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The committed dose in radiation protection or radiology is a measure of the stochastic (i.e., probabilistic) health effect on an individual due to an intake of radioactive material into their body. A committed dose from an internal source is intended to carry the same effective risk as the same amount of equivalent dose applied uniformly to the whole body from an external source, or the same amount of effective dose applied to part of the body. The committed dose is not intended as a measure for acute or threshold effects of radiation exposure such as erythema, radiation sickness or death. Equivalent dose is dimensionally a quantity of energy per unit of mass, and is measured in sieverts or rems. The leading model of radiation risk predicts that an effective dose of one sievert (100 rem) carries a 5.5% chance of developing cancer. The application of this model to committed dose is disputed.
Intake of radioactive material can occur through four pathways:
- inhalation of airborne contaminants such as radon,
- ingestion of contaminated food or liquids,
- absorption of vapours such as tritium oxide through the skin, or
- injection of medical radioisotopes such as technetium-99m.
An accurate evaluation of committed dose must take into account a variety of biochemical effects. The rate of biological uptake and elimination of the material will depend on its chemical nature, which is not necessarily defined by the radioisotope. The radioactive material may enter the body as part of a chemical compound, which might have very different biochemical properties from the element, and it may breakdown or undergo chemical reactions before leaving the body. Some artificial radioisotopes such as iodine-131 are chemically identical to natural isotopes needed by the body, and may be more readily absorbed if the individual has a deficit. Others have an affinity for particular tissues, such as plutonium into bone, and may be retained there for years in spite of their foreign nature.
Potassium iodide (KI), administered orally immediately after exposure, may be used to protect the thyroid from ingested radioactive iodine in the event of an accident or attack at a nuclear power plant, or the detonation of a nuclear explosive. KI would not be effective against a dirty bomb unless the bomb happened to contain radioactive iodine.
Since irradiation increases with proximity to the source, and since it is impossible to walk away from or shield an internal source, radioactive materials inside the body can deliver much higher doses to the host organs than they normally would from outside the body. This is particularly true for alpha and beta emitters that are easily shielded by skin and clothing. Some have hypothesized that alpha's high relative biological effectiveness might be attributable to cell's tendency to absorb transuranic metals into the cellular nucleus where they would be in very close proximity to the genome, though an elevated effectiveness can also be observed for external alpha radiation in cellular studies.
As in the calculations for equivalent dose and effective dose, committed dose must include corrections for the relative biological effectiveness of the radiation type and weightings for tissue sensitivity.
The dose rate from a single uptake decays over time due to both radioactive decay and biological decay. (i.e. excretion from the body.) The combined radioactive and biological half-life, called the effective half-life of the material, may range from hours for medical radioisotopes to decades for transuranic waste. Committed dose is the integral of this decaying dose rate over the presumed remaining lifespan of the organism. Most regulations require this integral to be taken over 50 years for uptakes during adulthood or over 70 years for uptakes during childhood. In dosimetry accounting, the entire committed dose is conservatively assigned to the year of uptake, even though it may take many years for the tissues to actually accumulate this dose.
There is no direct way to measure committed dose. Estimates can be made by analyzing the data from whole body counting, blood samples, urine samples, fecal samples, biopsies, and measurement of intake.
Whole body counting (WBC) is the most direct approach, but has some limitations: it cannot detect beta emitters such as tritium; it provides no chemical information about any compound that the radioisotope may be bound to; it may be inconclusive regarding the nature of the radioisotope detected; and it is a complex measurement subject to many sources of measurement and calibration error.
Analysis of blood samples, urine samples, fecal samples, and biopsies can provide more exact information about the chemical and isotopic nature of the contaminant, its distribution in the body, and the rate of elimination. Urine samples are the standard way to measure tritium intake, while fecal samples are the standard way to measure transuranic intake.
If the nature and quantity of radioactive materials taken into the body is known, and a reliable biochemical model of this material is available, this can be sufficient to determine committed dose. In occupational or accident scenarios, approximate estimates can be based on measurements of the environment that people were exposed to, but this cannot take into account factors such as breathing rate and adherence to hygiene practices. Exact information about the intake and its biochemical impact is usually only available in medical situations where radiopharmaceuticals are measured in a radioisotope dose calibrator prior to injection.
Annual limit on intake (ALI) is the derived limit for the amount of radioactive material taken into the body of an adult worker by inhalation or ingestion in a year. ALI is the intake of a given radionuclide in a year that would result in:
- a committed effective dose equivalent of 0.05 Sv (5 rems) for a "reference human body", or
- a committed dose equivalent of 0.5 Sv (50 rems) to any individual organ or tissue,
whatever dose is the smaller.
Intake of radioactive materials into the body tends to increase the risk of cancer, and possibly other stochastic effects. The International Commission on Radiological Protection has proposed a model whereby the incidence of cancers increases linearly with effective dose at a rate of 5.5% per sievert. This model is widely accepted for external radiation, but its application to internal contamination is disputed. This model fails to account for the low rates of cancer in early workers at Los Alamos National Laboratory who were exposed to plutonium dust, and the high rates of thyroid cancer in children following the Chernobyl accident. The European Committee on Radiation Risk calls the ICRP model "fatally flawed" when it comes to internal exposure.
The true relationship between committed dose and cancer is almost certainly non-linear. For example, iodine-131 is notable in that high doses of the isotope are sometimes less dangerous than low doses, since they tend to kill thyroid tissues that would otherwise become cancerous as a result of the radiation. Most studies of very-high-dose I-131 for treatment of Graves disease have failed to find any increase in thyroid cancer, even though there is linear increase in thyroid cancer risk with I-131 absorption at moderate doses.
Internal exposure of the public is controlled by regulatory limits on the radioactive content of food and water. These limits are typically expressed in becquerel/kilogram, with different limits set for each contaminant.
Intake of very large amounts of radioactive material can cause acute radiation syndrome (ARS) in rare instances. Examples include the Alexander Litvinenko poisoning and Leide das Neves Ferreira. While there is no doubt that internal contamination was the cause of ARS in these cases, there is not enough data to establish what quantities of committed dose might cause ARS symptoms. In most scenarios where ARS is a concern, the external effective radiation dose is usually much more hazardous than the internal dose. Normally, the greatest concern with internal exposure is that the radioactive material may stay in the body for an extended period of time, "committing" the subject to accumulating dose long after the initial exposure has ceased. Over a hundred people, including Eben Byers and the radium girls, have received committed doses in excess of 10 Gy and went on to die of cancer or natural causes, whereas the same amount of acute external dose would invariably cause an earlier death by ARS.
Below are a series of examples of internal exposure.
- The exposure caused by Potassium-40 present within a normal person.
- The exposure to the ingestion of a soluble radioactive substance, such as 89Sr in cows' milk.
- A person who is being treated for cancer by means of an unsealed source radiotherapy method where a radioisotope is used as a drug (usually a liquid or pill). A review of this topic was published in 1999. Because the radioactive material becomes intimately mixed with the affected object it is often difficult to decontaminate the object or person in a case where internal exposure is occurring. While some very insoluble materials such as fission products within a uranium dioxide matrix might never be able to truly become part of an organism, it is normal to consider such particles in the lungs and digestive tract as a form of internal contamination which results in internal exposure.
- Boron neutron capture therapy (BNCT) involves injecting a boron-10 tagged chemical that preferentially binds to tumor cells. Neutrons from a nuclear reactor are shaped by a neutron moderator to the neutron energy spectrum suitable for BNCT treatment. The tumor is selectively bombarded with these neutrons. The neutrons quickly slow down in the body to become low energy thermal neutrons. These thermal neutrons are captured by the injected boron-10, forming excited (boron-11) which breaks down into lithium-7 and a helium-4 alpha particle both of these produce closely spaced ionizing radiation.This concept is described as a binary system using two separate components for the therapy of cancer. Each component in itself is relatively harmless to the cells, but when combined together for treatment they produce a highly cytocidal (cytotoxic) effect which is lethal (within a limited range of 5-9 micrometers or approximately one cell diameter). Clinical trials, with promising results, are currently carried out in Finland and Japan.
Ingestion and inhalation
When radioactive compounds enter the human body, the effects are different from those resulting from exposure to an external radiation source. Especially in the case of alpha radiation, which normally does not penetrate the skin, the exposure can be much more damaging after ingestion or inhalation. The radiation exposure is normally expressed as a committed effective dose equivalent (CEDE).
The US Nuclear Regulatory commission defines some specific methods for the calculation of committed dose and names the resulting quantities:
- Committed dose equivalent (CDE) is the equivalent dose received by a particular organ or tissue from an internal source, without weighting for tissue sensitivity. This is essentially an intermediate calculation result that cannot be directly compared to final dosimetry quantities
- Committed effective dose equivalent (CEDE) is the effective dose to the entire organism from an internal source, considering the committed dose equivalent to every part of the body with its appropriate tissue sensitivity weighting. This figure is comparable to effective doses and whole-body equivalent doses, as they carry the same proportional risk.
- NRC: Glossary - Annual limit on intake (ALI)
- "The 2007 Recommendations of the International Commission on Radiological Protection". Annals of the ICRP. ICRP publication 103 37 (2-4). 2007. ISBN 978-0-7020-3048-2. Retrieved 17 May 2012.
- European Committee on Radiation Risk (2010). Busby, Chris et al, ed. 2010 recommendations of the ECRR : the health effects of exposure to low doses of ionizing radiation (Regulators' ed. ed.). Aberystwyth: Green Audit. ISBN 978-1-897761-16-8. Retrieved 18 May 2012.
- Rivkees, Scott A.; Sklar, Charles; Freemark, Michael (1998). "The Management of Graves' Disease in Children, with Special Emphasis on Radioiodine Treatment". Journal of Clinical Endocrinology & Metabolism 83 (11): 3767–76. doi:10.1210/jc.83.11.3767. PMID 9814445.
- Rowland, R.E. (1994). Radium in Humans: A Review of U.S. Studies. Argonne National Laboratory. Retrieved 24 May 2012.
- Wynn, Volkert; Hoffman, Timothy (1999). "Therapeutic Radiopharmaceuticals afrtin=2+3=9000" (PDF). Chemical Reviews 99 (9): 2269–92. doi:10.1021/cr9804386. PMID 11749482.
- US nuclear regulatory commission glossary
- Argonne national laboratory glossary
- Limitation of Exposure to Ionizing Radiation (Report No. 116). National Council on Radiation Protection and Measurements (NCRP).
- internal dosimetry
- Ionizing radiation
- Collective dose
- Total effective dose equivalent
- Cumulative dose
- Committed dose equivalent