Linda Walsh

University of Zurich | UZH · Medical Physics and Radiation Research Group

An illustrative sample mission of a Mars swing-by mission lasting one calendar year was chosen to highlight the application of European risk assessment software to cancer (all solid cancer plus leukaemia) risks from radiation exposures in space quantified with organ dose equivalent rates from model calculations based on the quantity Radiation Attri...

Purpose: Risk analyses, based on relative biological effectiveness (RBE) estimates for neutrons relative to gammas, were performed; and the change in the curvature of the risk to dose response with increasing neutron RBE was analyzed using all solid cancer mortality data from the Radiation Effect Research Foundation (RERF). Results were compared t...

Background: Radiation is one of the most important stressors related to missions in space beyond Earth's orbit. Epidemiologic studies of exposed workers have reported elevated rates of Parkinson's disease. The importance of cognitive dysfunction related to low-dose rate radiation in humans is not defined. A meta-analysis was conducted of six cohor...

The impact of including model-averaged excess radiation risks (ER) into a measure of radiation attributed decrease of survival (RADS) for the outcome all solid cancer incidence and the impact on the uncertainties is demonstrated. It is shown that RADS applying weighted model averaged ER based on AIC weights result in smaller risk estimates with nar...

Abstract The use of ionising radiation (IR) for medical diagnosis and treatment procedures has had a major impact on the survival of paediatric patients. Although the benefits of these techniques lead to efficient health care, evaluation of potential associated long-term health effects is required. HARMONIC aims to better understand the increased...

Human spaceflight is entering a new era of sustainable human space exploration. By 2030 humans will regularly fly to the Moon’s orbit, return to the Moon’s surface and preparations for crewed Mars missions will intensify. In planning these undertakings, several challenges will need to be addressed in order to ensure the safety of astronauts during...

In assessments of detrimental health risks from exposures to ionising radiation, many forms of risk to dose–response models are available in the literature. The usual practice is to base risk assessment on one specific model and ignore model uncertainty. The analysis illustrated here considers model uncertainty for the outcome all solid cancer inci...

Purpose Development of a model characterizing risk variation with RBE to investigate how the incidence risk for all solid cancers combined varies with higher neutron RBEs and different organ dose types. Material and methods The model is based on RERF data with separate neutron and gamma dose information. Results For both additive and multiplicati...

Intensity modulated radiation therapy (IMRT) introduced marked changes to cancer treatment in animals by reducing dose to organs at risk (OAR). As the next technological step, volumetric modulated arc therapy (VMAT) has advantages (increased degrees-of-freedom, faster delivery) compared to fixed-field IMRT. Our objective was to investigate a possib...

After the nuclear accident in Fukushima, the public interest in radiation related cancer-risk assessment increased. However, interpretations of results from epidemiological studies and comprehension of cancer risk assessment methods can be unclear and involve questions about correctness and validity of the approaches. To shed some light on this pot...

Recently, several compilations of individual radiation epidemiology study results have aimed to obtain direct evidence on the magnitudes of dose-rate effects on radiation-related cancer risks. These compilations have relied on meta-analyses of ratios of risks from low dose-rate studies and matched risks from the solid cancer Excess Relative Risk mo...

An alternative approach that is particularly suitable for the radiation health risk assessment (HRA) of astronauts is presented. The quantity, Radiation Attributed Decrease of Survival (RADS), representing the cumulative decrease in the unknown survival curve at a certain attained age, due to the radiation exposure at an earlier age, forms the basi...

Background Image‐guided, intensity modulated radiation therapy (IG‐IMRT) reduces dose to pelvic organs at risk without losing dose coverage to the planning target volume (PTV) and might permit margin reductions potentially resulting in lower toxicity. Appropriate PTV margins have not been established for IG‐IMRT in abdominopelvic tumors in dogs, an...

The concept of lifetime radiation risk of stochastic detrimental health outcomes is important in contemporary radiation protection, being used either to calculate detriment-weighted effective dose or to express risks following radiation accidents or medical uses of radiation. The conventionally applied time-integrated risks of radiation exposure ar...

The risk assessment quantities called lifetime attributable risk (LAR) and risk of exposure-induced cancer (REIC) are used to calculate the cumulative cancer incidence risks for astronauts, attributable to radiation exposure accumulated during long term lunar and Mars missions. These risk quantities are based on the most recently published epidemio...

The development and application of new European software for cancer risk assessment after radiation exposure from a nuclear accident is described here. This software computes lifetime risks for several types of cancer and is intended to provide information for consideration by decision makers in the urgent and transition phases of nuclear emergenci...

The CONFIDENCE dissemination workshop “Coping with uncertainties for improved modelling and decision making in nuclear emergencies” was held in December 2–5, 2019 (Bratislava, Slovak Republic). About 90 scientists and decision makers attended the workshop. The dissemination workshop allowed the presentation of the CONFIDENCE project results, demons...

Current radiological emergency response recommendations have been provided by the International Commission on Radiological Protection and adopted by the International Atomic Energy Agency in comprehensive Safety Standards. These standards provide dose-based guidance for decision making (e.g., on sheltering or relocation) via generic criteria in ter...

The problem of expressing cumulative detrimental effect of radiation exposure is revisited. All conventionally used and computationally complex lifetime or time-integrated risks are based on current population and health statistical data, with unknown future secular trends, that are projected far into the future. It is shown that application of con...

The European Space Agency (ESA) is currently expanding its efforts in identifying requirements and promoting research towards optimizing radiation protection of astronauts. Space agencies use common limits for tissue (deterministic) effects on the International Space Station. However, the agencies have in place different career radiation exposure l...

National Council on Radiation Protection and Measurements Commentary 27 examines recent epidemiologic data primarily from low-dose or low dose-rate studies of low linear-energy-transfer radiation and cancer to assess whether they support the linear no-threshold model as used in radiation protection. The commentary provides a critical review of low-...

Dose and dose-rate effects

Obtaining a correct dose–response relationship for radiation-induced cancer after radiotherapy presents a major challenge for epidemiological studies. The purpose of this paper is to gain a better understanding of the associated uncertainties. To accomplish this goal, some aspects of an epidemiological study on breast cancer following radiotherapy...

The recently published NCRP Commentary No. 27 evaluated the new information from epidemiologic studies as to their degree of support for applying the linear nonthreshold (LNT) model of carcinogenic effects for radiation protection purposes [1]. The aim was to determine whether recent epidemiologic studies of low-LET radiation, particularly those at...

In order to quantify radiation risks at exposure scenarios relevant for radiation protection, often extrapolation of data obtained at high doses and high dose rates down to low doses and low dose rates is needed. Task Group TG91 on ‘Radiation Risk Inference at Low-dose and Low-dose Rate Exposure for Radiological Protection Purposes’ of the Internat...

Purpose: Age dependent radiation sensitivity for DNA damage after in vitro blood exposure by computer tomography (CT) was investigated. Materials and methods: Radiation biomarkers (dicentrics and gammaH2AX) in blood samples of newborns, children under 5 years and adults after sham exposure (0 mGy), low dose (41 mGy) and high dose (978 mGy) in vitro...

Purpose: Estimated radiation risks used for radiation protection purposes have been based primarily on the Life Span Study (LSS) of atomic bomb survivors who received brief exposures at high dose rates, many with high doses. Information is needed regarding radiation risks from low dose-rate (LDR) exposures to low linear-energy-transfer (low-LET) ra...

Epidemiological studies of long term radiotherapy survivors provide useful insights into dose-response relationships for secondary cancer induction risk at high doses. There are uncertainties involved in estimating the dose to the location of the second malignancy, because the dose distributions in radiotherapy patients can be spatially highly hete...

Determinations of the lowest colon dose, D min, below which there is a statistically significant excess relative risk of all solid cancer, when analyses are restricted to the range [0, D min], are of current interest in research related to radiation protection and risk assessment. In reviewing recent cancer mortality reports on the Life Span Study...

Objectives: In recent years, concern has been raised about Juvenile Idiopathic Arthritis (JIA) that it could be associated with an increased risk for malignancies. Therefore, the cancer incidence in the JIA patients was evaluated and compared to the cancer incidence in the German population. Methods: A retrospective single-center hospital-based...

Quantification of biological effects (cancer, other diseases, and cell damage) associated with exposure to ionising radiation has been a major issue for the International Commission on Radiological Protection (ICRP) since its foundation in 1928. While there is a wealth of information on the effects on human health for whole-body doses above approxi...

In the assessment of health risks after nuclear accidents, some health consequences require special attention. For example, in their 2013 report on health risk assessment after the Fukushima nuclear accident, the World Health Organisation (WHO) panel of experts considered risks of breast cancer, thyroid cancer and leukaemia. For these specific canc...

Background: A determination of the risk of lung cancer at low levels of radon exposure is important for occupational radiation protection. Methods: The risk of death from lung cancer at low radon exposure rates was investigated in the subcohort of 26 766 German uranium miners hired in 1960 or later. Results: A clear association between lung ca...

Purpose: Phenomenological risk models for radiation-induced cancer are frequently applied to estimate the risk of radiation-induced cancers at radiotherapy doses. Such models often include the effect modification, of the main risk to radiation dose response, by age at exposure and attained age. The aim of this paper is to compare the patterns in r...

Objective: The German uranium miners cohort study comprises 58,982 men employed in the GDR by the Wismut company for at least six months between 1946 and 1989. Particularly in the early years, miners were exposed to high levels of radon, silica and other harmful substances. The aim of the cohort study is to investigate the health effects of occupat...

The Wismut cohort is currently the largest single study on the health risks associated with occupational exposures to ionising radiation and dust accrued during activities related to uranium mining. The cohort has ∼59 000 male workers, first employed between 1946 and 1989, at the Wismut Company in Germany. The main effect is a statistically signifi...

We present here a methodology for health risk assessment adopted by the World Health Organization that provides a framework for estimating risks from the Fukushima nuclear accident after the March 11, 2011 Japanese major earthquake and tsunami. Substantial attention has been given to the possible health risks associated with human exposure to radia...

Purpose: To examine exposure-response relationships between ionizing radiation and several mortality outcomes in a subgroup of 4,054 men of the German uranium miner cohort study, who worked between 1946 and 1989 in milling facilities, but never underground or in open pit mines. Methods: Mortality follow-up was from 1946 to 2008, accumulating 158...

Purpose: The reliability of exposure scenarios used in the World Health Organization's Health Risk Assessment (HRA) for Fukushima workers was examined. HRA risk estimates for cancer incidence in these workers were then reviewed. Materials and methods: The HRA constructed four exposure scenarios to estimate worker radiation doses; recent individu...

ZUSAMMENFASSUNG Occupational exposure and mortality in the German uranium miner cohort Objective: The German uranium miners cohort study comprises 58,982 men employed in the GDR by the Wismut company for at least six months between 1946 and 1989. Particularly in the early years, miners were exposed to high levels of radon, silica and other harmful...

Purpose: Inhalation of radon progeny can cause high lung and respiratory tract radiation doses. The aim of this paper was to examine the relationship between radon progeny and cancers of the extra-thoracic airways in the German uranium miner cohort for an extended follow-up through 2008. Methods: The cohort included 58,690 workers employed betwe...

Substantial effort is now under way to identify and follow up patients who have received a computed tomography (CT) scan, to determine whether any increased risk of cancer resulting from exposure to ionising radiation during a scan can be detected. CT scans are becoming an increasingly popular and effective diagnostic tool, and their usage has rise...

To quantify the relationship between death from non-malignant respiratory diseases (NMRD) and exposure to silica dust or radon in a cohort of 58 690 former German uranium miners. In the follow-up period from 1946 to 2008, a total of 2336 underlying deaths from NMRDs occurred, including 715 deaths from chronic obstructive pulmonary diseases (COPD) a...

Objectives To investigate possible associations between silica dust exposure and death from chronic obstructive pulmonary diseases (COPD) and silicosis in German uranium miners. Methods The cohort consists of 58,672 miners comprising 2,167,600 person-years and 25,239 deaths in the follow-up period 1946–2008. A detailed job-exposure matrix was used...

Objectives To investigate the exposure-response relationship between silica dust and lung cancer mortality within German uranium miners in the extended follow-up period from 1946 to 2008. The cohort consists of 58,672 miners including 2.2 Mio person-years and 3,477 lung cancer deaths. Methods Individual information on occupational exposure to cryst...

An increased risk of mortality from primary liver cancers among uranium miners has been observed in various studies. An analysis of the data from a German uranium miner cohort (the 'Wismut cohort') was used to assess the relationship with ionising radiation. To that end the absorbed organ dose due to high and low linear energy transfer radiation wa...

https://www.urotodayinternationaljournal.com/Prostate-Cancer/prostate-cancer-mortality-risk-in-relation-to-working-underground-in-the-wismut-cohort-study-of-german-uranium-miners-1970-2003-beyond-the-abstract-by-linda-walsh-florian-dufey-and-mic.html-in

http://www.bmj.com/content/346/bmj.f2360/rr/648506

It is currently unclear whether exposure of the heart and vascular system, at lifetime accumulated dose levels relevant to the general public (<500 mGy), is associated with an increased risk of cardiovascular disease. Therefore, data from the German WISMUT cohort of uranium miners were investigated for evidence of a relationship between external ga...

Radiation-related risks of cancer can be transported from one population to another population at risk, for the purpose of calculating lifetime risks from radiation exposure. Transfer via excess relative risks (ERR) or excess absolute risks (EAR) or a mixture of both (i.e., from the life span study (LSS) of Japanese atomic bomb survivors) has been...

It has generally been assumed that the neutron and γ-ray absorbed doses in the data from the life span study (LSS) of the Japanese A-bomb survivors are too highly correlated for an independent separation of the all solid cancer risks due to neutrons and due to γ-rays. However, with the release of the most recent data for all solid cancer incidence...

A recent analysis of leukaemia mortality in Japanese A-bomb survivors has applied descriptive models, collected together from previous studies, to derive a joint excess relative risk estimate (ERR) by multi-model inference (MMI) (Walsh and Kaiser in Radiat Environ Biophys 50:21–35, 2011). The models use a linear-quadratic dose response with differi...

Background: In 1996 and 2009, the International Agency for Research on Cancer classified silica as carcinogenic to humans. The exposure–response relationship between silica and lung cancer risk, however, is still debated. Data from the German uranium miner cohort study were used to further investigate this relationship. Methods: The cohort include...

A recent study and comprehensive literature review has indicated that mining could be protective against prostate cancer. This indication has been explored further here by analysing prostate cancer mortality in the German 'Wismut' uranium miner cohort, which has detailed information on the number of days worked underground. An historical cohort stu...

The non-cancer mortality data for cerebrovascular disease (CVD) and cardiovascular diseases from Report 13 on the atomic bomb survivors published by the Radiation Effects Research Foundation were analysed to investigate the dose–response for the influence of radiation on these detrimental health effects. Various parametric and categorical models (s...

A previous analysis of the radon-related lung cancer mortality risk, in the German uranium miners cohort, using Poisson modeling techniques, noted internal (spontaneous) rates that were higher on average than the external rates by 16.5% (95% CI: 9%; 24%). The main purpose of the present paper is to investigate the nature of, and possible reasons fo...

The assessment of detrimental health risks for humans, due to exposures from ionising radiation sources such as γ-rays, x-rays and neutrons, which penetrate deeply into the human body, has been an endeavour which has increased in magnitude and effort over the last century. Solid cancer and leukaemia incidence and mortality have emerged as having ra...

Some relatively new issues that augment the usual practice of ignoring model uncertainty, when making inference about parameters of a specific model, are brought to the attention of the radiation protection community here. Nine recently published leukaemia risk models, developed with the Japanese A-bomb epidemiological mortality data, have been inc...

Uranium mining occurred between 1946 and 1990 at the former Wismut mining company in East Germany. 58,987 male former employees form the largest single uranium miners cohort, which has been followed up for causes of mortality occurring from the beginning of 1946 to the end of 2003. The purpose of this paper is to present the radon exposure related...

The "Spiess study" follows the health of 899 persons who received multiple injections of the short-lived alpha-particle emitter (224)Ra mainly between 1945 and 1955 for the treatment of tuberculosis, ankylosing spondylitis and some other diseases. In December 2007, 124 persons were still alive. The most striking health effect, observed shortly afte...

Extensive uranium extraction took place from 1946 until 1990 at the former Wismut mining company in East Germany. A total of 58,987 male former employees of this company form the largest single uranium miners cohort that has been followed up for causes of mortality occurring from the beginning of 1946 to the end of 2003. The purpose of this study w...

Two recent studies analyzed thyroid cancer incidence in Belarus and Ukraine during the period from 1990 to 2001, for the birth cohort 1968 to 1985, and the related (131)I exposure associated with the Chernobyl accident in 1986. Contradictory age-at-exposure and time-since-exposure effect modifications of the excess relative risk (ERR) were reported...

Data from the German uranium miners cohort study were analyzed to investigate the radon-related risk of mortality from cancer and cardiovascular diseases. The Wismut cohort includes 58,987 men who were employed for at least 6 months from 1946 to 1989 at the former Wismut uranium mining company in Eastern Germany. By the end of 2003, a total of 3,01...

Analyses of the epidemiological data on the Japanese A-bomb survivors, who were exposed to γ-rays and neutrons, provide most current information on the dose–response of radiation-induced cancer. Since the dose span of main interest is usually between 0 and 1 Gy, for radiation protection purposes, the analysis of the A-bomb survivors is often focuse...

Occupational exposures to ionising radiation mainly occur at low-dose rates and may accumulate effective doses of up to several hundred milligray. The objective of the present study is to evaluate the evidence of cancer risks from such low-dose-rate, moderate-dose (LDRMD) exposures. Our literature search for primary epidemiological studies on cance...

General reductions in cancer relative risk with increasing age at exposure are observed in the Japanese atomic bomb survivors and in other groups. However, there has been little evidence of heterogeneity in such trends by cancer type within the Japanese cohort, nor for cancer-type variations in other factors (sex, attained age) that modify relative...

The biological effectiveness of neutrons from the neutron therapy facility MEDAPP (mean neutron energy 1.9 MeV) at the new research reactor FRM II at Garching, Germany, has been analyzed, at different depths in a polyethylene phantom. Whole blood samples were exposed to the MEDAPP beam in special irradiation chambers to total doses of 0.14-3.52 Gy...

Data from the German miners' cohort study were analysed to investigate whether radon in ambient air causes cancers other than lung cancer. The cohort includes 58,987 men who were employed for at least 6 months from 1946 to 1989 at the former Wismut uranium mining company in Eastern Germany. A total of 20,684 deaths were observed in the follow-up pe...

The two-stage clonal expansion (TSCE) model of carcinogenesis has been applied to cancer mortality data from the atomic bomb survivors, to examine the possible influence of radiation-induced cell inactivation on excess relative risk (ERR) and excess absolute risk (EAR) estimates. Cell survival curve forms being either conventional or allowing for l...

Most information on the dose-response of radiation-induced cancer is derived from data on the A-bomb survivors who were exposed to gamma-rays and neutrons. Since, for radiation protection purposes, the dose span of main interest is between 0 and 1 Gy, the analysis of the A-bomb survivors is usually focused on this range. However, estimates of cance...

The use of CT scans has increased rapidly during the last years in adults and children as well. CT involves larger radiation doses than the more common conventional x – ray imaging procedures. To examine the biological effect in the peripheral blood of the paediatric patients chromosome analysis was carried out in 10 children for whom the medical j...

Background It is well established that lung cancer is caused by radon, while uncertainty exists as to whether cancers other than lung might be related to exposure from radon. To investigate further the risk of extra-pulmonary cancers, mortality data from the German uranium miners cohort study are analysed. Materials and methods The cohort includes...

A common type of statistical challenge, widespread across many areas of research, involves the selection of a preferred model to describe the main features and trends in a particular data set. The objective of model selection is to balance the quality of fit to data against the complexity and predictive ability of the model achieving that fit. Seve...

To determine whether computed tomography (CT) could enhance the chromosome aberration yields in paediatric patients. Blood samples were taken before and after CT scans from 10 children for whom the medical justifications for CT examinations were accidental injuries and not diseases as investigated in earlier studies. Chromosome analysis was carried...