Putting People First in Low-Dose Radiation Research

It is urgent and feasible to improve our understanding of low-dose and low-dose-rate ionizing radiation health effects according to a new report released by the National Academies of Sciences, Engineering, and Medicine (NAS). At the request of the U.S. Congress, the NAS formed a committee of experts to conduct the study, sponsored by the U.S. Department of Energy. The report’s primary goal was to recommend a research program to increase the certainty of how exposure to low-dose and low-dose-rate radiation affects human health.  

NRDC agrees that this is the right time to reconsider low-dose interdisciplinary radiation research in the United States and explore opportunities that advances in radiation health physics and information technology are providing. A large fraction of the U.S. population is exposed to low-dose, and low-dose-rate radiation and this number is increasing. Low-dose radiation research is most relevant to impacted communities due to disproportionate level of radiation exposure these communities have experienced compared to the general U.S. population due to activities carried out as part of the U.S. nuclear weapons program. Going forward, the study should give an opportunity for stakeholders and impacted communities to have deep and meaningful engagement at all stages of the research program by identifying priorities of research that concern them. The study should also prioritize trust building and make use of local community expertise.

How are we exposed to low-dose radiation?

People are exposed to ionizing radiation from a variety of sources. Most of this exposure comes from background radiation sources and from medical procedures.

Ionizing radiation is radiation that carries with it enough energy to remove an electron from an atom. This process can initiate a chain of events leading to health problems. When considering the health effects of radiation, understanding the amount of radiation dose absorbed by a person or an organ is critical.

Low-dose and low-dose-rate (low-dose accumulated over several years) are defined to mean a dose below 100 milligray and 5 milligray per hour, respectively. Gray is a unit used to measure the amount of radiation absorbed by an object or person, reflecting the amount of energy that radioactive sources deposit in materials through which they pass. Low-dose radiation exposure includes exposure to natural radiation, medical applications, and occupational exposures. According to the NAS report, low doses of radiation delivered over long periods do not cause prompt tissue or organ damage but may cause cellular damage that increases an individual’s long-term risk of cancer and hereditary disorders in a stochastic (or probabilistic) fashion.

The NAS report identified the following seven low-dose and low-dose-rate radiation exposure sources to be relevant for the study:

• exposure from natural radiation sources
• exposure to patients from medical applications
• occupational exposures
• exposure of workers that results from nuclear power routine operations and accidents
• exposure from nuclear or radiological incidents
• exposures from the nuclear weapons program, and
• exposure from nuclear waste.

Key recommendations from the report

Research agenda

Ionizing radiation occurs in a wide range of settings and the number of exposed individuals is increasing. However, the relationship between exposure to radiation and cancer risk at the very low doses is not well established. Currently, there is also no dedicated low-dose and low-dose-rate radiation research program or coordinated research strategy in the United States.

The report recommended research programs that leverage advances in modern science to obtain direct information on low-dose and low-dose-rate radiation health effects. These are:

• advances in epidemiological study design and analysis
• advances in radiobiological research
• advances in biotechnology and research infrastructure

For the research to achieve its goals, integration and interaction between these research programs is critical.

Program funding

The report found that a significant investment over a sustained period spanning several decades is necessary to accomplish the research goals. The report estimated that $100 million annually is needed during the first 10 to 15 years with periodic assessments. The report cautioned that inadequate funding for the program would lead to the possible inadequate protection of patients, workers, and members of the public from the adverse effects of radiation.

Leadership for low-dose research in the United States

The report proposed joint Department of Energy and National Institutes of Health leadership for low-dose radiation research that involves division of tasks based on capabilities. The report also recommended that the Department of Energy take strong and transparent steps to mitigate the issues of distrust toward research that it manages.

Engagement with impacted communities

Success of the low-dose radiation program would depend not only on its scientific integrity but also on its ability to meaningfully engage and communicate with the stakeholders, which includes impacted communities.

Impacted communities, according to the report, include Indigenous communities; atomic veterans; nuclear workers; uranium miners, transporters, and their families; and individuals or communities impacted by radioactive contamination or nuclear fallout due to nuclear weapons testing, offsite radiation releases from nuclear weapons production sites, and nuclear waste cleanup activities. 

Impacted communities have strongly objected to the Department of Energy’s management of the low-dose radiation program due to the Department’s responsibility for management and cleanup of nuclear sites conflicting with its role as a manager of studies on low-dose and low-dose-rate radiation health effects.

For the success of the low-dose radiation program, the program needs to:

• develop a transparent process for stakeholder identification, engagement, and communication
• include members of the impacted communities in the independent advisory committee so that they may participate in various aspects of research planning and implementation, and
• set up additional advisory subcommittees with substantial stakeholder participation to advise on specific projects that involve human populations exposed to low-dose radiation.