of 0.15 Gy or less. Radiation Effects のホームページに 文献 Research 1 Foundation 2のデータをもとにした図表 が記載されている これを見ると 被爆者のように急激な被曝を受けた場合には 少量の線量で もリスクが増大するように思える しきい値
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1 放射線被曝と癌の関係 ( ) ここでは 医療被曝のような 急激に被曝する場合を想定して考えていきたいと思う ( 自然放射 線や原発事故の影響のある地域のような 少量で慢性的に受ける被曝についてはここでは当て はまらない可能性があるため ) 自分の不完全な知識としては 放射線により損傷を受けた DNAは修復されるが 必ずしも完全 に修復されないこともあり それが繰り返されることにより癌化する可能性が増大する なんてこ とぐらいだが 間違っていたら教えてほしい 急激に大量に受けた損傷ほど修復されにくいこと や 損傷を繰り返し受けたなら 不完全に修復された DNAが蓄積することで 問題が生じるという ことはイメージとしてつかみやすい メルクマールになりそうな論文のいくつかを見てみる 文献 は被爆者のデータ もとの論文を入手できなかったので 抄録と対応する別論文な どの図表を眺めてみることにした 文献 1によると 0~150mSV の被曝でも固形癌のリスクが増す可能性を指摘している We estimate that about 440 (5%) of the solid cance were associated with The the xcess e radiation solid cancer exposure. risks app dose even for doses -msv range. in While the excess 0 to 150 rates -related for cancers radiat increase throughout the study period, a new findi attained as well age, as being highest for those exposed representative value is that for those exposed at per sievert at age 70. 文献 2 では 5mSv 以上の被曝が癌の発生と関連している可能性を指摘している For solid all cancers as a group, about 850 it was (about estimated 11%) of tha t cohort members with colon doses in excess of 0.0 radiation The exposure. data were consistent with -to a -Gy 2linear d range, while there was some flattening of the dos a statistically significant dose response ers with when doses an
2 of 0.15 Gy or less. Radiation Effects のホームページに 文献 Research 1 Foundation 2のデータをもとにした図表 が記載されている これを見ると 被爆者のように急激な被曝を受けた場合には 少量の線量で もリスクが増大するように思える しきい値は無い もちろん リスクが増すといっても その大きさ を考慮する必要がある リスクの大きさを無視した過剰な心配はむしろ有害にさえなると思う 医 療被曝のように管理された被曝であれば そのリスクの絶対値は少ないケースがほとんどだと思 う それでも 根拠もなく 問題ない と説明したり 医療被曝について 意識をしない というのはプ ロフェッショナルとしては通用しない Table. Excess risk of developing solid cancers Cancers Weighted colon LSS dose subjects (Gy) Attributable ObservedEstimated excess risk ,789 4, % , % ,935 1, % , % , % > % Total 44,635 7, % ( 参考文献 6 より引用 ) Figure. LSS 1 solid cancer incidence, k by radiation excess The dose, relative thick 1958 solid ri line is the -averaged fitted excess linear relative sexresponse risk (ERR) at age dose 70 afte at age 30. The e is thick non-parametric a dashed lin smoothed e of estimat dose -specific category
3 risks and the es thin are one dashed standard lin below error this above smoothed es ( 参考文献 6 より引用 ) 文献 3も 0~0.1Sv の少量の被曝でも癌のリスクが増すことを示している There statistically a he significant range -0.1 and Sv, 0 an risk upper in confidence t possible threshold is computed as 0.06 Sv. It is estimates currently under consideration would not この論文のデータをもとにした図が文献 4 に記載されていた これを見ても 線量が少ないから 影響がないとは言えない 線量が少なくても癌リスクの増加はあるととらえるのが普通だ ただ 常識的な医療被曝であれば そのリスクは極めて小さいと考えるのが妥当だ 必要性を無視して 造影 CTを毎年何度も受けるような馬鹿げた被曝はかなり問題だと思うが 例えば単純 CTを 1 回受けて 10mSv 造影をするともう 1 回で 20mSv だとする 1 年に 4~5 回撮影して5 年続けた とすると これだけであっという間に 400 msv~500 msv(0.4 ~0.5 ) になる Sv Figure Illustration 4: of the relationship between dose an bomb survivor cohort; d Preston adapted [21] Note (2000). from in Pierce particular an that to low doses (<0.5 Sv), whilst consistent with a li ( 参考文献 4 より引用 ) 放射性作業従事者は 被曝線量が精確に管理されている 文献 5は平均 19.4mSv の被曝を 認める放射線作業従事者のデータ 100mSv あたり 白血病を除く癌による死亡リスクは 9.7 % ず つ増加すると報告されている この研究の対象になった集団でも 1~2% の癌による死亡が放射 線の被曝によるものと推定している
4 The excess ive relat risk for cancers leukaemia other was, 95% than 0.97 confidence per Sv interval Analyses to f death of causes related smoking o or indicate unrelated that, ough alth confounding be by present, smoking it may is all unlikely of this increased Th excess risk. relative for leukaemia risk excluding lymphocytic chr leukaemia 3 per was ( < Sv to 8.47). basis of On tes, these 1-2% of estima deaths from cancer workers amongin this cohort may be attributa The overall average cumulative recorded dose was 19.4 msv. Ourestimates suggest cumul ative that exposure a lead of 100 to msv a 9.7% would (1 19.7%) ased incre mortality excluding from all and leukaemia cancers 5.9% a -2.9 ( to 17.0%) increased from mortality all cancers ing leukaemia, exclud compared lung, and with ple background es. The ratcorresponding 19% ( < 0 figure to 84.7%) rom is leukaemia for mort excluding chronic lymphocytic leukaemia. ( 参考文献 5 より引用 ) ( 参考文献 5 より引用 ) 平均 20mSv 程度の集団なのに 評価は 100mSv あたり9.7 % とかなり大雑把 大多数が少
5 量被曝なのだから むしろ 100mSv までの間の被曝量と癌のリスクの直線的な関係を示したグラフ が示されるとスッキリするのだけれど 他の論文のように これを明示しないのには理由があ るのだろうか この点は少量の被曝の影響はハッキリしないといわれる隙を与えているような気が する ( 気づいていないだけかもしれないので 詳細が分かる人がいたら教えてほしい ) そもそも しきい値が無いことを認めるなら結論は単純 不要なリスクはあるより無い方がいいに 決まっている CTを撮らなかったばかりに失敗した経験もあるので 何とも説得力がないが 取 り敢えず CT というのもやはり慎むべきなのだと思う 参考文献 1.Preston Shimizu DL, Y, Pierce uchi DA, K. Suyama Studies atomic A, of Mabmortalit bomb survivors. Report nd noncancer 13: Solid disease cancer amortality: Radiat Res 2003 Oct;160(4): Med PubPMID: Preston DL, Ron E, S, Tokuoka Nishi N, S, Soda Funamoto K. M, Solid Mabuchi K cancer incidence in atomic bomb Radiat Jul;168(1):1 survivors: Res PubMed PMID: Pierce DA, Preston -related cancer DL. Radiation risks at atomic low doses bomb am survivors. adiat Res. R 2000 : Aug;154(2) PubMed PMID: Taylor ML, Kron T. Consideration of treatment the radiati field to patients in radiotherapy. -71.doi: J Med / D: PubMed ; PMI PubMed Central PM 5.Cardis E, Vrijheid kama M, Blettner M, Hill M, C, J, Gilbert Howe Muirhead G, E, Kald CR, Ha Schubauer -Berigan M, T, Yoshimura Bermann F, Hacker Cowper C, G, Heinmill Fix J, Marshall -Chef M, I, Thierry Utterback D, E, Ahn Ashmore YO, Amoros P, Auvinen A Solano A, JB, Combalot Biau E, Sacristan Deboodt P, A, Diez Eklof M, Enge Gulis, Habib G R, Holan Kerekes K, Hyvonen A, Kurtinaitis H, J, Mal Mastauskas onnet A, A, M Pearce Moser MS, M, Richardson -Artalejo DB, gel F, Rodrig A, Tardy -Lamberton H, Telle M, Turai I, Usel cer M, Veress after low K. Risk dose ionizing radiation: retrospective in 15 countries. cohort 9;331(7508):77 study BMJ J Epub 2005 Jun ; PubMed PubMed PMID: PMC Central PMCID: 6.Solid cancer risks -bomb survivors among. Radiation atomiceffects ホ Research ームページ
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