NCRP REPORT No 126 UNCERTAINTIES IN FATAL CANCER RISK ESTIMATES USED IN RADIATION PROTECTION Recommendations of the NATIONAL COUNCIL ON RADIATION PROTECTIONANDMEASUREMENTS Issued October 17, 1997 National Council on Radiation Protection and Measurement 7910 Woodmont Avenue / Bethesda, Maryland 20814-3095 LEGAL NOTICE This Report was prepared by the National Council on Radiation Protection and Measurements (NCRP) The Council strives to provide accurate, complete and useful information in its documents However, neither the NCRP, the members of NCRP, other persons contributing to or assisting in the preparation of this Report, nor any person acting on the behalf of any of these parties: (a) makes any warranty or representation, express or implied, with respect to the accuracy, completeness or usefulness of the information contained in this Report, or that the use of any information, method or process disclosed in this Report may not infringe on privately owned rights; or (b) assumes any liability with respect to the use of, or for damages resulting from the use of any information, method or process disclosed in this Report, under the Civil Rights Act of 1964, Section.701 et seq a s amended 42 US.C Section 2000e et seq (Title VZZ) or any other statutory or common law theorygoverning liability Library of Congress Cataloging-in-PublicationData National Council on Radiation Protection and Measurements Uncertainties in fatal cancer risk estimates used in radiation protection :recommendations of the National Council on Radiation Protection and Measurements p cm (NCRP report ; no 126) "Issued October 1997." Includes bibliographical references and index ISBN 0-929600-57-6 Radiation carcinogenesis Cancer Mortality Cancer Risk factors Health risk assessment Radiation Dosimetry I Title 11 Series [DNLM: 1.Neoplasms, Radiation-Induced etiology Neoplasms, Radiation -Induced mortality Radiation Protection Risk Factors Radiation Dosage QZ 200 N2745c 19971 RC269.55.N36 1997 616.99'4071 dc21 97-41391 CIP Copyright O National Council on Radiation Protection and Measurements 1997 All rights reserved This publication is protected by copyright No part of this publication may be reproduced in any fonn or by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyrightowner,except for brief quotation in critical articles or reviews Preface In recent years, the practice of providing uncertainties when formulating estimates of dose and risk in human and environmental exposure circumstances has become recognized as an important step in expressing the degree of confidence appropriate to stated values Knowledge of the magnitude of uncertainties in the nominal values of the coefficient for risk of fatal cancer per unit dose can be very helpful in providing perspective to those involved in radiation protection practice In human cancer risk estimation, however, only rather tentative approaches to the evaluation of these uncertainties have been made, starting with the report of the NIH Ad Hoc Working Group on Radioepidemiological Tables in 1985 and with relatively brief attempts by the United Nations Scientific Committee on the Effects of Atomic Radiation and the National Academy of Sciences/National Research Council's Committee on the Biological Effects of Ionizing Radiation The data on mortality from the Lifespan Study of the Japanese atomic-bomb survivors up to 1985 are virtually the sole numerical source used for risk estimates for low-LET radiation exposure today (Later evaluations of the LSS data to 1987 and to 1990 are of wide interest in epidemiology but have not so far modified the risks recommended for use in radiation protection.) Other sources of risk information are used mainly to support and complement the data from the LSS In the NCRP Taylor Lecture in 1993, it was pointed out that the singularity of the LSS as a source of low-LET risk information simplifies the assessment of uncertainties in the risk estimates Because the LSS risk estimates depend on five distinct components, uncertainties overall can be evaluated by examining the uncertainties in each of these components In the 1993 Taylor Lecture, the evaluation (and discussion) of the five components was quite limited, although an overall picture was outlined The NCRP decided recently to build on that Taylor Lecture by looking at each of the five components in more detail and attempting to be more quantitative about their uncertainties This Report is the result It makes clear that the fundamental basis on which the evaluation of some of the components rests is, itself, uncertain and difficult to quantify Nevertheless, the Report seeks not only to clarify the foundation of estimates of iv / PREFACE uncertainty, but also to make a reasonable overall appraisal of the uncertainties in the average risk estimates presently used in low-LET radiation protection Risk estimates for individual organs involve greater uncertainties than for total cancer and are not dealt with specifically in this Report This Report was prepared by Scientific Committee 1-5 on Uncertainty in Risk Estimates Serving on Scientific Committee 1-5 were: Warren K Sinclair, Chairman National Council on Radiation Protection and Measurements Bethesda, Maryland Members And& Bouville National Cancer Institute Bethesda, Maryland Charles E Land National Cancer Institute Bethesda, Maryland NCRP Secretariat William M Beckner, Senior StaffScientist Cindy L O'Brien, Editorial Assistant The Council wishes to express its appreciation to the Committee members for the time and effort devoted to the preparation of this Report Charles B Meinhold President Contents Preface 111 Intmdudion 1.1 Risk Estimates for Radiation Protection 1.2 Past Risk Estimates 1.3 Present Risk Estimates 1.3.1 Age and Sex Dependence .3 1.3.2 Lifetime Risk 1.3.3 Risk Estimates for Low Dose and Dose Rate 1.4 Uncertainties in Risk Estimates 1.4.1 Past Uncertainty Evaluations 1.4.2 NCRP Approach to Uncertainty in Risk Estimates for Radiation Protection 1.4.3 City Differences 1.5 Dose Response Epidemiological Uncertainties 10 2.1 Introduction 10 2.2 Specific Epidemiological Uncertainties 13 2.3 Bias in Risk Estimates Due to Errors of Detection and Confirmation 16 2.4 Biases Affecting Risk Estimates of Cancer Morbidity 18 2.5 Unrepresentative Population 20 2.6 Bias Deriving from City Differences 21 2.7 Summary of Epidemiological Uncertainty - 2 Dosimetrical Uncertainty 23 3.1 Random Errors and Biases 23 3.2 Bias Resulting from Random Errors in Dose 24 3.3 Bias in Gamma-Ray Measurements Versus DS86 30 3.4 Uncertainty Due to Survivor Shielding Characterization in DS86 32 3.5 Uncertainty Due to Neutron Weight (Relative Biological Effectiveness) 32 3.6 Bias and Uncertainties Due to the Presence of Thermal Neutrons a t Hiroshima in Excess of Those Predicted by DS86 34 3.7 Combination of Uncertainties and Bias for Dosimetry 37 vi / CONTENTS Transfer of Risk Between Populations 40 4.1 General Considerations 40 4.2 Factors Modifying Risk in Relation to Transfer Between Populations 42 4.3 Site-Specific Evidence for Selecting the Transfer Model -47 4.4 Uncertainty Due to Method of Transfer 49 Projection to Lifetime Risk 51 5.1 Constant Relative Risk Projection Model 51 5.2 Considerations Regarding the Projection to Lifetime 5.3 5.4 5.5 Risks in the Lifespan Study 51 Attained Age Model 53 Lifetime Risk of Those Exposed a t Young Ages 55 Uncertainty in Lifetime Risk 57 Extrapolation to Low Dose or Dose Rate 6.1 Effect of Dose Rate and Dose in Radiobiology 6.1.1 The Effect of Dose Rate 6.1.2 The Effect of Dose 6.2 Human Data and Dose-Rate Effects 6.3 The ICRP Choice of a Dose and Dose-Rate 60 60 60 60 61 Effectiveness Factor 63 6.4 The NCRP Position on the Application of a Dose and Dose-Rate Effectiveness Factor 64 6.5 UNSCEAR Evaluation of a Dose and Dose-Rate Effectiveness Factor and Recent Studies 64 6.6 Uncertainties in the Application of a Dose and Dose-Rate Effectiveness Fador 65 Combination of Uncertainties 67 7.1 Sources of Uncertainty 67 7.2 Method to Propagate Uncertainties 69 7.3 Results 71 7.3.1 Population of A11 Ages 71 7.3.2 Adult Worker Population 73 7.4 Conclusions 74 Glossary 77 References 83 TheNCRP 92 NCRPPublications 100 Index 109 Introduction 1.1 Risk Estimates for Radiation Protection This Report is concerned with the evaluation of uncertainties in the risk estimates of fatal cancer induced by low-LET radiation (see Glossary) as presently used in radiation protection, i.e., in estimates of the risk of fatal cancer following exposure of individuals or populations in occupational, environmental or domestic circumstances These cancers are the main component of the health detriment following radiation exposure identified by the International Commission on Radiological Protection [ICRP (1991)l and the National Council on Radiation Protection and Measurements [NCRP (1993a)l as pertinent in low-LET radiation protection Recent evaluations of the risk of fatal cancer induced by low-LET radiation are numerically based on the 1950 to 1985 mortality experience of the survivors of the atomic bombs dropped in Japan, as ascertained by the Lifespan Study (LSS) (EPA, 1994; ICRP, 1991; NASLNRC, 1990; NCRP, 1993a; NRPB, 1993; UNSCEAR, 1988) Other epidemiological studies, although they can be highly informative with regard to particular cancer sites, have served mainly to support the results from the LSS, and to show that the LSS results are not isolated, but are generally and broadly supported by these other sources of data Later evaluations of induced fatal cancer risk in the LSS include the mortality and incidence data up to 1987 reviewed by the United Nations Scientific Committee on the Effects of Atomic Radiation [UNSCEAR (199411 and the more recent mortality evaluations up to 1990 (Pierce et al., 1996a) These new studies provide additional information, especially on cancer incidence, but they not alter substantially the risk estimates derived in the 1988 to 1990 reports and, more especially, the derivation procedure, which is the source of the uncertainty considerations, remains the same Not all aspects of radiation protection (notably those involving high-LET exposures)use risk estimates based on the LSS of the atomic-bomb survivors For example, any consideration of radon exposure to workers or to the public uses risk estimates based on radon 1 INTRODUCTION exposures to miners However, many radiation protection situations in which risk is at issue will use the results of the LSS The results of the.LSS indicate that lifetime risk coefficients for fatal cancer derived from the high-dose rate exposures of the SV-' for a population of atomic-bomb survivors are about 10 x all ages and about x S V - ~ for an adult (worker) population 1.2 Past Risk Estimates It is worth noting, [see Table 1.1,taken from ICRP (1991), Table B-101 that lifetime risk estimates for an acute exposure [i.e., no dose and dose-rate effectiveness factor (DDREF) applied1] have ranged over t,he period 1972 to 1990 from about to about Table 1.1-Excess lifetime mortality from all cancer, attributable to 1Gy (or 1Sv)acute uniform whole-body low-LET irradiation of the general population (ICRP, 1991) Probability of Death Source of Estimate NASNRC, 1972 UNSCEAR, 1977 NASNRC, 1980 Evans et al., 1985 UNSCEAR, 1988* NASNRC, 1990d Gilbert, 1991d Additive Risk Projection Model Multiplicative Risk Projection Model 6.2 - 2.3 to 5.0 5.2 7.0' to 11.0~ 8.gdP.f 7.1d a Population of Japan Estimate based on age-specific coefficients of probability 'Estimate based on constant (age-averaged) coefficient of probability United States population Modified multiplicative model "LOW-dose"leukemia component multiplied by two or low-LET radiation, the ratio between the biological effect of high-dose rate radiation to that of the effect of low-dose rate radiation a t the same dose is known as the dose and dose-rate effectiveness factor, DDREF 1.3 PRESENT RISK ESTIMATES / 11x SV-lwith the type of projection model used being one of the largest contributorsto the variation of risk estimates Risk estimates have been more consistent over time when the multiplicative risk projection model is used UNSCEAR, BEIR I11 [Committee on the Biological Effects of Ionizing Radiation of the National Academy of ScienceslNational Research Council (NASINRC)],ICRP and NCRP, in the period 1977 to 1980, were all in substantial agreement about estimates of lifetime risk coefficients for fatal cancer that were several times lower SV-l, compared with to than those in use now (about 1to x 5x SV-~) Evident1y;risk values agreed upon today must still be considered subject to future change as different information comes forward on any of those aspects on which the estimates are based 1.3 Present Risk Estimates The ICRP (1991) and the NCRP (1993b) have further derived the nominal values of risk to be used for (low-dose rate) radiation protection as x SV-l for a population of all ages and x ~o-~sv-' for adult workers, after dividing the average high-dose rate estimate by a DDREF of two It is uncertainties in these estimates of risk, now widely used in radiation protection, with which this Report is concerned 1.3.1 Age and Sex Dependence These risk estimates apply to the populations specified If the age and sex of the population group is known in more detail, tables such as Table 1.2 can be used to apply risk estimates more accurately More detail on age and sex dependencies is provided in references such as Land and Sinclair (1991) and Pierce et al (1996a) 1.3.2 Lifetime Risk The term "lifetime risk estimate" is not a unique description of the risk resulting from exposure to a tumor inducing agent For a detailed discussion of some of the issues relating to lifetime risk see Thomas et al (1992) and UNSCEAR (1994) One point only with reference to lifetime risk estimates will be cited here It concerns the choice of "risk of exposure-induced death* (REID) or the choice of "excess lifetime riskn (ELR) as a measure of radiation-related / 1.INTRODUCTION Table 1.2-Fatal cancer risk for different ages and sex after low SU-l) (Sinclair, 1992).a dose or low-dose rate exposure (x Age (Y) Male Female Average 'United States population, average of multiplicative and NIH transfer models (Land and Sinclair, 1991) population detriment REID represents the probability of an "untimely" death due to exposure ELR is the difference between the probability of a cancer death given a specific exposure history and the probability of a cancer death in the absence of the specific exposure history Consequently, the REID includes the exposure-induced earlier deaths of those who would have later died of cancer without the exposure Because about 20 percent of the population would be expected to die of cancer in the absence of radiation exposure, the REID is about 20 percent higher than the ELR for all cancer sites combined for uniform whole-body exposure For exposure limited to a single organ (e.g.,salivary gland, for which lifetime mortality rates are considerably below one percent) the REID and the ELR are more closely comparable It should also be pointed out that single values (point estimates) of lifetime risk coefficients not convey the wealth of information already known about sex and age variations in risk, which should usually be accounted for when dealing with specific practical situations Consequently, uncertainties in past estimates are only a beginning to the consideration of uncertainties in many risk circumstances Furthermore, uncertainties in risk estimates for individual organ and tissue sites are also of practical importance and probably differ among themselves; but these will not be addressed in this Report 1.3.3 Risk Estimates for Low Dose and Dose Rate The lifetime risk coefficients presently recommended by ICRP and NCRP were derived from the LSS data of the atomic-bomb survivors taking into account the following evaluations: (1)the REID values given by UNSCEAR (1988)for the multiplicative projection model for the period of observation to the end of life and a Japanese 98 / THENCRP New York Power Authority Nuclear Energy Institute Southern California Edison Company Westinghouse Electric Corporation The Council's activities are made possible by the voluntary contribution of time and effort by its members and participants and the generous support of the following organizations: Agfa Corporation Alfred P Sloan Foundation Alliance of American Insurers American Academy of Dermatology American Academy of Health Physics American Academy of Oral and Maxillofacial Radiology American Association of Physicists i n 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North America Richard Lounsbery Foundation Sandia National Laboratory Siemens Medical Systems, Inc Society of Nuclear Medicine Society of Pediatric Radiology United States Department of Energy United States Department of Labor United States Environmental Protection Agency United States Navy United States Nuclear Regulatory Commission Victoreen, Inc Initial funds for publication of NCRP reports were provided by a grant from the James Picker Foundation The NCRP seeks to promulgate information and recornmen-dations based on leading scientificjudgment on matters of radiation protection and measurement and to foster cooperation among organizations concerned with these matters These efforts are intended to serve the public interest and the Council welcomes comments and suggestions on its reports or activities from those interested in its work NCRP Publications Information on NCRP publications may be obtained from the NCRP website (http://www.ncrp.com) or by telephone (800-229-2652) and fax (301-907-8768) The address is: NCRP Publications 7910 Woodmont Avenue Suite 800 Bethesda, MD 20814-3095 Abstracts of NCRP reports published since 1980,abstracts o f all NCRP commentaries, and the text of all NCRP statements are available at the NCRP website Currently available publications are listed below NCRP Reports No Title Control and Removal of Radioactive Contamination in Laboratories (1951) Maximum Permissible Body Burdens and Maximum Permissible Concentrations of Radionuclides in Air and i n Water for Occupational Exposure (1959)[IncludesAddendum issued i n August 19631 Measurement of Neutron Flux and Spectra for Physical and Biological Applications (1960) Measurement ofAbsorbed Dose of Neutrons, and of Mixtures of Neutrons and Gamma Rays (1961) Stopping Powers for Use with Cavity Chambers (1961) Safe Handling of Radioactive Materials (1964) Radiation Protection i n Educational Institutions (1966) Dental X-Ray Protection (1970) Radiation Protection i n Veterinary Medicine (1970) Precautions i n the Management of Patients Who Have Received Therapeutic Amounts of Radionuclides (1970) Protection Against Neutron Radiation (1971) Specification of Gamma-Ray Brachytherapy Sources (1974) NCRP PUBLICATIONS / 101 42 Radiological Factors Mecting Decision-Making i n a Nuclear Attack (1974) 44 Krypton-85 in the Atmosphere-Accumulation, Biological Significance, and Control Technology (1975) 46 Alpha-Emitting Particles i n Lungs (1975) 47 Tritium Measurement Techniques (1976) 49 Structural Shielding Design and Evaluation for Medical Use of X Rays and Gamma Rays of Energies Up to 10 MeV (1976) 50 Environmental Radiation Measurements (1976) 52 Cesium-137 from the Environment to Man: Metabolism and Dose (1977) 54 Medical Radiation Exposure of Pregnant and Potentially Pregnant Women (1977) 55 Protection of the Thyroid Gland i n the Event of Releases of Radioiodine (1977) 57 Instrumentation and Monitoring Methods for Radiation Protection (1978) 58 A Handbook of Radioactivity Measurements Procedures, 2nd ed (1985) 59 Operational Radiation Safety Program (1978) 60 Physical, Chemical, and Biological Properties of Radiocerium Relevant to Radiation Protection Guidelines (1978) 61 Radiation Safety Training Criteria for Industrial Radiography (1978) 62 Tritium i n the Environment (1979) 63 Tritium and Other Radionuclide Labeled Organic Compounds Incorporated i n Genetic Material (1979) 64 Influence of Dose and Its Distribution in Time on Dose-Response Relationships for Low-LET Radiations (1980) 65 Management of Persons Accidentally Contaminated with Radionuclides (1980) 67 Radiofrequency Electromagnetic Fields-Properties, Quantities and Units, Biophysical Interaction, and Measurements (1981) 68 Radiation Protection i n Pediatric Radiology (1981) 69 Dosimetry of X-Ray and Gamma-Ray Beams for Radiation Therapy i n the Energy Range 10 keV to 50 MeV (1981) 70 Nuclear Medicine-Factors Influencing the Choice and Use of Radionuclides in Diagnosis and Therapy (1982) 71 Operational Radiation Safety-Training (1983) 72 Radiation Protection and Measurement for Low-Voltage Neutron Generators (1983) 73 Protection i n Nuclear Medicine and Ultrasound Diagnostic Procedures i n Children (1983) 74 Biological Effects of Ultrasound: Mechanisms and Clinical Implications (1983) 75 Iodine-129: Evaluation of Releases from Nuclear Power Generation (1983) 102 / NCRP PUBLICATIONS 77 Exposures from the Uranium Series with Emphasis on Radon and Its Daughters (1984) 78 Evaluation of Occupational and Environmental Exposures to Radon and Radon Daughters in the United States (1984) 79 Neutron Contamination from Medical Electron Accelerators (1984) 80 Induction of Thyroid Cancer by Ionizing Radiation (1985) 81 Carbon-14 in the Environment (1985) 82 SI Units in Radiation Protection and Measurements (1985) 83 The Experimental Basis for Absorbed-Dose Calculations i n Medical Uses of Radionuclides (1985) 84 General Concepts for the Dosimetry of Internally Deposited Radionuclides (1985) 86 Biological Effects and Exposure Criteria for Radiofrequency Electromagnetic Fields (1986) 87 Use of Bioassay Procedures for Assessment of Internal Radionuclide Deposition (1987) 88 Radiation Alarms and Access Control Systems (1986) 89 Genetic Effects from Internally Deposited Radionuclides (1987) 90 Neptunium: Radiation Protection Guidelines (1988) 92 Public Radiation Exposure from Nuclear Power Generation i n the United States (1987) 93 Ionizing Radiation Exposure of the Population of the United States (1987) 94 Exposure of the Population i n the United States and Canada from Natural Background Radiation (1987) 95 Radiation Exposure of the U S Population from Consumer Products and Miscellaneous Sources (1987) 96 Comparative Carcinogenicity of Ionizing Radiation and Chemicals (1989) 97 Measurement of Radon and Radon Daughters in Air (1988) 98 Guidance on Radiation Received i n Space Activities (1989) 99 Quality Assurance for Diagnostic Imaging (1988) 100 Exposure of the U S Population from Diagnostic Medical Radiation (1989) 101 Exposure of the U S Population from Occupational Radiation (1989) 102 Medical X-Ray, Electron Beam and Gamma-Ray Protection for Energies Up to 50 MeV (Equipment Design, Pefirmance and Use) (1989) 103 Control of Radon i n Houses (1989) 104 The Relative Biological Effectiveness of Radiations of Different Quality (1990) 105 Radiation Protection for Medical and Allied Health Personnel (1989) 106 Limit for Exposure to "Hot Particles" on the Skin (1989) NCRP PUBLICATIONS / 103 107 Implementation of the Principle o f A s Low As Reasonably Achievable ( ' L A W for Medical and Dental Personnel (1990) 108 Conceptual Basis for Calculations ofAbsorbed-Dose Distributions (1991) 109 Effects of Ionizing Radiation on Aquatic Organisms (1991) 110 Some Aspects of Strontium Radiobiology (1991) 111 Developing Radiation Emergency Plans for Academic, Medical or Industrial Facilities (1991) 112 Calibration of Survey Instruments Used in Radiation Protection for the Assessment of Ionizing Radiation Fields and Radioactive Surface Contamination (1991) 113 Exposure Criteria for Medical Diagnostic Ultrasound: I Criteria Based on Thermal Mechanisms (1992) 114 Maintaining Radiation Protection Records (1992) 115 Risk Estimates for Radiation Protection (1993) 116 Limitation of Exposure to Ionizing Radiation (1993) 117 Research Needs for Radiation Protection (1993) 118 Radiation Protection in the Mineral Extraction Industry (1993) 119 A Practical Guide to the Determination of Human Exposure to Radiofrequency Fields (1993) 120 Dose Control at Nuclear Power Plants (1994) 121 Principles and Application of Collective Dose in Radiation Protection (1995) 122 Use of Personal Monitors to Estimate Effective Dose Equivalent and EffectiveDose to Workersfor External Exposure to Low-LET Radiation (1995) 123 Screening Models for Releases of Radionuclides to Atmosphere, Surface Water, and Ground (1996) 124 Sources and Magnitude of Occupational and Public Exposures from Nuclear Medicine Procedures (1996) 125 Deposition, Retention and Dosimetry of Inhaled Radioactive Substances (1997) 126 Uncertainties in Fatal Cancer Risk Estimates Used in Radiation Protection (1997) Binders for NCRP reports are available Two sizes make it possible to collect into small binders the "old series" of reports (NCRP Reports Nos 8-30) and into large binders the more recent publications (NCRP Reports Nos 32-126).Each binder will accommodate from five to seven reports The binders c a n y the identification "NCRP Reports" and come with label holders which permit the user to attach labels showing the reports contained in each binder The following bound sets of NCRP reports are also available: Volume I NCRP Reports Nos 8,22 Volume 11 NCRP Reports Nos 23,25,27,30 Volume ID NCRP Reports Nos 32,35,36,37 104 / NCRP PUBLICATIONS Volume IV.NCRP Reports Nos 38,40,41 Volume V NCRP Reports Nos 42,44,46 Volume VI NCRP Reports Nos 47,49,50,51 Volume VII NCRP Reports Nos 52,53,54,55,57 Volume VIII NCRP Report No 58 Volume IX NCRP Reports Nos 59,60,61,62,63 Volume X NCRP Reports Nos 64,65,66,67 Volume XI.NCRP Reports Nos 68,69,70,71,72 Volume XII NCRP Reports Nos 73,74,75,76 Volume XIII NCRP Reports Nos 77,78,79,80 Volume XTV NCRP Reports Nos 81,82,83,84,85 Volume XV.NCRP Reports Nos 86,87,88,89 Volume XVI NCRP Reports Nos 90,91,92,93 Volume XVII.NCRP Reports Nos 94,95,96,97 Volume XVIII.NCRP Reports Nos 98,99,100 Volume XM NCRP Reports Nos 101,102,103,104 Volume XX NCRP Reports Nos 105,106,107,108 Volume XXI NCRP Reports Nos 109,110,111 Volume XXII.NCRP Reports Nos 112,113,114 Volume XXIII NCRP Reports Nos 115,116,117,118 Volume XXW NCRP Reports Nos 119,120,121,122 Volume XXV NCRP Report No 1231 and 12311 (Titles of the individual reports contained in each volume are given above.) NCRP Commentaries No Title Krypton-85 i n the Atmosphere-With Specific Reference to the Public Health Significance of the Proposed Controlled Release at Three Mile Island (1980) Screening Techniques for Determining Compliance with Environmental Standards-Releases of Radionuclides to the Atmosphere (1986),Revised (1989) Guidelines for the Release of Waste Water from Nuclear Facilities with Special Reference to the Public Health Significance of the Proposed Release of Treated Waste Waters at Three Mile Island (1987) Review of the Publication, Living Without Landfills (1989) Radon Exposure of the U S Population-Status of the Problem (1991) Misadministration of Radioactive Material i n Medicine-Scientific Background (1991) NCRP PUBLICATIONS / 105 10 11 12 13 14 Uncertainty i n NCRP Screening Models Relating to Atmospheric Transport, Deposition and Uptake by Humans (1993) Considerations Regarding the Unintended Radiation Exposure of the Embryo, Fetus or Nursing Child (1994) Advising the Public about Radiation EmergenciesrA Document for Public Comment (1994) Dose Limits for Individuals Who Receive Exposure from Radionuclide Therapy Patients (1995) Radiation Exposure and High-Altitude Flight (1995) An Introduction to Efficacy in Diagnostic Radiology and Nuclear Medicine (Justification of Medical Radiation Exposure) (1995) A Guide for Uncertainty Analysis i n Dose and Risk Assessments Related to Environmental Contamination (1996) Proceedings of the Annual Meeting No Title Perceptions ofRisk, Proceedings of the Fifteenth Annual Meeting held on March 14-15, 1979 (including Taylor Lecture No 3) (1980) Critical Issues in Setting Radiation Dose Limits, Proceedings of the Seventeenth Annual Meeting held on April 8-9,1981 (including Taylor Lecture No 5) (1982) Radiation Protection and New Medical Diagnostic Approaches, Proceedings of the Eighteenth Annual Meeting held on April 6-7, 1982 (includingTaylor Lecture No 6) (1983) Environmental Radioactivity, Proceedings of the Nineteenth Annual Meeting held on April 6-7, 1983 (including Taylor Lecture No 7) (1983) Some Issues Important in Developing Basic Radiation Protection Recommendations, Proceedings of the Twentieth Annual Meeting held on April 4-5,1984 (includingTaylor Lecture No 8) (1985) Radioactive Waste, Proceedings of the Twenty-first Annual Meeting held on April 3-4,1985 (including Taylor Lecture No 9)(1986) Nonionizing Electromagnetic Radiations and Ultrasound, Proceedingsof the Twenty-secondAnnual Meeting held on April 2-3,1986 (includingTaylor Lecture No 10) (1988) New Dosimetry at Hiroshima and Nagasaki and Its Implications for Risk Estimates, Proceedings of the Twenty-third Annual Meeting held on April 8-9, 1987 (including Taylor Lecture No 11)(1988) Radon, Proceedings of the Twenty-fourthAnnual Meeting held on March 30-31,1988 (including Taylor Lecture No 12) (1989) 106 / NCRP PUBLICATIONS 11 Radiation Protection Today-The NCRP at Sixty Years, Proceedings of the Twenty-fifth Annual Meeting held on April 5-6, 1989 (including Taylor Lecture No 13) (1990) 12 Health and Ecological Implications of Radioactively Contaminated Environments, Proceedings of the Twenty-sixth Annual Meeting held on April 4-5,1990 (including Taylor Lecture No 14) (1991) 13 Genes, Cancer and Radiation Protection, Proceedings of the Twenty-seventh Annual Meeting held on April 3-4,1991 (including Taylor Lecture No 15) (1992) 14 Radiation Protection i n Medicine, Proceedings of the Twenty-eighth Annual Meeting held on April 1-2, 1992 (including Taylor Lecture No 16) (1993) 15 Radiation Science and Societal Decision Making, Proceedings of the Twenty-ninth Annual Meeting held on April 7-8,1993 (including Taylor Lecture No 17) (1994) 17 Environmental Dose Reconstruction and Risk Implications, Proceedings of the Thirty-first Annual Meeting held on April 12-13, 1995 (including Taylor Lecture No 19) (1996) 18 Implications of New Data on Radiation Cancer Risk, Proceedings of the Thirty-second Annual Meeting held on April 3-4, 1996 (including Taylor Lecture No 20) (1997) Lauriston S Taylor Lectures No Title The Squares of the Natural Numbers in Radiation Protection by Herbert M Parker (1977) Why be Quantitative about Radiation Risk Estimates? by Sir Edward Pochin (1978) Radiation Protection Concepts and Trade Offsby Hymer L Friedell (1979) [Available also in Perceptions of Risk, see above] R o m "Quantity of Radiation" and "Dose" to UExposure"and Xbsorbed Dose9'-An Historical Review by Harold 0.Wyckoff (1980) How Well Can WeAssess Genetic Risk? Not Very by James F Crow (1981) [Available also in Critical Issues in Setting Radiation Dose Limits, see above] Ethics, Trade-offsand Medical Radiation by Eugene L Saenger (1982) [Available also in Radiation Protection and New Medical Diagnostic Approaches, see above] The Human Environment-Past, Present and Future by Merril Eisenbud (1983) [Available also in Environmental Radioactivity, see above] NCRP PUBLICATIONS / 107 Limitation and Assessment in Radiation Protection by Harald H Rossi (1984) [Available also in Some Issues Important in Developing Basic Radiation Protection Recommendations, see above] D u t h (and Beauty) in Radiation Measurement by John H Harley (1985) [Available also in Radioactive Waste, see abovel Biological Effects of Non-ionizing Radiations: Cellular Properties and Interactions by Herman P Schwan (1987)[Available also in Nonionizing Electromagnetic Radiations and Ultrasound, see above] How to be Quantitative about Radiation Risk Estimates by Seymour Jablon (1988) [Available also in New Dosimetry at Hiroshima and Nagasaki and its Implications for Risk Estimates, see above] How Safe is Safe Enough? by Bo Lindell(1988) [Available also in Radon, see above] Radiobiology and Radiation Protection: The Past Century and Prospects for the Future by Arthur C Upton (1989) [Available also in Radiation Protection Today, see abovel Radiation Protection and the Internal Emitter Saga by J Newel1 Stannard (1990) [Available also in Health and Ecological Implications of Radioactively Contaminated Environments, see above] When is a Dose Not a Dose? by Victor P Bond (1992) [Available also in Genes, Cancer and Radiation Protection, see abovel Dose and Risk in Diagnostic Radiology: How Big? How Little? by Edward W Webster (1992)[Available also i n Radiation Protection in Medicine, see above] Science, Radiation Protection and the NCRP by Warren K Sinclair (1993)[Available also in Radiation Science and Societal Decision Making, see above] Mice, Myths and Men by R.J Michael Fry (1995) Symposium Proceedings No Title The Control of Exposure of the Public to Ionizing Radiation in the Event of Accident or Attack, Proceedings of a Symposium held April 27-29, 1981 (1982) Radioactive and Mired Waste-Risk as a Basis for Waste Classification, Proceedings of a Symposium held November 9, 1994 (1995) Acceptability of Risk from Radiation-Application to Human Space Flight, Proceedings of a Symposium held May 29,1996 (1997) 108 / NCRP PUBLICATIONS NCRP Statements No Title "Blood Counts, Statement of the National Committee on Radiation Protection," Radiology 63,428 (1954) "Statements on Maximum Permissible Dose from Television Receivers and Maximum Permissible Dose to the Skin of the Whole Body," Am J Roentgenol., Radium Ther and Nucl Med 84,152 (1960) and Radiology 75,122 (1960) X-Ray Protection Standards for Home Television Receivers, Interim Statement of the National Council on Radiation Protection and Measurements (1968) Specification of Units of Natural Uranium and Natural Thorium, Statement of the National Council on Radiation Protection and Measurements (1973) NCRP Statement on Dose Limit for Neutrons (1980) Control of Air Emissions of Radionuclides (1984) The Probability That a Particular Malignancy May Have Been Caused by a Specified Irradiation (1992) Other Documents The following documents of the NCRP were published outside of the NCRP report, commentary and statement series: Somatic Radiation Dose for the General Population, Report of the Ad Hoc Committee of the National Council on Radiation Protection and Measurements, May 1959, Science, February 19, 1960, Vol 131, No 3399, pages 482-486 Dose Effect Modifjling Factors I n Radiation Protection, Report of Subcommittee M-4 (Relative Biological Effectiveness) of the National Council on Radiation Protection and Measurements, Report BNL 50073 (T-471) (1967) Brookhaven National Laboratory (National Technical Information Service Springfield, Virginia) Index Absolute risk (AR) 77 Absorbed dose 62,77 induced tumor incidence 62 Additive (absolute risk) model 77 Additive risk projection model Adult worker population 73 uncertainties in risk 73 Age and sex dependence Atomic-bomb survivors Attained age model 53 lifetime risks 53 Baseline rate 77 Benign gynecological disease 48 stomach doses 48 Biases 18,21,23,24,30,34 due to thermal neutrons 34 in gamma-ray measurements 30 random errors 23 risk estimates 18 Cancer morbidity 18 risk estimates 18 Chromosome aberrations 35 induced by neutrons 35 City dmerences 8,21 bias 21 risk estimates Coefficients of probability age-averaged age-specific Coefficient of variation 77 Collective dose 77 Colon cancer 48 Combined uncertainties Competing risks 77 Confidence interval 6,77 Confirmation error 16 Detection error 16 Deviance 77 Dose 77 Dose and dose-rate effectiveness factor (DDREF) 2,7,63,64, 65,77 NCRP position 64 uncertainties in 65 UNSCEAR evaluation 64 Dose-effect (dose-response) model 77 Dose estimates 25 uncertainties in 25 Dose rate 60, 77 effects 60 Dose rate and dose 60 effect 60 in radiobiology 60 Dose rate effect 61 human data 61 Dose response 8,9,12,15 by site 12 DDREF linear linear quadratic 8,15 supralinear Dosmetrical uncertainties 7,23, 36,38 Effect of dose 60 Effective dose 78 Epidemiological uncertainties 7, 22 summary of 22 Equivalent dose 78 Errors 16 due to misclassification 16 110 / INDEX of confirmation 16 of detection 16 Excess absolute risk (EAR) 78 Excess lifetime mortality additive risk projection model all cancer multiplicative risk projection model Excess lifetime risk (ELR) 3,78 Excess relative risk (ERR)11,78 Fatal cancer risk different ages and sex Fractionation 78 Gamma radiation 78 Gamma-ray dose estimates 31 distribution of uncertainties 31 Gamma-ray measurements 30 bias 30 Geometrical standard deviations (GSD) 6,78 Geometric mean (GM) 78 Gray (Gy) 78 Health detriment 78 Healthy worker effect Hiroshima and Nagasaki 30 risk estimates 30 Incidence 78 Individual organs 31 risk coefficients 31 Individual uncertainty Kerma (kinetic energy released per unit mass of material) 23, 78 fission product (delayed) gamma ray 23 fission product (delayed) neutron 23 prompt gamma ray 23 prompt neutron 23 Lag period 79 Latent period or latency 79 Lifespan Study (LSS) 1,10,79 number of people 10 shielded kerma 10 total sample 10 Lifetime excess risk 43 by age at exposure 43 Lifetime projection model 59 uncertainty in risk due to 59 Lifetime risk 51,53, 55,57,79 attained age model 53 in the Lifespan Study 51 relative risk projection model 51 those exposed at young ages 55 Lifetimerisk coefficient 2,3,4,6, 14,57,74 atomic-bomb survivors fatal cancer , high-dose and dose rate 14 modular components point estimates probability distribution 74 uncertainty in 57 Lifetime risk estimate population of all ages workers Lifetime risk of solid tumors 56 projection methods 56 Linear energy transfer (LET) 79 Linear model 79 Linear-quadratic model 79 Log-normal distribution 79 Low dose 5,79 Low-dose rate 5,79 Mean 79 Median 79 Method of transfer 49 uncertainty 49 Misclassification 16, 17,22 ascertainment errors 22 90 percent confidence limits 17 cancer deaths 16 INDEX / 111 noncancer deaths 16 probability of 17 Mode 80 Monte Carlo calculation 80 Monte Carlo methods Mortality (rate) 80 Mortality risks 54 for all cancers except leukemia 54 Multiplicative model 80 Multiplicative risk projection model , risk estimates Multiplicative transfer 80 Neutron 80 Neutron component a t Hiroshima 37 distribution of uncertainties 37 Neutron weight 21,28 RBE 28 NIH transfer (model) 80 Normal distribution 80 Null hypothesis 11 alternative hypothesis 11 Oncogenes 80 Peptic ulcer patients 47 stomach cancer mortality 47 Person-gray 80 Person-year (PY)80 Population of all ages lifetime risk estimates Population transfer model Projection model 80 Projection to lifetime Promoter Radiation-induced cancer 42 relative risk 42 Radiation weighting factor (wR) 24,81 Random error 7,23,24 biases 23,24 Hiroshima and Nagasaki 24 in dose estimates 24 Relative biological effectiveness (RBE) 32,81 uncertainties 32 Relative risk (RR) 42,81 radiation-induced cancer 42 Relative risk projection model 51 lifetime risk 51 Risk 81 Risk coefficient Risk estimate 1,3,4,5,6,8,13, 14,16, 18,30,81 age and sex dependence biased estimate 13 bias in 16, 18 cancer morbidity 18 city differences evaluation of uncertainties fatal cancer high-dose and dose rate 14 Hiroshima and Nagasaki 30 lifetime risk low dose and dose rate multiplicative risk projection model present presently recommended uncertainties , Risk of exposure-induced death (REID) 3,81 Risk projection model additive modified multiplicative multiplicative Saturation 15 Shielded kerma 11,81 SI units Sievert 81 Significance level Standard deviation 82 Standard deviation of the mean 82 Standard error 82 Statistical uncertainties 15,22 distribution 15 Stochastic effects 82 112 f INDEX Stomach cancer data 47 Stomach cancer mortality 47 peptic ulcer patients 47 Systematic errors 23 Thermoluminescence dosimetry 30 measurements 30 Threshold hypothesis 82 Tissue weighting factor (wT)5,82 Transfer model 47 evidence for selecting 47 Transfer of risk between populations 40,42 factors modifying risk 42 general considerations 40 Transformed cells 82 Triangular distribution 82 Tumor Registry 19 Uncertainty analysis 14 Uncertainty evaluations Uncertainties 10,13,22,23,25, 26,29,31,32,33,34,35,49 distribution of 29,31 dosimetrical23 due to choice of W 35 due to random errors 26 due to neutron weight 32 due to survivor shielding 32 epidemiological 10,13,22 equivalent dose 34 individual organs 31 in dose estimates 25 in gamma-ray dose estimates 31 in risk 29 in weighted dose 33 method of transfer 49 sources of 25 statistical 22 thermal neutrons 34 Uncertainties in risk 50,59,67, 69,73 adult worker population 73 combination of 67 due to transfer 50 lifetime projection model 59 propagate of 69 Uncertainties in risk estimates 5,8 for radiation protection Uniform distribution 82 Unrepresentative population 20 Variance 82 Weighted dose 82 Workers lifetime risk estimates X radiation 82 ... the uncertainties in the average risk estimates presently used in low-LET radiation protection Risk estimates for individual organs involve greater uncertainties than for total cancer and are not... theorygoverning liability Library of Congress Cataloging -in- PublicationData National Council on Radiation Protection and Measurements Uncertainties in fatal cancer risk estimates used in radiation protection. .. the issue of uncertainties in risk estimates recommended for use in radiation protection 1.4.2 NCRP Approach to Uncertainty in Risk Estimates for Radiation Protection The question now arises,