1. Health effects of radiation exposure Tilman A Ruff Nossal Institute for Global Health, University of Melbourne Advisor: Australian Red Cross, AusAID/UNICEF Consultant: GSK Biologicals, Novartis Vaccines Medical Association for Prevention of War International Campaign to Abolish Nuclear Weapons Hunter’s Hill Inquiry, Sydney 4 July 2008

5. Ionising radiation

8. Radiation types

9. DNA injury … somatic and germ-line effects

13. Ionizing Radiation Sources

21. U-238 radioactive decay

22. tissue injury: alpha-particle track … lung cells

25. Radon risk per 1000 of lung cancer by age 75 y WHO Factsheet 291 June 2005 160 7 400 Bq/m 3 120 5 100 Bq/m 3 100 4 0 Bq/m 3 Smoker Non-smoker

30. Varying tissue sensitivities

32. Health Effects of Radiation

44. Latency Period

49. Possible Extrapolations

58. Probability of bearing healthy children as a function of radiation dose 5 Higher Possible >100 99.1 97 100 99.4 97 50 99.6 97 10 99.7 97 99.7 97 1 99.7 97 0 Probability of no cancer (0-19 years) Probability of no malformation Dose to conceptus (mSv) above natural background

67. Years of Life Lost

68. Days of Life Lost

69. Hours of Life Lost

76. Medical Radiation Exposure 1:2800 440 669 220 4.4 Nuclear bone scan 1:1000 1200 1825 600 12 Nuclear myocardial perfusion study 1:125000 10 15 5 0.1 mammography 1:1400 870 1323 435 8.7 Ba enema 1:4200 300 456 150 3-11 Conventional coronary angio 1:1250 1000 1521 500 10 CT coronary angio 1:1100 1100 1673 550 11 CT abdo/pelvis 1:1600 800 1217 400 8 CT chest 1:4200 300 456 150 3 CT brain 1:625,000 2 3 1 0.02 Chest x-ray (PA) Probability of fatal cancer Equivalent aircraft flight hours EBR (days) Equivalent CXR Effective dose (mSv) Procedure

79. Worldwide diagnostic radiation cancer risks United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and effects of ionizing radiation. New York: United Nations, 2000.

80. CT Scanners

81. CT Scanners

82. CT Scanners

83. CT Scanners

84. Cancer Risks-how good are we ? Radiology 2004; 231:393-398

89. Nuclear industry workers vs Japanese bomb survivors* 3 0.26 – 4.01 1.86 Lung cancer *Men aged 20-60 at time of exposure ^Assuming linear dose response with no threshold “ Assuming linear-quadratic response 0.03 - 1.88 0.01 – 0.50 0.87 0.32 Solid cancer, 4770 3246 <0 – 8.47 1.58 – 5.67^ -1.14 – 5.33” 1.93 3.15^ 1.54” Leukemia excl CLL, 196 83 0.14 -1.97 0.97 All cancers excl leukemia, 5024 95% CI Excess relative risk per Sv Cause of death , N Workers Survivors