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
*
( )
(
– .
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
*
( )
(, , ...)
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
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
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
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
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-, - , .
:
. - .
1.
1.
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
*
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
*
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
,
; 2-
Nuclear Medicine
100-200 , ,
100 3- 20
1.
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Nuclear Medicine
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Nuclear Medicine
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Nuclear Medicine
1.
1.
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
*
Estimated threshold doses. Data are primarily based on animal
experiments
Nuclear Medicine
,
, , / ,
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Nuclear Medicine
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International Atomic Energy Agency
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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
*
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
, « , » 50
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
*
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
0.1 ()/ ( )
P -
/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
0.2
0.4
0.2
0.4
beta
0.1
0.02
0.1
0.02
a/b
2
20
2
20
N
1
1
1
1
dose
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
,
, 30 , , , ,
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
( )
20
15
10
5
0
(%/)
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%
1.
1.
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 .
, , , (6% ), 10 (Doll Wakeford, 1997).
, , , .
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
*
From NCRP, 1997
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
15% /
1% /
1.
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
1.
0.06
-
(1 17)
8- 25- 5 x 10-3
b (1 200)
4- 1 x 10-3
c (1 1000)
a . ~ 0,1
b 30 IQ : 8-15 ; <30 IQ : 16 - 25
C ~ < 10
1.
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
> 15%
Nuclear Medicine
1.
1.
()
Nuclear Medicine
*
() ,
1.
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0.6
0.3
0.55
0.04
0.15
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
Tc 4.3 1.0 10-5 1.3 10-4
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
*
() () (%)
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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From L Collins 2000
1 17000 1,5 /
1.
Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
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1989
(20 / 1000 )
1.
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
10
1,4
6
1,5
2
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Part 1. Biological effects of ionizing radiation
Part 1. Biological effects of ionizing radiation
Radiation Protection in Nuclear Medicine
*
2250
30% 1300
980
30
6
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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. , . . , .
1.
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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
*
() (1000 99mTc).
?
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