the radiation risk.
Bearing in mind the long latency periods and short observation times for certain types of cancer, a model must be able to predict the future risk of a single exposure. It is now generally recognized that the multiplicative model gives the best fit to epidemiological data and it has been used by ICRP in the estimates of the probability of fatal cancer. The multiplicative model is based upon the assumption that the exposure adds an extra risk per year which increases by age at the same rate as the baseline cancer mortality range. The additive model is based upon the assumption that the exposure adds an extra risk which is constant every following year.
The figure might be too complicated for technicians and nurses etc.
Nuclear Medicine


Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Nuclear Medicine
( )
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0


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1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
The diagram illustrates the increased risk for children and young people. Discuss how this knowledge should be applied in the daily work in a nuclear medicine department e.g. the importance of having special diagnostic methods for kids and why workers <18 y are not allowed in the department.
77.psd
*
(2000) .
, - 1000 9% 13% 11% . (DDREF) 2, 10 .
- = 5%
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
*
(1986-1990), LSS 12, (Pierce .., 1996) , (5% ) 50 .
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*


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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
From NCRP, 1997


Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
15% /
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1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Lots of information - this slide, while self explanatory may take 3 minutes to present. If a short lecture is to be delivered it should be omitted.
Nuclear Medicine

3 10-3 4 10-2 7 10-3 1 10-3 0.2
1992
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
This figure can be used in a discussion of national policies regarding termination of pregnancy due to medical exposure.
Dose
()

1
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Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*

() 14

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1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
NRPB (1993) Board statement on diagnostic medical exposures during pregnancy, Documents of the NRPB, 4, 1-14.
Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Cancer deaths /year/1M people
0.1
2000
1
2000
2
10
2000
20
100
2000
200
1000
2000
2000
2000
2000
4000
10000
2000
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: 23% (230/1000) - ( 5 )

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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
() () (%)
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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From L Collins 2000
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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Part 1. Biological effects of ionizing radiation
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Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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() (1000 99mTc).
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*

WHO/IAEA. Manual on Radiation Protection in Hospital and General Practice. Volume 1. Basic requirements (draft manuscript)
ICRP publications (41, 60, 84)
UNSCEAR reports
RUSSEL, J.G.B., Diagnostic radiation, pregnancy and termination, Br. J. Radiol. 62 733 (1989) 92-3.
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
..
...
.....
.........
....
050100150200250300199019911992199319941995199619971998
1998 0-17

Average
follow-up
Mean dose 0.24 Gy 1.9 Gy Inhomogeneous
Range of doses 0.01 – 6.0 Gy 0 – 8.06 Gy
Type of
Dose
()


1101001000100000.1110100100010000
Coal mining 1 in 7,000
Oil and gas extraction 1 in 8,000
Construction 1 in 16,000
Metal manufacture 1 in 34,000
All manufacture 1 in 90,000
Chemical production 1 in 100,000
All services 1 in 220,000